NUTRITION: READING BETWEEN THE LINES Cara Karner MS, RD, LD, CDE Catherine Robinson MS, RD, LD, CDE Revised 2010

TOPICS TO DISCUSS Food Labels Nutrition Health Claims on Food Labels Required Nutrients Daily Value Serving Sizes False Information Nutrition Health Claims on Food Labels Laws regarding claims Definitions of common claims

BENEFITS OF FOOD LABELS Understand the nutrition information Make better food choices Improve nutritional intake Work toward prevention of disease -Calories for weight control -Lipid reduction for heart disease -Blood sugar control in Diabetes -Reduce blood pressure for hypertension -Avoid food intolerances and allergies

Servings Per Container 12 Calories 14 Calories from Fat 130 NUTRITION FACTS Serving Size: 1 oz. Servings Per Container 12 Calories 14 Calories from Fat 130 % Daily Value Total Fat 14 g 22% Saturated Fat 2 g 9% Trans Fat 0g Cholesterol 0 mg 0% Sodium 115 mg 5% Total Carbohydrate 6 g 2% Dietary Fiber 2 g 10% Sugars 1 g Protein 7 g 7% Vitamin A 0 % Vitamin C 2 % Iron 2 % Calcium 190 % % Daily Values are based on a 2,000 calorie diet

WHAT MUST HAVE A FOOD LABEL? Most foods you buy at the grocery store. They do not have to have a label if they do not contain significant amounts of nutrients

NOT REQUIRED TO HAVE LABELS Raw produce Fresh fish Restaurant foods unless they make a health or nutrition claim Food served for immediate consumption Ready to eat food prepared on site Food shipped in bulk (not sold in bulk) Food produced by very small businesses

ALSO NOT REQUIRED TO HAVE LABELS Foods that contain no significant amount of any nutrient Alcohol- it is not a food, therefore does not require a food label Plain coffee, tea, and some spices

WHAT IS REQUIRED ON THE LABEL? Serving Size Servings per Container Calories Calories from Fat Fat Saturated Fat Trans fat (required January 1, 2006) Cholesterol

ALSO REQUIRED Total Carbohydrates Protein Ingredients Fiber Sugar listed by amount in the product

REQUIRED VITAMINS AND MINERALS Sodium Vitamin C Vitamin A Iron Calcium ALL OTHER NUTRIENTS ARE OPTIONAL

Servings Per Container 12 Calories 14 Calories from Fat 130 NUTRITION FACTS Serving Size: 1 oz. Servings Per Container 12 Calories 14 Calories from Fat 130 % Daily Value Total Fat 14 g 22% Saturated Fat 2 g 9% Cholesterol 0 mg 0% Sodium 115 mg 5% Total Carbohydrate 6 g 2% Dietary Fiber 2 g 10% Sugars 1 g Protein 7 g 7% Vitamin A 0 % Vitamin C 2 % Iron 2 % Calcium 190 % % Daily Values are based on a 2,000 calorie diet

SERVING SIZE Should be the FIRST thing observed on the label Is up to the manufacture, now more uniform Everything on the label is based on that serving size If serving size is not clear, check “servings per container” Many serving sizes on labels are not realistic! (Ice cream ½ cup)

Nutrition Facts Serving Size 1 cup (236 ml) Servings Per Container 2 Amount Per Serving Calories: 120 Calories from Fat 45 Total Fat 5 g

Calories Calories provide a measure of how much energy you get from a serving of food. Calories relate to serving size listed on label 40 calories is low 100 calories is moderate 400 calories or more is high

Nutrition Facts Serving Size: 1 cup (236 ml) Servings Per Container 2 Amount Per Serving Calories: 120 Calories from Fat 45 Total Fat 5 g

FAT Total Fat content per serving is required Saturated fat is required Bad, “artery clogging” fat Trans fatty acids are required and listed under saturated fat on the label - Bad, “artery clogging” fat Monounsaturated and polyunsaturated fat content is optional

Nutrition Facts Serving Size 1 cup (236 ml) Servings Per Container 2 Amount Per Serving Calories: 120 Calories from Fat 45 % Daily Value Total Fat 5 g 8% Saturated Fat 3 g 15% Trans Fat 0 g Cholesterol 20 mg 7%

CARBOHYDRATES Total Carbohydrates are required Total fiber is required is important for people with diabetes fiber and sugar grams are included in the total carbohydrates Total fiber is required does not distinguish between the types of fiber Sugar is required does not distinguish between naturally occurring sugars and added sugars

Total Sugars The American Heart Association recommends reductions in the intake of added sugars. A prudent upper limit of intake is half of the discretionary calorie allowance, which for most American women is no more than 100 calories per day (25 g) and for most American men is no more than 150 calories per day (37.5 g) from added sugars (2009).

