For many people, shopping for food is just one more thing to do in an already time-pressed day. Often, the goal is simply to purchase the food as quickly as possible. So, why should anyone set aside additional time to read food labels? Some people have medical conditions that require the elimination of certain foods, so reading labels is a mandatory component of shopping for them. For example, people with peanut allergies must be certain that their food contains no peanuts and was not prepared near any peanuts, which could result in cross-contamination. Similarly, people with celiac disease, an autoimmune disorder, need to avoid foods with gluten found in wheat, barley, rye, and oats (via cross-contamination). Eating foods with gluten may trigger a host of different medical concerns including anemia, diarrhea, bloating, and infertility. People may also have a food intolerance. It is not uncommon for adults to lack the ability to digest milk; people with a milk intolerance may wish to avoid foods containing milk and milk products.
There are still more reasons for people to read food labels. The millions of people who are trying to lose weight may wish to eat foods that have fewer calories. Those who are trying to lower their blood pressure may want foods lower in sodium, also known as salt, sodium benzoate, and disodium. And, those who want to eliminate trans fats, which are discussed in another entry, may be searching for partially hydrogenated oil and hydrogenated oil on the label. It is interesting to note that a food may be labeled trans fat-free even if it contains up to a half gram of trans fats per serving.
When discussing food labels, it is important to realize that the ingredients are listed in descending order. As a result, the first few listed ingredients are the ones that are most important. Thus, if the first ingredient is sugar, then the food contains more sugar than any other ingredient.
It may be hard for people to believe, but the U.S. Food and Drug Administration (FDA) did not become seriously involved with food labeling until the 1980s. Then, the passage of the Nutrition Labeling and Education Act of 1990 launched the first Nutrition Facts label. According to the FDA, improved food labeling would “reduce consumer confusion about labels, help consumers make better food choices and encourage innovation by giving manufacturers an incentive to improve the nutrition profiles of foods.” The law went into effect on May 8, 1994. Since then, all packaged food must have food labels. In 2006, the FDA required the listing of trans fats on labels. Early in 2014, the FDA proposed more changes to the Nutrition Facts label. The FDA wants to increase the calorie and serving size information as well as shift the location of the Percent Daily Value column to the left. In addition, the FDA wants the serving sizes to reflect the amount of food that people actually eat or drink. Other changes include requiring manufacturers to indicate the amount of “nutrients of public health significance” and “added sugar.” 1
In a study published in 2011 in Public Health Nutrition, researchers from Switzerland wanted to learn more about factors that determine who uses food labels. Questionnaires were sent to a sample of households in German-speaking sections of Switzerland. Residents completed and returned 1,162 questionnaires, a response rate of 38 percent. While 13 percent of the respondents reported that they never used labels, only 5 percent said that they always used them. Knowledge about nutrition and the belief that healthy eating is a cornerstone to good health were pivotal predictors of food label reading. “Respondents who considered health, healthy eating, and the nutritional value of food as important reported more frequent label use than respondents who did not place importance on these aspects.” On the other hand, disease-related aspects seemed to play a lesser role in predicting the use of labels. The researchers noted that their findings “implied that people rather use labels because they are interested in health and healthy eating and not primarily because they are afraid of falling ill.” 3
In a study published in 2012 in the Journal of the Academy of Nutrition and Dietetics, researchers from Minneapolis, Minnesota, investigated the association between the reading of food labels and quality of diet in a diverse group of college age students. The cohort consisted of 1,201 students; 598 attended a two-year community college and 603 attended a public four-year university. The students had a mean age of 21.5 years. The researchers classified 35 percent of the students as “frequent label readers.” When compared to the students who infrequently read food labels, the frequent label readers had healthier dietary behaviors, such as eating more fiber and limiting their consumption of fast food, and they demonstrated more knowledge about nutrition. The researchers concluded that “reading nutrition labels appears to be a mechanism through which college students who value healthy meal preparation make healthy dietary decisions.” Moreover, “even among those who do not believe it is important to prepare healthy meals, nutrition label use is linked with healthier dietary intake, suggesting that label use among college relates to healthful dietary intake independently of attitude toward healthy meals.” 4
Of course, there are barriers to reading food labels. And, there is a research study that found a serious underutilization of food ingredient labels, even by people who should be more motivated. In a cross-sectional trial published in 2013 in the Pakistan Journal of Biological Sciences, researchers from Iran wanted to assess the knowledge women have about nutrition and food labels. The cohort consisted of 380 women who were interviewed in person in 2012 at four large supermarkets. Only 49.7 percent of the women were considered healthy; the majority had chronic illnesses, especially high blood pressure. Yet, only 32.9 percent of the women “always use nutritional labels.” Of the women who read labels, they were most often looking for low calorie counts and reduced amounts of fat; they were least likely to be looking for foods with low levels of sugar. And, despite the high rates of elevated blood pressure, women tended not to look at the levels of sodium, which is known to raise blood pressure. In addition, the women who read the food labels had more knowledge about nutrition and higher levels of education. 5
Other researchers have investigated additional barriers and problems related to the use of food labels.
