Front and Center: FDA Proposes Nutrition Facts Label Changes

Walk down any grocery store aisle, and you’ll see food packages with bold colors, images, graphics and words — all geared toward catching the customer’s eye. But United States manufacturers may have to start accounting for a new mandatory front-of-package (FOP) nutrition label in their designs.

Proposed by the U.S. Food and Drug Administration (FDA), this “Nutrition Info Box” would highlight the amounts of three nutrients — saturated fat, sodium and added sugars — in a single serving of food. These proposed FDA changes to the nutrition facts label mark an important step toward helping consumers make more informed decisions on what they buy and how they spend their money.

“In general, FOP labels provide information for consumers who either don’t understand, don’t have time or can’t interpret the nutrition facts panel and the ingredient list,” said Jennifer L. Pomeranz, an associate professor of public health policy and management at New York University. “By having that important information upfront, they can make quicker decisions. It can also help them to compare across products.”

Grocery stores are full of ultra-processed foods — almost 70% of our food supply. Eating an excessive amount of ultra-processed foods may increase your risk of obesity, Type 2 diabetes, heart disease and other nutrition-related diseases.

“These foods are covered in health and nutrition claims. That makes it very hard to tell which products are truly healthy,” said Lindsey Smith Taillie, an associate professor at the UNC Gillings School of Global Public Health. “Well-designed FOP labels can help consumers quickly and easily tell which products are healthy vs. unhealthy.”

Other countries are ahead of the curve and have already implemented FOP labels on their products. In fact, research from these countries shows that clear FOP labels are beneficial. Yet, enforcing such a rule here in the U.S. may come with its own set of challenges from manufacturers and legal experts. 

Lessons from around the globe.

FOP labels can be a powerful public health tool. But around the world, these labels can run the gamut of designs, information and enforcement.

For example, several countries have opted for a voluntary traffic-light system that uses red, yellow or green to quickly denote risk levels of key nutrients. Some countries, like the United Kingdom, combine traffic light labels with “Guideline Daily Allowance,” or GDAs, which show how a serving of that food contributes to daily recommended amounts.

“One of the potential pitfalls of a label that uses color is that the packages themselves are very colorful,” said Francesca Renee Dillman Carpentier, a professor at UNC’s Hussman School of Journalism and Media. “Some of that color can actually get lost in the noise of the existing packages.”

Other types of labels include a “Nutri-Score,” which is used voluntarily in France, Spain, Belgium, Germany, Switzerland, Netherlands and Luxemburg, to provide a color spectrum along with a letter grade. Australia and New Zealand use a “Health Star Rating,” or HSR. This type of label is based off an algorithm that determines a product’s risk and assigns a product a score from 0.5 stars (the least healthy) to 5 stars (the healthiest).

In 2016, Chile became the first country to implement mandatory FOP labels with a black hexagon warning. Other countries, like Mexico, Peru and Uruguay, have since started to use a black stop-sign, hexagon or octagon warning from products that are high in sugar, salt, saturated fat or calories.

Both Taillie and Dillman Carpentier have spent time on policy evaluations and studies looking at which labels may be the most effective. For example, they were both part of a research team that conducted focus groups of mothers of preschool children in Peru. To determine how successful FOP labels are, researchers analyzed the conversations for awareness, understanding and influence.

“We’ve done a lot of policy evaluations, and the outcomes were not perfect, but they certainly have shown that people can make those quick decisions a lot easier, a lot faster and a lot better for themselves and their families,” said Dillman Carpentier. “Especially if they’re in a situation where they need to watch their sugar or sodium intake.”

So, where do the proposed FDA changes to the nutrition facts label fit in the grand scheme of options?

“In my opinion, the FDA proposed label doesn’t align with global standards, which show that distinct labels that signal when a food is high in a nutrient of concern are more effective than labels that look at low/medium/high,” said Taillie. “This is because in the latter label type, you can have conflicting or confusing information. For example, a package of sour gummy worms might be labeled as having low saturated fat and low sodium, even as it’s high in sugar — potentially making it seem healthier than it is.”

