NUTRITION: READING BETWEEN THE

LINESCara Karner MS, RD, LD, CDE

Catherine Robinson MS, RD, LD, CDERevised 2010

TOPICS TO DISCUSS

• 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

NUTRITION FACTSServing Size: 1 oz.Servings Per Container 12Calories 14 Calories from Fat 130

% Daily ValueTotal Fat 14 g 22% Saturated Fat 2 g 9% Trans Fat 0gCholesterol 0 mg 0%Sodium 115 mg 5%Total Carbohydrate 6 g 2% Dietary Fiber 2 g 10% Sugars 1 gProtein 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– Fiber– Sugar

• Protein• Ingredients

– listed by amount in the product

REQUIRED VITAMINS AND MINERALS

• Sodium• Vitamin C• Vitamin A• Iron• Calcium

ALL OTHER NUTRIENTS ARE OPTIONAL

NUTRITION FACTSServing Size: 1 oz.Servings Per Container 12Calories 14 Calories from Fat 130

% Daily ValueTotal 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 gProtein 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 FactsServing Size 1 cup (236 ml)

Servings Per Container 2

Amount Per Serving

Calories: 120 Calories from Fat 45

Total Fat 5 g

CaloriesCalories 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 FactsServing 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 FactsServing 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

– 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).

NUTRITION FACTSServing Size: 1 oz.Servings Per Container 12Calories 14 Calories from Fat 130

% Daily ValueTotal 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 gProtein 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

NUTRITION FACTSServing Size: 1 oz.Servings Per Container 12Calories 14 Calories from Fat 130

Percent Daily ValueTotal 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 gProtein 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

NUTRITION FACTSServing Size: 1 oz.Servings Per Container 12Calories 14 Calories from Fat 130

% Daily ValueTotal 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 gProtein 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