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Date: Dec. 11, 2003
Contacts: Christine Stencel, Media Relations Officer
Heather McDonald, Media Relations Assistant
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Nutrition Facts on Food Labels and Guidelines for Fortifying Food
Should Be Updated, Report Says

WASHINGTON – Government authorities in the United States and Canada should use the current Dietary Reference Intakes (DRIs) to update nutrition information on food and dietary supplement labels so that consumers can compare products more easily and make informed food choices based on the latest science, says a new report from the Institute of Medicine of the National Academies. The familiar "percent Daily Value" figures included in Nutrition Facts boxes, which are required on the labels of most food products in both countries, are not based on the most current scientific information. In the United States, most nutrient reference values published on food labels are based on the government-issued Recommended Daily Allowances from 1968, the report notes.

The committee that wrote the report offered U.S. and Canadian officials 10 guiding principles for incorporating current scientific information into nutrition labeling, and six principles to guide "discretionary fortification," which is the voluntary addition of nutrients to food by manufacturers. The report addresses many technical issues that government scientists and policy-makers would face in the proposed effort. Ultimately, the recommended changes would help consumers use food and dietary supplement labels to choose healthier diets.

"We hope that the U.S. Food and Drug Administration, the U.S. Department of Agriculture, and Health Canada will use these principles to revise the scientific basis for nutrition labels and discretionary fortification," said committee chair Irwin H. Rosenberg, dean, Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, and senior scientist, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston.

DRIs present the latest scientific information on how much of various nutrients people need to consume regularly to maintain good health and, where data are available, prevent chronic disease. The DRIs have been developed since the mid-1990s by U.S. and Canadian nutritional scientists working under the auspices of IOM's Food and Nutrition Board. DRIs refer collectively to four categories of values based on a thorough review of the latest laboratory and clinical evidence. The Estimated Average Requirement (EAR) is the intake level that best represents the distribution of nutrient requirements among a population. The EAR for a nutrient is used as the basis for developing a Recommended Dietary Allowance (RDA) for that nutrient. When scientific evidence is insufficient to estimate an EAR and therefore to set an RDA, Adequate Intakes (AIs) are formulated based on diets known to be nutritionally adequate for the U.S. and Canadian populations. Another set of values called Tolerable Upper Intake Levels (ULs) helps consumers avoid getting too much of a nutrient. On the whole, DRIs are designed for individuals in the United States and Canada who are healthy and free from specific diseases or conditions that may alter their nutritional requirements.

Principles for Nutrition Labeling

Nutrition Facts boxes must appear on the labels of nearly all food products in the United States, and on those in Canada by 2005. Thirteen nutrients -- such as total fat, sodium, and vitamin A -- must be listed in a designated order in these boxes. Supplement Facts boxes on dietary supplements, including botanical products, also are regulated by the FDA and must include the same nutrients listed in the Nutrition Facts box plus information on the other ingredients in the supplement.

Information on Nutrition Facts boxes should continue to be expressed as percent Daily Values, which allow consumers to readily understand how particular foods fit into the context of a healthy diet, the report says. The boxes should display a single reference value for each nutrient, and this value should be relevant for healthy individuals ages 4 and older, excluding pregnant or lactating women. DRIs for this base population consist of data for 13 distinct life stages, but it would be impractical to provide Daily Values for each subgroup on nutrition labels. The most scientifically valid approach to combining the multiple figures is to apply the statistical technique of "weighting," which uses U.S. or Canadian census data to determine the proportions of each subgroup in the overall national population, and gives the largest subgroups most weight when formulating Daily Values.

Further, the Estimated Average Requirement, weighted by population, should be the basis for Daily Values whenever possible, the report says. If an EAR cannot be identified for a given nutrient, population-weighted Adequate Intakes should serve as the basis for percent Daily Values.

