Media Diet Lessons from the Embattled History of Nutrition Labels (and the Torturous Stretching of an Innocent Metaphor) | MIT Center for Civic Media

When we started telling people about our "nutrition label for the news" project, one question came up fairly frequently: “Do nutrition labels even work?”

Of course, when people ask if labels work, they implicitly mean, "Have nutritional labels prevented America from growing more obese each year?" In this case, the obvious answer is “No.”

This doesn't mean that labels don't serve their purpose, or that we don't need them to get healthier. Your political identity is shaped by many things other than where you get your news: your parents, your siblings, your childhood, your education, your workplace, or hey, maybe even your most basic morals or the type of bacteria in your belly.

Likewise, our obesity failure has many fathers: the cheap calorie revolution of the 1970s, automobile-centric communities (PDF), and maybe even doctors telling pregnant women to smoke cigarettes rather than gain weight during pregnancy. The point is, we still need the opportunity to know what we’re feeding our bodies if we’re going to improve it.

I decided to look into the history of nutrition labels in the United States to see if there were any lessons we should learn as we go about designing a platform for tracking media diets. There’s quite a history. In The Omnivore’s Dilemma, Michael Pollan refers to the ingredient section of the label as "a literary genre unknown until the third age."

A Brief Modern History of Labeling Our Food

The first discovery that surprised me was that nutrition labels didn't even exist in the US until 1990, and were vehemently opposed by the food manufacturers’ lobby at the time. This seems incredibly recent, given the ubiquity of that monochrome food label. The 1990 Nutrition Labeling and Education Act (NLEA) required “all packaged foods to bear nutrition labeling and all health claims for foods to be consistent with terms defined by the Secretary of Health and Human Services.” Fooducate

And, “As a concession to food manufacturers, the FDA authorizes some health claims for foods.” That phrase, “a concession to food manufacturers,” ends up being really important to anyone considering the efficacy of nutritional labeling. It turns out that the basic nutrition label we know today was strongly opposed by the people who package and sell us our food. As you might guess, these manufacturers have significantly more clout and lobbyists in Washington, DC than public health nutritionists. They worked to prevent even the most basic labeling of calories, and then trans fats, and still today baked goods and most restaurants.

Almost every word or description or measurement on the rather boring label has been a battle since day one, between nutritionists and public health professionals and agribusiness and food processors. It would behoove our media diet research team to take this into consideration. We’ve been clear since day one that we’re not looking to actually judge media diets, so much as measure them, but there are clearly people out there who consider the mere act of measurement a political act. Measuring consumption and sharing results gives consumers knowledge with which they might make changes, and there are always interests for and against changes in a given industry.

Just as I was surprised by how recently the nutrition label came about, you might be surprised by the official nutritional label’s tenuous relationship with empirical nutritional truth. Loopholes abound. The label applies to most, but not all, packaged foods. Notable exceptions include “fresh” foods like the supermarket’s baked goods section and until just recently, beef. Even the weight of meat can be off by 15%, as some processors inject it with salt water to increase flavor (and sodium and profit margins for a product sold by weight).

Trans fats weren’t labeled until 2006, even though it was established in the early 1990s, when the food label was first introduced, that they are actually deadly. Opposition from food manufacturers prevented trans fats from labeled, even though the FDA estimated that the changes in regulations would save “between $900 million and $1.8 billion each year in medical costs, lost productivity and pain and suffering.” Even now, a product can be labeled as having zero trans fats as long as it contains under 0.5 grams of trans fat per serving, which matters when you’re talking about an ingredient where the healthy amount is the mathematical version of “zero.” (The American Heart Association recommends consuming no more than 2 grams of trans fats a day, “about as much as one might get from the naturally occurring trans fat in milk and meat”).

How do labels work?

Nutritional labels are required by the government via the Food and Drug Administration (FDA). They reach out for input prior to making any new decisions about the label, and they are lobbied over individual decisions (e.g. delayed requiring labeling of trans fats until 2006, labeling meat or genetically modified foods). The government spends years revising labels, as they review scientific literature and gather input from manufacturers. The government also invests in educational programs around labels.

The history of nutritional labels in modern times is a game of cat and mouse between researchers, regulatory agencies, and food manufacturers. The general pattern in the 20th century appears to have consisted of food companies free to sell most anything until a major outcry, poisoning, or exposé leads to new regulation.

Do nutrition labels work?

The labels work for those who read them:

People who consult nutrition labels consumed fewer calories and less total fat, saturated fat, cholesterol and added sugars than nonlabel users. But only 61.6% of those surveyed said they regularly check the Nutrition Facts panel. Usage of other label resources was even lower: 51.6% check the ingredients list, 47.2% look at serving size, and 43.8% consider health claims when pondering a food purchase. (Tufts Health Letter)

Another study found that “the percentage of people who say they read the nutrition label before buying a product for the first time increased from 44% in 2002 to 54% in 2008.” So, a slight majority, with the trend increasing towards us being a more health-conscious populace.

This might not seem like a very high number, but labels work in a variety of ways. The nutritional decision-making ecosystem is far more complicated than the conclusion that labels haven’t prevented us from becoming an obese nation. Take the trans fat example we just discussed. The reason food manufacturers fought tooth-and-nail to prevent trans fats from being clearly disclosed on packaging was because they knew that as soon as labels included the deadly fat, they’d be pressured by the marketplace to change their products and use more expensive ingredients. In this case, the very act of making the contents of the product transparent made our diets remarkably healthier, almost overnight, regardless of whether or not you ever look at a label. By 2006, a significantly high enough percentage of consumers had been educated to avoid trans fats, and food manufacturers knew from market research that the lost sales would be higher cost than the cheaper, deadlier ingredients. It didn’t matter if everyone knew about trans fats or made purchasing decisions about trans fats; it mattered that a combination of government regulation and educated consumers was enough to convince manufacturers to revert to healthier ingredients.

