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  1. Schor, Danielle RD
  2. Maniscalco, Shelley MPH, RD
  3. Tuttle, Michele M. MPH, RD
  4. Alligood, Sarah MPH, RD
  5. Reinhardt Kapsak, Wendy MS, RD


In this day and age, American consumers are more interested in health and nutrition than ever before, and with our technologically advanced world, nutrition information from a wide variety of sources is increasingly available. According to the 2009 International Food Information Council Foundation Food & Health Survey, 67% of consumers agree that reading or hearing about the relationship between food and health is of interest, but 42% also agree that food and health information is confusing and conflicting.


As a result, for many health and nutrition experts, the process of developing science-based dietary recommendations that are clear to consumers is top of mind. Experts increasingly recognize that having good tools to help consumers apply dietary guidance is as important as the recommendations themselves. The US government is currently updating nutrition recommendations through the development of the 2010 Dietary Guidelines for Americans. It is also looking at how to most effectively use consumer tools, including the Nutrition Facts panel (NFP), to present recommendations to the public and is interested in the role that nutrition symbols play in consumers' dietary choices.


Consumers report using many aspects of information on food packages when making purchase decisions, including the NFP, and they are most likely to report consulting it when purchasing a product for the first time. However, ethnographic research shows that consumers do not actually use the NFP as frequently as they report doing so but are more likely to use it when, among other factors, nutrition information is present on the front of the package. Still, understanding and applying nutrition information, particularly to evaluate the nutrient content of individual foods and beverages in the context of a daily diet, seem to be lacking.


Mounting interest and activity globally have been seen in developing comprehensive mechanisms to provide consumers with information about the nutritional quality of foods and beverages at the point of purchase, either on product packaging or shelf tags in retail settings, also known as front-of-pack (FOP) nutrition labeling systems. Several types of FOP systems have emerged:


* Fact-based systems provide FOP information that brings to the front panel information that is provided in the NFP.


* Better-for-you systems use symbols to indicate how a product ranks against a defined set of nutritional criteria.


* Graded better-for-you systems also use symbols, but with indicators to convey good, better, and best nutritional quality.


* Numerical rating systems use numbers to rank the overall nutritional quality of a food or beverage.


* Color-coded systems use colors to provide at-a-glance information about the levels of individual nutrients in a food or beverage.


There are a variety of approaches with respect to communicating nutritional quality and nutrient quantity. The US Food and Drug Administration is devoting increased attention to the use of FOP labeling and will play a large role in shaping the future of this approach. Options must be carefully thought out and thoroughly tested with consumers to maximize effectiveness and usefulness in maintaining overall diet quality over time and, ultimately, positively impacting health. In addition, it is imperative that appropriate education accompany any programs developed for the public