First lady Michelle Obama talks about the impact of the nutrition label and the FDA's proposed updates. Lauren Caruba / Medill News Service

First lady Michelle Obama talks about the impact of the nutrition label and the FDA’s proposed updates. Cat Zakrzewski / Medill News Service

WASHINGTON — Americans see it every day. It appears on cans, boxes and drink containers, on everything from frozen chicken breasts to cans of Coke to boxes of cereal.

The nutrition facts label has become integral to the country’s packaged and manufactured food system over the past 20 years. But since the label’s creation, there have been almost no adjustments or improvements to its overall design and how the information is displayed, despite mounting scientific research on public health and nutrition.

That will change soon, as the Food and Drug Administration announced in late February plans to update the iconic label — a white, rectangular chart located on the back of food packages — with a reduced focus on fat and increased emphasis on calories.

The FDA’s proposed changes to the nutrition label follow a November announcement that the agency plans to remove trans fat from the food supply. Together, the two measures represent concerted efforts by the FDA to improve transparency among food providers about what goes into food and improve Americans’ diets in the face of the obesity epidemic.

“When FDA makes these actions there’s two targets — there’s the consumer and giving them more information,” said Renie Schapiro, director of integrated cases at the University of Wisconsin-Madison School of Medicine and Public Health and a former FDA official who helped develop the nutrition label. “The other one is definitely industry.”

However, implementing the initiatives will require significant cooperation between the FDA and the food industry, which would incur significant costs from the proposed regulations.

Setting new standards

Over the past several decades, weight gain among Americans has spiked, with more than one-third of adults and 17 percent of children now classified as obese. Between the 1960s and 2002, the average American was 24 pounds heavier, new research indicates, and weight-related conditions like heart disease and type two diabetes are on the rise.

Food_quote 1

“We really have a crisis. It’s a health crisis, it’s an economic crisis,” said Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health. “We really have not been responding in a way that we really should be doing if we’re serious about controlling it.”

At the unveiling of the proposed new label, first lady Michelle Obama, who has made childhood obesity her hallmark issue, described the confusion the existing label creates for consumers. Rather than direct shoppers toward the healthiest foods, Obama said the label generates a “stream of questions, of worries.”

“Too often it’s nearly impossible to get the most basic facts about the food we buy for our children,” Obama said.

More prominently displaying total calories and serving sizes, the proposed label departs from focusing on fat as a product’s most important nutritional component. Former FDA officials who developed the original nutrition label recognize the overemphasis on fat and now say eating the rights types of fats — unsaturated and monounsaturated — is more important than percentage of calories from fat.

The updated label would also more clearly display serving size and disclose the amount of added sugar, allowing consumers to choose healthier products, said FDA commissioner Margaret Hamburg at the label’s announcement.

Graphic by Lauren Caruba

Graphic by Lauren Caruba

Efforts to eradicate partially hydrogenated oils, commonly known as trans fat, have grown gradually over years. Manufacturers began adding trans fat, formed by combining hydrogen with vegetable oils, to products in the early 1900s, and fast food companies started using it in the mid-1980s because it was thought to be safer than saturated fats.

After research exposed trans fat’s link to heart disease and high cholesterol, in 1999 the FDA proposed listing it on nutrition labels. Facing opposition, the initiative did not pass scrutiny until 2003 and did not take effect until 2006.

“Our job is to ensure food is safe,” said FDA consumer safety officer Mical Honigfort. “We determined there were safety issues with the use of partially hydrogenated oils and that’s why we moved to restrict their use.”

Tackling transparency

Listing trans fat on nutrition labels launched a wave of transparency among food manufacturers.

Food manufacturers got motivated to remove trans fat from products once they were required list it on nutrition labels, Willett said.

“You would have hoped they would have been motivated just on the basis of a healthier product, but transparency really made a big difference,” he said.

Although about half of consumers regularly consult food labels, many may not necessarily understand what the provided information means. Much of it is expressed in grams, and many people often don’t notice when a package contains multiple servings.

The label in use today emphasizes the wrong nutritional aspects of food and “steers consumers toward something that’s irrelevant,” Willett said.

Food_quote 2

“You could say people should be aware of it, but obviously a huge amount is consumed by kids,” Willett said in a telephone interview. “Not everybody’s able to decode the label.”

