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    FDA revamps nutrition facts label box

    In May 2016, the US Food and Drug Administration (FDA) announced the revamping of the rules for the "nutrition facts" label box on packaged foods, the first major such overall in 20 years.

    With the obesity epidemic continuing, much of the emphasis in the announcement was on things such as the FDA's new requirement that manufacturers list "added sugars" and that they use a new format which, among other things, will display the calories much more prominently.

    Less talked about was the fact that in the 2 years since the FDA proposed the changes, there has been a massive discussion, via the agency's regulatory process, on the many aspects of nutrition science and policy.

    As 1 example, in a comment to the FDA last fall the American Academy of Pediatrics (AAP) said it was comfortable with the proposal of a Daily Reference Value (DRV) of 25g "for added sugars based on a 1000-calorie reference amount for children 1 through 3 years of age."

    However, the AAP said, it's a problem that the rules would, in effect, extend the added sugar recommendations for an adult to children as young as age 4 years, which would indicate it would be okay for them to eat up to 14% of their calories in added sugar.

    The FDA declined to make a change based on the AAP's comment, saying that a separate DRV for different child age groups "could clutter the label, cause confusion, and draw attention to the added sugars declaration because more space would be required for 2 separate percent DV declarations on the label."

    In another instance, the AAP, the March of Dimes, and about 22 other groups said the change in the way the FDA will require that folic acid be listed could lead to public confusion, limit the ability to monitor intake and safety, and negatively impact birth outcomes.

    The new rule would mandate the expression of the Recommended Dietary Allowance (RDA) for folate in "Dietary Folate Equivalents (DFEs)." The groups' comments said, "Because of the difference between measuring folate/folic acid in DFEs versus micrograms, this means the RDA is lower than the [US Public Health Service] recommendation for intake among women of childbearing age."

    Next: 5 steps to better nutrition

    The FDA, however, noted that the DFE, developed by the Institute of Medicine, "accounts for the differences in bioavailability between food folate (natural folate) and folic acid, which is more bioavailable (about 1.7 times more bioavailable)."

    The AAP also urged the FDA to require that foods be labeled for caffeine because of its numerous adverse effects. It noted findings from the American Association of Poison Control Centers that "more than 40% of 5156 calls about energy drinks to US poison control centers involved children [aged] younger than 6 [years], with some suffering serious cardiac and neurological symptoms."

    In other rules related to obesity, the FDA says that because package size affects what people eat, packages that are between 1 and 2 servings must be labeled as 1 serving in terms of calories and other nutrients because people typically consume those packages in 1 sitting. Examples are a 20-ounce soda or a 15-ounce can of soup.

    Large food manufacturers have 2 years to comply with all the new requirements, by July 26, 2018, and those with less than $10 million in sales have another year after that.


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