The meaningless and misleading nature of food health claims

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On Tuesday I was giving a presentation, and part of my advice was for individuals to avoid eating much in the way of processed food, including those emblazoned with health-related claims. Terms such as ‘low fat’, ‘low cholesterol’, and ‘high in fibre’ are misleading, to begin with, because these qualities have dubious health benefits (if any). And any claim of this nature needs to be taken in context of the food as a whole. As I pointed out in my presentation, when my dog does a poo(p) in the park, what he produces is both high in fibre and low in fat. It’s not something you’d necessarily want to eat, though.

Anyway, with this in mind, I was interested to read a recent piece in the Journal of the American Medical Association which raises important and pertinent issues to do with food labelling (I think) [1]. In particular, the authors cite several instances in which front-of-package food labels may mislead, namely:

(1) Few, if any, claims can be verified. To be marketed, drugs must be proved safe and effective through randomized controlled trials. Although specific dietary components may be linked to improved health outcomes, food products containing that dietary component might not have the same effect. A diet of whole and minimally processed foods provides more than 40 essential nutrients and countless phytochemicals that interact in complex ways to promote health. The claim, for example, that a refined breakfast cereal could boost a child’s immune system due to the presence of few antioxidants is tenuous at best. No independent agency would likely invest funds in high-quality clinical trials to test such possibilities.

(2) Claims based on individual nutritional factors are misleading. Whereas drug adverse effects must be disclosed in advertisements, front-of-package health claims have a selective focus, ignoring the presence of potentially unhealthful aspects (eg, the sugar or salt content in a prepared breakfast cereal).

(3) Even front-of-package labels restricted to nutrient content can be deceptive by presenting information out of context. Although an 8-oz serving of a sugared beverage has fewer calories than a 1-oz serving of nuts, a dietary choice based on this difference would be misguided.

(4) “Healthier” processed foods are not necessarily healthy. Manufacturers can manipulate snack food ingredients by replacing fat or sugar with refined starch, yielding a higher rating score with little meaningful improvement in nutritional quality. Moreover, health claims confer an aura of healthfulness that might encourage consumption of products of poor nutritional quality.

(5) Front-of-package claims produce conflicts of interest. Unless the FDA specifically dictates allowable claims for each food product (a logistically unfeasible approach), food companies’ interest in selling more products will undermine the educational purpose of labelling.

In their recommendations, the authors of this piece state: “If health claims are allowed on food packages, they should be regulated more strictly according to rigorous, evidence-based national standards. Because such standards are inevitably arbitrary and subject to manipulation, consideration should be given to an outright ban on all front-of-package claims. Doing so would aid educational efforts to encourage the public to eat whole or minimally processed foods and to read the ingredient lists on processed foods.”

I think anything that encourages individuals to eat minimally or unprocessed foods is worthwhile. However, by and large, reading the ingredients lists on processed foods should be redundant. As I pointed out to my audience on Tuesday, if someone does find themselves scrutinising an ingredients label, the chances are they have the wrong food in their hands. Not all ‘processed’ foods are a non-starter. A ready-meal made up of fish or meat and vegetables might contain more salt than you or I may cook with, but otherwise might be made of largely natural, unprocessed ingredients. It’s not too far off being something we might cook ourselves. Such food is perhaps not the best thing we could eat, but it is, for some, a decent compromise when time is in short supply.

In general terms, though, I advise buying and consuming foods that simply don’t require any scrutinisation of the label and make no claims. You wouldn’t pick up a salmon or bag of apples or joint of meat and look for the ingredients and nutritional information panels, would you? The reality is the natural, quite unprocessed nature of such foods means they are, broadly speaking, going to be utterly appropriate for our consumption.

References:

1. Nestle M, et al. Front-of-Package Food Labels – Public Health or Propaganda? JAMA. 2010;303(8):771-772

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