Food health rating programs aim to help grocery buyers make better choices.
By Kathleen Zelman, MPH, RD/LD
WebMD Weight Loss Clinic - Feature
Reviewed By Louise Chang, MD
You know you should get in the habit of reading food labels when you shop for groceries, but it's not always easy. When you're in a hurry, it's easy to grab familiar foods without checking much more than the front of the package. And with so many foods to choose from -- and so much confusing information on labels - it can be hard to make choices with confidence.
Consumers are confused and not totally comfortable reading labels because the information on the label does not make it clear how it relates to national health recommendations," says Mary Hartley, MPH, RD, nutritionist for Calorie Count Plus, a food-scoring program at the About.com web site.
The fact is that some of the claims on the fronts of the packages don't tell the whole story, says Supermarket Savvy newsletter editor Linda McDonald, RD.
"Many packages trumpet the benefit of a single attribute, like no trans fats, while ignoring other important information that consumers need to know, like how much saturated fat or added sodium is in that trans fat-free product," McDonald says.
The good news is that some grocery chains, food companies, and other groups are implementing food scoring programs aimed at making it easier to choose wisely. These programs range from icons on the front of packages, to markers on store shelves, to online programs in which foods are scored according to their healthfulness.
How the Scoring Systems Work
In these scoring systems, foods are scored according to their nutritional profiles for both healthy ingredients (like nutrients, fiber, protein quality, and whole grains) and not-so healthy ones (like saturated and trans fats, added sugars, salt, and cholesterol). The scores allow consumers to compare different types of the same food within a category (for example, breakfast cereals).
Most systems use a mathematical formula that takes certain nutritional factors into account and generates a score. These formulas vary from system to system; the exact formulas have generally not been made public for fear they could be replicated.
Experts warn that scoring systems are not foolproof. Some say that, depending on the criteria used to score foods, some healthy foods might actually score poorly. For example, vegetable juice could get a low score because of its high sodium content, and yogurt with added fruit could score low because it contains added sugar.
Supermarket Health Rating Systems
One of the newest nutrition rating programs is the Overall Nutritional Quality Index (ONQI), developed by David Katz, MD, chair of the Yale Griffin Prevention Research Center along with a group of nutrition and health scientists. The ONQI rates food on a scale from 1-100, with 100 being the healthiest.
In August 2008, ONQI scores are expected to appear on shelf markers in many of the 13,000 Topco supermarkets (Wegmans, IGA, Hy-Vee, and Food City).Scores are also slated to show up on Topco brands, and to be available online. Consumers will be able to search for their favorite foods and brands online to see how they scored.
"The online option allows us to provide consumers with deeper levels of functionality, additional information and explanation on food scoring, diet recommendations, and how to use the scoring system for diabetes, cardiovascular disease, and obesity," says Katz.
In 2006, the New England chain Hannaford Brothers became the first grocer to launch a food scoring program. Their proprietary program, called "Guiding Stars," was developed by a group of nutrition scientists. Hannaford plans to license the nutrition navigation system to supermarket chains, vendors, health care groups and anyone else interested in helping people make nutritious food choices.
"At Hannaford, we evaluate each food and beverage based on the information from the nutrition facts panel and list of ingredients within a 100-calorie serving," says Caren Epstein, communications director for Hannaford.
Hannaford presents the results on a scale of 0-3 stars, with 3 being the healthiest. Hannaford has scored more than 25,500 foods and beverages.
"Our customers love the program and it has helped them make better food choices within certain categories and teach their children about good nutrition," says Epstein.
In Harris Teeter's "yourwellness" program, color-coded wellness keys are placed on foods that meet the FDA's criteria for certain label terms. The markers distinguish foods that are "excellent" or "good" sources of particular nutrients, as well as foods that are free of fat, lactose, sodium, or sugar; low in sodium, fat, or calories; heart-healthy; lean; organic; vegan; or contain zero trans fats.
Even markets that don't have formal rating systems usually have some way to help consumers select healthier foods -- through newsletters, demonstrations, and/or shelf markers.
