BMJ 2014;348:g1852 doi: 10.1136/bmj.g1852 (Published 28 February 2014)

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NEWS Proposed US food labels would highlight calories, added sugars, and serving sizes Michael McCarthy Seattle

The US Food and Drug Administration has proposed the first major revision in two decades of the nutrition facts labels on packaged foods.1

The proposed changes would require the labels to highlight calories and added sugars and to show serving sizes that more accurately reflect the portions that people actually eat.

“The current nutrition label has served us well for the past 20 years, but we must be sure that what is iconic doesn’t become a relic,” said Margaret Hamburg, the FDA commissioner. “The proposed changes to the nutrition facts label should make it easier than ever to judge a food by its label and reflect the latest evidence on how what we eat affects our health.”

The proposal is due to be published in the Federal Register on 3 March and will be open for public comment for 90 days.

In its proposal2 the FDA noted that serving sizes on current labels were based on dietary surveys conducted in the 1970s and 1980s and did not reflect the larger serving sizes that people now ate. For example, the serving size for ice cream on current labels is half a cup; but under the proposal new labels would have the more realistic serving size of one cup, the FDA said.

In addition, under the new rules packages of products that could be eaten in one sitting would be required to have labels with a dual column format—one column to indicate the “per serving” calorie and nutrition information and one to indicate the same information “per package.” For example, such dual labels would be required for 24 ounce bottles of soda, 19 ounce cans of soup, or pint cartons of ice cream, which many people consume in one sitting. Currently the nutrition information on a 24 ounce bottle of soda is based on an 8 ounce serving, with one bottle considered to contain two and a half servings. The dual column (per serving and per package) format would be required for all packages that contained the equivalent of two to four servings. Dual column labels would not be required for packages containing more than four servings because most consumers

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would not eat more than four servings in one sitting, the FDA said.

The calorie content and the servings per container would be printed in a large, bold typeface at the top of the labels to make it easier for consumers to find the information, the FDA said.

Because many US residents have low levels of vitamin D and because of the blood pressure lowering effect of potassium, information about both of these micronutrients would be added to the new labels. Information about iron and calcium content would remain, but information about vitamin A and C content would no longer be required, since deficiencies in these vitamins are uncommon. The labels would still include information about total fat, saturated fat, and trans fat but would no longer list “calories from fat,” as recent research showed that the type of fat was more important than the amount, the FDA said.

However, the labels would now include the amount of added sugars, which are thought to be major contributors to the US obesity epidemic. Sugars added during the production of processed foods are said to account for 16% of the calories that people eat each day. The FDA’s proposal would also lower the “daily value” of sodium from 2400 mg to 2300 mg. This value is supposed to represent the “tolerable” upper intake level for sodium.

However, the FDA asked for additional comment on whether it should lower this value further to 1500 mg per day. This is the recommended limit for groups that are at increased risk of elevated blood pressure due to dietary salt, including older people, African Americans, and people with existing hypertension, kidney disease, or diabetes—groups that make up half of the general US population, the FDA noted. 1 2

McCarthy M. US plans to revamp food labels. BMJ 2014;348:g1165. Federal Register. Food labelings: serving sizes of foods that can reasonably be consumed at one eating occasion, et al. (Unpublished proposed rule). 27 Feb 2014. www. federalregister.gov/articles/2014/03/03/2014-04385/serving-sizes-of-foods-that-canreasonably-be-consumed-at-one-eating-occasion-et-al-food-labelings.

Cite this as: BMJ 2014;348:g1852 © BMJ Publishing Group Ltd 2014

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Proposed US food labels would highlight calories, added sugars, and serving sizes.

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