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In what will surely be good news to people with celiac disease and other problems related to gluten intolerance, the FDA has just issued a final rule for defining foods as “gluten-free.”

This, after nine years of work on this issue (see timeline below).

The rule states that companies can label their products gluten-free if they contain less than 20 ppm (parts per million) gluten.  This, says FDA,

is the lowest level that can be consistently detected in foods using valid scientific analytical tools. Also, most people with celiac disease can tolerate foods with very small amounts of gluten. This level is consistent with those set by other countries and international bodies that set food safety standards.

As for gluten intolerance: Roughly 1% of the U.S. population has diagnosable gluten intolerance.  For those who do, eating grains containing gluten (wheat and some others) triggers an abnormal immune response that damages the intestinal tract.  To prevent symptoms—of which there can be many, none of them pleasant—people with this condition must scrupulously avoid eating gluten-containing foods.

The new rule will help establish some uniformity in labeling.  Note: gluten-free does not mean sugar-free.

In reading through the FDA’s notice in the Federal Register, I am struck by the complexity of the agency’s processes for doing something like this.

Policy wonk that I am, I immediately made a timeline.  This indicates that the FDA spent nine years getting to this point. Impressive, no?

Timeline: FDA’s Gluten-Free Rule

FDA’s documents on the gluten-free rule:

• FDA: Gluten-Free Labeling
• FDA: Gluten-Free Labeling Final Rule Q&A
• Consumer Update

The Grocery Manufacturers Association (GMA) recently released an interactive  guide to using Facts Up Front, its front-of-package nutrition symbols.

Here’s an excerpt from the GMA’s Infographic:

The GMA’s press release said Facts Up Front

empowers consumers to make informed choices. It arms them with critical nutrition information about their favorite products…Through this website, we are providing consumers with the knowledge and tools they need to build a healthful diet.

The website includes, among other things:

• Nutrition Calculator
• Interactive Label
• Nutrition Quiz
• Information for professionals
• Spanish-language version

The GMA says:

Facts Up Front labels…highlight nutrition information – calories, saturated fat, sodium and sugar per serving – in a clear, easy-to-understand format. The labels also provide consumers with valuable information about “nutrients to encourage”…The labeling program was developed in response to First Lady Michelle Obama’s call on the food and beverage industry to help consumers construct a healthy diet for themselves and their families.

As I’ve explained in previous posts, I can’t believe that this is what the First Lady had in mind.  I view Facts Up Front as the industry’s end run around the FDA’s long delayed attempt to make front-of-package nutrition information actually useful to consumers.

I’m greatly in favor of eating less, eating better, and moving more as a way to manage weight in today’s food marketing environment.  

But coming from GMA, the message takes on additional meaning: it’s up to you to make healthful food choices.  The companies represented by GMA take no responsibility for the effects of their products on health or of their marketing on your food choices.

Green labels are all that it takes to make consumers think that foods are healthier, says a new study (see full reference below):

You don’t believe this?

Decide for yourself: Which candy bar is healthier?

This clever study found that green labels increase perceived healthfulness, especially among consumers who place high importance on healthy eating.

Read it and weep: Jonathon P. Schuldt (2013): Does Green Mean Healthy? Nutrition Label Color Affects Perceptions of Healthfulness, Health Communication, DOI:10.1080/10410236.2012.725270.

Here’s another one of those occasional queries from Kerry Trueman.  This one, posted at Huffington, is about FDA regulations for labeling sugars.

Trueman: I’ve just begun to sink my teeth into Michael Moss’s extraordinary food industry exposé, Salt Sugar Fat: How the Food Giants Hooked Us, a book you’ve rightly lauded as a “breathtaking feat of reporting.” As Moss points out, the FDA is happy to give us guidelines on how much salt and fat to include in our daily diets, but–as a glance at any nutritional label shows–they’ve declined to make any recommendation at all about sugar.

