Nutrition Rating Systems – Do Consumers Need Them?

One of the interesting sessions here at the annual Food and Nutrition Conference in Denver hosted a panel of 3 experts who presented their views on what the rating systems are, why and how they were created, and how they will improve nutrition.

First up was  Susan Crockett, PhD, RD, FADA, who for the last 10 years has been with General Mills. She presented the Smart Choices program of Fruit Loop infamy, and addressed the specific backlash against pre-sweetened cereal. In her attempt to justify the benchmark that allows such a culinary and nutrition horror to be considered a smart choice, Dr. Crocket first provided a background on how General Mills is committed to health and nutrition. She then showed that the Smart Choice panel was composed of both industry and academic experts, and lastly dug deep into the numbers to show how the benchmark for cereals was chosen.

Let us say that we commend General Mills that contribute 5% of pretax profit to nutrition and wellness programs. That was about $80M last year. But let’s not forget that this is a huge profit driven enterprise. The company and its peers has seen consumer confusion regarding nutrition labels and decided to handle it as a business opportunity. Working with “non-industry” experts is a way to lend credibility to the program. However, many experts are affiliated in some way or another with the industry.

As to sugar in cereal – the Smart Choices panel took a recommendation for 10% of daily calories from added sugar. In a 2000 calorie a day diet, that means 200 calories. They divided the 200 calories into 4 eating events of 50 calories. 12 grams of sugar, which is what you’ll find in Froot Loops, Apple Jacks, and others, add up to 48 calories per serving. And that, by their book is a Smart Choice. Wonderful, no?

We were left with some hope, as Dr. Crocket said that Smart Choices is continually evolving, and that with time benchmarks will be adapted to feedback from the field.

Next speaker was Annette Maggi, MS, RD, LD, FADA from NuVal. Maggi is the director of the business arm of NuVal, which licenses its 1-100 rating system to supermarkets for display on shelf tags. The NuVal system was not funded by the industry, rather by a group of scientists with a stated goal of becoming a nutrition GPS at the supermarket. The idea is to tag every single product in the supermarket with a score. That way, in the supermarket, people can compare products within a category.

So far 33,000 products have been scored. In an earlier talk we had with Prof. Keith Ayoob, of the Nuval Scientific board, he said that the group was working on rating over 100,000 items in supermarkets. The Nuval algorithm is quite complex when compared to Smart Choices, with hundreds of factors taken into consideration for each product.

Without referring specifically to Smart Choices, Maggi stated that one of the clear advantages of NuVal was its independence. A Kraft PR spokesperson tried to refute that statement in the ensuing Q&A by mentioning that the wife of one of the NuVal board members has a conflict of interest.

Last to present was Susan Moores, MS, RD who does not represent any rating system, but has been working with grocers on a variety of health and nutrition issues over the years. She provided an interesting viewpoint whose main message was stop looking for the numbers and the stickers, focus on the food: “A number will not put a meal on the table”.

Moores said that the nutrition labels have had an effect on industry. Food manufactures have reformulated products to get better scores. For example, the notorious Froot Loops lowered sugar by one gram and upped fiber by one gram. Supermarkets who adopt one system or other are able to differentiate themselves.

Mostly though, these programs have created controversy and chaos. And wherever there is a mess, there’s an opportunity for dietitians to help their clients  with guidance and sound advice.

The session was very informative, but did not provide any substantially new information. Our position is that any industry funded rating system is inherently flawed because of the direct conflict of interest between companies’ need to sell more processed food to make more money, and consumers’ need to get away from these types of foods.

What to do at the supermarket:

Skip the health claims, benchmarks, and other marketing tricks. Learn to read a nutrition panel and familiarize yourself with ingredients to watch out for in the ingredient list. When sugar is the first ingredient in a cereal, that is not a smart choice, no matter how many PhDs in the room will tell you it is.

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  • Leah McGrath, RD, LDN

    “Learn to read a nutrition panel and familiarize yourself with ingredients to watch out for in the ingredient list. When sugar is the first ingredient in a cereal, that is not a smart choice, no matter how many PhDs in the room will tell you it is.”
    couldn’t agree more or is that MOORES….yeah Susan Moores!

  • http://www.palateworks.com Carol

    2000 calories a day is a lot for a kid — that’s the average daily intake for an adult — so 10% of that is too high for calories from sugar for a kid, especially younger ones (e.g., the ones who eat Fruit Loops, etc.). Unfortunately, most of these “smarter choice” foods do meet FDA’s current criteria for “healthy” (same for just about every breakfast cereal), because sugar is not part of the criteria, and the sodium limit is too lenient.

    Fortunately, FDA is (finally) “developing a proposed regulation that would define the nutritional criteria that would have to be met by manufacturers making broad FOP or shelf label claims….”
    http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/FoodLabelingNutrition/ucm187208.htm

  • http://www.davidkatzmd.com Dr. David L. Katz

    As I weigh in, I hasten to note I am the primary inventor of the Overall Nutritional Quality Index (ONQI) algorithm used in the NuVal system- lest anyone think I am feigning impartiality.

    This post is fundamentally reasonable- but I think much comes down to who the erstwhile “consumers” in the title actually are. If you have in mind those who frequent sites such as Fooducate, you may well be right.

