Nutrition labels help shoppers determine the nutritional content of most of the foods they purchase. These labels are printed on the packaging of foods sold in grocery stores and other shops. Consumers can use this information to help craft a well-balanced diet that boosts their health and reduces the risk of illness.

For years, people had relatively little information about the nutrition content of many foods available for sale. However, in 1990, the U.S. Food and Drug Administration (FDA) passed a law called the Nutrition Labeling and Education Act (NLEA) requiring most types of packaged food to carry nutritional information on food labels.

The nutrition facts panel is intended to help consumers gain insight into what they are eating. It is divided into two parts:

• Specific information about the food. This makes up most of the panel and includes details about the serving size, calories and nutrient information.
  
  
• General nutrition information. This is located in the footnote at the bottom of the panel. The percent daily value (% daily value) is provided for each nutrient and represents the percentage of a nutrient in a food product in relation to the total amount of that nutrient a person should consume in one day.

In addition to the nutrition facts labels, many foods may contain other nutrition information. Nutrient content claims are messages found on labels of foods and dietary supplements to describe the level of a nutrient or dietary substance found in the product. In most cases, the nutrient content claim enables manufacturers to promote aspects of their product that contribute positively to consumer health.

Health claims or disease-reduction claims are messages printed on the food label to describe a relationship between a food substance or nutrient and a health-related condition. However, health claims are different from nutrient content claims in that they are based on scientific research.

Nutrition labels provide standardized information about the nutritional content of most foods found on supermarket shelves. These labels are printed on the packaging of foods. Consumers can use this information to help craft a diet that is healthy and nutritious.

For years, people had relatively little information about the nutrition content of many foods available for sale. However, in 1990 the U.S. Food and Drug Administration (FDA) passed a law called the Nutrition Labeling and Education Act (NLEA). It required that most types of packaged food carry nutritional information on food labels and that all nutrient content claims (e.g., high fiber, low fat) and health claims be consistent with agency regulations.

Important nutritional information on food labels is found in the nutrition facts panel, which lists the amount of nutrients and calories found in a single serving of a food. Shoppers can use these labels to learn about the amount of protein, fat, vitamins, minerals and other nutrients present per serving. People can use this information to help determine how the food fits into a well-balanced diet.

Food labels also must include a listing of ingredients whenever more than one ingredient is present in the food. These are listed in order of their prominence in the food (by weight), with the ingredients used in the largest amounts listed first. This information also can help people choose foods that are more nutritious. For example, a canned fruit with ingredients listed as “peaches, water” is likely to be healthier than a canned fruit with ingredients listed as “sugar, peaches, water.”

Other information present on food labels includes:

• Common name of the primary food. This includes identifiers such as “rice” or “mixed vegetables.”
  
  
• Measurement of the amount of food in the package. The weight is shown as net weight in both standard English and metric weights.
  
  
• Information about the manufacturer or distributor of the item.
  
  
• Description of the food. This includes descriptive phrases such as “pineapple slices” or “pineapple chunks.” If certain nutritional requirements of a processed food do not compare with its traditional form, words such as “imitation” or “substitute” may appear.
  
  
• Percentage of natural juice in fruit or vegetable juice beverages. Juices made from concentrate must state this fact, and beverages that are less than 100 percent juice must be called juice drinks, beverages or cocktails. The names of the fruits or vegetables in mixed juices appear on the ingredients list in descending order (from greatest to lowest quantity by weight).
  
  
• Health claims and nutrient content claims. Health claims establish a relationship between a food and disease or medical condition. For example, they may state that consuming a certain product may lower the risk of certain types of cancer. Nutrient content claims are written messages on the food label that quickly inform a consumer of the level of nutrients contained in a product. Examples of these messages are “low-fat food” or “fat-free.”

Certain foods that should be included in a balanced diet may not have a nutrition facts panel on them. These include fresh fruits and vegetables, fish, poultry and meat. However, many supermarkets and other food sellers have begun to provide nutrition labels for these items on a voluntary basis. Meat and poultry products are regulated by the U.S. Department of Agriculture (USDA) and are not covered by NLEA. However, the 45 most popular cuts of meat also have a similar voluntary labeling program under the USDA’s program.