Servings Per Container 12 Calories 14 Calories from Fat 130 NUTRITION FACTS Serving Size: 1 oz. Servings Per Container 12 Calories 14 Calories from Fat 130 % Daily Value Total Fat 14 g 22% Saturated Fat 2 g 9% Cholesterol 0 mg 0% Sodium 115 mg 5% Total Carbohydrate 6 g 2% Dietary Fiber 2 g 10% Sugars 1 g Protein 7 g 7% Vitamin A 0 % Vitamin C 2 % Iron 2 % Calcium 190 % % Daily Values are based on a 2,000 calorie diet

DAILY VALUE Only used on food labels All daily values for nutrients are based on a 2,000 calorie diet Tells you what percentage of your daily requirement for a nutrient one serving of that food would provide 5% DV or less is low 20% DV or more is high

Servings Per Container 12 Calories 14 Calories from Fat 130 NUTRITION FACTS Serving Size: 1 oz. Servings Per Container 12 Calories 14 Calories from Fat 130 Percent Daily Value Total Fat 14 g 22% Saturated Fat 2 g 9% Cholesterol 0 mg 0% Sodium 115 mg 5% Total Carbohydrate 6 g 2% Dietary Fiber 2 g 10% Sugars 1 g Protein 7 g 7% Vitamin A 0 % Vitamin C 2 % Iron 2 % Calcium 190 % % Daily Values are based on a 2,000 calorie diet

Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs. Calories: 2,000 2,500 Total Fat less than 65g 80g Saturated Fat less than 20g 25g Cholesterol less than 300mg 300mg Sodium less than 2,400mg 2,400mg Total Carbohydrate 300g 375g Fiber 25g 30g

NUTRITION CLAIMS Regulated by the FDA It is illegal for a manufacturer to make definitive claims that their product can prevent or treat any disease May use words such as: might may it is possible

REDUCED FAT Must contain at least 25% or less fat than the comparison product Not necessarily a low fat item! Example: 2% milk

LOW FAT Must contain 3 grams or less fat per serving Example: 1% milk

FAT FREE Must contain less than .5 grams of fat per serving Example: Skim milk

LOW CALORIE Must contain less than 40 calories per serving If it contains less than 20 calories, then the item is “free” on an exchange meal plan

LOW SODIUM Must contain 140 mg or less sodium per serving Daily recommendation for all adults is less than 2,400 mg. per day

LIGHT May refer to either calories or color Contains 1/3 fewer calories or half the fat of the original product

SUGAR FREE Contains less than .5 grams of sugar per serving Product may contain “sugar alcohols” Does not mean the product is low in carbohydrates, so it can still raise your blood sugar!

WHAT ARE SUGAR ALCOHOLS? Type of sugar replacers (Polyols) gotten naturally from fruits and vegetables and then processed into a wide variety of foods with half the calories of sugar May cause gastrointestinal side effects such as gas, upset stomach, and diarrhea Common types (included in the ingredient list) include: Sorbitol, Mannitol, Maltitol, Xylitol, Isomalt, Lactitol, Hydrogenated starch hydrolysates (HSH), Erythritol

Servings Per Container 12 Calories 14 Calories from Fat 130 NUTRITION FACTS Serving Size: 1 oz. Servings Per Container 12 Calories 14 Calories from Fat 130 % Daily Value Total Fat 14 g 22% Saturated Fat 2 g 9% Cholesterol 0 mg 0% Sodium 115 mg 5% Total Carbohydrate 8 g 2% Dietary Fiber 2 g 10% Sugar Alcohols 6 g Protein 7 g 7% Vitamin A 0 % Vitamin C 2 % Iron 2 % Calcium 190 % % Daily Values are based on a 2,000 calorie diet

HOW DO I COUNT SUGAR ALCOHOLS? Divide the grams of sugar alcohols by 2 Subtract these grams from the total carbohydrate grams May still be a high carbohydrate item!

NO SUGAR ADDED The manufacturer did not add sugar to the product The product may contain naturally occurring sugar grams Does not always indicate a low sugar item

HIGH IN FIBER Contains 20% or more of the DV for fiber Product has at least 5 grams of fiber per serving Healthy goal is at least 25 grams of fiber per day (increase liquids to 6-8 cups/day)

GOOD SOURCE OF …. Contains 10-19% of the Daily Value for that nutrient Example: Peanuts are a good source of vitamin E

HIGH IN …. Contains 20% or more of the Daily Value for that nutrient Better than “A Good Source of….” Example: Carrots are high in vitamin A

LEAN Describes meat or poultry, per 100 grams Item contains less than 10 grams fat, less than 4.5 grams of saturated fat, and less than 95 mg. cholesterol per serving Does not always indicate a low-fat item!

RECENT PROBLEMS WITH LABELS Incorrect Information Example: Big Daddy’s ice cream (had triple the calories, double the carbohydrates, and more fat than the label claimed) Information doesn’t have to be 100% accurate

Health Claims Calcium and Osteoporosis Sodium and Hypertension Dietary saturated fat, cholesterol and risk of heart disease Fiber-containing grain products, fruits, and vegetables and cancer Fruits, vegetables, grain products that contain fiber, particularly soluble fiber, and risk of heart disease

Health Claims Fruits and vegetables and cancer Folate and neural tube birth defects Dietary sugar alcohol and dental cavities Dietary soluble fiber, such as found in whole oats and psyllium seed husk, and coronary heart disease

Health Claims Heart Disease and Fats – food must be low in fat, saturated fat, and cholesterol Blood Pressure and Sodium – food must be low in sodium Heart Disease – a fruit, vegetable or grain product low in fat, saturated fat and cholesterol, that contains at least .6 gram soluble fiber, without fortification, per serving

SUMMARY Never assume you know what you are eating unless you read the label Always check serving size on the label People with diabetes need to focus on total carbohydrates, NOT sugar BEST Nutritional Advice: Eat a variety of foods!

ANY QUESTIONS?

We Can Help! For additional information or questions, contact the Health Education Department at Florida Health Care Plans To set up an appointment with a registered dietitian call (386) 676-7133