Does this mean that:

(a) It’s OK to eat as much sugar as you like, or:

(b) There may be an unsafe level of sugar consumption, but the FDA just doesn’t have the resources to figure out what that level is, or:

(c) The FDA knows how much sugar we can eat without harming our health, but the food industry won’t let them tell us.

How is the average American supposed to interpret this absence of information?

Nestle: Whoa. Slow down. Let’s back up a minute. The FDA sets nutritional standards for food labels, but the Institute of Medicine (IOM) sets nutritional standards for dietary intake. To understand what’s happening with the FDA and food labels, we have to talk about what the IOM used to call the Recommended Dietary Allowances (RDAs) but now calls Dietary Reference Intakes (which, confusingly, include RDAs and other standards, such as Upper Limits).

In 2002, the IOM set standards for total carbohydrates–sugars and starches (which are converted to sugars in the body). In its review of the evidence, the IOM set the RDA for total carbohydrates at 130 grams a day (roughly 4 ounces) to meet the needs of the brain for fuel. This amount is much less than typically consumed by adults.

As for sugars, the IOM noted that the average intake of sugars among adolescent males was 143 grams per day, and that the heaviest users were consuming 208 grams per day–much more than the amount of total carbohydrate needed.

Since sugars are not required nutrients, the IOM could not set an RDA. And although it did not have enough evidence to set an Upper Limit, the IOM suggested that the maximum level of intake of added sugars (as opposed to those naturally present in foods) should be a whopping 25% or less of calories.

Americans typically consume around 20% of calories from added sugars. Taken at face value, the IOM suggestion made it sound as if current intake levels were just fine. The sugar industry happily viewed 25% as a recommendation, not a maximum.

Before the sugar industry got after them, many countries recommended an upper level of sugar intake at 10% of calories. That’s what the U.S. Pyramid did in 1992.

The sugar industry does not like the 10% recommendation. It means, for example, that just one of Mayor Bloomberg’s 16-ounce sodas takes care of recommended sugar intake for the day.

Robert Lustig, who is largely concerned about what too much fructose does to us, thinks that 50 grams of sugar (sucrose or HFCS) is a reasonable Upper Limit for most people. This would provide 25 grams of fructose, which the body can handle with relative ease. What’s interesting about his cut point is that it means 200 calories a day, or 10% of calories for a 2000 calorie diet. So there we are at 10% of calories again.

If the FDA wanted to be helpful, it could do two things.

1. Require companies to list added sugars under the carbohydrate category on food labels.

2. Set a DV for sugars at 50 grams.

In the meantime, everyone would be healthier eating less sugar. 

Center for Science in the Public Interest (CSPI) held a press conference this morning to announce that 10 health departments, 20 health and consumer organizations, and 41 health professionals (including me) have signed a letter in support of its petition asking the FDA to:

Our letter of support begins:

The undersigned scientists and organizations are concerned about Americans’ excess consumption of added sugars…Every edition of the Dietary Guidelines for Americans (going back to 1980) has recommended reducing consumption of added sugars, but Americans are consuming more added sugars (including sucrose, high-fructose corn syrup, corn syrup, and other caloric sweeteners) now than they did in 1980. And that high level of consumption…is contributing to serious health problems.

If the situation with trans fats was any indication, the food industry will reduce the sugars in its products if it has to disclose them.

This is not the first time that CSPI has tried to get added sugars labeled (see petition from 1999).  I’m hoping the letter of support will encourage the FDA to take action this time.

Maybe it will even put sugars on front-of-package labels, as the Institute of Medicine suggested in 2011.

Stephanie Strom reports in today’s New York Times that a group of food companies—among them several that put millions of dollars into opposing California’s Proposition 37 last November—are now favoring labeling of genetically modified foods.

Those companies won the election; Proposition 37 lost, although not by a very wide margin.   

But in the process, two things happened: they lost credibility, and they created a movement for GMO labeling initiatives in other states.

