The New Food Label: Help in Preventing Heart Disease By Paula Kurtzwell My mother, an on again, off again low fat, low cholesterol dieter, rushed up to me in the grocery store one day last year. She was clutching a package of turkey frankfurters. Knowing I'm a registered dietitian, she pointed to the 5 milligrams of cholesterol listed on the package's nutrition panel and said, "No, tell me: Is this high or low in cholesterol?" If she had been holding a package with the new Nutrition Facts panel, I wouldn't have had to stand there sputtering and stammering as I did, waiting for the answer to come to me. Instead, I would have quickly referred her to the % Daily Value column on the panel's right side. There, she would have seen at a glance that a serving of those turkey franks (two of them, about 55 grams) provided only 2 percent of the Daily Value for cholesterol. As a rule of thumb, foods containing 5 percent or less of the Daily Value for a nutrient are low in that nutrient. So, a serving of those franks was low in cholesterol. Now when my mother and others like her shop for "heart healthy" foods, they can easily find this information on many products. Regulations requiring it and other labeling changes went into effect for many food products May 1994, and many now carry the label. The regulations come from the Food and Drug Administration and the U.S. Department of Agriculture. FDA's rules implement the Nutrition Labeling and Education Act of 1990. Besides percent Daily Values, consumers will find the new label helpful in other ways. For one thing, nutrition information in bigger, more readable type will be on most packaged foods. It also is available at the point of purchase for many fresh foods like fruits and vegetables and fish and meat. Second, the information is more complete. In addition to the amount of calories, fat, carbohydrate, protein, iron, calcium, and vitamins A and C on some labels before, most nutrition labels now must include additional information about saturated fat, cholesterol, fiber, calories from fat, and other dietary components important to today's consumers. (See "'Nutrition Facts' To Help Consumers Eat Smart" in the May 1993 FDA Consumer.) Third, the serving sizes are more realistic and thus more useful. Fourth, nutrient content claims, like "low cholesterol" and "no saturated fat," can be believed because the claims must follow strict government rules. (See "A Little 'Lite' Reading" in the June 1993 FDA Consumer.) Consumers also will be able to trust health claims, which describe the relationship of a food or nutrient to a disease or health condition, such as heart disease. Only claims about which there is significant scientific agreement are allowed. (See "Starting This Month, Look for 'Legit' Health Claims on Foods" in the May 1993 FDA Consumer.) Fat and Cholesterol Some of the label information, such as that about fat, particularly saturated fat, and cholesterol, will be of special interest to people concerned about high blood cholesterol and heart disease. High intakes of saturated fat and cholesterol are linked to high blood cholesterol, which in turn is linked to increased risk of coronary heart disease (CHD). CHD is the most common form of heart disease and is caused by narrowing of the arteries that feed the heart. (See "Lowering Cholesterol" in the March 1994 FDA Consumer and "A Consumer's Guide to Fats" in the May 1994 FDA Consumer.) For the general population, the Dietary Guidelines for Americans recommend that fat intake be limited to no more than 30 percent of the day's total calorie intake. Saturated fat intake should be limited to no more than 10 percent of the day's calories. The Daily Values used in food labeling follow these same guidelines. (See " 'Daily Values' Encourage Healthy Diet" in the May 1993 FDA Consumer.) Thus, people eating 2,000 calories a day should limit their daily fat intake to no more than 65 grams (g). (30 percent times 2,000 calories = 600 calories divided by 9 calories/gram of fat = 65g.) They should limit saturated fat intake to no more than 20 g a day. (10 percent times 2,000 calories equals 200 calories divided by 9 calories/gram of fat equals 20 g.) The 2,000 calorie level is the basis on which percent Daily Values on the label are calculated. According to Ed Scarbrough, PhD., director of FDA's Office of Food Labeling, FDA and USDA chose this level partly because it is a "user friendly" number that allows for easy adjustments in Daily Value numbers, if consumers want to figure them to their own diet and calorie intakes. The Daily Value for cholesterol is 300 milligrams (mg). It remains the same whatever the person's calorie intake. FDA and USDA chose this level because it corresponds to the recommendations of other health organizations, such as the American Heart Association, the