In this blog, we continue to dissect the front of the food package, exploring nutrition and health claims, and efforts by manufacturers, of all groups, to regulate what food packages can say about themselves.

Nutrition claims on food labels, when they’re understood, can sometimes help you make shopping decisions. Health claims, in contrast, are some of the most contentious, slippery pieces of information you’re likely to find anywhere. What food manufacturers love to call consumer education is often just cleverly placed pieces of marketing. In this installment of Reading Food Labels, we’ll look at some of the differences.

Nutrition Claims

Nutrition claims are statements the Food and Drug Administration (FDA) allows food manufacturers to place on the package fronts of foods that meet certain nutritional standards.

Good or Excellent Sources

This claim calls attention to the food’s content of a particular nutrient (for example, “A good source of calcium” or “low sodium.”) The terms “good source” “excellent source,” and “reduced” or “low” are defined by the FDA or USDA in the Code of Federal Regulations (CFR) and communicate the amounts of the nutrient in a single serving:

• An “excellent source” (or “high in” or “rich in”) means that one serving of the food (serving sizes are also defined by the feds) provides 20% or more of the Daily Value (see below) of that nutrient.
• A “good source” provides 10-19% of the Daily Value.

NOTE! A food can be a good or excellent source of a nutrient without its package stating that fact: Seldom will you see a milk container emblazoned with the claim, “Excellent source of calcium and vitamin D,” or a package of steak whose label states, “Excellent source of protein and iron!” Maybe milk and meat producers assume we consumers know these things? Far more often, the claims appear on more highly processed commercial products like breakfast cereal, lending support to the idea that these claims are mostly used as advertising.

Low and Reduced…

It goes without saying that food manufacturers that use claims like “low fat” or “low sodium” are hoping to capitalize on consumers’ knowledge that dietary guidelines recommend reducing our intakes of those nutrients. The term “low” or “low in” has different legal definitions, depending on the food, nutrient, or ingredient. The terms, which are allowed only for certain nutrients, can be worth paying attention to, depending on the nutrient and your goals. Although not exhaustive, here is a list of some examples.

Low Sodium

A low-sodium product is one that provides 140 mg or less sodium per serving. To give you some perspective, the current recommended sodium intake is 2300mg per day.

Low- vs. Reduced Fat

The legal definition of “low fat” is not the same as the legal definition of “reduced fat.” What?!? “Low fat” means 3 grams of fat or less per serving; “reduced fat” means that a serving of the food contains at least 25% less fat than the standard (non-reduced fat) version of the food product, which can vary from product to product.  So, it follows that a reduced fat product is not necessarily low in fat; it’s simply lower than its full-fat counterpart.

A few additional words here about low-fat products

First, dietary guidelines no longer emphasize the need to reduce total fat in our diets, just saturated fat (remember, the fat in animal products and coconut oil). So, while reduced fat beef, milk, cheese, and sour cream might be a good choice, reduced fat peanut butter…not so much.

Second, when manufacturers remove the fat from a product, they usually need to add other things to make their product taste good and have a texture similar to the normal-fat product. Although sometimes these additions are just spices, herbs, other flavorings, or non-caloric ingredients that mimic the effects of fat on food texture, the additives might well be salt (which of course increases your sodium intake); sugar, which adds calories; or other caloric ingredients! Back in the day, low-fat Snackwells and Fig Newtons had at least as many calories as their regular-fat counterparts!

Questionable Nutrient Claims and Food Manufacturers’ Attempts at Transparency

Cholesterol Free

Some food packages make claims like “Cholesterol-free,” hoping to attract consumers who are trying to lower their cholesterol. But these are nearly always plant-based foods like nuts or peanut butter, which never ever contained cholesterol in the first place, or nutritionally empty foods like potato chips that are still high in fat and calories, regardless of their absence of cholesterol!! Even more deceiving is that we have known for years that the cholesterol in (meats and other animal-based) foods contributes little to the cholesterol that circulates in our blood (the bigger contributors being our intake of saturated fat and…our genes!). Therefore, the content of cholesterol itself in a food is much less important than the content of saturated fat (more on fat in Part 3 of this Blog!).

X Grams of Protein

Another questionable nutrient claim is the recitation of a product’s protein content. As a nutrient, protein has enjoyed a halo effect not bestowed on any other nutrient. Many of us have been convinced we need more protein, which is almost never the case unless we’re professional athletes. Worse, except for Greek style yogurt, the foods that most often boast their protein content tend to be junk foods masquerading as healthy foods, such as bars, cookies, pretzels, and things that should not be occupying large parts of our diets. The protein we get from eating meats, fish, and dairy products; legumes and nuts; and whole grain bread, pasta, and cereal is higher in quality than the protein stuffed into snack bars and canned smoothies and is more than adequate to satisfy our needs.

