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Labelling foods to improve nutrition in the United States

Étiqueter les aliments pour améliorer la nutrition aux États-Unis
Etiquetado de los alimentos para mejorar la nutrición en los Estados Unidos

V. Wilkening, P. Dexter and C. Lewis

Virginia Wilkening is Chief of the Nutrition Regulations Unit, United States Food and Drug Administration (FDA). Patricia Dexter worked previously for FDA and FAO as a nutritionist. Christine Lewis is Director of the Division of Technical Evaluation in the Office of Food Labeling, FDA, Washington, DC, USA.

In the United States, nutrition labelling is an integral component of nutrition education efforts to raise consumers' awareness and encourage positive dietary behaviour change. The labelling regulations are designed to be consistent and complementary to national nutrition education campaigns aimed at the general public. The need for improved labelling grew out of public demand for accurate and clear information in the marketplace to help consumers choose foods for a healthy diet. With the passage of the Nutrition Labeling and Education Act (NLEA) of 1990, food manufacturers are now required to put nutrition labels on almost all processed foods regulated by the Food and Drug Administration (FDA) of the United States Department of Health and Human Services. In addition, the United States Department of Agriculture (USDA) has voluntarily instituted similar food labelling regulations to apply to meats and poultry.

For Americans, the benefits of nutrition labelling in terms of lower health care costs related to coronary heart disease and cancer, the two largest public health problems in the country, are estimated to surpass by far the costs incurred by food companies to comply with the labelling reforms. When the new labels were proposed, it was estimated that the total costs of nutrition labelling would be between US$ 1400 million and US$ 2300 million for the food industry, plus US$ 160 million for the government. A cost-benefit study commissioned by FDA estimated that if consumers change their consumption practices as a result of food labelling, the reduction in risk of cancer and coronary heart disease alone will bring benefits ranging from US$ 4400 million to US$ 26000 million.


FDA labelling regulations for declaring the nutrient content of packaged and processed foods using a standard format were first established in 1973. However, provision of a label was voluntary unless a nutrient was added to the food or a claim about a nutrient was made on the label or in advertising, in which case it was mandatory. In response to the country's public health concerns about the effects of over-consumption of certain nutrients, strategies to reform labelling regulations were developed in the late 1980s.

In 1989, FDA and USDA issued a request for comments and held nationwide hearings to find out what consumers, food manufacturers and health professionals wanted on food labels. In response to comments received, FDA proposed in July 1990 that regulations mandate nutrition labelling for almost all processed foods, establish reference daily values for certain nutrients and define serving sizes. In 1990, the NLEA was passed by the United States Congress and signed by the president, giving more force to nutrition labelling efforts.

The goal of the NLEA is to provide consistent, understandable and usable food labels to enable consumers to make healthy food choices and to provide an incentive for manufacturers to improve the quality of the foods they produce, FDA was given authority to require nutrition information on the label even when no nutrient claim is made. Developing the regulations required extensive data analyses related to the nutrient content of foods, daily reference values for various nutrients and food components and customary serving sizes for categories of foods. In addition, the scientific literature on diet and health relationships was examined to establish which health claims would be allowed on food labels. FDA reviewed over 40 000 comments from the- food industry, consumer advocacy groups, professional organizations and individuals before finalizing the NLEA regulations, which take effect in 1994.


Under the NLEA, about 90 percent of processed food sold in the United States is required to carry nutrition information.1 The USDA has made nutrition labelling mandatory on processed and packaged meat and poultry products as well. Nutrition labelling will remain voluntary for many raw foods. A voluntary point-of-purchase programme has been developed by FDA for providing nutrition information for raw foods, including fish and the 20 most frequently eaten raw fruits and vegetables, USDA has developed a similar voluntary programme to provide nutrition information for 45 major cuts of meat and poultry.

1 Foods sold by small businesses, in restaurants and by food service vendors, ready-to-eat foods and donated foods are exempt from the regulations, as are coffee beans, tea, food colours and flavours which have no nutritional significance.


To help consumers focus on the nutritional factors most important to public health, the number of nutrients allowed on the nutrition label is limited. The required information and order of appearance on the food label were selected to reflect public health priorities and to minimize confusion.