Impact on U.S. food manufacturers.

If you’re a food manufacturer, you may have plenty of questions about how the FDA’s proposal may affect your company. Could FOP labels and their enforcement disrupt the economy? Will packaging changes lead to steep costs or job losses?

“In Chile, there were a lot of predictions about the economy and job loss. Looking at the aftermath, it seems like many of those predictions didn’t come to fruition,” said Dillman Carpentier.

In fact, many other countries that have implemented FOP labels saw food manufacturers adapt to any necessary changes. And it’s happened here before in the U.S. when the FDA required removal of trans fat from processed foods and the addition of added sugar amounts on labels.

“A lot of the food industry reformulated products to remove trans fat before it was even banned from food,” said Pomeranz. “Labeling actually can be a very powerful tool when it comes to reformulation.”

“Well-designed FOP labels can help consumers quickly and easily tell which products are healthy vs. unhealthy.” —Lindsey Smith Taillie

In many cases, that’s what companies do. They opt to reformulate products to make them healthier or roll out newer, different products that have less sugar or sodium.

“Fanta reformulated their products in Chile so that none of their sodas needed those warning labels because they were actually under that threshold for sugar content,” said Dillman Carpentier.

Regardless, change takes time — and businesses would need to retool certain products, redesign packaging and oversee existing inventory.

“I understand why the food industry may not want that label,” said Dillman Carpentier. “But from a consumer standpoint, if a manufacturer is providing a good product, it could be a win-win for you and the consumer.”

Legal hurdles on the horizon.

The FDA’s rule about FOP labels will more than likely face legal challenges. The primary argument will be centered around the First Amendment and the government’s oversight of commercial speech.

“The Supreme Court has increasingly provided protection to commercial speech. Food labels are considered commercial speech,” said Pomeranz. “That means the government cannot do two things. It cannot prohibit truthful, non-deceptive commercial speech, and it cannot require the disclosure of nonfactual information.”

Pomeranz said arguments may come down to what is considered or interpreted as factual and uncontroversial.

“There are outstanding questions, based on other Supreme Court cases, on what will pass this test,” said Pomeranz. “In my opinion, looking at the FDA’s proposal, it seems very clear that the information is factual.”

There could be some pushback on including saturated fat in the FDA’s proposed label. Some people aren’t sure if including how much saturated fat is in a certain food is a good indicator of whether a product is healthy or unhealthy.

“Labeling actually can be a very powerful tool when it comes to reformulation.” —Jennifer L. Pomeranz

“Some scientists believe that the saturated fat disclosure is based on outdated science,” said Pomeranz. “There are studies that show healthfulness is more based on the food source and thus the type of saturated fat.”

What's next?

Don’t expect any packaging changes to happen overnight. While the FDA put out a notice for public comment that ended last July, the next steps are unclear. After advocacy groups, food manufacturers and the public weigh in, proposed FDA changes to the nutrition facts label could be adjusted.

But if the FDA establishes a mandatory FOP label requirement, companies will have time to adjust their products and packaging. The agency has proposed a compliance date of three years from the rule’s effectiveness for businesses with annual food sales of $10 million or more. Smaller businesses — those with annual sales less than $10 million — would have four years to comply.

Any legal challenges may halt potential rule enforcement, though.

“Generally, the courts issue a stay of enforcement. This means they will hold off on allowing the FDA to enforce the rule until the courts decide whether it’s constitutional,” said Pomeranz. “That could prolong the enforcement by years.”

While the inclusion of FOP labels may spark debates, what experts don’t want to get lost among the chatter is that providing some kind of label will help consumers make informed decisions.

“Poor diets are a top driver of chronic disease, and we need to make it easier for people to make healthy choices,” said Taillie. “Nutrition information is currently available but not presented in a way that is easily accessible or well understood. Consumers have a right to know what’s in their food.”