The “Facts Up Front” Campaign 

In 2010, as part of her mission to improve the nation’s nutrition, First Lady Michele Obama asked food manufacturers to help consumers make better food choices by increasing the transparency of nutrient information on food labels. The Grocery Manufacturers’ Association and the Food Marketers’ Institute, organizations that represent the major food manufacturing companies, designed—and obtained permission from the FDA to display—an icon on processed foods under FDA control. The ribbon-like icons boast the contents of particular nutrients or calories in a serving of the food, a tiny excerpt of information found on the Nutrition Facts label (which we’ll visit in Part 3). Because no guidelines regulate which nutrients can or must be shown, the manufacturers are free to showcase whatever nutrients they wish, although popular ones seem to be calories, saturated fat, sodium, sugars, and fiber (in cereal). And although the icon shows the serving size and sometimes shows how the nutrient contents compare to our daily requirements, the information is not as helpful as it could be. One reason is that because not all foods display the icons, they don’t allow comparisons among varieties or brands or different foods. But another reason is simply that food labels carry a lot of confusing information, and the “Facts Up Front” label is just one more piece of such information.

Health Claims

As the average age of our population and the rate of chronic, age-related diseases increases, there’s a big push by the medical community for us to “eat healthier,” to the extent evidence shows some link between nutrition and health. This reality has not been lost on the food manufacturers.  Foods that call themselves lean, low fat, or reduced fat are appealing to consumers who are trying to reduce their intake of fat for health reasons: either to lose weight or to decrease their risk for heart disease. And foods that make nutrient claims are also trying to appeal to our desire to stay healthy. But there is also a whole category of other claims that compete for space on food labels that we need to understand.

Authorized and Qualified Health Claims

Some health claims, notably authorized and qualified health claims, are really a subset of nutrition claims, stating that consuming the food (or an ingredient or nutrient in the food) in question has been associated with lowering your risk for a disease or condition.

Health claims are government-permitted statements about evidence-based health benefits. These claims have been controversial and often stand on shaky ground. Two types of health claims are allowed: “authorized” claims, which are based on strong evidence, and “qualified” claims, which are similar but with less supporting evidence.

An example of an “authorized” claim is the one linking calcium (in, say, dairy products) with reducing the risk for osteoporosis. Another example of an “authorized” health claim is that the soluble fiber from whole oats can help reduce the risk for coronary heart disease.

An example of a “qualified” health claim is the one associating nuts with decreasing the risk for heart disease.

Health claims can state only that the food may help prevent or reduce the risk for a particular condition: They cannot state that a food treats or cures any disease or condition. These claims should be taken with a grain of salt (pun intended): They are not in any way an indication that the product is a “miracle food”! In fact, these claims must undergo periodic review and can be rescinded if newer evidence fails to support the claim, as happened with soy products.

Structure-Function Claims

Structure-function claims are confusing statements found on some processed foods and dietary supplements that describe an association of a nutrient with the maintenance of a normal health state (specious claims of foods that help support gut health or bone health are examples of ones the general public are unfortunately falling for). Structure-function claims must stop short of stating that the food or a nutrient in the food can help prevent any disease state or process. These statements are not required to be backed by evidence, and products that carry such claims must carry a warning that the claim has not been approved by the FDA. These structure-function claims are some of the shadiest claims you’ll see anywhere. Consider the often seen, “Helps boost immune function,” which has absolutely no meaning, since no one nutrient has been shown to increase the function of the immune system in adequately nourished people.

Safety Claims

Before I launch into a discussion of safety claims, you might be wondering how or why I’m distinguishing health claims from safety claims. After all, doesn’t safety relate to health?

Health claims generally refer to properties of foods (what they contain or what they don’t) that may help prevent chronic diseases over the long term. Safety claims generally refer to properties of foods that might prevent—or induce—immediate events such as poisoning, infection, or allergic reactions. As a result, claims about the apparent safety of a food are some of the claims most likely to be used to market foods based on scare-mongering. For that reason, they may be some of the most confusing and easy to get tripped up on. While some are important, some are no more than clever ways food manufacturers have found to circumvent the laws regarding health claims. I will start with some of the most important ones.