In a study published in 2014 in the Journal of the Academy of Nutrition and Dietetics, researchers from Los Angeles and Tucson, Arizona, wanted to learn if the Latino population of two East Los Angeles neighborhoods read and utilized food labels. The researchers noted that there have been few studies on this topic. Studies that have been completed have found “low levels of awareness of the labels as well as language barriers that hinder comprehension.” The cohort consisted of 269 people aged 18 years or older who lived within certain block clusters; all the participants identified themselves as “Latino.” More than three-quarters of the participants were female. The researchers found that the participants scored poorly. There was “no statistically significant association between Nutrition Facts label utilization and adequate comprehension.” Thus, “those who reported using the Nutrition Facts label more often did not have a higher performance of reading and interpreting the label correctly.” Thus, while the participants may well be reading the labels, they are incorrectly interpreting the information. 6
In a study published in 2014 in Public Health Nutrition, researchers from New Zealand conducted in person semistructured interviews with 10 women and six men, who were grocery shoppers between the ages of 28 and 63 years. The researchers wanted to determine how they did or did not use food labels and other behaviors to control their intake of sodium. The researchers learned that their food purchases were primarily a function of “practical considerations.”
The most important element in choosing a product was “price.” But, brand familiarity also played a role. No one reported using nutrition information. Although 13 participants recalled that they had seen such information, nine noted that they did not “pay particular attention to it.” At the same time, the participants reported that they “paid attention to eating healthy food.” And, according to them, because they ate well, they did not need to read food labels.
During a portion of the interview, the participants were asked specific questions about their intake of salt. They appeared to have little understanding of the relationship between salt and health problems. “Ironically, participants were more concerned they might be consuming inadequate quantities of salt, which they believed could be bad for their health.” The researchers concluded that New Zealand consumers need more food and nutrition education. 8
In a cross-sectional study published in 2014 in Public Health Nutrition, researchers from India wanted to learn more about what Indian consumers knew about food labels. As a result, they conducted interviews with 1,832 consumers at supermarket sites. They also led focus groups; each had between four and nine participants. The researchers learned that more than 12 percent of all consumers reported purchasing prepackaged foods every day. Over 44 percent said that they bought prepackaged food once weekly. While the participants noted that they checked labels for brand name, manufacturing date, and expiration date, they generally did not review nutrition information. They were concerned primarily with “safety aspects of foods.” The technical information on the label was deemed too difficult to comprehend. The researchers concluded that “there is a need to take up educational activities and/or introduce new forms of labeling.” 9
1. U.S. Food and Drug Administration, www.fda.gov.
2. Min-Gyou Kim, Seung-Won Oh, Na-Rae Han et al., “Association Between Nutrition Label Reading and Nutrient Intake in Korean Adults: Korea National Health and Nutritional Examination Survey, 2007-2009 (KNHANES IV),” Korean Journal of Family Medicine 35, no. 4 (2014): 190-98.
3. Rebecca Hess, Vivianne H. M. Visschers, and Michael Siegrist, “The Role of Health-Related, Motivational and Sociodemographic Aspects in Predicting Food Label Use: A Comprehensive Study.” Public Health Nutrition 15, no. 3 (2012): 407-14.
4. Dan J. Graham and Melissa N. Laska, “Nutrition Label Use Partially Mediates the Relationship Between Attitude Toward Healthy Eating and Overall Dietary Quality Among College Students,” Journal of the Academy of Nutrition and Dietetics 112, no. 3 (2012): 414-18.
5. Afsane Ahmadi, Pariya Torkamani, Zahra Sohrabi, and Fariba Ghahremani, “Nutrition Knowledge: Application and Perception of Food Labels Among Women,” Pakistan Journal of Biological Sciences 16, no. 24 (2013): 2026-30.
6. Mienah Sharif, Shemra Rizzo, Michael L. Prelip et al., “The Association Between Nutrition Fact Label Utilization and Comprehension Among Latinos in Two East Los Angeles Neighborhoods,” Journal of the Academy of Nutrition and Dietetics 114, no. 12 (2014): 1915-22.