    But as a public health practitioner- who convened colleagues to develop the ONQI for public health purposes- I would point out that those are scarcely the “consumers” we had primarily in mind. The “average” consumer is no more likely to stop by here, than to “Learn to read a nutrition panel and familiarize yourself with ingredients.” That is much easier said than done, and requires the savvy to make sense out of it all. What about consumers with limited education, even limited literacy? Whom, exactly, do you think the food industry is most likely to exploit?

    Our thinking, quite simply, was that experts should do the heavy lifting so the average shopper didn’t have to. For those not-so-average shoppers fully capable of doing the heavy lifting on their own and preferring to- what’s to stop them? An analogy I like is a doctor’s visit: the doctor does not just give the average patient a print-out of their lab results and leave them to figure out on their own if they are healthy. The doctor does, and should, interpret the data for the patient- since the doctor has pertinent expertise. If the patient happens to have relevant expertise- perhaps the patient is a doctor- they are at liberty to interpret for themselves. But most patients cannot review their CRP, LDL, Lpa, SBP, DBP, CBD, LFTs, Bun, Cre, EKG, etc. on their own and make summative sense of it. Frankly, and alas, much the same is true of most consumers- and the combination of nutrition facts and ingredients.

    That said, I would note that NuVal helps even me- and I hope it is not immodest to say my nutrition expertise is quite robust, encompassing, among other things, two editions of a textbook on the topic.

    Please note that your comment- “Our position is that any industry funded rating system is inherently flawed”- does not pertain to NuVal. Funding to develop this system came from a not-for-profit community hospital affiliated with the Yale School of Medicine- Griffin Hospital in Derby, CT. It came ONLY from there, and the science of the ONQI algorithm is owned by Griffin Hospital. NuVal, the company, exists to ‘market’ the ONQI, but the science remains entirely independent. There are no ties here to industry whatsoever.

    Again, my commendation for a fundamentally reasonable post. But I dare to hope we might all agree that not all consumers are created equal, and neither is all nutrition guidance. The modern food supply can be pretty damn confusing- NuVal was developed by public health and nutrition experts, and only by them, to help with that.

    -Dr. David L. Katz
    Director, Prevention Research Center
    Yale University School of Medicine

    Principal Inventor,
    the Overall Nutritional Quality Index (ONQI)
    used to power NuVal

  • http://www.fooducate.com/blog staff

    @Dr. Katz – thanks for weighing in with your clarifications. I agree that the average consumer does not read our blog or similar websites. I agree that simplifying the nutritional information is important for 95% of consumers who don’t have a clue (Just as I, a dad to three toddlers, had no clue, only 3 years ago). Consumers need to be 100% confident that the information presented in reliable. We saw just yesterday what happened with Smart Choices.
    I had a chance to speak with one of the NuVal board members, Dr. Keith Ayoob, at FNCE earlier this week and he reiterated,as you have, the objectivity of NuVal.
    While NuVal is certainly not taking money from food manufacturers, it does “sell” information to food retailers. Some folks may view the fact that NuVal is receiving its revenue stream from supermarkets as a possible conflict of interest.
    Once again, thanks for your comments, and may we all be healthy…

  • http://www.guidingstars.com Lori Kaley, MS, RD, LD, MSB

    Thank you for your thoughtful comments on this session presented at FNCE last year. Are you planning on attending ADA FNCE this year in November in Boston? I have a poster presentation on the impact of Guiding Stars in a high school cafeteria and hope to see you there. I am a Registered Dietitian and a member of the Guiding Stars Scientific Advisory Panel. Guiding Stars was developed in response to consumer research which demonstrated that consumers were confused by the overwhelming amount of nutrition information available. Consumers stated that they would be interested in using a system like Guiding Stars and furthermore, they thought that the three star system would be simple and easy to use and only wanted to see more nutritious foods highlighted. In an unprecedented move, Hannaford Bros. Co. invested in the development and implementation of Guiding Stars giving full authority to the Scientific Advisory Panel to determine the algorithm. The algorithm is based on recommendations and guidance of leading national and international scientific authoritative bodies in nutrition and health. Foods and beverages that receive stars (1, 2, or 3 stars for good, better, or best nutritional value) have attributes that promote health and support disease prevention. Foods and beverages with stars have more vitamins, minerals, fiber, and/or whole grains and less saturated and trans fats, cholesterol, added sugars and added sodium. This is a higher standard that about 25% of the foods and beverages in the supermarket environment meet. To date, over 70,000 products have been analyzed. Guiding Stars is blind to brand, price and manufacturer. In complete integrity, Hannaford’s private label foods and beverages were analyzed right alongside all the other manufacturers’ products and the resultant star values were revealed at the same time. And, whether or not consumers need Guiding Stars, they are indeed using the stars! Over a two year period, the proportion of products purchased with stars increased by 1.39% which translates to approximately 2.9 million more products with stars being purchased monthly (and the equivalent amount of products without stars not being purchased) over that time period. Consumers are using Guiding Stars to quickly and easily locate the most nutritious choices in over 1500 supermarkets across the country, as well as in schools, universities, colleges and hospitals. Please visit http://www.guidingstars.com for the latest on Guiding Stars and for information that consumers can use.