Un-Pasteurized (Raw) vs. Pasteurized

Pasteurization is the process of heating a substance at a specific temperature for a specific duration to kill dangerous pathogenic bacteria. Commonly pasteurized foods include milk (and therefore the cheese, yogurt, and butter made from this milk), some eggs, some fruit juices, and some commercial sauerkraut, among others. Cheese and yogurt are produced by inoculating milk with specific molds and/or bacteria; so, it shouldn’t be a surprise that sometimes, unwanted, toxic molds or bacteria could creep into the unpasteurized versions of these products! Sauerkraut is fermented cabbage: the organisms that ferment it are not bacteria but fungi; nevertheless, those crocks of cabbage are just ripe for growing all sorts of unwanted organisms you definitely need to stay away from but that can often surface in untreated sauerkraut.

Pasteurization is single-handedly responsible for preventing countless deaths and serious illnesses over its 100-year history. But to read some completely non-evidence-based websites or to listen to proponents of legalizing the sale of raw (unpasteurized) milk, pasteurization is responsible for every ill to have befallen mankind. Without pasteurization, foods like milk, eggs, and juice are, for all intent and purposes, just like the stuff used in labs to grow bacteria and fungi! And in the case of raw milk and other dairy products, the bacteria are some of the deadliest (listeria). Some groups of people, especially children, elderly, and others with weaker immune systems, have become severely ill and have died from consuming raw milk and raw milk products (several raw milk cheeses are sold legally, but pregnant women and those with weak immune systems are cautioned by competent physicians not to consume them—a caution with which I’m in complete agreement!).

Gluten-free

Gluten is a protein (yes, a protein!) naturally found in wheat and several other grains. If you have been diagnosed with Celiac disease by a qualified allergist or gastroenterologist, you need to avoid consuming even minute amounts of gluten: For you, the gluten-free label is vital (because gluten is used in a wide variety of processed foods and other products, some of which you would never suspect).

But the gluten-free label and the whole concept of gluten-free foods has problems. First, contrary to popular belief, if you are one of the vast majority who do not have Celiac disease, gluten-free foods are not inherently healthier or more nutritious than their gluten-containing counterparts: Processed foods labeled gluten free are still processed, and in fact, some evidence shows gluten-free processed foods may be less nutritious and less healthy than their gluten-containing counterparts. Gluten-free cereals, breads, and other baked goods lack the vitamins, minerals, and fiber found in wheat-containing products, and those produced with rice flour in place of wheat flour may contribute to consuming unacceptably high levels of lead or arsenic. If you have been diagnosed with Celiac disease, you’re better off going gluten free by filling your plate with vegetables, fruits, beans, oats, and lower-fat animal-based foods, rather than relying on heavily processed foods with gluten substitutes.

Second, because the gluten-free label has become a marketing tool, just like cholesterol-free, it’s being slapped on everything from applesauce to frozen zucchini— including a whole lot of junk foods—that would never, ever contain gluten (think: gluten-free potato chips). But because some folks have come to associate the “gluten-free” label with a completely undeserved health halo, some totally worthless foods are experiencing skyrocketing sales.

Finally, if you suspect you might have Celiac disease and are scheduled to undergo testing, don’t avoid gluten in the weeks prior to the test! Avoiding gluten will cause the diagnostic signs to disappear, resulting in a false negative result and unnecessarily delaying proper treatment.

If you believe you may have Celiac disease, you should be tested: If the test is negative and you have been consuming gluten-containing foods, you may be reacting to other food ingredients and should speak with your provider or nutritionist about eliminating foods that contain a certain group of carbohydrates called Fermentable Oligo-, Di-, Mono-saccharides and Polyols (FODMAPs). The list of foods that contain FODMAPS is virtually endless and includes asparagus, broccoli, cauliflower, cashews, and dairy products, to name a few. But I digress.

Claims about the Source or Manner of Production

Claims like “organic” and “free-range” have legal definitions established by the federal government, which has implemented rigorous inspection processes for every step of the farming, harvesting, transport, and processing of these products.  The exact standards for what can be called an organic product differ for each type of food product (e.g., milk, eggs, and fruit) and are regulated by different government agencies and departments, depending on the food. When consumers who tend to prefer organic products are asked why, they express a variety of beliefs about the safety and nutritional advantages of these products, most of which have no basis in reality. No reputable studies have consistently demonstrated that any organic food is safer or nutritionally superior to its conventionally grown counterpart, despite the French study you read or heard about a week or two ago.

