It's All About the Numbers

The National Consumers League requested that the FDA halt misleading nutrition rating systems used by retail supermarkets, which often appear in grocery stores as shelf tags next to the price of the food product and include a nutrition score or symbol indicating healthfulness.
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The National Consumers League (NCL), founded in 1899, is the oldest consumer advocacy organization in the country and since its inception has been fighting for fairness in the marketplace. As early as 1904, NCL exposed adulterated vegetables at the World's Fair. Recently, we have exposed brands of watered-down lemon juices and have worked with the FDA and FTC to stop misleading health claims by cereal and beverage manufacturers. NCL's letter to the Food and Drug Administration (FDA) regarding deficiencies in the NuVal system continues in this proud tradition.

NCL requested that the FDA halt misleading nutrition rating systems used by retail supermarkets, which often appear in grocery stores as shelf tags next to the price of the food product and include a nutrition score or symbol indicating healthfulness. NCL urged the FDA to follow up on a 2009 enforcement policy that says the agency "... would be concerned if any ... labeling systems used criteria that ... had the effect of encouraging consumers to choose highly processed foods and refined grains instead of fruits, vegetables, and whole grains." [1] One leading supermarket rating system, NuVal, does just that.

NuVal rates products on a scale of 1-100, based on a variety of nutritional criteria. In The Huffington Post on May 11, 2012, Dr. David Katz, developer of the NuVal system, fails to directly address the misleading NuVal scores NCL raises in its complaint to the FDA. Under the NuVal system, a can of Diet Coke and a serving of Tostitos made with olestra, artificial fat, receive higher scores than a serving of canned fruit. In our view, Diet Coke should get a "0" -- after all, what possible nutritional value is there in Diet Coke? But NuVal awards it a "15."

These concerns have been documented in a report by the Institute of Medicine (IOM). Phase I of the IOM report (2010) found that NuVal scores have the potential to lead to "inconsistencies" making it difficult for consumers to compare products in the grocery store. [2]

Katz's defense of the score awarded by NuVal to chocolate brownies is dubious at best. According to Katz, the walnuts in the brownies help justify a NuVal score of "22," three times higher than many canned fruits.

Indeed, it is true that consumers like a system that provides a single number to rate the nutritional value of a food, as the NuVal system does. However, that number must be based on a transparent evaluation system and make sense. The Research Triangle Institute (RTI) reviewed these systems and said this:

Labels [and shelf markers] relying more heavily on numeric information such as the %GDA ... and the Health Protection Shield (e.g., summary FOP nutrition label concepts that included a numeric rating similar to the NuVal system) were perceived as more difficult to understand. [3]

What this means is that NuVal has become commercially successful by persuading large numbers of consumers to rely on what experts believe is misleading nutrition information as part of a plan to draw consumers into specific grocery store chains.

Phase II of the IOM report (2011) calls on the FDA to ensure that any system be "transparent and non-proprietary." [4] NuVal is neither, as it keeps its rating formula secret. Only scientists chosen by NuVal can review it, and even those individuals have to sign a confidentiality agreement so they can't tell anyone that they may disagree with it. Katz claims that the NuVal formula is "complex" and few people are qualified to review it. Apparently that includes researchers at the National Institutes of Health, who raised concerns in an editorial in the American Journal of Preventive Medicine that NuVal's secrecy prevents proper scientific discourse about the value of the system to consumers. Calling the NuVal formula "a 'black box' proprietary tool..." the researchers state that the inability to answer questions about the inconsistencies in the NuVal scoring system "limits its application as a public policy tool." [5] [6]

Dr. Katz's response to the NIH researchers is the same as his response to NCL: They never "asked" to see the formula. [7] Instead of showing it to them, Katz apparently wrote a letter to the journal critical of their views. NCL believes that the time has come for the FDA to step in and establish a standardized nutrition rating system based on IOM's recommendations and not allow a rating system like NuVal to confuse and mislead consumers. That system will look a lot different than NuVal; it will certainly not advise consumers to drink Diet Coke and eat Doritos over consuming fruit and vegetables.

"You betcha," it is all about the numbers. The General Manager of NuVal, Mike Nugent, was quoted in Food Navigator as saying "our business will be unaffected by these claims." [8] Well, at least Mr. Nugent calls it like it is. NuVal is a business scheme used by grocery chains to draw consumers into their stores. Until the FDA acts, consumers should think carefully about relying on any nutritional rating system that encourages consumption of chips and soft drinks over vegetables and fruit.

1. http://www.fda.gov/Food/LabelingNutrition/LabelClaims/ucm180146.htm Letter from Michael R. Taylor, Senior Advisor for Food Safety, Food and Drug Administration
Department of Health and Human Services , and Jerold R. Mande, Deputy Undersecretary for Food Safety, Department of Agriculture, to Sarah Kohl, General Manager, Smart Choices Program, August 19, 2009.

2. Institute of Medicine, Front of Package Nutrition Rating Systems and Symbols - Phase I Report (2010), p. 56, http://www.iom.edu/Reports/2010/Examination-of-Front-of-Package-Nutrition-Rating-Systems-and-Symbols-Phase-1-Report.aspx.

4. Institute of Medicine, Front of Package Nutrition Rating Systems and Symbols - Phase II Report (2011), Chap. 9, p. 3, ), http://www.iom.edu/Reports/2011/Front-of-Package-Nutrition-Rating-Systems-and-Symbols-Promoting-Healthier-Choices.aspx

5. Reedy, Jill, PhD, Kirkpatrick, Sharon, PhD, "The Use of Proprietary Nutrition Profile Tools in Nutrition Science and Policy," American Journal of Preventive Medicine, Vol. 40, Issue 5, Pages 581-582, (May 2011).

6. Reedy, Jill, PhD, Kirkpatrick, Sharon, PhD, "The Use of Proprietary Nutrition Profile Tools in Nutrition Science and Policy," American Journal of Preventive Medicine, Vol. 40, Issue 5, Pages 581-582, (May 2011).

7. Katz, et al., "The ONQI is Not a Black Box." American Journal of Preventive Medicine, Vol. 41, Issue 3, Pages e-15-e16 September 2011.

Sally Greenberg is Executive Director at the National Consumers League. The National Consumers League is America's oldest consumer organization, representing consumers and workers on marketplace and workplace issues since our founding in 1899. NCL provides government, businesses, and other organizations with the consumer's perspective on concerns including child labor, privacy, food safety, and medication information.

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