Institute of Medicine. 2012. Front-of-Package Nutrition Rating Systems and Symbols: Promoting Healthier Choices. Washington, DC: The National Academies Press.

Abstract

Relevance and background Over the past half century, food preparation methods and consumption patterns have moved steadily away from reliance on relatively simple, basic foods to dependence on more prepared, processed, and “convenience” foods. At the same time, nutrition concerns in the United States have transitioned from primarily nutrient deficiencies to a combination of positive energy balance, nutrient imbalances, and overconsumption of food components associated with chronic, degenerative diseases. Consequently, since the early 1970s and in response to the 1969 White House Conference on Food, Nutrition and Health, the FDA has responded to consumer demand by requiring certain nutrition-related information be provided on food packaging. What is required and how it must be presented has evolved tremendously since that time, but the main goal of federal regulations in this regard has remained the provision of consumer-friendly nutrition information to improve health. In one of its most recent attempts to accomplish this goal, Congress directed the CDC to undertake a study in collaboration with the Institute of Medicine (IOM) to examine and provide recommendations regarding front-of-package nutrition rating systems and symbols. This initiative was implemented in 2 phases. In Phase I, an expert committee reviewed front-ofpackage systems being used in the United States and abroad and considered their purpose, overall merits, and scientifi cu nderpinnings. Among other findings, they concluded that the most critical nutritional components to include in front-of-package nutrition rating systems are calories, saturated fat and trans fats, and sodium; they found insufficient evidence that other nutrients and food components (including total fat, cholesterol, added sugars, vitamins, and minerals other than sodium) should be included. After the publication of the Phase I report (IOM, 2010), Phase II was collaboratively commenced by the CDC, FDA, and the U.S. Department of Agriculture’s Center for Nutrition Policy and Promotion. The findings and recommendations of the Phase II initiative are the subject of the publication reviewed here. Objectives and approach The tasks of the Phase II committee were as follows.