Advocates for GMO labeling figured out that although Big Food and Big Soda were willing to invest $40 million to defeat the California labeling initiative, they might hesitate if confronted with initiatives in many other states.

Good thinking.  Ms. Strom reports the previously unthinkable:

Some of the major food companies and Wal-Mart, the country’s largest grocery store operator, have been discussing lobbying for a national labeling program.

Executives from PepsiCo, ConAgra and about 20 other major food companies, as well as Wal-Mart and advocacy groups that favor labeling, attended a meeting in January in Washington convened by the Meridian Institute, which organizes discussions of major issues.

…“They spent an awful lot of money in California — talk about a lack of return on investment,” said Gary Hirshberg, co-chairman of the Just Label It campaign, which advocates national labeling, and chairman of Stonyfield, an organic dairy company.

…Mr. Hirshberg said some company representatives wanted to find ways to persuade the Food and Drug Administration to proceed with federal labeling.

I have to say that I never thought I’d live to see this happen.  I was one of four consumer representatives to the FDA’s Food Advisory Committee in the early 1990s when the FDA was considering approval of GMOs and whether or not to require them to be labeled.

We warned the FDA that if GMOs were not labeled, the public would wonder what the industry was trying to hide.  This, we said, would not only hurt the FDA’s credibility, but would end up hurting the GMO industry as well.

As I discuss in my book, Safe Food: The Politics of Food Safety, the FDA’s main arguments at the time were that (a) it would be misleading to label GMOs because they were no different from foods produced through traditional genetic crosses, and (b) the process by which foods are produced is not material.

Even then, it was evident that argument (b) made no sense.  The FDA already permitted foods to be labeled as Made from Concentrate, Previously Frozen, Irradiated, and, later, Organic.

As I’ve discussed previously, GMO labeling is no big deal.  All the label needs to say is “May be made from genetically modified corn, soy, or sugar,” as Hershey’s does in Great Britain.

Let’s hope the FDA takes notice.

Nutrition Facts panels on food labels are notoriously confusing.  People who use them usually look for only one item such as fat or calories.

As I’ve discussed previously. the label is so difficult to interpret that the FDA devotes pages on its website to explaining it.  When the FDA did the original research in the early 1990s, it tested a large number of formats.  When it became clear that people did not understand any of them very well, the FDA chose the least worst—the one that was understood least poorly.

Two decades later, the FDA is revisiting the Nutrition Facts panel to make it easier to understand in the light of today’s concerns about calories and obesity.  Once again, it is testing multiple formats.  The results of the first round of research have just been published in the Journal of the Academy of Nutrition and Dietetics (JAND), and reporters are trying to make sense of them.

FDA researchers tested 10 formats differing in number of servings and columns (1 or 2, each), font size, and wording.  They asked respondents for opinions about the healthfulness of the product, number of calories and nutrients per serving, perceptions of the label, and the ability to choose healthier products and those with fewer calories.  This, like the research in the early 1990s, is complicated.

The result:

For products that contain 2 servings but are customarily consumed at a single eating occasion, using a single-serving or dual-column labeling approach may help consumers make healthier food choices.

Here’s an example of one of the formats that may help:

Soda companies are already doing something like this, but a 20-ounce soda has more than 2 servings.  Serving size is what confuses.  If it’s 100 calories per serving, those calories have to be multiplied by the number of servings per container.

The Institute of Medicine produced two reports for the FDA on front-of-package labels and also suggested a way to integrate its ideas into the Nutrition Facts label.

Is the FDA testing this idea?  I hope so.

For my monthly (first Sunday) Food Matters column in the San Francisco Chronicle, I devote the one in January every year to predictions.  Last year I got them all pretty much on target.  It didn’t take much genius to figure out that election-year politics would bring things to a standstill.  This year’s column was much harder to do, not least because the FDA was releasing blocked initiatives right up to the printing deadline.

 Q: I just looked at your 2012 crystal ball column. Your predictions were spot on. But what about 2013? Any possibility for good news in food politics?

