1. Label Reading 101 Heather Mackie, MS, RD, LD Sponsored by:
Often times we go to the grocery store and get overwhelmed with reading food labels.
This presentation should help you to know what is important to review when grocery shopping and comparing labels.
Sponsored by:

2. Basics Nutrition Facts Panel/Label (NFP/NFL) Ingredients
Nutrient Content Claims
Health Messages
There are several parts of the food label to review.
We will discuss these 4 parts of the label:
Nutrition facts panel or nutrition facts label
The ingredients section
Nutrient content claims
Health messages

3. Food Labels People look at food labels for different reasons
This is to help you use the information provided on the food label more effectively and easily
Why do you look at food labels?
What have you been told to look at before?

4. I generally recommend that we start with the serving size (#1/green section)
This way you know how the rest of the label applies to what we are eating
Then most people look at calories next (#2)
Remember to increase the calories if you eat more than one serving
Fat, cholesterol, and sodium should be limited (#3/the yellow section)
We want to get fiber, vitamins, and minerals (#4/blue section)
The footnotes provide information related to what is a suggested diet ( calories/day) (#5 section)
% Daily Values (#6/purple section) – provides information related to how much of each category is in relation to the “suggested diet”

5. Nutrition Facts Label
Numbers 1-4, 6: contain product specific information
Serving size, calories, and nutrient information
Number 5: contains a footnote with Daily Values (DVs) for 2,000 and 2,500 caloric diets
Provides recommended dietary information for important nutrients, including fats, sodium, and fiber
The footnote is found only on larger packages and does not change from product to product
While the % DV may be important for many people in the US, it may not apply to the weight loss surgery patient.
How many calories does the average WLS patient consume per day?
How would that change the % DV in regards to a WLS pt?
It won’t change the recommendations for fiber, vitamins, and minerals
However it will change fat, sodium, and cholesterol

6. Serving Size
Pay attention to the serving size, especially how many servings are in the package
Then ask yourself how many servings am I consuming?
For example, if a serving size is 1 cup, and you eat 2 cups – then that doubles all the calories and nutrients
Very important because many things we consume are more than one serving

7. Serving Size Example
Portion control is important for weight management, but don’t expect manufacturers to make it easy for you
Pop-Tarts, for instance, come two to a package
The label says one serving is 200 calories – for “one pastry”
So how many calories would be in one package of Pop-Tarts?
Answer: 400 calories

8. Calories
Calories provide a measure of how much energy you get from a serving of food
The calorie section of the label can help you manage your weight (gain, lose, maintain)

9. Calories from Fat
In the sample label, there are 250 calories in one serving…
How many calories from fat are there in ONE serving?
Which means what percentage of the calories come from fat?
There are 12 grams of fat in this one serving
1 gram of fat has 9 calories
12 x 9 = 108 calories (they round up to 110)
108 calories (from fat) / 250 calories (per serving) = 43% of these calories are from fat
The 18% listed means:
According to the 2000 calorie/day diet, they allow 65 grams of fat
12 g fat / 65 g fat = 18% fat will be consumed

10. General Guide to Calories
General reference for calories when you look at a Nutrition Facts label
This guide is based on 2,000 calories diet
General Guide to Calories
40 calories is low
100 calories is moderate
400 calories or more is high
Eating too many calories per day is linked to overweight and obesity
How do you split your calories out each day?
Most WLS pts consume ~ cals/d
3 meals per day = calories/meal

11. The Nutrients: How Much?
Section #3: The nutrients listed first are ones Americans generally eat in adequate amounts, or even too much
Fat, saturated fat, trans fat, cholesterol, sodium can all increase your risk of certain chronic diseases if eaten in excess
What diseases can they increase your risk of?
Heart disease, cancer, high blood pressure, etc.
What level of fat, cholesterol, or sodium do you try to consume (limit yourself too each day)?
Fat – as WLS pt maybe g/day
Cholesterol – American Heart Assoc. recommends less than 300 mg/d
Sodium – Dietary Guidelines recommend less than 2300 mg/d and if you have high blood pressure, less than 1500 mg/d

12. The Nutrients: How Much?
Section #4: Most Americans don’t get enough of these nutrients in their diets
Fiber, Vitamin A, Vitamin C, Calcium, and Iron
Eating enough of these nutrients can improve your health and help reduce the risk of some diseases and conditions
How much fiber is recommended to consume each day?
25 grams/day

13. Ingredients Listed in order from the greatest amount to the least
A good rule of thumb
The fewer the ingredients, the better
Avoid artificial ingredients
Avoid ingredients you can’t pronounce

14. The Footnote
Section #5: The * used after the heading “% Daily Value” on the Ntr Facts Label
Refers to the footnote in the lower part of nutrition label, which tells you that %DVs are based on a 2,000 calorie diet
This statement must be on ALL food labels
All food labels note:
But, the remaining information in the full footnote may not be on the package if the size of the label is too small