7. Miri Sharf, Ruti Sela, Gary Zentner et al., “Figuring Out Food Labels. Young Adults’ Understanding of Nutritional Information Presented on Food Labels Is Inadequate,” Appetite 58 (2012): 531-34.
8. Rachael McLean and Janet Hoek, “Sodium and Nutrition Labelling: A Qualitative Study Exploring New Zealand Consumers’ Food Purchasing Behaviours,” Public Health Nutrition 17, no. 5 (2014): 1138-46.
9. Sudershan R. Vemula, SubbaRao M. Gavaravarapu, Vishnu Vardhana Rao Mendu et al., “Use of Food Label Information by Urban Consumers in India—A Study Among Supermarket Shoppers,” Public Health Nutrition 17, no. 9 (2014): 2104-14.
10. Laura Fitzpatrick, JoAnne Arcand, Mary L’Abbe et al., “Accuracy of Canadian Food Labels for Sodium Content of Food,” Nutrients 6, no. 8 (2014): 3326-35.
Ahmadi, Afsane, Pariya Torkamani, Zahra Sohrabi, and Fariba Ghahremani. “Nutrition Knowledge: Application and Perception of Food Labels Among Women.” Pakistan Journal of Biological Sciences 16, no. 24 (2013): 2026-30.
Chen, Xiaoli, Lisa Jahns, Joel Gittelsohn, and Youfa Wang. “Who Is Missing the Message? Targeting Strategies to Increase Food Label Use Among US Adults.” Public Health Nutrition 15, no. 5 (2011): 760-72.
Deville-Almond, J., and K. Halliwell. “Understanding and Interpreting Nutrition Information on Food Labels.” Nursing Standard 28, no. 29 (2014): 50-57.
Fitzpatrick, Laura, JoAnne Arcand, Mary L’Abbe et al. “Accuracy of Canadian Food Labels for Sodium Content of Food.” Nutrients 6, no. 8 (2014): 3326-35.
Graham, Dan J., and Melissa N. Laska. “Nutrition Label Use Partially Mediates the Relationship Between Attitude Toward Healthy Eating and Overall Dietary Quality Among College Students.” Journal of the Academy of Nutrition and Dietetics 112, no. 3 (2012): 414-18.
Hess, Rebecca, Vivianne H. M. Visschers, and Michael Siegrist. “The Role of Health-Related, Motivational and Sociodemographic Aspects in Predicting Food Label Use: A Comprehensive Study.” Public Health Nutrition 15, no. 3 (2012): 407-14.
Kim, Min-Gyou, Seung-Won Oh, Na-Rae Han et al. “Association Between Nutrition Label Reading and Nutrient Intake in Korean Adults: Korea National Health and Nutritional Examination Survey, 2007-2009 (KNHANES IV).” Korean Journal of Family Medicine 35, no. 4 (2014): 190-98.
McLean, Rachael, and Janet Hoek. “Sodium and Nutrition Labelling: A Qualitative Study Exploring New Zealand Consumers’ Food Purchasing Behaviours.” Public Health Nutrition 17, no. 5 (2014): 1138-46.
Ratnayake, W. M. Nimal, Eleonora Swist, Rana Zoka et al. “Mandatory Trans Fat Labeling Regulations and Nationwide Product Reformulations to Reduce Trans Fatty Acid Content in Foods Contributed to Lowered Concentrations of Trans Fat in Canadian Women’s Breast Milk Samples Collected in 2009-2011.” American Journal of Clinical Nutrition 100, no. 4 (2014): 1036-40.
Sharf, Miri, Ruti Sela, Gary Zentner et al. “Figuring Out Food Labels. Young Adults’ Understanding of Nutritional Information Presented on Food Labels Is Inadequate.” Appetite 58 (2012): 531-34.
Sharif, Mienah, Shemra Rizzo, Michael L. Prelip et al. “The Association Between Nutrition Fact Label Utilization and Comprehension Among Latinos in Two East Los Angeles Neighborhoods.” Journal of the Academy of Nutrition and Dietetics 114, no. 12 (2014): 1915-22.
Vemula, Sudershan R., SubbaRao M. Gavaravarapu, Vishnu Vardhana Rao Mendu et al. “Use of Food Label Information by Urban Consumers in India—A Study Among Supermarket Shoppers.” Public Health Nutrition 17, no. 9 (2014): 2104-14.
American Heart Association. www.heart.org .
U.S. Food and Drug Administration. www.fda.gov .