He Said, She Said: Nutrition Facts Labels

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He Said

Those working in policy are often charged with impossible tasks. Given the differences that make us each unique, coming up with guidelines that will work for some will inevitably alienate others. My suggestion is to abandon attempts to use food labels as nutrition-education tools and instead focus on accurately conveying the contents of the food itself.

Said attempts to provide education and context frequently result in nothing but confusion. Consider the inclusion of percent-of-daily-value calculations. If people understood that these percentages refer to the needs of a fictitious, generic example, fine, but I know from experience that all too often people are misled into believing these percentages pertain to them. Consider the differences in sodium needs of an individual with hypertension versus a marathoner who leaves white streaks of dried salt on his singlet.

Along those same lines, people misunderstand the term “serving” and think they are supposed to have the specified amount. Aiming for the serving size can lead to overeating or undereating and trigger negative feelings, such as guilt. In reality, serving size is not a mandate, but rather a unit label that gives us shorthand language with which to talk about and compare foods. I would like to see the term “serving” removed and replaced with less loaded term, such as “unit,” that still serves the function of easy discussion but without the baggage.

Another one of my gripes with food labels is the rounding off that manufacturers are legally allowed to do with their numbers. For example, if a food has less than 0.5 grams of trans fat per serving, they can round down to zero. In a way, it makes sense. A piece of paper is so thin that we might call it two-dimensional. Gather a bunch of papers together into a ream, however, and suddenly the thickness is substantial. That is the problem with rounding. Joanne has a patient who was using a pump margarine that stated it was calorie-free, but she was using such a high quantity that the calories, which had legally been rounded down to zero, significantly accumulated.

Rounding also happens in a qualitative sense on the ingredient list. What exactly are “natural flavors,” for example? People should have the right to know exactly what they are consuming, and more detailed information would surely make life easier for people with food allergies.

Nutrition education is certainly needed in our society, but food labels are not the place for it.

She Said

Ah, the nutrition label. As a practitioner specializing in eating disorders (EDs), I am well aware of how the nutrition label has the potential to be used (and abused). Many of my clients could spend an hour or more in the grocery store, looking at label after label to find the healthiest food option. I had one patient tell me that she spent 30 minutes in the cereal aisle comparing labels for different types of granola, determined to find the one that had the least amount of carbohydrates and fat, while also boasting at least five grams of fiber. And, of course, the ingredient label needed to have less than 10 ingredients listed, most of the items needed to be organic, etc.

You see, for those struggling with EDs, the nutrition label is not usually their friend. Nutrition label reading is a practice in self-torture for most of them. Having that information listed on the box or bag gives the eating disordered individual the information he or she needs to make choices about his or her eating, and it often causes them to analyze and over-analyze their food choices. In some cases, my patients will refuse to look at labels altogether for fear of getting sucked down the rabbit hole of “healthiest choice.”

For most of my ED patients, I suggest that they avoid reading the nutrition labels. Why? Well, for one, to prevent the above scenario from playing out at every grocery shopping trip. Also, my goal for most of my patients is to learn to engage in Intuitive Eating (IE), and using nutrition labels to make food-based decisions (when one is struggling with an ED) is anything but intuitive; instead, it is using an external control to decide what one should eat. Ideally, I would prefer the patient choose the type of granola she enjoys eating the most, regardless of the amount of carbs, fat, or fiber grams it contains. As I have noted before, when we enjoy what we are eating, we are more likely to absorb the nutrients in that food than if we simply choke down a less yummy version of that food.

Of course, if someone has a health condition that warrants them to read labels (e.g. diabetes or celiac disease), I would suggest that they do so in order to be safe and as a health-promoting behavior. But if someone has no dietary restrictions placed upon them by their doctor, and they are struggling with an ED, avoiding the nutrition label is the way to go.