By David Kiefer, MD, Editor

Clinical Assistant Professor, Department of Family Medicine, University of Wisconsin; Clinical Assistant Professor of Medicine, Arizona Center for Integrative Medicine, University of Arizona, Tucson

Dr. Kiefer reports he is a consultant for WebMD.

SOURCE: FDA. Changes to the Nutrition Facts Label. Available at: www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm385663.htm. Accessed June 15, 2016.

Occasionally, there is current, hot-off-the-press information that is relevant to the readers of Integrative Medicine Alert but nonetheless doesn’t fit the traditional genres of review article, abstract & commentary, or short report. We feel that it is important to share these pearls with you, and may use “Editor’s Note” as such a medium.

On May 20, 2016, the FDA announced changes to the nutrition facts panel required as a label on all foods. There were some cosmetic changes, such as making serving size and servings per container more visible and easier to read, an important feature that perhaps will address the confusion surrounding the number of servings in a package and help to prevent overeating. Another detail is the new requirement to list vitamin D, calcium, iron, and potassium in actual milligrams (or micrograms), not just as percent daily value. To see vitamin D listed in micrograms might be confusing for some people because recommendations and media reviews refer to vitamin D in international units. Another telling change is that “added sugar” has its own line, a new feature that may or may not help consumers improve food choices (some foods “naturally” contain large amounts of sugar; is the label recommending that these are OK?).

In addition, serving sizes have been adjusted to reflect what people are actually eating, and this may be smaller or larger than it was before. For example, one serving of soda is 12 ounces (not 8), and there are only three servings (not 4) in a pint of ice cream. In theory, the serving size change will increase the calories per serving and, hopefully, affect people’s decision-making about the quantity of food consumption. However, it does not help to downshift the oversized eating that is part of the U.S. food crisis; it almost seems to validate it. We will have to see how this all plays out with food decision-making. On this topic, the label also will require two columns of information if there is more than one serving size in a package, one set of information for one serving, and the other column for those instances when the consumer eats the whole package (sound familiar: Doritos, ice cream, etc.?). Another layer of complexity is tied to the question of whether consumers will understand or correctly use this information.

Change is good, especially in the realm of U.S. eating habits and nutritional malaise. Will these label changes help or contribute to the confusion? It remains to be seen, but healthcare providers should be aware of the new label so they can answer patient questions and provide nutritional counseling and health promotion advice to patients in clinic.