FDA Urged to Develop Nutrition Ratings

FDAFor many, grocery shopping today is more about hunting for bargains; it's about finding the healthiest offerings on the shelves.

Labels play a big part in helping shoppers separate the healthy choices from the junk. But with dozens of apparent ratings systems out there -- from Kraft's "Sensible Solution" accolade to the American Heart Association's "Heart-Check" endorsement, consumers may be left wondering how much weight these approvals carry.

Now, the nonprofit Center for Science in the Public Interest (CSPI) is petitioning the Food and Drug Administration (FDA) to design a national set of symbols to help consumers quickly identify healthier foods.

"The supermarket is teeming with competing 'healthy food' symbols that run the gamut from highly helpful to fatally flawed," said CSPI executive director Michael Jacobson in a press release today. "But a prominent and reliable symbol on the fronts of packages would be a tremendous help to those harried shoppers racing through the supermarket."

With the suggestion come concerns from some that a confusing or oversimplified rating system may be ineffective -- or even do more harm than good.

Some experts, however, support the suggestion.

"Simplified food labels would be very helpful for consumers," says Dr. James Anderson, professor of medicine and clinical nutrition at the University of Kentucky in Lexington, Ky. "Each Wednesday, I walk the aisles of a supermarket for exercise and observation. I see consumers puzzling over labels."

"This is practical," says David Katz, associate clinical professor of public health and medicine at Yale University in New Haven, Conn. "Other countries have done it. Our lab has developed an index for this use, which will be released soon. It can, and should, be done."

Finding the Right Symbols

The U.S. government would not be the first to implement such a plan. The United Kingdom and Sweden already implemented a symbol-based nutritional ratings system. And recently, the Hannaford's chain of grocery stores developed a star-based system, rating saturated fat and cholesterol content of foods.

But agreeing over what form the symbols here should take -- or what nutritional aspects they should indicate -- is still a matter for debate.

"The execution can be tricky, and the more symbols there are, the more confusing it becomes to the consumer," says Keith-Thomas Ayoob, associate professor at the Albert Einstein College of Medicine's department of pediatrics in Bronx, N.Y. "To someone like me who works with consumers to change eating behavior, confusion is the enemy. A confused consumer sits still and does nothing.

"Too many conflicting messages and they can also get overwhelmed, and that's even worse. An overwhelmed consumer gets downright rebellious."

There is also the concern of oversimplification if just one set of symbols is used.

"While one unified symbol sounds like the perfect answer to healthy eating, the problem is that single foods are not the cause of poor eating behaviors. It is how all the foods we choose come together in a meal plan that makes the difference," says Connie Diekman, director of university nutrition at Washington University in St. Louis, Mo.

"The other problem with a symbol for single foods is the criteria might cause some nutrition benefits to be lost due to a single nutrient problem."

Diekman provides the example of children's sweetened cereals, which are fortified with vitamins and minerals and are usually consumed with milk. A low mark by the FDA could cause parents to cut the cereal out of their kids' diets, depriving them of the nutritional benefits that come along with the perceived "evil" of a sugary treat.

This concern has also been raised by the National Dairy Council. "Proper nutrition requires balanced nutrition, including consuming foods that help individuals meet daily nutritional needs," said the council in a statement. "It is not simply about avoiding certain foods because, as research and history show, avoiding categories of foods based on single nutrients can create unintended consequences.

"Just because a food contains small amounts of 'avoidance' nutrients, does not mean that it does not also include many nutrients that are important for public health."

And some experts say the matter has been further complicated by food companies themselves, many of whom are allowed to make their own health claims on food labels.

"All of these self-congratulatory health messages are confusing and counterproductive," says Dr. Darwin Deen of the department of family medicine and community health at the Albert Einstein College of Medicine in Bronx, N.Y. "As a physician, I am ashamed at some of the products endorsed by the American Heart Association. Each company is now coming up with their own criteria and advertising over-processed foods as healthy."

Will Symbols Make Us Healthier?

Confusion aside, some experts remain skeptical that a symbol-based ratings system would have a huge impact on public health.

"I don't think symbols would do much, if anything, to solving the problem of obesity," says Dr. Terry Maratos-Flier, associate professor at Beth Israel Deaconess Medical Center in Boston, Mass. "They could have detrimental unforeseen effects. Overweight, obese and dieting individuals might be more likely to consume excess portions of something that is labeled 'sensible' or 'smart choice.'"

Maratos-Flier says extra space on the label would be better utilized by making important nutritional information, such as calorie content and nutrition, more easily readable.

And, of course, there is the question of whether the symbols would even matter to shoppers.

"Many people would likely be indifferent; we label cigarettes as causing cancer but people still smoke," Maratos-Flier says. "If somebody eats something and likes it, they are probably not going to pay too much attention to whether it's good for them."