Among other guiding principles recommended by the committee:

> Daily Values for saturated fatty acids, trans fatty acids, and cholesterol should be set at the lowest level possible in the context of an achievable diet that promotes health.
> Supplement Facts boxes should use the same nutrient Daily Values as Nutrition Facts boxes. Moreover, because nutrients in food and dietary supplements have the same science base, the recommended guiding principles for nutrition labeling of foods should apply to both types of products.
> Absolute values for all nutrients, in grams or milligrams, should be included in Nutrition Facts and Supplement Facts boxes to help people who want to consume specific amounts of a particular nutrient, and to improve consistency between the two types of boxes.

Principles for Discretionary Fortification

The United States gives food manufacturers broad discretion in deciding when and how much to fortify foods. Canada mandates certain types of food fortification. IOM's Dietary Reference Intake reports have pointed out the potential for specific populations to be overexposed or underexposed to some nutrients. However, fortification has helped remedy certain nutrient inadequacies in the diets of subgroups throughout North America.

The committee offered several principles, informed by the DRIs, to guide discretionary fortification in the future, including:

> The scientific justification for fortifying foods should be based on documented public health needs, especially dietary inadequacies in particular populations. Regulatory agencies should develop criteria for deciding when evidence of dietary inadequacy indicates a documented public health need.
> When gauging how a population's exposure to certain nutrients would be altered by discretionary fortification of particular foods or supplements, agencies should consider the adverse effects that may result when the Tolerable Upper Intake Levels are exceeded.
> The committee proposed a decision-modeling approach for regulatory agencies to use in evaluating the scientific justification for fortification.

More Research Needed

The committee noted a lack of high-quality scientific research in several areas, including how consumers use nutrition labels and the appropriate intake requirements for nutrients for which EARs could not be developed. More research is also needed to determine the impact of discretionary fortification on consumers' health, the report says.

The study was sponsored by the U.S. Food and Drug Administration, U.S. Food Safety and Inspection Service, and Health Canada. The Institute of Medicine is a private, nonprofit organization that provides health policy advice under a congressional charter granted to the National Academy of Sciences. A committee roster follows.

Pre-publication copies of Dietary Reference Intakes: Guiding Principles for Nutrition Labeling and Fortification are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).

Food and Nutrition Board

Committee on Use of Dietary Reference Intakes in Nutrition Labeling

Irwin H. Rosenberg, M.D. (chair)
Senior Scientist
Jean Mayer USDA Human Nutrition Research Center on Aging, and
University Professor and Dean
Friedman School of Nutrition Science and Policy
Tufts University

Steven A. Abrams, M.D.
Department of Pediatrics
Children's Nutrition Research Center
Baylor College of Medicine

Gary R. Beecher, Ph.D.
Lothian, Md.

Catherine Champagne, Ph.D., R.D.
Professor-Research and Chief of Nutritional Epidemiology/Dietary Assessment and Counseling
Pennington Biomedical Research Center
Louisiana State University
Baton Rouge

Fergus M. Clydesdale, Ph.D.
Distinguished Professor
Department of Food Science
University of Massachusetts

Jeanne P. Goldberg, Ph.D.
Professor of Nutrition and Director
Center on Nutrition Communication and Graduate Program in Nutrition Communication
Friedman School of Nutrition Science and Policy
Tufts University

Penny Kris-Etherton, Ph.D., R.D.
Distinguished Professor
Nutrition Department
Pennsylvania State University
University Park

Jerold R. Mande, M.P.H.
Associate Director for Policy
Yale Cancer Center
School of Medicine
Yale University
New Haven, Conn.

George P. McCabe, Ph.D.
Department of Statistics
Purdue University
West Lafayette, Ind.

Frances H. Seligson, Ph.D., R.D.
Hershey, Pa.

Valerie Tarasuk, Ph.D.
Associate Professor
Department of Nutrition Sciences and Public Health Sciences
University of Toronto

Susan Whiting, Ph.D.
College of Pharmacy and Nutrition
University of Saskatchewan
Saskatoon, Canada


Linda D. Meyers, Ph.D.
Study Director