Information on 14 nutrients must be listed on the label, in the following order: calories, calories from fat, total fat, saturated fat, cholesterol, sodium, total carbohydrate, dietary fibre, sugars, protein, vitamin A, vitamin C, calcium and iron. In addition, several nutrients may be voluntarily declared by food manufacturers, including: calories from saturated fat, mono- and polyunsaturated fat, potassium, soluble fibre, insoluble fibre, sugar alcohol, other carbohydrates, other vitamins and minerals for which Reference Daily Intakes (RDIs)2 have been established and beta-carotene (as a percentage of vitamin A). If a claim is made about any of the nutrients or food components that are otherwise optional to list or if the food is fortified or enriched with one of them, they must be listed on the nutrition label.

2 The term RDI replaces FDA's earlier term US RDA (US Recommended Daily Allowance) to avoid confusion with the Recommended Dietary Allowances (also abbreviated RDA) determined by the United States National Academy of Sciences for various population groups.


In addition to RDIs, FDA established Daily Reference Values (DRVs) for total fat, saturated fat, cholesterol, total carbohydrate, dietary fibre, sodium and potassium to help consumers evaluate how a particular food fits into a healthy diet. For the nutrition label, the simpler term Daily Value was chosen to refer to both the RDIs and the DRVs.

Currently, recommendations for the general American public suggest that individuals limit total fat intake to 30 percent or less of calories and saturated fat to 10 percent or less of calories; obtain 60 percent of calories from carbohydrate and 10 percent of calories from protein; and consume 11.5 g of fibre per 1000 calories. Although it is recommended that Americans moderate their sugar consumption, a DRV was not established for sugars because the natural sugars in milk, fruits, vegetables and grain products would make setting such a value very difficult.

Since the dietary guidance recommendations were made relative to calorie intake, FDA had to choose a particular calorie value on which to base the DRVs. A 2000-calorie diet was selected for labelling purposes because it is a basis from which consumers can easily calculate specific values for their own estimated calorie intake. A diet of 2000 calories is considered appropriate for most women, including teenage girls, and for some sedentary men.

To enable consumers to compare the nutrient content of similar foods, more consistent serving sizes are to be specified on the label. Serving sizes must be expressed in both household measures and metric measures. For example, the serving size for milk may be stated as "1 cup (240 ml)" and that for bread as "1 slice (28 g)". To define serving sizes for the over 40000 foods on the market in the United States, FDA grouped foods into 139 food product categories and specified "reference amounts customarily consumed" for each category. These are the portions normally eaten at one time according to USDA's national food intake surveys.

On the label the absolute quantitative amount of each nutrient per serving is listed next to the name of the nutrient so the consumer can find it easily. However, as the absolute quantity of a nutrient may have little meaning to some consumers, the amount must also be expressed as Percent Daily Value, which indicates the food's contribution of the nutrient in the context of the daily diet.

Since protein deficiency is not a public health concern in the United States, listing of Percent Daily Value for protein is not required. However, protein quality information must be declared for foods for infants and children under four years of age and if claims are made about a food's protein content.


Manufacturers often wish to make positive claims about the nutrient contents in a food. To give consumers greater confidence in what they read on the label, FDA regulations state which nutrient content claims are allowed and under what circumstances they can be used. FDA has defined criteria for the use of terms such as the following; free, low, lean, extra lean, high, good source, reduced, less, light, modified, more. For example, for a food to be labelled "reduced" in calories, it must have at least 25 percent fewer calories per serving than the usual form of the food established as a reference.


When consumers were asked about nutrition labels, they emphasized the need to keep the nutrition label format as simple as possible, to retain the listing of nutrients with quantitative amounts per serving, to allow consumers to compare the nutritional quality of various foods and to estimate the foods' contributions towards a total daily diet.

To help the consumer recognize information on the label quickly, the regulations include specific graphic requirements such as easy-to-read type styles, upper- and lower-case letters, larger type size and specific line and letter spacing (Figure 1). Exceptions will be granted to make nutrition labelling practical on smaller packages.

A simplified format (Figure 2) is allowed for those foods where at least half of the nutrients are present in insignificant amounts, for example, foods that are primarily carbohydrate or fat such as margarines, oils, sugars, jams, syrups, fruit juices and some fruits and vegetables. When a simplified format is used, the label must include five "core" nutrients: calories, total fat, sodium, carbohydrate and protein, even when they are present at 0 levels.

