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You want your patients to eat healthier. But American food labels don’t make that easy. A few diet and nutrition specialists offer tips for teaching your patients about food labels — including updated federal “healthy” guidelines — so they can make better dietary choices.

Mary Zupke, RDN, LDN, a dietitian at Northwestern Medicine in Chicago, said she keeps a bag of food labels in her office so she can review them with patients to help them improve their health.

“I educate them on what is on the label and in certain categories,” she said.

Zupke discusses the benefits of increasing fiber in patients’ diet and decreasing sodium, saturated fat, and sugar based on federal dietary standards, recently revised in response to rising diet-related illnesses and poor food choice trends.

The vast majority of Americans, 90%, exceed chronic disease risk reduction limits for sodium, according to the US Food and Drug Administration (FDA). In addition, 77% exceed dietary limits for saturated fat, 63% for added sugars, and 75% have diets low in fruit, vegetables, and dairy, the FDA reported.

The federal agency updated its dietary standards for manufacturers to be able to claim their products meet “healthy” nutrient content. The new standards are expected to go into effect April 28. To qualify as healthy under the new criteria, a food product must meet specific limits for added sugars, saturated fat, and sodium.

The product also must contain a certain amount of food from at least one of the food groups or subgroups such as fruit, vegetables, grains, protein, and fat-free and low-fat dairy.

What’s Healthy 

• Avocados
• Nuts and seeds
• Higher fat fish, such as salmon
• Olive oil

What’s Not

• White bread, fortified
• Yogurt with added sugar
• Sweetened cereal
• Fruit snacks, bars, and punch/juice with added sugars

The new guidelines attempt to address the country’s “ever-growing epidemic of preventable diet-related chronic diseases such as cardiovascular disease, type 2 diabetes, and obesity,” the FDA said in announcing the new standards. “Improving nutrition is one of the best public health interventions for reducing these and other chronic illnesses and premature death.” 

The FDA also proposed rules for front-of-package nutritional labeling that would help consumers more easily identify whether foods have low, medium, or high amounts of saturated fat, sodium, and added sugars in a serving.

Nutrients Per Serving

• Low: ≤ 5% of the recommended daily value (amount of nutrients to consume or not exceed a day)
• Medium: 6%-19% of daily value
• High: 20% of daily value

Zupke believes the new labels will help her patients more quickly navigate food labels and decide whether a product is healthy.

For instance, if a product is designated as having low sugar, ≤ 5% of daily value, that’s less than six teaspoons a day, she said. Current dietary guidelines recommend limiting added sugars to < 10% of daily caloric intake, or 12 teaspoons of sugar based on a diet of 2000 calories a day.

“As dietitians and nutrition healthcare professionals, we can tell patients to look for foods with < 5% daily value, having that on the label. I tell them to look for 6 g or less of added sugar per serving.” Soon they’ll be able to quickly determine if a product has low sugar. “It’s much easier for consumers to see, find, and interpret.” 

Zupke’s colleague, Dietitian Nancy Zawicki, RDN, LDN, advises patients to start asking their healthcare professionals about their diet and nutrition as it relates to the new labeling regulations. “We do counseling about what to look for, how to interpret and read labels.” 

Coaching patients how to read the new labels will be extremely important as they adjust to the new standards, Zawicki said. Ultimately, patients are responsible for selecting foods wisely based on the new product information, she said.

“We know food labels are one of the most underutilized tools in preventing chronic disease, like heart disease and hypertension,” said Teresa Eury, RDN, LDN, MPH, a dietitian with Cleveland Clinic, Cleveland.

The labels help consumers make informed choices about nutrients such as sodium, added sugars, and saturated fats, which play a role in many chronic conditions.

“Every bite adds up over time, and small, repeated choices can have a big impact on overall health and potentially weight,” Eury said.

At least 1 in 5 adults in the country experience obesity, according to the Centers for Disease Control and Prevention (CDC).