Other items not covered by the NLEA include:

• Restaurant food, except foods that make a nutrition content or health claim
  
  
• Airplane food
  
  
• Hospital food
  
  
• Food service vendors (including food vending machines)
  
  
• Ready-to-eat/prepared food such as deli and bakery items
  
  
• Plain coffee and tea
  
  
• Some spices, food coloring and flavor extracts
  
  
• Food shipped in bulk, as long as it is not for sale in that form to consumers
  
  
• Medical foods, such as those used to address the nutritional needs of patients with certain diseases

Foods sold in small packaging (e.g., about the size of a pack of gum) are also exempt from the NLEA label requirement, as long as no nutrition claim has been made about the food. However, a telephone number must be included on such packaging so that people who have questions can have them answered promptly.

The nutrition facts panel provides information on many nutrients that have an impact on overall health. The U.S. Food and Drug Administration (FDA) regulates the nutrition facts panel. The nutrients required on the nutrition facts panel were selected because they address health concerns relating to illnesses such as heart disease, high blood pressure, diabetes and obesity.

Although the FDA regulates the information that appears in the nutrition facts panel, it is up to the manufacturer to determine the food’s content. For this reason, inaccuracies may occur.

Nutrient information and the order in which it must appear on the label are as follows:

The accompanying diagram and information, How to Read a Nutrition Facts Label, is provided as guidance on how to understand and use the nutrition facts panel in order to make quick and informed food choices.

The nutrition facts panel is intended to help consumers gain insight into what they are eating. It is divided into two parts:

• Specific information about the food. This makes up most of the panel and includes details about the serving size, calories and nutrient information. Not all nutrients are listed. Instead, the panel highlights those nutrients that specifically relate to important health issues. Other nutrients may be listed on a voluntary basis.
  
  
• General nutrition information. This is located in the footnote at the bottom of the panel. It includes information about the dietary daily reference value (DRV) that appears on the label as daily value (DV). The percent daily value (% daily value) is provided for each nutrient (except for sugars and protein). It represents the percentage of a nutrient’s recommended daily amount that is contained in one serving. This amount is based on either a 2,000-calorie or 2,500-calorie diet. A 2,000-calorie diet is generally recommended for most moderately active women, teenage girls and sedentary men. Many men, teenage boys and active women are advised to consume 2,500 calories daily. This portion of the nutrition facts box enables a person to determine the level of nutrients in a food.

The individual components of the label include:

• Serving size. Serving size may represent a common household measure (1 cup) and its metric equivalent (227 grams) or a count (two cookies, for example). It varies from package to package and does not always reflect the typical amount of a food that an adult would likely consume in a single meal. However, the FDA mandates that all labels for a given product contain the same serving sizes. This helps consumers to compare products from different manufacturers. It is important to remember that the serving size listed in the nutrition facts panel does not necessarily correspond to serving sizes in the USDA’s Food Guide Pyramid.
  

  

• Servings per container. The number of servings per container is based on the total volume or weight of the product as well as the serving size. All of the nutrient information on the nutrition facts panel is based on the size of one serving of that food. People who eat one-half of a serving have consumed only one-half of the calories, saturated fat, trans fat and other nutrients listed. People who eat two servings double their intake of the nutrients listed.
  
  
• Calories. Total calories and calories from fat are required to be listed on food labels. Some labels may also voluntarily include calories from saturated fat. Fat, carbohydrates and protein are the three nutrients in foods that are sources of calories. About 30 percent of total daily calorie intake should come from fats, 45 percent to 65 percent from carbohydrates and the rest from protein. For this reason, the nutrition label lists how many calories from fats are in a food product.
  
  
• Total fat. Total fat, saturated fat and trans fat content are required to be listed in grams. Some labels may voluntarily include levels of unsaturated fat (broken down into polyunsaturated fat and monounsaturated fat). The daily value is based on a daily intake of 2,000 calories, where total fat is 30 percent of daily calories and saturated fat makes up 10 percent of daily calories.
  
