What is the Food and Drug Administration’s Nutrition Innovation Strategy, and Why Does it Matter?
A Nutrition Innovation Strategy- why do we need that?
Chronic disease burden is a growing problem in America, six in ten adults have one chronic disease, while four in ten have two or more. The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) report a link between chronic disease states such as cancer and heart disease to lifelong nutrition habits. Although treatment for these conditions continues to improve, we know that the best treatment is prevention. On March 29, 2018, the FDA Commissioner at the time, Dr. Scott Gottlieb, gave an effective speech on reducing the burden of chronic disease and the critical role FDA plays in this, including policy implementation. During this speech, he announced the FDA’s nutrition innovation strategy. This nutrition innovation strategy lays out six key elements to promote nutrition knowledge and healthy food access in the marketplace: implementing the nutrition facts label and restaurant menu labeling laws, modernizing ingredient labels, modernizing standards of identity, modernizing claims, reducing sodium, and nutrition education.
Nutrition to Prevent Chronic Disease
Label ch-ch-cha-changes
Over the past few years you may have noticed or heard about updated nutrition labels on food and beverage packaging. The FDA updated the nutrition facts panel through a multi-year process using public comments, research and rolling release dates. The updated nutrition facts panel includes updates to the format and nutrition information. From a new added sugars line to larger font size for calories and different listed vitamins, these changes are intended to better inform consumers about the foods and beverages they are choosing. They were based on what Americans are currently consuming and what we should be consuming to improve health and nutrition. These changes were required for the majority of food manufacturers beginning January 1, 2020 putting a mostly complete check mark on this nutrition strategy for the FDA. Want to know more about the changes to the nutrition facts panel and how they can reduce chronic disease? Check out our recent blog post on that topic.
Calorie Counts Everywhere
The restaurant menu labeling changes were proposed by the Obama administration, but as with most proposals and policies, the regulation took many years to finalize and they were implemented under the current administration. After delays, push back from the restaurant industry, and wading through tons of public comments, the menu calorie labeling law in restaurants went into effect in May 2018. The intention of this requirement was to provide calorie information so that consumers could make informed and healthful choices when eating out. Because many restaurants started posting the information years before it was required, there are some published research findings on the impact this information has had on consumer purchasing decisions. The results vary from no changes, a decrease in calories purchased, and unable to draw conclusions on how the labeling can translate to a healthier population. As time goes on I anticipate more research that will give us a clearer picture on the impact of this regulation.
Keep it Simple: Modernizing Ingredient Labels
Public beliefs and how we interact with our food choices are what drive the food and beverage marketplace. A recent survey revealed that the marketplace is driving towards “cleaner” or simpler ingredient labels and anyone who has seen an ad for a food or beverage lately or taken a trip to the grocery store can confirm this. The FDA is seeing this market force and as part of the modernizing ingredient label strategy, they are creating more consumer-friendly labels, focusing on readability, and understanding. The first step in creating simpler labels, is changing how ingredients are listed to commonly known names. We have all seen long and complicated ingredients on a food label, such as pyridoxine, or cyanocobalamin, only those who have studied chemistry, nutrition, biology or biochemistry would understand these are the chemical names for Vitamin B6 and Vitamin B12. The FDA’s aim is to work away from overly complicated chemical names and improve people’s understanding of the food they are consuming and how food and nutrition affects their short-term and long-term health.
Different Foods Mean Different Rules: Modernizing Standards of Identity
What about standards of identity, what does that even mean? A standard of identity also known as standards of food are foods with regulated recipes like mayonnaise, breads, jam, juice, or chocolate. This means that for a product to put mayonnaise, or mayo, on the label it needs to include both eggs and vinegar in its recipe. This is for consumer protection, ensuring the product you think you are buying is what you are getting. Sounds pretty good right, so why does it need to be updated or modernized? The way Americans are eating has changed and is continuing to change, with many new food choices and entirely new categories of food being created every day. Is almond milk still considered a “milk” or are plant-based meats still “burgers” or “sausages”? This is what the FDA aims to clarify and create protections for by modernizing the current standards of identities, to help clear up any confusion and reduce uncertainty in the marketplace.
But It’s All-Natural: Modernizing Claims
Just like the FDA regulates specific recipes for standards of identity, the nutrition claims a product can make, such as “heart healthy”, “low-fat” and even “light” and “lite” are also defined and regulated terms. This means products need to show they meet established criteria before they can add these claims to their labels. As part of the nutrition innovation strategy, the FDA is modernizing claims, including updating current claims and defining claims like “Healthy” and “Natural”. In 2016, there was a lawsuit against Hormel which is one example of how the term “natural” can land food manufacturers in legal trouble. The FDA accepted public comments in 2016-2017 on the use of the word “healthy” when referring to food and beverage products. Those of us working in nutrition are anxiously awaiting updates from the FDA on the final definition of both “healthy” and “natural” because these are two claims that are definitely used incorrectly.
(Don’t) Shake that Saltshaker!
That sounds like a lot of changes right, affecting a lot of different products and their ingredients and nutrients, so why does sodium specifically need to be reduced? Reducing Sodium is currently seen as the most effective public health action to related to nutrition; it is topped only by a non-nutrition action like smoking cessation. Diets high in sodium can lead to high blood pressure which increases the likelihood of strokes and heart attacks. The nutrition innovation strategy is using open dialogue debates within the FDA and from public commentary to determine how to approach sodium reduction. Currently, voluntary sodium limits are in place for nutrition fact labels with draft guidelines, with a plan to establish long-term sodium limits.
Spreading the Health Message with Nutrition Education
The final element is nutrition education, why make all the changes if we don’t tell everyone about them? The FDA has developed free education materials, to help consumers understand a variety of their nutrition initiatives, including new nutrition facts label changes. These materials are also released to healthcare, education, and community professionals to help spread the word. Registered Dietitians working in the public health, community and clinical fields all partake in improving public understanding of nutrition fact labels and nutrition on both the population and individual levels.
What’s Next for the Nutrition Innovation Strategy?
So, this strategy has been happening all around us for almost two years, but where does the nutrition innovation strategy stand now? Public comments have been received for various parts of the nutrition innovation strategy, including defining “natural” and “healthy”, changes to the nutrition facts label, changes to menu labeling, and many more. Many say these changes are long overdo given our prevalence of chronic diseases and it is yet to be seen what these strategies may have on our disease states. With FDA leadership changes, including a new commissioner, and a possible federal administration change with the November 2020 election, it will be interesting to see how, if at all, this impacts the strategy and all of its pieces. No matter how long it takes for some of these strategies to be implemented, I look forward to seeing how we can improve the health of consumers to potentially reduce and prevent chronic diseases.