15. How the Daily Values Relate to the %DVs
Less Than:
The nutrients that have “upper daily limits” are listed first on the footnote of larger labels
Upper limits means it is recommended that you stay below – eat “less than” – the DV nutrient amounts listed per day
For example, the DV for saturated fat is 20 grams
This label example is 15% of %DV for saturated fat
Upper limits = recommended that you stay below or “eat less” than the DV listed
So DV for Saturated Fat is 20 grams per day
It is recommended that you eat less than 20 grams/day
For example, eat 3 grams of saturated fat
3 g sat. fat / 20 g DV rec fat = 15% of recommended fat

16. How the Daily Values Relate to the %DVs
At Least:
The DV for dietary fiber is 25 g, which is 100% DV
This means it is recommended that you eat “at least” this amount of dietary fiber per day
The DV for total carbohydrate is 300 g or 100% DV
This amount is recommended for a balanced daily diet that is based on 2,000 calories, but can vary, depending upon your daily intake of fat and protein

17. Percent Daily Value
%DV helps you determine if a serving of food is high or low in a nutrient
Quick guide to %DV:
0-5% DV is low
Nutrients you want to limit (fat, saturated fat, cholesterol, sodium)
20% DV or more is high
Nutrients you want to consume in greater amounts (fiber, calcium, etc.)
In this example, this food is a good source of calcium
It provides one-third of recommended daily intake

18. %DV, but No Weight Listed
Spotlight on Calcium:
%DV for calcium on food packages so you know how much one serving contributes to the total amount you need per day
Recommendation: mg Calcium/day (non-WLS pts)
WLS pts need mg Calcium/day
The DV for calcium on food labels is 1000 mg
Don’t be fooled – always check the label for calcium because you can’t assume about the amount of calcium in specific food categories
The calcium in milk, skim or whole, is generally the same per serving, whereas the amount of calcium in the same size yogurt container (8 oz) can vary from 20-45% DV.
So in this example – it provides 30% of calcium
30% of 1000 mg DV Calcium = 333 mg
This is 1/5th or 1/8th of the calcium a WLS pt needs; very different from 30%

19. Nutrients Without a %DV
Trans Fats
Experts could not provide a reference value for trans fat nor any other information that FDA believes is sufficient to establish a DV or %DV
Health experts recommend that you keep your intake of saturated fat, trans fat, and cholesterol as low as possible as part of a nutritionally balanced diet

20. Nutrients Without a %DV
Protein
A %DV is required to be listed if a claim is made for protein, such as “high in protein”
Otherwise, unless the food is meant for use by infants and children < 4 year old, none is needed
Current scientific evidence indicates that protein intake is not a public health concern for adults and children over 4 years of age
Not a public health concern for the average American
However, WLS patients do need to be aware of their protein intake
Most patients need between grams of protein per day depending upon age, weight, gender, activity level, etc.

21. Nutrients Without a %DV
Sugar
No daily reference value has been established for sugars because no recommendations have been made for the total amount to eat in a day
Keep in mind, the sugars listed on the Ntr Facts Panel include naturally occurring sugars (like those in fruit and milk) as well as those added to food or drink
Check the ingredients list for specifics on added sugars

22. Sugar: Natural or Added
Plain yogurt: 10 g
Fruit yogurt: 44 g
Look at ingredients…
Ingredients are listed in descending order of weight (from most to least)
Plain – only has naturally occurring sugars (lactose in the milk)
Fruit – high fructose corn syrup
Make sure that added sugars are not listed as one of the first few ingredients
Other names for added sugars include: corn syrup, high-fructose corn syrup, fruit juice concentrate, maltose, dextrose, sucrose, honey, and maple syrup

23. Food Label Quiz Which milk has more calories? More saturated fat?
More calcium?
Obviously reduced-fat milk has less calories and saturated fat than whole milk, but they have the same amount of calcium

24. Food Label Quiz How many servings are in package A?
How much total fat is in one serving of the food in package A?
Which food is lower in total fat? A or B?
Which food has more fiber? A or B?
10 servings
2 grams fat
Package B is lower in total fat
Fiber is same for both

25. Food Label Quiz
Which of these muffins would you choose to maximize your fiber intake?

26. Left = Oat Bran
Right = Honey Wheat
To maximize fiber intake, would want to pick honey wheat muffins

27. Food Label Quiz
True or False?
These pretzels are low in sodium

28. Food Label Quiz True or False? Answer:
These pretzels are low in sodium
Answer:
False, 0-5% is considered low, these pretzels provide 20% Daily Value
20% Daily Value or more is high

29. Food Label Quiz Which of these is lower in calories?
Half the container of frozen yogurt OR
Whole container of low- fat cherry yogurt?

30. Food Label Quiz Don’t Guess – Read the Label!!!
The whole container of low-fat cherry yogurt has fewer calories
Half Blueberry Frozen Yogurt:
½ container = 2 servings
2 x 160 = 320 calories
Whole Cherry Yogurt:
1 container = 1 serving
1 x 250 = 250 calories

31. Food Label Quiz Which has more calcium?
Half the container of frozen yogurt OR
Whole container of low-fat cherry yogurt?