  The nutrition facts panel requires that only total fat, saturated fat and trans fat be listed because unsaturated fats tend to have a positive effect on blood cholesterol levels. Trans fat is the newest ingredient to be included on a food label. A consumer uses this information to determine the “lowest combined amount” in a product. Food labels will list the grams (g) of trans fats separately from saturated fats and the two must be added to determine the total combined amount. For example, a product listing 2 g of saturated fat and 3 g of trans fat has a combined amount of 5 g. The product with the lowest combined amount will be a healthier choice.
  
  
• Cholesterol. Cholesterol is a waxy, fatty substance (lipid) that is carried through the bloodstream. Cholesterol from animal products such as meat, eggs and dairy products is required to be listed in milligrams.
  
  
• Sodium. Salt (sodium) can occur naturally in foods, or may be added during the food production process. It is listed in milligrams on the nutrition facts label.
  
  
• Total carbohydrates. Total carbohydrates, total sugars and total dietary fiber are required to be listed in grams. Some labels may also list levels of sugar alcohol, soluble fiber, insoluble fiber and/or other carbohydrates. Total carbohydrates on the nutrition facts panel include three types of carbohydrates – simple sugars, complex carbohydrates and dietary fiber. They are also listed in grams.
  
  
• Proteins. Proteins are essential to overall health and are listed in grams on the nutrition facts label. They provide what are called essential amino acids – substances that the human body needs, but cannot produce and thus are available only through the diet.
  
  
• Vitamins and minerals. Vitamin A, vitamin C, calcium and iron levels must be listed on the nutrition facts panel. Some labels also voluntarily list Potassium and other vitamins and minerals. Vitamins and minerals are micronutrients. That is, the human body needs a small amount of these naturally occurring chemicals to maintain health. Nevertheless, those small amounts are vitally important.
  
  
• Daily values. The nutrition facts panel includes percent of daily values (DV). The DV represents the percentage of a nutrient in one serving of a food product, compared with the total amount of that nutrient a person should have in one day, based on a 2,000-calorie diet.

The nutrition facts panel and the percent of daily values can help people gauge how much of certain nutrients they consume daily. These labels enable people to reduce the amount of total fats, saturated fats, cholesterol and sodium they eat. So, a low DV for these foods is preferred. For other nutrients – such as vitamin A, vitamin C, calcium, fiber or iron – people should strive to reach 100 percent each day.

Nutrient content claims are messages found on labels of foods and dietary supplements to describe the level of a nutrient or dietary substance found in the product. In rare cases, a food manufacturer must provide a statement of disclosure when excessive amounts of unhealthy nutrients are present that may increase the risk of disease or illness. However, in most cases, the nutrient content claim allows manufacturers to promote aspects of their product that contribute positively to consumer health.

The soundness of these claims rests with manufacturers and the U.S. Food and Drug Administration (FDA). Nutrient content claims can be made mainly for nutrients or dietary substances that have an established daily value (DV). The FDA has set guidelines that govern the use of nutrient claims to ensure that descriptive terms such as “low,” “free” or “reduced” are used consistently for all products. These nutrient content claims are described below.

In addition to these, according to the Food and Drug Modernization Act (FDAMA) of 1997, manufacturers are permitted to use nutrient content claims based on current, published “authoritative statements” made by certain federal agencies and by the National Academy of Sciences (NAS). Lastly, there are nutrient content claims that are percentage claims for dietary supplements. These claims describe the percentage level of a dietary ingredient for which there is no established DV.

FDA rules can be quite complicated, but basic nutrient content claims are as follows, with their FDA-authorized definition. Note that many of these terms refer to the amount of nutrients per serving. Be aware that a serving size may vary by product. The amount of each nutrient in one serving of the food item will appear on the nutrition facts panel.

Calories

Fats

*Next to all of the saturated fat claims, manufacturers must declare the amount of cholesterol if the item contains 2 or more milligrams of cholesterol per serving and the amount of total fat if it is more than 3 grams total fat per serving.

Cholesterol

*Label must declare the total amount of fat per serving next to cholesterol claims when total fat exceeds 13 grams per serving of food, 19.5 grams per serving of main dishes or 26 grams per serving of meal products.

Sodium

Sugars

Comparative Claims (messages that provide nutrient content claims in relation to another, similar product).

