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David Katz, M.D.

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Is 'Nutrition Keys' Anything More Than a Location Change?

Posted: 01/27/11 08:03 AM ET

With the fanfare one would expect of large organizations that have fairly deep pockets at their disposal, the Food Marketing Institute (FMI) and the Grocery Manufacturers Association (GMA) announced their plans this week for front-of-pack nutrition guidance.

The program, called Nutrition Keys, will ostensibly provide just that: front-of-pack nutrition guidance. But the guidance comes down to this: select information from the nutrition facts panel on the back-of-pack will now be featured on the front-of-pack.

A colleague of mine at NuVal had the following insight about this innovation: "Well, if the problem was people's inability to turn the package around, then I guess this could be the solution."

Hard to improve on that! Of course, the problem was never people's inability to turn the package around. The problem was the inability of anyone other than a highly trained expert to put all the nutrition facts and ingredient details together, and reach an accurate and reliable conclusion about the overall nutritional quality of one product compared to another.

I know that some people take offense when it is suggested that they lack the ability to do this task without help, but honestly that makes no sense. My wife has a Ph.D. in neuroscience from Princeton University; is married to a nutrition expert; is a mother of five; and is an expert cook in her own right, with several recipe books to her credit. Yet she readily admits that it can be all but impossible to determine -- let alone quickly and conveniently determine -- which bread, or sauce, or spread or dressing is the most nutritious choice. There really is no shame in acknowledging this -- and frankly anything else is either denial, or confusion that runs so deep you don't even know you're confused!

Products routinely make health claims that are true, but nonetheless misleading about overall nutritional quality. One product may be higher in sodium, but also higher in fiber; is it a better or worse choice for health? One product may be lower in sugar, but higher in sodium; better or worse? One product may be lower in calories, but also lower in nutrients; better or worse? Diet soda has no calories, no sodium, no sugar, and no saturated fat, so by the Nutrition Keys criteria, it would look like a perfect food. Does anybody believe it is?

Only by putting all of the relevant nutrition facts and ingredients together can you make a determination about the better product, but Nutrition Keys does not put the facts together. It just changes their location.

I have long compared nutrition facts and ingredient lists to medical information. As a physician, I might conclude a checkup by simply handing my patient a print out of their health facts and the main ingredients in their history and physical: lab values, ECG findings, biometric data. But I think they very reasonably expect something more from me. They expect me to use the 9+ years of postgraduate medical education I have had, and they have not, to interpret those data. In other words, they want, and are entitled to, my expert medical opinion about their overall health.

They still may want, and are equally entitled to, the data and the details. But the professional assessment of overall health status is, and always has been, a fundamental part of the formula. Facts are not knowledge; knowledge lies in the interpretation of facts. And, more often than not, some genuine expertise is required to interpret facts reliably. This is true in medicine; and it is just as true in nutrition. Everyone is entitled to an opinion, but not all opinions are created equal.

So, per my colleague's pithy insight, if the reason the typical American diet is far from expert recommendations; and the reason we have epidemic obesity; and the reason we have epidemic diabetes; and so on, is the inability of the average shopper to turn a food package around, then I suppose Nutrition Keys could be the solution.

If, however, something other than the challenge of turning a box or jar around stands, and has long stood, between us and better health through better food choices then this particular set of Nutrition Keys is very unlikely to open any relevant doors. We will need a very different set of keys to do so.


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