1 - The new food label - Le nouvel étiquetage des aliments - La nueva etiqueta de los alimentos

Nutrition Facts
Serving Size ½ cup (114 g)
Servings Per Container 4

Amount Per Serving

Calories 260

Calories from Fat 120

% Daily Value*

Total Fat 13 g


Saturated Fat 5 g


Cholesterol 30 mg


Sodium 660 mg


Total Carbohydrate 31g


Dietary Fiber 0 g


Sugars 5 g

Protein 5 g

Vitamin A 4 %

Vitamin C 2 %

Calcium 15 %

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:




Total Fat

Less than

65 g

80 g

Sat Fat

Less than

20 g

25 g


Less than

300 mg

300 mg


Less than

2,400 mg

2,400 mg

Total Carbohydrate

300 g

375 g

Dietary Fiber

25 g

30 g

Calories per gram:

Fat 9

Carbohydrate 4

Protein 4

2 The simplified nutrition label - Etiquetage simplifié des informations nutritionnelles - La etiqueta simplificada con información nutricional

Nutrition Facts
Serving Size 1 can (360 mL)

Amount Per Serving

Calories 140

% Daily Value*

Total Fat 0 g

0 %

Sodium 20 mg

1 %

Total Carbohydrate 36 g

12 %

Sugars 36 g

Protein 0 g

* Percent Daily Values are based on a 2,000 calorie diet.

Some claims refer to the nutrient content of the food relative to the Daily Value for that nutrient. For a product to qualify as an "excellent source" of a nutrient, a serving of the food must contain 20 percent or more of the Daily Value for that nutrient. To qualify for a "good source of..." claim, a serving must contain 10 to 19 percent or more of the Daily Value for that nutrient.

The claim "-free" and its synonyms are allowed when the food is absolutely free of the nutrient or if the amount is so small that it is considered "dietetically trivial or physiologically insignificant". For example, the regulations will allow a "fat-free" claim on a label if the food has less than 0.5 g of fat per serving. This amount is considered physiologically insignificant even if a person eats several servings.


For the first time, food labels will be allowed to carry information about the link between certain nutrients and the risk of specific diseases or health conditions. For such a "health claim" to be permitted on a package, FDA must first determine that the link between diet and disease risk is supported by scientific evidence. As with the nutrient content claims discussed above, health claims may be made on the label only if they are authorized by FDA.

At this time, FDA allows eight such health claims, as listed in the table. The nutrient content of foods bearing these health claims must meet the criteria set for the terms listed in the "food characteristics" column. Health claims must also be phrased so that the consumer can understand the relationship between the nutrient and the health condition and the nutrient's importance in the daily diet. Model claim statements have been developed by FDA (see table).

When the scientific evidence has not been conclusive, FDA has not allowed health claims. In addition, the NLEA specifically prohibits health claims about any food that contains any nutrient in an amount that generally increases the risk of disease or a health-related condition.


To help consumers learn how to use the new label, FDA and USDA have embarked on a joint national food labelling education campaign which is carried out in conjunction with consumer, trade and health groups as well as other government agencies. The goal is to provide consistent messages on the use and importance of the new food label. The campaign features national annual conferences; a labelling Education Information Center that includes a database of activities, materials, research and publications; a research and evaluation component; and a strong focus on media and materials development.

As part of the United States' nutrition education campaigns, USDA and the Department of Health and Human Services jointly issued the Dietary Guidelines for Americans and developed the Food Guide Pyramid (see Figure 3) to illustrate them. Through the widespread dissémination of the Food Guide Pyramid and the nutrition label, it is hoped that consumers will understand the appropriate amounts of each type of food that should be eaten on a daily basis to maintain good health.

The dietary information presented on the food label is complex, and consumers vary in their ability to understand and make use of it. Perhaps one of the greatest challenges of nutrition labelling lies in educating the public on how to use the information on the label to make wise food choices for an overall healthy diet. FDA brochures, messages, educational guidelines and media activities all emphasize this focus.

