Reading Updated Food Nutrition Labels May Help People Adhere to Dietary Guidelines and Prevent Cancer

November 12, 2020
Beth Fand Incollingo

CURE, CURE® Fall 2020 Issue, Volume 19, Issue 4

Paying attention to the updated nutritional labels on food can help Americans stay within dietary guidelines and prevent illness, including cancer.

It had been 25 years since the requirements for what’s included on nutritional labels had been updated. Because our eating habits and understanding of dietary health have changed quite a bit since then, the Food and Drug Administration (FDA) recently updated its format for the labels attached to nearly all foods sold in the United States.

The FDA published its final rule on the subject in 2016, and by January of this year, most major food manufacturers were in compliance. Smaller food manufacturers have until January 2021 to start using the new labels. Jill Reedy, chief of the Risk Factor Assessment Branch in the National Cancer Institute’s Division of Cancer Control and Population Sciences, contributed to some of the research that helped inform the Dietary Guidelines for Americans, which serves as the basis for information on the labels and prompted some of the changes.

“It was really time to update that food label for consumers,” says Reedy, who holds a doctorate in nutrition and a master’s degree in public health. “Now there’s updated science, nutrition and public health information, including updated dietary guidance.”

In an interview with CURE®, Reedy shared more about what shoppers will see on food labels and why.

CURE®: What is the main goal of the changes?

Reedy: The goal is to ensure that the nutrition facts label is aligned with the science about diet and its impact on health — because the label has been and will continue to be a key tool that helps consumers follow the Dietary Guidelines for Americans and make better-informed food choices.

The guidance that we have from the dietary guidelines recommends a healthy dietary pattern that includes and encourages foods like fruits, vegetables, whole grains, low-fat dairy and a variety of lean proteins, and limits and constrains foods that are high in added sugars, saturated fats and sodium. And so, some of these recent changes to the food label, like the inclusion of added sugars, tie back to research that’s been done to understand the relationship between diet and health outcomes, including cardiovascular disease and cancer. It’s exciting to see an updated food label that reflects that current science for overall health promotion and disease prevention, including cancer prevention.

Have there been any changes in what constitutes a serving of a food?

How much Americans eat and drink have changed since that previous food label over 25 years ago. One example ... is the reference amount that’s used to set a serving. For example, a serving of ice cream used to be half a cup on the food label, and now it’s two-thirds of a cup. And the reference amount for a soda used to be 8 ounces and now is 12 ounces on the food label. The serving sizes that are included on the label have to be based on the amount of food and beverages that people are actually consuming, not what’s recommended that they should be eating.

As far as vitamins and minerals, what has been added and deleted from the nutritional label?

We now see vitamin D and potassium as new things listed on the updated food label. They’re included because of data (showing) that Americans don’t always get enough (of them). We will still see calcium and iron on the food label; those were there before. What we won’t see are vitamins A and C. Those are no longer required on the food label because most Americans are consuming enough of those.

What are the changes on the labels regarding sugar?

To follow a healthy dietary pattern, the recommendation is to limit calories from added sugars to less than 10% of total calories per day. We know from our data looking at the state of the American diet that we’re consuming too many calories from added sugars, and that makes it really difficult to meet our overall nutrient needs while staying within our calorie limits. Added sugars come from obvious sources like sugar-sweetened beverages, such as soda and sweetened coffees and teas.

But then they are also in some packaged foods where we might not be thinking that there would be added sugars, like ketchup, spaghetti sauce or yogurt. That’s something we can now look at on the food label, and having that information can help increase our awareness and help us make choices to limit added sugars.

What is the Dietary Patterns Methods Project, and how did its findings contribute to this initiative?

Researchers have done a lot of research on this topic, with the goal of strengthening the evidence base for the dietary guidelines, and that includes the Dietary Patterns Methods Project. In that project, we looked at key quality indices, including the Mediterranean diet score, DASH (Dietary Approaches to Stop Hypertension) score, the Healthy Eating Index and the Alternative Healthy Eating Index. We used those indices to examine the dietary patterns of people who participated in three very large studies, the NIH-AARP (National Institutes of Health-American Association of Retired Persons) Diet and Health Study, the Women’s Health Initiative and the Multiethnic/Minority Cohort Study of Diet and Cancer.

And we found very similar results across all three cohorts. People whose diets were consistent with any of these dietary indices had anywhere from an 11% to 28% reduced risk of dying from cancers, from cardiovascular diseases and from all causes combined. We also found that the healthier the diet based on these indices, the greater the reduction in the risk of dying, including from cancer.

Relevant to the new, updated label is that higher intake of added sugars was associated with an increased risk for those negative health outcomes. So we can really see from this kind of analysis that a healthier diet, defined by any of these dietary patterns, is associated with better health outcomes.

What should people know about diet and lifestyle as they read the information on food labels?

We can consider information about each food through tools like the food label but also in the context of the overall dietary pattern. We also know that there are interrelationships with diet, physical activity, sleep and weight; these things are all connected. Diet, physical activity and obesity are all linked to many cancers, and so our goal is to support and address all these behaviors because it’s not necessarily just one or the other. It’s all of those things together. And as part of that, the nutrition facts label and the dietary guidelines are great resources for the public.

How will people know about the changes to food labels?

To help people better understand the updated nutrition label, the FDA has developed a really comprehensive public education campaign. They have videos and a lot of other helpful information on their website that folks can access to answer specific questions, either for us as consumers or for us as health educators.

What percentage of Americans pay attention to food nutrition labels?

There are studies that look at this, and we see that the majority of Americans do read the food label. And studies show that those who are using the food label are more likely to consume more fruits and vegetables and fewer sodas. So more frequent use of the food labels is associated with better diet quality.

What else should people know?

The science underlying the dietary guidelines and the food label comes from research that’s grounded in the idea of the total diet and dietary patterns. And it’s important for us to take this more holistic approach and look at dietary patterns — rather than only looking at an individual food or nutrient — as we think across our lifetime, and any person’s lifetime, because we know it’s not just one thing that we eat that can affect health. It’s really that totality of our diet. And the food labels are an important tool that we have to continue to improve our dietary patterns.

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