Other Food Rating Programs
Since 1995, the American Heart Association (AHA) has been trying to make heart-healthy grocery shopping easier with its heart check symbol. To qualify for the AHA Food Certification Program, a single serving of the food must, according to Food and Drug Administration criteria:
- Contain no more than 3 grams of total fat
- Contain no more than 1 gram of saturated fat
- Contain no more than 20 grams of cholesterol
- Contain no more than 480 milligrams of sodium
- Contain at least 10% or more of one of these naturally occurring nutrients: protein, fiber, vitamin A, vitamin C, calcium, or iron.
About.com has an online Calorie Count Plus system that rates foods, on a scale of A+ to F, according to a formula that takes into account both healthy and not-so healthy components in the food, Hartley says. The food's nutrient density (that is, the number of nutrients per calories) is also taken into consideration. A registered dietitian makes the final rating determination by hand.
Further, many food companies have developed front-of-package icons to reflect healthier foods, like Pepsi's "Smart Spot" and Kraft's "Sensible Solutions" programs
While foods bearing these icons are among the healthiest in their product line, experts say it's important for consumers to see these health promotions in the context of a healthy diet.
"Healthy icons on foods like baked chips and diet soda imply these foods are healthy, and while they are better than fried chips or sweet soda, they are not as nutritious and good for you as a piece of fruit," says McDonald.
She advises that consumers not rely on the front of package, but turn it over and read the nutrition facts panel to get the whole picture.
Limitations of Food Scoring Systems
No one questions the need to educate shoppers on the healthiest food choices. But there are so many different scoring programs that some experts fear this goal is not being accomplished.
The watchdog group Center for Science in the Public Interest (CSPI) thinks there are too many different logos, icons, and shelf markers, and has petitioned the government to establish a uniform system.
"Consumers need to be skeptical," says CSPI executive director Michael Jacobson. "Some of the information on the fronts of packages or the shelf markers suggests the foods are probably better than other foods, but there are flaws and inconsistencies in how all the different parties are scoring foods -- which is why we need the government to take the lead."
Phil Lempert, supermarket guru for The Today Show, says nutrition rating systems are actually making grocery shopping more confusing.
"Branded logos with terms like 'smart' or 'healthier choice' lead consumers to purchase these foods," he says. "Yet obesity has gone up in the U.S., and more ratings systems is not the answer -- we need one universal system that is transparent."
ONQI developer Katz agrees, but says that it would take years for the FDA to implement a food rating system.
"The way to fix the problem is open-market competition for the best possible system, which we think we have developed with the ONQI, a state-of-the-art sophisticated scoring system based on science," he says.
Food companies also have concerns with some of the scoring formulas, because they have little room to dispute the ratings of foods.
The issue is further compounded by those who question the health value of foods that are heavily fortified with vitamins, minerals, and phytochemicals, or that contain artificial sweeteners. Some think organic foods should receive extra points, while others just find the rating systems too complicated.
"It is great to know a food is healthy, but we have to educate consumers how we made these decisions so they can also apply the same thought process when selecting foods without rating systems," says Hartley.
The Bottom Line
If you're looking for a quick trip through the grocery store, these food rating programs can help you make better choices. But experts warn that you still need to look at labels and consider foods within the context of your whole diet to make wise decisions.
"I applaud all of the food companies, grocery stores, and rating programs that help consumers select healthier products, but consumers still need to put the information into context of a healthy diet," says McDonald.
Originally Published September 12, 2007.
Medically Reviewed January 18, 2008.
SOURCES: Michael Jacobson, PhD, executive director, Center for Science in the Public Interest. Mary Hartley, MPH, RD, nutritionist, Calorie Count Plus, a food-scoring program at About.com. Linda McDonald, RD, editor, Supermarket Savvy newsletter. Caren Epstein, communications director, Hannaford Brothers. American Heart Association web site. Phil Lempert, food trends editor, The Today Show. David Katz, MD, MPH, director, Yale Prevention Research Center; professor, Yale University; developer, ONQI. Hannaford web site.
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