Health claims allowed on food labels - Informations sur la santé pouvant figurer sur l'étiquette des aliments - Informaciones sobre la salud permitidas en las etiquetas de los alimentos

Food characteristics

Health claim -reduced risk of:

Model claim statements

High in assimilable (bioavailable) calcium; supplements must disintegrate and dissolve; phosphorus content cannot exceed calcium content


Regular exercise and a healthy diet with enough calcium helps teens and young adult white and Asian women maintain good bone health and may reduce their high risk of osteoporosis later in life.

Low sodium


Diets low in sodium may reduce the risk of high blood pressure, a disease associated with many factors.

Low fat; fish and game meats must be "extra lean"


Development of cancer depends on many factors. A diet low in total fat may reduce the risk of some cancers.

Low saturated fat, low cholesterol and low fat; fish and game meats must be "extra lean"

Coronary heart disease

While many factors affect heart disease, diets low in saturated fat and cholesterol may reduce the risk of this disease.

Grain products, fruits or vegetables that contain dietary fibre; low fat; good source of dietary fibre (without fortification)


Low-fat diets rich in fibre-containing grain products, fruits and vegetables may reduce the risk of some types of cancer, a disease associated with many factors.

Fruit, vegetable or grain products that contain fibre; low saturated fat; low cholesterol; low fat; at least 0.6 g of soluble fibre per reference amount (without fortification)

Coronary heart disease

Diets low in saturated fat and cholesterol and rich in fruits, vegetables and grain products that contain some types of dietary fibre, particularly soluble fibre, may reduce the risk of heart disease, a disease associated with many factors.

A fruit or vegetable; low fat; good source (without fortification) of at least one of the following: vitamin A, vitamin C or dietary fibre


Low-fat diets rich in fruits and vegetables (foods that are low in fat and may contain dietary fibre, vitamin A or vitamin C) may reduce the risk of some types of cancer, a disease associated with many factors. Broccoli is high in vitamins A and C, and it is a good source of dietary fibre.

Good source of folate

Neural tube defects

Women who consume adequate amounts of folate, a B vitamin, daily throughout their childbearing years may reduce their risk of having a child with a neural tube birth defect. Such birth defects, while not widespread, are very serious. They can have many causes. Adequate amounts of folate can be obtained from diets rich in fruits, dark-green leafy vegetables and legumes, enriched grain products, fortified cereals or a supplement. Folate consumption should be limited to 1 000 mg per day from all sources.

3 - Food Guide Pyramid created to assist United States consumers in daily food choices - Pyramide alimentaire mise au point pour aider les consommateurs américains à choisir leur régime alimentaire journalier - Pirámide guía de los alimentos elaborada para ayudara los consumidores de los Estados Unidos a elegir su dieta diaria

Food advertising presents another challenge within the objective of providing consistent and accurate messages to consumers. The Federal Trade Commission (FTC) Is being asked to abide by the same standards as those created under the NLEA so that food advertising related to health claims and nutrient content claims will be consistent with information allowed on the food label.


The nutrition labelling policy being implemented in the United States will result in the provision of more information about food products under a single national uniform system and will benefit both consumers and ' manufacturers. Efforts by FDA to develop regulations to improve nutrition labelling have focused on making the information on the label useful, to consumers in light of current public health concerns and useful to manufacturers for promoting foods that will contribute to a healthy diet.

The United States' efforts to establish comprehensive and far-reaching nutrition labelling regulations illustrate some of the many factors that should be considered in developing labelling policies. As scientific evidence linking the nutrient content of foods to health conditions continues to emerge, public health policy and dietary guidance may shift and may vary from country to country. Each country may establish its own requirements for providing nutrition information through food labelling in light of its own priorities. It is hoped that these priorities will also include a major focus on educating consumers to understand and use the food label in ways that will improve their health and make society the greatest beneficiary.

Étiqueter les aliments pour améliorer la nutrition aux États-Unis

Pour répondre au besoin accru d'information des consommateurs sur la qualité nutritionnelle des aliments, les États-Unis ont promulgué en 1990 une loi sur l'éducation nutritionnelle et l'étiquetage des aliments, qui oblige à donner des informations nutritionnelles sur l'étiquette de presque tous les produits transformés réglementés par la Food and Drug Administration (FDA). Le Département de l'agriculture a institué en outre une réglementation sur l'étiquetage des viandes et de la volaille. Les grandes lignes de cette réglementation sont les suivantes:

· obligation de fournir des indications nutritionnelles sur l'étiquette pour presque tous les produits transformés;

· autorisation d'indiquer sur l'étiquette certains éléments nutritifs et bienfaits pour la santé;

· établissement de valeurs journalières de référence pour les macronutriments et harmonisation des tailles des portions entre les différentes marques.