National Research Council of the National Academy of Sciences, and the National Cholesterol Education Program of the National Institutes of Health. People with severe high blood cholesterol or heart disease may need to limit their saturated fat and cholesterol intakes even further. Camile Brewer, a registered dietitian and nutritionist in FDA's Office of Food Labeling, advises people with specific health problems that require a low saturated fat, low cholesterol diet to see a physician, registered dietitian, or nutritionist first. These professionals can help tailor a diet to a person's specific health needs. Fiber and Others A food's fiber content also may be of interest to consumers seeking "heart healthy" foods. Some studies suggest that dietary fiber, that is, fiber from foods such as fruits, vegetables and grains, may help lower the risk of heart disease. The Daily Values for fiber is 25 g. This is based roughly on FDA and USDA reference amounts of 11.5 g of fiber per 1,000 calories. Fiber information is important for weight reduction, too. Overweight is a risk factor for heart disease, and reducing fat while increasing fiber can benefit those who want to lose or maintain their weight. The reason for fiber's importance, according to FDA's Brewer, is that high fiber foods tend to be lower in calories because they are mostly carbohydrate and tend to have little, if any, fat. (One gram of carbohydrate and protein each provides 4 calories, while one gram of fat gives 9 calories.) And, Brewer said, "High fiber foods take longer to chew and increase the feeling of fullness, which may reduce meal size. Therefore, unless their high food, like broccoli, is swimming in butter, people are likely to eat fewer calories." Calorie information also may be important to these individuals. (See the first article in this series, "Making It Easier to Shed Pounds," in the July, August 1994 FDA Consumer.) Consumers interested in "heart healthy" foods who also have high blood pressure should check the label for information about the food's sodium content, too. (See the second article in this series, "Scouting for Sodium and Other Nutrients Important to Blood Pressure," in the September 1994 FDA Consumer.) Check the "Nutrition Facts" panel, usually on the side or back of the package. It will give more complete nutrition information about food. Nutrition Facts Serving Size 3 oz 84 g/about 1/2 stalk Servings per Container about 2.5 Amount per serving Calories 30 Calories from fat 0 %Daily Value* Total Fat 0 g 0% Saturated fat 0 g 0% Cholesterol 0 mg 0% Sodium 20 mg 1% Total Carbohydrate 5 g 2% Dietary Fiber 3 g 11% Soluble Fiber 1 g Sugars 0 g Protein 3 g Vitamin A 25% Calcium 4% Vitamin C 110% Iron 4% Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs. Calories 2,000 2,500 Total Fat Less than 65mg 80mg Sat Fat Less than 20g 25g Cholesterol Less than 300mg 300mg Sodium Less than 2400mg 2400mg Total Carbohydrate 300g 375g Dietary fiber 25g 30g Look at the serving size. It is about the same for similar items. So it's easy to compare the nutritional qualities of similar foods. Look at the column called "% Daily Value" It tells you if a food has large or small amounts of saturated fat, cholesterol, fiber, and other nutrients. Try to select as many foods as possible with a % Daily Value for fat, saturated fat, and cholesterol of 5 or less. Look for claims (such as those shown at right), usually on the front, describing a food's nutritional content or stating a food or health benefit. Broccoli is a healthful food that is saturated fat free, cholesterol free, and a good source of fiber. (See back panel for nutrition information.) Development of heart disease depends on many factors. Eating a diet low in saturated fat and cholesterol and high in fruits, vegetables and grain products that contain fiber may lower blood cholesterol levels and reduce your risk of heart disease. Figuring Fat Fat information for products claiming to be reduced fat, such as these labels representing reduced fat corn in butter sauce, was the old label (right), but the information didn't show how the amount of fat fit into a person's daily diet. And consumers couldn't really tell if the product was in fact reduced in fat. The % Daily Values information on the new label (left) solves that problem. In general, if a product has a % Daily Value of 5 percent or less, it is considered low in that nutrient. High blood pressure is another risk factor for heart disease, and in some people, sodium increases the risk of high blood pressure. % Daily Values The place to find out whether a food is relatively high or low in a nutrient is the % Daily Value column on the Nutrition Facts panel, usually on the side or back of the food package. For people concerned about high blood cholesterol and heart disease, the % Daily