A: Food issues are invariably controversial and anyone could see that nothing would get done about them during an election year. With the election over, the big question is whether and when the stalled actions will be released.

The Food and Drug Administration has already unblocked one pending decision. In December, it released the draft environmental assessment on genetically modified salmon – dated May 4, 2012. Here comes my first prediction:

The FDA will approve production of genetically modified salmon: Because these salmon are raised in Canada and Panama with safeguards against escape, the FDA finds they have no environmental impact on the United States. The decision is now open for public comment. Unless responses force the FDA to seek further delays, expect to see genetically modified salmon in production by the end of the year.

Pressures to label genetically modified foods will increase: If approval of the genetically modified salmon does nothing else, it will intensify efforts to push states and the FDA to require GM labeling.

Whatever Congress does with the farm bill will reflect no fundamental change in policy: Unwilling to stand up to Southern farm lobbies, Congress extended the worst parts of the 2008 farm bill until September. Don’t count on this Congress to do what’s most needed in 2013: restructure agricultural policy to promote health and sustainability.

The FDA will start the formal rule-making process for more effective food safety regulations: President Obama signed the Food Safety Modernization Act in January 2011. Two years later, despite the FDA’s best efforts, its regulations – held up by the White House – have just been released for public comment. Lives are at stake on this one.

The FDA will issue rules for menu labels: The Affordable Care Act of 2010 required calorie information to be posted by fast-food and chain restaurants and vending machines. The FDA’s draft applied to foods served by movie theaters, lunch wagons, bowling alleys, trains and airlines, but lobbying led the FDA to propose rules that no longer covered those venues. Will its final rules at least apply to movie theaters? Fingers crossed.

The U.S. Department of Agriculture will delay issuing nutrition standards for competitive foods: When the USDA issued nutrition standards for school meals in January 2012, the rules elicited unexpected levels of opposition. Congress intervened and forced the tomato sauce on pizza to count as a vegetable serving. The USDA, reeling, agreed to give schools greater flexibility. Still to come are nutrition standards for snacks and sodas sold in competition with school meals. Unhappy prediction: an uproar from food companies defending their “right” to sell junk foods to kids in schools and more congressional micromanagement.

The FDA will delay revising food labels: Late in 2009, the FDA began research on the understanding of food labels and listed more relevant labels as a goal in its strategic plan for 2012-16. Although the Institute of Medicine produced two reports on how to deal with front-of-package labeling and advised the FDA to allow only four items – calories, saturated and trans fat, sodium and sugars – in such labels, food companies jumped the gun. They started using Facts Up Front labels that include “good” nutrients as well as “bad.”

Will the FDA insist on labels that actually help consumers make better choices? Will it require added sugars to be listed, define “natural” or clarify rules for whole-grain claims? I’m not holding my breath.

Supplemental Nutrition Assistance Program participation will increase, but so will pressure to cut benefits: Demands on Snap – food stamps – reached record levels in 2012 and show no sign of decline. Antihunger advocates will be working hard to retain the program’s benefits, while antiobesity advocates work to transform the benefits to promote purchases of healthier foods. My dream: The groups will join forces to do both.

Sugar-sweetened beverages will continue to be the flash point for efforts to counter childhood obesity: The defeat of soda tax initiatives in Richmond and El Monte (Los Angeles County) will inspire other communities to try their own versions of soda tax and size-cap initiatives. As research increasingly links sugary drinks to poor diets and health, soda companies will find it difficult to oppose such initiatives.

Grassroots efforts will have greater impact: Because so little progress can be expected from government these days, I’m predicting bigger and noisier grassroots efforts to create systems of food production and consumption that are healthier for people and the planet. Much work needs to be done. This is the year to do it.

And a personal note: In 2013, I’m looking forward to publication of the 10th anniversary edition of “Food Politics” and, in September, my new editorial cartoon book with Rodale Press: “Eat, Drink, Vote: An Illustrated Guide to Food Politics.”