Food Labels and Special Diets

by Food and Drug Administration (FDA)

The right diet is important for everyone, but for Tony Robinson of Orlando, Fla., it truly is his lifeblood.

Robinson has end-stage renal disease. Three times a week, he goes to a local medical center, where a dialysis machine does what his kidneys no longer can: purify his blood.

Between treatments, he's careful about what he eats because some nutrients can cause harmful — sometimes deadly — levels of substances to build up in his blood. He eats a diet low in protein, sodium and potassium to keep these substances — which can be dangerous in his condition — minimal, and high in calories to maintain his weight.

Until recently, he and his wife, who does most of the cooking, kept mainly to foods listed in a brochure of "foods to eat" and "foods to avoid" for people with end-stage renal disease. But now they're using the new food label as another source of information.

"The new label adds to what we already know," Robinson said. "And mandatory nutrition labeling gives us the information we need to choose from a wider range of food products."

Label Benefits

Under the Nutrition Labeling and Education Act of 1990 and regulations from the Food and Drug Administration and the U.S. Department of Agriculture, virtually all food labels must now give information about a food's nutritional content.

That wasn't always the case. Until 1994, nutrition information was voluntary. Manufacturers had to provide it only when a food contained added nutrients or when nutrition claims appeared on the label. Nearly 40 percent of products didn't carry nutrition information.

"Just to have the information on the label is a big plus for consumers on therapeutic diets," said Camille Brewer, a registered dietitian and nutritionist in FDA's Office of Food Labeling.

Another group the regulations help is people with food sensitivities. Every product with two or more ingredients must now list the ingredients on the label. That includes standardized foods, such as peanut butter, and some baked goods. These foods previously were exempt from ingredient labeling because at one time, most Americans were familiar with the recipes since they were foods routinely prepared at home.

Also, the source of some ingredients (for example, hydrolyzed soy protein) must now be identified.

Get the Nutrition Facts

Consumers looking for nutrition information about a food should first look at "Nutrition Facts," usually on the side or back of the package.

For many people on special diets, the amount of the nutrient in grams or milligrams is most important because their diets are based on a set amount of one or more nutrients a day specific to their needs — for example, 60 grams (g) of protein, 2,000 milligrams (mg) of sodium a day. Special dieters can find the amount by weight of nutrients listed in the top part of the Nutrition Facts panel.

Some important points about the Nutrition Facts panel: The values listed for total carbohydrate include all carbohydrates, including dietary fiber and sugars listed below it.

The sugars include naturally present sugars, such as lactose in milk and fructose in fruits, as well as those added to the food, such as table sugar, corn syrup, and dextrose. The label can claim "no sugar added" but still have naturally occurring sugar. An example is fruit juice.

Also, potassium may be listed voluntarily with the nutrients listed on the top part of the panel, just below sodium. Its %Daily Value is based on a recommended intake of 3,500 mg a day.

Other vitamins and minerals may be listed on the Nutrition Facts panel, along with vitamins A and C, iron, and calcium.

Amounts of vitamins and minerals are only presented as percentages of the Daily Value.

Calorie information appears at the top of the Nutrition Facts panel, following serving size information. This information is important for those needing to increase or decrease their calories.

Serving Size

The serving size information gives the amount of food to which all the other numbers on the Nutrition Facts panel apply.

Now serving sizes are more uniform among similar products and are designed to reflect the amounts people actually eat. Also, serving sizes must be about the same for the same types of products — for example, different brands of frozen yogurt — and for similar products within a food category — for example, ice cream, ice milk, and sherbet within the category frozen dairy-type desserts.

Having more uniform serving sizes makes it easier to compare the nutritional values of related foods.

People who follow special diets should be aware that the serving size on the label may not be the same as that recommended for their specific needs. For example, the label serving size for cooked fish is 3 ounces (84 g). A person following a 60-gram protein diet may be allowed only 1 ounce (28 g) of fish at a meal. So, in this case, the nutrient values would have to be divided by 3 to determine the nutritional content of the 1-ounce portion eaten.

Ingredients

The ingredient list is a source of information especially useful for people with food sensitivities. Some new requirements that provide more information in the list are:

Listing protein hydrolysates by source — instead of "hydrolyzed vegetable protein," the list must state the type of vegetable (for example, "hydrolyzed corn protein").

Stating FDA food-certified color additives by name — for example, "FD&C Blue No. 1" and "FD&C Yellow No. 6." Before, they could be listed simply as "colorings."

Declaring caseinate as a milk derivative in foods that claim to be non-dairy, such as coffee whiteners.

On some labels, the ingredient list may state the source of sweeteners, too, although this is voluntary. For example, instead of "dextrose" or "dextrose monohydrate," the ingredient may be listed as "corn sugar monohydrate."

About the Author

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FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.