Values for fat (especially saturated fat), cholesterol, and fiber are important. If, for individual foods, the % Daily Value is 5 or less, the food is generally considered low in that nutrient. The more foods chosen that have a % Daily Value of 5 or less for fat, saturated fat, cholesterol, and sodium, the easier it is to eat a healthier daily diet. Foods with 10 percent or more of the Daily Value for fiber are considered good sources of that dietary component. The overall goal should be to select foods that together do not exceed 100 per cent of the Daily Value for fat, saturated fat, cholesterol, and sodium and that will meet or exceed that amount for other nutrients. Serving Size The serving size information on the Nutrition Facts panel also is important. It tells the amount of food, stated in both common household and metric measures, to which all other numbers apply. Unlike before, servings sizes now are more uniform among similar products and reflect the amounts people actually eat. For example, the reference amount for a serving of snack crackers is 30 g. So, the serving size for soda crackers is 10, while the serving size for Goldfish crackers is 55, because those amounts are the ones that come closest to weighing 30 g. This makes it easy to compare the nutritional qualities of related foods. Front Label Info On some food packages, short label statements describing the food's nutritional benefits may appear. Often, they will be on the front label, where shoppers can readily see them. Some statements, like "low in saturated fat" and "no cholesterol," are called nutrient content claims. They are used to highlight foods with desirable levels of nutrients. Other statements are health claims. FDA approved eight of them, two of which relate to heart disease. These two can state that: # A diet low in saturated fat and cholesterol may reduce the risk of coronary heart disease. # A diet high in fruits, vegetables and grain products that contain fiber, particularly soluble fiber, and low in saturated fat and cholesterol may reduce the risk of coronary heart disease. These health claims also must state that the risk of coronary heart disease depends on many factors. Both types of claims signal that the food contains desirable levels of the stated nutrients. Other Nutrition Information "Calories from Fat" appears on the Nutrition Facts panel, listed next to "calories." This informations helps people limit their total fat intake to 30 percent or less of their total daily calorie intake. Here's how to use "Calories from Fat": At the end of the day, add up total calories and then calories from fat eaten. Divide calories from fat by total calories. The answer gives the percentage of calories from fat eaten that day. For example, 450 calories from fat divided by 1,800 calories = 0.25 (25 percent), an amount within the recommended level of not more than 30 percent. The Nutrition Facts panel also gives the amount by weight, in grams or milligrams, of certain nutrients, including fat, saturated fat, cholesterol, and sodium. These amounts are helpful for people who monitor their daily consumption of these nutrients. The amount by weight of polyunsaturated and monounsaturated fats also may appear under Nutrition Facts Information about each is required when a claim is made on the label about the food's saturated fat or cholesterol content. Otherwise, it's voluntary. If the information is provided, it will appear below saturated fat and be given in grams per serving of the food. This information is helpful for people who closely monitor their fat intake to reduce their risk of heart disease. Polyunsaturated fats, when substituted for saturated fats in the diet, tend to lower blood cholesterol levels. Monounsaturated fats are considered neutral in terms of increasing the risk of fatty deposits in the arteries. Look to the Label Whenever my mother and other consumers check the label for the nutritional qualities of the foods they eat, they'll find plenty of information to help them choose foods that may help reduce their risk of heart disease. On the Nutrition Facts panel, % Daily Values will tell them at a glance whether a food has desirable levels of cholesterol, saturated fat, fiber and other nutrients that may be beneficial for them. Claims, usually on the front of labels, will signal to them right away that the food contains appropriate levels of certain nutrients. And all of the information will be easy for them to read and use so, like my mother, they won't have to rely on a dietitian or nutritionist to help them out. As FDA Commissioner David A. Kessler, M.D., says about the new label: "You don't have to be a nutritionist to understand. Just take a minute to find the % Daily Values on the label. They really tell you what's in a food." Tips to Reduce Fat and Cholesterol # Try whole grain flours to enhance flavors of baked goods made with less fat and fewer or no cholesterol containing ingredients. # Replace whole milk with low fat or skim milk in puddings, soups and baked products. # Substitute plain low fat yogurt or blender whipped low fat cottage for sour cream or mayonnaise. # Steam, boil, bake, or microwave vegetables rather than frying. # Season vegetables with herbs and spices instead of fatty sauces, butter or margarine. # Try flavored vinegars or lemon juice on salads or use smaller servings of oil based or low fat salad dressings. # Use vegetable oil instead of solid shortening, margarine and butter whenever possible. # Choose lean cuts of meat, and trim fat from meat and poultry before and after cooking. Remove skin from poultry before or after cooking. # Roast, bake, broil, or simmer meat, poultry and fish rather than frying. # Cook meat or poultry on a rack so the fat will drain off. Use a non stick pan for cooking so added fat is unnecessary. # Chill meat and poultry broth until the fat becomes solid. Remove the fat before using the broth. # Limit egg yolks to one per serving when making scrambled eggs. Use additional egg whites for larger servings. # Try substituting egg whites in recipes calling for whole eggs. Use two egg whites in place of one whole egg in muffins, cookies and puddings. (Source: U.S. Department of Agriculture) Guide to Label Nutrient Claims Fat Fat free: less than 0.5 grams (g) per labeled serving size Low fat: 3 g or less per reference amount and, if the serving size is 30 g or less or 2 tablespoons or less, per 50 g of the food Reduced or less fat: at least 25 percent less per serving than reference food Saturated Fat Saturated fat free: less than 0.5 g and less than 0.5 g trans fatty acids per serving. (Trans fatty acid is found in solid fat products, like margarine and vegetable shortenings. Evidence suggests that trans fatty acid has the same effect on blood cholesterol as saturated fat; therefore, FDA believes the level of trans fatty acid should be limited in products claiming to be "saturated fat free.") Low saturated fat: 1 g or less per serving and not more than 15 percent of calories from saturated fatty acids. Reduced or less saturated fat: at least 25 percent less per serving than reference food. Cholesterol Cholesterol free: less than 2 milligrams (mg) and 2 g or less of saturated fat per serving. Low Cholesterol: 20 mg or less and 2 g or less of saturated fat per serving and if the serving is 30 g or less or 2 tablespoons or less, per 30 g of the food. Reduced or less cholesterol: at least 25 percent less than reference food and 2 g or less of saturated fat per serving. The following claims can be used to describe meat, poultry, seafood and game meats. Lean: less than 10 g fat, 4.5 g or less saturated fat and less than 95 mg cholesterol per reference amount and per 100 g Extra Lean: less than 5 g fat, less than 2 g saturated fat, and less than 95 mg cholesterol per reference amount and per 100 g Healthy # "Low fat," "low saturated fat," with 60 mg or less cholesterol per serving (or, if raw meat, poultry and fish, "extra lean") # At least 10 percent of Daily Value for one or more of vitamins A and C, iron, calcium, protein, and fiber per serving # 480 mg or less sodium per serving, and if the serving is 30 g or less or 2 tablespoons or less, per 50 g of the food. (After Jan. 1, 1998, maximum sodium levels drop to 360 mg.) Fiber High fiber: 5 g or more per serving Good source of fiber: at least 2.5 g more per serving than the reference food. (The label will say the food has 10 percent more of the Daily Value for fiber.) Foods making claims about increased fiber content also must meet the definition for "low fat" or the amount of total fat per serving must appear next to the claim. Special Report In depth and easy to understand information about the new food label is provided in an FDA Consumer special report, Focus on Food Labeling. Copies cost $5 each. To order, write to Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Ask for stock number S/N 017-012-00360-5 Paula Kurtzweil is a member of FDA'a public affairs staff. This article originally appeared in the December 1994 issue of FDA Consumer. Public Health Service Food and Drug Administration We hope you found this reprint from FDA Consumer magazine useful and informative. FDA Consumer, the magazine of the U.S. Food and Drug Administration, provides a wealth of information on FDA related health issues: food safety, nutrition, drugs, medical devices, cosmetics, radiation protection, vaccines, blood products, and veterinary medicine. For a sample copy of FDA Consumer and a subscription order form, write to: Food and Drug Administration, HFI-40, Rockville, MD 20857

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