Safety wise, one common reason consumers give for choosing organic produce (or foods made from that produce, such as bread or cereal) is its lack of exposure to inorganic pesticides and fertilizers. Some tests of the pesticide contents of fruits and vegetables that are eaten whole and have thin skins (think, berries) show slightly higher levels of inorganic pesticide residues in conventionally grown produce than in those that are organically grown. But it’s also important to understand that these small amounts of pesticide have never been proven to have any detrimental health effects. It’s also important to know that organic pesticides are not necessarily healthier than their inorganic counterparts and that some kinds of plants even produce their own pesticides. If you have young, growing children, and if you can afford the additional cost of organic berries, apples, peaches, peppers, and other produce with thin, edible skins, and if feeding them organic produce helps you sleep better at night, just make sure to wash those fruits and veggies carefully before serving, because exposure to the contents of organic fertilizer (animal poop) is no walk in the park! The bottom line is that “organic” is not necessarily better or worth the extra cost. There’s nothing wrong with eating these products. Just understand you’re paying more, simply for the word “organic,” or “free-range” on the label.

GMO-free Claims

One of the biggest culprits in the category of scare tactics used as marketing ploys is the “GMO-free” claim. Evidence has shown over and over that GMO-free foods (foods from plants that have not been genetically modified through the introduction of genes from a different species) are no healthier or safer than GMO-containing foods.  No GMO food has ever been found to cause any health condition. In fact, some GMO foods are healthier and more nutritious than their non-GMO-containing counterparts.  For example, do you really want to eat a tomato that’s been sprayed with pesticides when there’s one available that’s pesticide free because of an added gene from a different type of plant that makes the tomato plants insect resistant? Other uses for GMO technologies can include increasing the nutrient content or extending freshness.

Growth-hormone Free Claims

Another term worth ignoring is bovine growth hormone (BGH)-free (also known as bovine somatotrophin [BST]-free), when applied to dairy products. Cows naturally produce their own growth hormone, some of which finds its way into milk. Some cows are given injections of cow growth hormone to improve their milk production, slightly raising the amount of growth hormone in the milk.  Strong evidence has shown that growth hormones in milk have absolutely no negative health effects. Because growth hormone is a protein, it is digested along with all the other proteins in the milk (growth hormone in milk has the same non-effect as would insulin if taken by mouth: That’s why insulin must be injected).

Other “Hormone-free” Claims

Although some packages of meat and poultry may boast that the contents are from “hormone-free” animals, you need to know that hormones are never given to animals raised for consumption, including chickens maintained as egg layers. Of course, all animals contain their own natural hormones. 

Natural (Hogwash!)

The word “Natural” on a food product is completely meaningless. It says nothing about how the food was grown, processed, or manufactured; its nutritional status; or what it does or doesn’t contain. So, if, given the choice, you find yourself tempted to pick the one labeled, “natural,” remember: Arsenic, heroine, deathcap mushrooms, botulism, rabies toxins, and “deadly nightshade” plants are all totally natural…and lethal!!

Antibiotic-free Claims

A claim that you might want to pay attention to is the antibiotic-free claim.  Currently, U.S. agricultural regulations permit farmers to give healthy animals being raised for meat very small doses of certain antibiotics to improve the animals’ growth (possibly by helping prevent infection). These doses of antibiotics are much smaller than the ones that would be used to treat sick animals, and over time, they can encourage the growth of bacteria that are resistant to those antibiotics. For at least the past two decades, evidence has increasingly implicated this practice in just that outcome—the rise of antibiotic resistant bacteria in animals—which is strongly believed to contribute to antibiotic-resistant (difficult to treat) infections in people who handle or consume meat from these animals. Antibiotic resistant infections are a growing and deadly problem. Federal efforts are in place to limit and phase out the low-dose antibiotic treatment of farm animals: Farmers would continue to be allowed to use certain antibiotics to treat sick animals; however, they would no longer be permitted to use those antibiotics on “healthy” animals, in an effort to prevent those animals from developing resistance to those antibiotics. In fact, animals sold for their meat are not allowed to have any measurable amounts of antibiotics in their blood or tissues. Until the practice of routine low-dose antibiotic use is completely discontinued, it would seem prudent to try to purchase meat and poultry that is labeled “antibiotic free.” The problem is that the government has no standard definition for this term, as it is used on food labels.

NOTE: It’s important to be aware that the “organic” label tells us nothing about whether the product is from an animal that has or hasn’t been treated with antibiotics. Moreover, most of the popular fast food burger chains continue to use beef from antibiotic-treated cattle.  I will update you as things progress in this area.

Stay tuned for the next installment of this blog, where I’ll cover how to read the Nutrition Facts panel.