Le nouvel étiquetage nécessite des informations approfondies sur la composition des aliments et les habitudes alimentaires des Américains, et des preuves scientifiques pour étayer les allégations concernant les bienfaits pour la santé qui figurent sur l'étiquette. Les consommateurs, les fabricants et les professionnels de la santé ont été consultés pour mettre au point la législation et le nouvel étiquetage. Pour aider les consommateurs à tirer profit de ces indications, la FDA et le Département de l'agriculture ont entrepris une campagne d'éducation sur l'étiquetage des aliments, de plusieurs années.

La nouvelle étiquette type contient des informations sur 14 éléments nutritifs pour aider les consommateurs à suivre les Directives nutritionnelles à l'usage des Américains (voir encadré p. 41). Les consommateurs peuvent suivre les indications nutritionnelles de l'étiquette et la «pyramide alimentaire» récemment mise au point pour choisir les aliments qui leur permettront d'avoir un régime alimentaire sain et équilibré (voir figure p. 43).

Cette réforme de l'étiquetage aux États-Unis résulte du besoin d'informations claires et précises du grand public, afin d'aider les consommateurs à choisir les aliments qui leur assureront une alimentation équilibrée, compte tenu des problèmes de santé publique. Chaque pays devra établir ses propres besoins en matière d'informations nutritionnelles sur l'étiquette des aliments en fonction de ses priorités.

Etiquetado de los alimentos para mejorar la nutrición en los Estados Unidos

En respuesta a la necesidad de los consumidores de disponer de más información sobre las cualidades nutricionales de los alimentos, en 1990 en los Estados Unidos se promulgó la Ley de Etiquetado y Educación en materia de Nutrición, que exige que prácticamente todos los alimentos elaborados controlados por la Administración de Alimentos y Medicamentos (FDA) lleven una etiqueta con dicha información. Por otra parte, el Departamento de Agricultura (USDA) ha establecido una normativa para el etiquetado de la carne incluyendo la de aves de corral. Entre los principales aspectos de la normativa de etiquetado cabe señalar los siguientes:

· obligación de colocar etiquetas con información relativa a la nutrición en prácticamente todos los productos elaborados;

· posibilidad de incluir determinada información sobré el contenido nutricional y los beneficios para la salud en las etiquetas;

· establecimiento de valores de referencia diarios de macronutrientes y armonización del tamaño de las porciones de las diferentes marcas de productos.

Para crear las nuevas etiquetas con información nutricional fue necesario disponer de amplia información sobre la composición de los alimentos y las pautas de consumo alimenticio de la población, así como datos científicos que sirvieran como fundamento de la información sobre los beneficios para la salud que figura en las etiquetas. En el proceso de proponer la legislación y diseñar las etiquetas, se hicieron consultas a los consumidores, los productores y los profesionales de la salud. Con objeto de que los consumidores aprendan a interpretar las nuevas etiquetas, la FDA y el USDA han iniciado una campaña de divulgación de varios años sobre el etiquetado de los alimentos.

La etiqueta con información nutricional normalizada (véase el recuadro de la pág. 41) contiene información sobre 14 nutrientes para ayudar a los consumidores a seguir las directrices dietéticas establecidas en el país. Los consumidores pueden utilizar esta información así como la pirámide guía de los alimentos recientemente elaborada para escoger adecuadamente los alimentos y seguir una dieta saludable y equilibrada (véase la figura en la pág. 43).

La necesidad de reformar el etiquetado en los Estados Unidos surgió de la demanda de los consumidores por disponer de información clara y concisa que sirviera de ayuda para escoger los alimentos y poder seguir una dieta saludable, a la luz del reciente interés por la salud pública. Cada país deberá establecer sus propias exigencias a la hora de proporcionar información nutricional en las etiquetas de los alimentos, en función de sus prioridades.

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