Nutrition Labels

As people delve into the world of weight loss they are asked to begin “reading labels.” While some people feel very comfortable looking at calories and cholesterol, there is more to the label that we need to think about. I thought we could use this month as an opportunity to learn more. Below is a sample:



I recommend that people start at the top and work their way down the label in a systematic method so that they don't miss anything.

The first line states what the serving size is (for this example: 140 grams).

The second line lists how many servings are in the container (for this example: one serving). This is usually a tricky area. For example, on a 32 ounce bottle of a sports drink it may list 8 ounces as a serving with the statement that there are 4 servings in the bottle. The challenge is that it also list the calories (line 3) as per serving not for consumption of the entire bottle as many people will do. So watch serving size because that is what the calories are based on, not the actual volume that people generally eat based on packaging.

Moving down the label: Total Fat (with breakdown on saturated and trans fat), Cholesterol, Sodium, Total Carbohydrate (with dietary fiber and sugars broken out), and Protein are listed. According to the FDA if something is listed as containing 5% or less of one of these, that is “low,” whereas 20% or more is considered, “20%.”

Regarding fat intake: Saturated fat, trans-fatty acids and dietary cholesterol may raise blood cholesterol. Monounsaturated and polyunsaturated fats do not appear to raise LDL cholesterol Total fat intake is recommended to be less than 25-25 % of total calories.

Saturated fat is found in foods from animals and some plants including butter, lard, poultry fat, and dairy products made from whole milk. Plant sources include coconut, palm oil and cocoa butter. It is recommended to limit saturated fat to less than 7% of total daily calories.

Trans fat is considered to be the worst offender as it is thought to raise total cholesterol levels including LDL and lower HDL levels. It is recommended to be less than 1% of total daily calories. These are found in small amounts in various animal products and in the process of hydrogenation making margarine, shortening, and cooking oils. Other foods high in trans fats include french fries, doughnuts, cookies, crackers, muffins, pies, and cakes, not just because of use of shortening in the recipe but in the manufacture.

Dietary cholesterol generally comes from animal sources as it is an essential component of mammalian cells. As cholesterol can also be synthesized in the body so eating animal liver (ie pate)/brain/spinal cord can increase cholesterol intake immensely. The recommendations for cholesterol are intake of less than 300 mg daily.

Polyunsaturated and monounsaturated fats are found in fish, nuts, and vegetable oils. It is generally recommended to limit cholesterol intake to less than 300 mg per day (less than 200 in people with known heart disease or elevated LDL levels).

The next section is an attempt to break out specific nutrients that are of interest to consumers. This gives a person the opportunity to look for those foods that augment their health goals. For example, many of my female patients worry about osteoporosis. Looking for foods that are labeled as containing higher percentages of calcium may be important to them. However a patient with a problem retaining water may look to limit sodium in their diet.

The footnote at the bottom about Percent Daily Values has always been a bit of a mystery to me. It is the same on every package unless the package is too small to allow it to be there. Why do I find this challenging? A couple reasons really. 1) 2500 calories—are they kidding? That is a lot of calories. 2) Total carbohydrates at 300 grams for 2000 calories or 375 grams for 2500 calories. Again, are they kidding? No wonder we are a nation under one expanding waistline. Plus this is supposed to be expert advice. I would recommend generally ignoring this section as it really doesn't help my patients.

The take away message from all of this is that the ability to read the label on a packaged food is an important skill for dieters and maintainers alike. The ability to know what the serving size and nutrient composition is, and then translate this into an informed food choice decision is key.

Sources:
http://www.cfsan.fda.gov/~dms/foodlab.html
http://www.recipeanalysis.com/images/nutrition_facts_label_vertical_full_3eqy.png
http://www.americanheart.org/presenter.jhtml;jsessionid=KTRQIUMVRV3YECQFCXPSCZQ?identifier=532