On the flip side, this same combination of public awareness and government regulation is the reason genetically modified foods aren’t labeled in stores in the United States. In Europe, where the regulatory environment is stronger, GM foods are clearly labeled, and consumers respond by opting for the non-cloned porkchops at the supermarket. Food manufacturers in the US have prevented regulators from requiring GM foods to be labeled despite consistently strong public opinion in favor of GM labeling, because they understand that given the choice, many consumers wouldn’t purchase the GM foods.

What Happens When Manufacturers Themselves Create the Labels?

Further confusing what, at the onset, seems like a simple label, is the explosion in front-of-package labels (so many that Lifehacker recently published a guide to what the labels mean and when they actually matter). This increase in manufacturer labeling isn’t a coincidence:

2003: The FDA announced plans to permit the manufacturers of food products sold in the United States to make health claims on food labels which are supported by less than conclusive evidence. From “significant scientific consensus” before a claim can be made, industry can now rely on “Some scientific evidence” or “Very limited and preliminary scientific research” to make a health claim. Opponents criticize it as opening the door to ill-founded claims. Advocates believe it will make more information available to the public. (Fooducate)

In fact, in recent years, manufacturers have added their own labels on the front of packaging, store shelves, and other locations that are both more prominent and more colorful than the official, regulated label on the back of packages. Manufacturers also benefit from key words on the front of packages, like ‘natural’ and ‘organic,’ which studies show consumers routinely conflate with ‘healthy.’ The word ‘natural’ means very little at all in the supermarket context, and ‘organic’ is applied to products like ice cream that do not qualify as ‘healthy,’ although consumers conflate the two terms and even confuse ‘organic’ and ‘low-calorie.’ These labels are popular because they allow consumers to "skip the fine print" and get a sense, at a glance, of whether or not a product is healthy. Manufacturers take advantage of this time-saving technique.

The Institute of Medicine and Center for Disease Control recently released a report on marketers’ labeling systems and consumers’ confusion. There are now numerous labeling systems (this report alone measured 20), with various designs and criteria, further confusing customers. Fifty-six percent of consumers said they didn’t believe such front-of-package claims as “low fat” or “high fiber,” even though these particular terms are regulated by the FDA.

The report found that the manufacturers optimize labels for sales, not health. (Did you know that Skittles are fat-free!?) They also found that the manufacturers' labels display the nutrients most strongly linked to consumer health concerns. You may have noticed an upsurge in labels promoting the benefits of Omega-3s in recent years, as well-publicized studies drive sales.

The report concludes that front-of-package labels should display the information most critical to our nation's health problems: calories and serving sizes. Serving sizes are better understood in household terms, rather than "per 100 grams." And lastly, certain nutrients are relatively very important to the problems facing our populace (saturated fats, trans fats, sodium, calories and serving size information) but many manufacturer-added labels focus on more popular nutrients (revestrol, omega 3s, flax seed).

Takeaways for Media Diet Labeling

Nutrition labels alone aren't going to make us a healthier nation. But nutrition labels are necessary for that to happen. They're kind of the "step zero" part of the infrastructure. Yes, being surrounded by others living healthy lifestyles and social pressure and Weight Watchers programs can all be effective. We could start investing in physical education and school lunches made with real food. Teaching new generations how to cook at home again could go a long way. But if we don't even have the basic empirical information about what's inside our food, none of these things matter very much.

The Institute of Medicine report had some specific nutritional labeling recommendations that could apply to media diet labeling:

  • The report recommends that in addition to listing ingredients, labels should go further and highlight the controversial elements within a product.
  • They advise against relying on industry-provided labeling schemes. It wouldn’t take much for news websites to come up with their own equally-misleading claims - just look at the widely derided Fox News tagline: Fair and Balanced.
  • A default, standard label can still be attractive; it doesn't have to be monochrome. Manufacturers’ professional designed labels do a better job of capturing consumers’ attention.
  • No matter how simple, a label will likely require educational initiatives
  • Content providers will likely prove to be willing partners as long as a tool highlights all of the good things about their product, and create opposition when less great qualities are displayed
  • Most importantly: Label design and every word involved is a normative judgement by definition. We’re not touching the area of media recommendations, but it would behoove us to keep this finding from the nutritional world in mind as we proceed.

Nutrition labels don't reach everyone (54-61%, depending on the survey), but they do reach primary consumers and decision-makers. Food companies scrambled to remove trans fat from their products once the FDA finally decided to require its inclusion on labels, because a subset of eagle-eyed customers do make purchasing decisions on key factors like trans fats. Most of my own interest and awareness of what goes into healthy and unhealthy foods originated in idly scanning food labels while looking for something to read while eating.

Right now, our media diets are where our food diets were before the Pure Food and Drug Act passed in 1906: we get the gist of what we’re consuming, but we have very little clue about much of it or how it all adds up. We know that we're consuming A LOT of media, which makes tracking even more difficult. We spend over 8 hours a day with screens, and the rise of mutli-channel consumption and simultaneous iPads, smartphone, and TV usage only drives this number higher.

But we know very little about the content we're seeing, who produced it, why we're seeing it when we're seeing it, or just about any other question we want to ask. Jason White, also known as Frugal Dad, was curious about “Who really produces, owns and airs the shows my kids are glued to every evening and which companies select the stories I read with such loyalty each morning?” The result of his research was this stunning infographic, which I’ll leave you with:

Media Consolidation Infographic