Simpler labels would be more transparent for consumers, experts say. The FDA is considering different food ratings, such as a color-coded stoplight system or scoring foods on a scale of one to 100 so consumers can easily identify the product’s quality, Willett said.

Likewise, reducing trans fat and updating nutrition labels would better inform consumers about food and “make nutrition content more transparent, more understandable,” said Bill Hubbard, who was with the FDA for more than 30 years and served as the agency’s deputy commissioner. About one-third of people do not understand the labels, he said.

“All of these things are part of an evolving trend to use government authority over nutrition,” he said.

However, resistance against initiatives like former New York City Mayor Michael Bloomberg’s attempt to ban large sugary drinks demonstrates the careful line regulators must walk, Schapiro said.

“There’s an interesting tension in that — how much you try to change behavior and how much you try to change the environment,” she said.

More conscious consumers

From the organic to gluten-free to locally-grown food movements, the FDA’s recent initiatives coincide with trends indicating increased consumer interest in healthful food and transparency from manufacturers, experts say.

The proliferation of health blogs, apps, magazines and other media contribute to growing awareness of what’s in the food supply. Books such as Eric Schlosser’s “Fast Food Nation” and documentaries like “Super Size Me” have brought American restaurant and food manufacturing practices to the forefront of public health debate.

“There’s different issues, different web sites, and different groups,” the University of Wisconsin’s Schapiro said. “It’s heightened people’s attention where the food comes from.”

Food_quote 3

Another indicator of consumer interest in health is the massive growth of the organic grocery chain Whole Foods, an increasingly popular destination for health-conscious consumers. The company did away with trans fat products in 2003 and carries many organic and gluten-free products.

“Ten years ago no one would have thought much about gluten and gluten-free labeling but now it’s important to a lot of people,” said Brian Todd, president of The Food Institute, a trade association.

The cost of cooperation

FDA officials and health experts recognize efforts by restaurants and food manufacturers in recent years to reduce trans fat in foods despite the absence of an official regulatory requirement. Major brands like Nabisco and General Mills no longer use trans fat, nor do restaurant chains like McDonald’s and Long John Silver’s.

In 2006 the city of New York banned trans fats in restaurants, followed by California two years later. Walmart recently pledged to stop stocking its shelves with products containing trans fat by 2015.

Many restaurants have already taken “tremendous strides” with trans fat and will continue working with manufacturers to address new federal regulations, Joan McGlockton, vice president of industry affairs and food policy for the National Restaurant Association, said in a statement.

But an FDA-mandated removal of trans fat and new nutrition labels would still come at a cost for food manufacturers. Many brands would need to reformulate products, replacing trans fat with another ingredient.

Manufacturers would also have to adjust product packaging for updated nutrition labels, which would cost the industry an estimated $2.3 billion, Todd said, adding that food prices could rise as a consequence.

It may also be difficult for companies to clearly distinguish between added sugar and sugar that occurs naturally, Todd said. The food industry’s strong lobbying presence in Washington could also affect policy decisions.

“It is a very well financed industry. It is able to overcome some efforts,” Schapiro said. “The Bloomberg soda ban was obviously highly opposed. The labeling in restaurants comes up against a very strong lobby. They are definitely a very powerful force in deciding food policy.”

FDA officials said they realize the obstacles manufacturers may face and will adjust the timeline for implementation accordingly. On March 8, the agency concluded a comment period for industry stakeholders to weigh in on the trans fat proposal and will do the same for the food label.

“We recognize that it’s going to take some time,” Honigfort said. “FDA’s intent is not to disrupt the food supply.”

Changing the culture

Although health experts and former FDA officials say targeting trans fat and the updated nutrition label are steps in the right direction, the agency and food manufacturers still have a long way to go to improve Americans’ understanding of nutrition.

Experts say the nutrition label should be revisited more frequently to keep up with research. But the FDA wants to make sure scientific evidence is solid before updating regulations. That can cause the government to lag behind research, said former FDA official Jim O’Hara, an original developer of the nutrition label and current director of health promotion policy at the Center for Science in the Public Interest.

Food_quote 4

In addition to added sugar and trans fat, the FDA will likely look next at proper sodium levels and at introducing standard regulation for front-of-the-package nutrition labeling, which manufacturers have been independently experimenting with for several years.

“FDA still has some work to do, but clearly the important point of giving consumers important nutritional information, giving consumers that information in a readable and understandable format — FDA is definitely fulfilling that mission,” O’Hara said.