32. Food Label Quiz Don’t Guess – Read the Label!!!
The frozen yogurt has more calcium
Blueberry Frozen Yogurt:
½ container = 2 servings
2 x 20% = 40% DV for Calcium
Cherry Yogurt:
1 container = 1 serving
1 x 30% = 30% DV for Calcium
Note: Compare what you actually eat with the amount listed on the label

33. Claims to Be Aware Of…
Manufacturers can say most anything they want on the front of the box
“No sugar added”
They didn’t add any extra sugar – doesn’t mean there is no sugar in the product
Product could still contain a lot of natural sugar, like in dried fruit, honey, or fruit juices

34. Claims to Be Aware Of… “Fortified, enriched, added, extra, plus”
Fortified – contains at least 10% more of DV than non-fortified food
Means nutrients such as minerals and fiber have been removed and vitamins added in processing
Look for 100% whole-wheat bread and high-fiber, low-sugar cereals
Examples of this claim include:
Fortified yogurt with calcium and vitamin D
Fortified OJ with Calcium
Fortified white bread

35. Claims to Be Aware Of… “Fruit drink”
This means there’s probably little or no real fruit and lots of sugar
Look for products that say “100% Fruit Juice”

36. Claims to Be Aware Of… “Made with wheat, rye, or multigrain”
These products may have very little whole grain
Look for the word “whole” before the grain to ensure you’re getting a 100% whole-grain product
When looking for “whole-grain” – look in the ingredients section

37. Claims to Be Aware Of… “Natural”
The manufacturer started with a natural source, but once it’s processed the food may not resemble anything natural
Look for “100% All Natural” and “No Preservatives”
Does natural always mean better?
Not necessarily
For example when talking about supplements, vitamin E as a supplement is better absorbed as synthetic form rather than natural form

38. Claims to Be Aware Of…
“Organically grown, pesticide-free, or no artificial ingredients”
Trust only labels that say “Certified Organically Grown”
This is an area to be especially smart in because you can spend a lot of money on organic foods that may not be truly organic

39. Claims to Be Aware Of… “Sugar-free or fat-free”
Don’t assume the product is low-calorie
The manufacturer may have compensated with unhealthy ingredients that don’t taste very good – and have no fewer calories than the real thing
Also, a product can contain < 0.5 g of an item and still say it is “free”
There are 3 main ingredients in food to provide flavor/taste – sugar, salt, and fat
Typically if one is removed there are higher amounts of the other
Example, an item that is fat-free, may have added sugar
Also, sugar-free items may use sugar alcohols which yes help to control blood sugar, but are still the same calorie for calorie as any other carbohydrate or sugar
This is how spray items can get away with saying “trans-fat free” because it may have < 0.5 g of trans fat even though you read the ingredients and see “hydrogenated vegetable oil”

40. Claims to Be Aware Of… “Fat-Free” – 0.5 g or less
“Low-Fat” – 3 g or less
“Cholesterol Free” – less than 2 mg cholesterol and less than 2 g of saturated fat
“Low Sodium” – less than 140 mg
“Good Source” – contains 10-19% of DV per serving

41. Health Messages Calcium and Osteoporosis Folate and Birth Defects
Fiber and Cardiovascular Disease
Fiber and Some Cancers
Soy and Cardiovascular Disease
Sugar and Tooth Decay
Sodium and Hypertension
Saturated Fat and Cardiovascular Disease
Fat and Some Cancers
A manufacturer cannot just put any claim out there on the front of their box.
These claims listed are the only allowed health messages that are backed by plenty of research
The item cannot say this food will prevent “XYZ” but can state, for example, a diet high in calcium can reduce the risk of osteoporosis

42. Health Message Example
Milk contains calcium
Skim Milk: Good Source of Calcium
Diet high in calcium, low saturated-fat may decrease cardiovascular disease
Whole Milk: Good Source of Calcium
Cannot make that claim because high in saturated-fat

43. Keep it simple 4 Basic Things to Look For: Serving Size Protein
Keep sugar in the single digits per serving
Keep fat in the single digits per serving
Not perfect but quick and easy method to read food labels

44. Food Label Sample First, look at serving size
Serving size is 1 cup
How many calories in one serving?
1 serving = 250 calories
How many calories in box?
2 servings in box
2 * 250 calories = 500 calories!

45. Food Label Sample Second, look at protein
How much protein in one serving?
1 serving = 5 grams protein
How much protein in box?
2 servings in box
2 * 5 g protein = 10 grams of protein

46. Food Label Sample Third, look at sugar How much sugar in one serving?
1 serving = 5 grams sugar
How much sugar in box?
2 servings in box
2 * 5 grams sugar = 10 grams of sugar
Too high – we said single digits, so can’t eat box

47. Food Label Sample Last, look at fat How much fat in one serving?
1 serving = 12 grams fat
How much fat in box?
2 servings in box
2 * 12 g fat = 24 grams of protein
Too high – we said single digits, so can’t eat box or single serving
But, what about ½ serving?
½ cup = 6 grams of fat – single digits = ok

48. Questions???