Harvard Heart Letter

The Nutrition Facts label finally gets a makeover

Updates that may benefit heart health include details on added sugars and more accurate serving sizes.

nutrition labels
Image: Noel Hendrickson/ Thinkstock

The information on the Nutrition Facts label—that small box of nutrition-related data on the back of all food packages—has stayed pretty much the same since its introduction back in 1993. But earlier this year, the FDA approved a number of revisions to the panel. The changes reflect the evolving scientific evidence on the connections between diet and chronic illness—particularly obesity and heart disease.

The updated labels won't be mandatory for nearly two years, but the agency provided a preview (see "The new label: What's different?"). These changes may benefit consumers not only by helping them choose more nutritious foods, but also by driving the food industry to make products healthier, says Dr. Eric Rimm, professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health. Many of the changes are relevant for people concerned about heart disease—especially the new data on added sugars.

How sweet it is

"The single most important part of the label change is adding information on added sugars," says Dr. Rimm. Growing evidence suggests people who eat sugar-rich diets are more likely to die from complications of diabetes and heart disease. The average American eats about 22 teaspoons of sugar a day, mostly from processed and prepared foods. Some sugars occur naturally in foods, such as fructose in fruit and lactose in milk; the rest are added. Some show up in foods that you might not expect, such as ketchup, barbecue sauce, and jarred spaghetti sauce (see "How to spot added sugars").

But the 2015 federal dietary guidelines recommend limiting added sugar to less than 10% of calories. That translates to roughly 12 teaspoons (48 grams) for a 2,000-calorie diet—a calorie target that's about right for most men but a bit high for many women.

The new label will include a line listing the grams and Daily Value (% DV) of added sugar. As an example, a breakfast cereal with 20 grams of added sugar per serving would account for 40% of the maximum amount of added sugar a person should consume per day.

Adding awareness

The change should help people become more aware of how much added sugar they're consuming from packaged foods. It's hard to get the healthful nutrients you need when you "spend" too many of your calories on sugar. "If you drink 150 calories of a sugary beverage, that's very different from consuming 150 calories from an olive oil–based dressing," Dr. Rimm explains. A big dose of concentrated sugar messes up your release of insulin (the hormone that controls blood sugar levels), which can leave you hungrier later and trigger your body to store fat more readily.

If you instead drizzle an olive oil–based dressing on vegetables, you'll feel more satiated and get far more heart-healthy nutrients (especially the monounsaturated fat in the oil) for about the same amount of calories. "It's not just about what you eat, but what that particular food choice replaces in your diet," Dr. Rimm says.

Reformulations afoot?

One possible effect of the label change is that companies might reformulate their products to reduce added sugars, similar to what has already happened with trans fat. Partially hydrogenated oils (the main source of artery-damaging trans fats) have been almost completely eliminated from processed foods, thanks to an earlier FDA mandate. The reduction won't be as dramatic for sugar because many products depend on added sugars for flavor, notes Dr. Rimm. But just like cutting back on salt, eating less sugar trains your palate so you don't crave it as much, he says.

Other label changes might modify the buying habits of people who are worried about weight gain, which also contributes to heart disease risk. Some serving sizes will change to more closely reflect what people typically consume. For example, a serving of ice cream will change from half a cup to two-thirds of a cup, and the grams of sugar and the calorie count will reflect that increase. The more prominent calorie listing will also make it easier for people to compare calories in bread, yogurt, and other commonly eaten staples.

Potassium and vitamin D

The addition of potassium and vitamin D to the label stems from recent research on the importance of these nutrients for health, coupled with the fact that most American diets don't provide very much of either one.

Potassium-rich diets appear to help lower blood pressure. When selecting frozen or canned fruits and vegetables, choose those with high potassium and low sodium, since sodium raises blood pressure, advises Dr. Rimm. Inadequate vitamin D levels have been linked to cardiovascular disease, but exactly why that's so—and how much vitamin D people actually need—remains unclear. Ongoing studies should provide clarity. Vitamin D occurs naturally in many types of fatty fish, eggs, and cheese. Milk, many breakfast cereals, and some brands of yogurt and orange juice are fortified with vitamin D.

How to spot added sugars

Until the Nutrition Facts panel revisions become mandatory in mid-2018, you need to look closely at a product's ingredient list to see if it contains added sugars. Aside from the obvious ingredients (sugar, honey, molasses), added sugar can appear as agave nectar, cane crystals, corn sweetener, crystalline fructose, dextrose, evaporated cane juice, fructose, high-fructose corn syrup, inverted sugar, lactose, maltose, or malt syrup.

A wise approach is to avoid products that have any of these added sugars at or near the top of the list of ingredients—or ones that have several different types of sugar scattered throughout the list.