Many factors contribute to obesity, including genetics, stress, underlying medical conditions, and limited access to healthy food. Packaging and marketing also can be misleading, which may cause some busy consumers to overestimate the “healthfulness” of certain products and divert them from making healthier choices, Eury said.

Healthcare professionals can explain to their patients that manufacturers don’t have to list every ingredient and can group ingredients into broader terms, she said.

Some examples include:

• “Added sugar” may appear as maple syrup, high-fructose corn syrup, or honey.
• “Natural flavors” or “spices” can represent dozens of additives.
• Trace additives and processing aids may not be clearly identified.
• Only four nutrients: Vitamin D, calcium, iron, and potassium are required to be listed in detail, leaving out many other essential vitamins and minerals.

Products labeled “healthy,” “natural,” or “immune boosting” may still be highly processed. “Items like trail mix and smoothies, which many consumers previously viewed as healthy, may now face stricter labeling standards to ensure transparency,” Eury said.

Understanding ingredient lists and percent daily values is especially important for people managing chronic conditions such as heart disease or high blood pressure, Eury said. “Clearer labeling can help patients quickly identify high- or low-sodium options.”

The American Heart Association (AHA) recommends no more than 2300 mg of sodium per day for healthy adults — about one teaspoon. Because the average American consumes significantly more, the AHA advises reducing intake by 1000 mg daily to improve blood pressure and heart health.

Training patients how to interpret serving size and total servings in a package can also help them make more mindful eating decisions, Eury said.

“Patients may not realize a product contains multiple servings,” Eury said. “If one bag contains nine servings at 230 calories each, eating the whole thing may add up to more than 2000 calories — the general reference for adults.”

Heed the Fine Print 

Interpreting the new food labels requires a deeper understanding of ingredients because some nutrients are more important to health than others, said Jerold Mande, MPH, adjunct professor of nutrition at the Harvard T.H. Chan School of Public Health, Boston, and a former senior policy leader in the FDA and US Department of Agriculture. He led the graphic design of the Nutrition Facts label and oversaw MyPlate to replace the food pyramid.

While consumers should aim for low levels, 5% of the percent daily value or less of saturated fat, added sugars, and sodium, they should seek high levels, more than 20% of fiber, Mande said. Fiber is a type of carbohydrate found mainly in fruits, vegetables, whole grains, and legumes, according to the CDC.

“You want your fiber to be 10% of total carbs on the label,” he said.

In addition to fiber, carbs include sugar and starches such as wheat, grains, corn, potatoes, and peas.

He also suggests consumers:

• Choose foods based on the quality of the first three ingredients on their label as they are listed in order of predominance in the product. “You want those to be healthy foods.”
• Recognize that “organic” is better for the environment, using fewer chemical pesticides that can pose health risks, but is not a proven way to improve diet. It’s more important to reduce sugar, fat, salt, and ultra-processing.
• Don’t microwave food in plastic containers because it releases chemicals into food. The FDA recently took steps to reduce dietary exposure to harmful chemicals in food packaging, part of a larger effort analyzing chemicals that interact with food.
• Use a smartphone app that can scan food and report on nutritional quality and impact on your health.

Food Labeling and Obesity

Mande said defining what is considered a healthy food won’t completely solve America’s obesity problem.

Other policy changes he believes are necessary to reverse the trend:

• A nutrition warning label on foods, such as used in Latin-American countries to alert consumers that the product contains excessive amounts of calories, sweeteners, sugars, fats, and sodium. Cancer warning labels helped curb America’s tobacco use decades ago and the US Surgeon General recently proposed similar labels on alcohol.
• Banning soft drinks and instore marketing of junk food from the federal food stamps program that helps low-income people pay for groceries, via the Supplemental Nutrition Assistance Program (SNAP). Several states are considering changing rules on SNAP benefits.

Zupke said teaching patients how to read food labels is yet another method for improving their habits and promoting behavior changes. “We want to help patients create new healthy eating patterns and help reduce disease.”