Other Claims

The FDA has set guidelines that govern the use of nutrient claims to ensure that the descriptive terms that appear on food labels, such as “low,” “free” or “reduced,” are used consistently for all products. However, the agency has not legally defined what the term “low-carb” means, resulting in much confusion for consumers. Nutrient content claims are mainly used to describe the calories, fat, cholesterol and sugar content of packaged foods.

Consumers are urged to carefully consider the claims made on nutrition labels. For example, one recent study found that people often consume up to 50 percent more calories when eating low-fat versions of foods than when eating regular versions of the same foods. Such overeating is especially likely among those who are overweight, according to the study authors.

Eating excessive amounts of low-fat foods negates the potential health benefits associated with such foods.

Another study found that significant numbers of Americans lack the reading and math skills necessary to comprehend and properly use the information contained on nutrition labels.

Health claims or disease-reduction claims are messages printed on the food label to describe a relationship between a food substance or nutrient and a health-related condition. However, health claims are different from nutrient content claims, which describe the level of a nutrient in a food substance. Health claims are based on scientific research.

If enough studies agree that certain nutrients contribute to good health, the U.S. Food and Drug Administration (FDA) may allow manufacturers to label foods containing these nutrients as helpful in reducing the risk of developing heart disease, cancer, bone disease, high blood pressure and other serious conditions.

Health claims can provide shoppers with some degree of confidence that the foods they are purchasing are contributing to a balanced diet. The FDA does make sure that foods making a health claim generally have several health benefits. It is possible, of course, that a food with a health claim may lack nutrients in other areas. Shoppers should take note of any health claims on a food label, and then carefully examine the nutrition facts panel and ingredients list to get a better overall picture of the healthiness of a food item.

The FDA requires all claims to be based on “current, published, and authoritative statements from certain federal scientific bodies.” This means the claims come from organizations with a commitment to protecting the public health and establishing sound and objective policies. A private company that wants to make a health claim must support it based on these criteria.

Health claims that have been approved by the FDA include the following:

In recent years, the FDA has created a system that permits manufacturers to make certain health claims for foods even though the stated benefits may still be the subject of scientific debate. The new rules establish a ranking system for a qualified health claim, categorizing the quality and strength of the scientific evidence. The claim given the highest ranking is designated by the letter A. The other end of the scale is a claim given the letter D, as follows:

• A (HIGH): Significant scientific agreement.
  
  
• B (MODERATE): There is good evidence to support the health claim; however the evidence is not conclusive.
  
  
• C (LOW): Apply to those claims where the evidence is limited and not conclusive.
  
  
• D (EXTREMELY LOW): There is little scientific evidence supporting these claims.

The B, C and D level health claims are referred to as qualified health claims because they require a disclaimer to ensure that they do not mislead consumers. In contrast, the A level health claim is referred to as an “unqualified health claim,” due to the level of scientific research and agreement.

Structure and function claims on a label differ from health claims in that they do not make associations between food substances and certain diseases or conditions, but instead merely describe how a substance may affect the body. These claims must be accompanied by a disclaimer noting the claim has not been evaluated by the FDA and that it is not intended to diagnose, treat, cure or prevent any disease.

Preparing questions in advance can help patients have more meaningful discussions regarding their conditions. Patients may wish to ask their doctor or registered dietitian the following questions related to nutrition labels and claims:

1. When I look at a food label, what information is important for me to focus on?
   
   
2. Can you explain the total fat portion of the food label? Which type of fat is it most important that I avoid?
   
   
3. How important is it for me to read all the ingredients on the nutrition label?
   
   
4. Is there anything in particular that indicates a product is an unhealthy choice?
   
   
5. What health claims can I trust? Which should I consider suspect?
   
   
6. Should I try to incorporate low-fat, high-fiber or other types of food in my diet? What is the best indication of these foods on the food label?
   
   
7. Might I benefit from consulting with a dietitian? Can you recommend one?
   
   
8. Can you explain how I should use the FDA’s A-to-D code for health claims?
   
   
9. Is there a simple way to convert the percentages in the nutrition facts label so they represent a 2,500-calorie diet?
   
   
10. Do you have tips for how I can estimate the nutritional content of food in restaurants?