In the war against obesity, is it bad foods that are the enemy, or just bad eating habits?
For one prominent medical expert, it's the food itself that's to blame for an epidemic of weight gain in the United States. And despite critics' claims to the contrary, he says we should arm consumers by literally labeling the enemy — junk food.
Snack foods like desserts, soft drinks, and salty snacks, all of which have been linked to poor eating habits and nutrient deficiencies, make up nearly one third of the average American diet.
"It's time for junk food to wear a name tag," argues Dr. David Katz, founder and director of the Yale Prevention Research Center in New Haven, Conn., and author of The Way to Eat.
A "scarlet J" to mark junk food packages, he suggests, would put the blame where he says it belongs — on "bad foods" rather than on the people who eat them.
Katz maintains labels currently provided by the food manufacturers that advertise "no cholesterol" or "low in transfats" fail to inform consumers about the food's overall nutritional quality. A kid's cereal, for example, is often full of refined sugars and empty calories, but a parent may purchase it because of a label saying it is fortified with vitamins and minerals.
His proposal aims to encompass many nutrition indicators into one government-sanctioned label on the front of the package — the "prime real estate" of the product. A panel of nutrition experts would assign ratings to foods based on a "Nutrient Quality Index" that includes calories, bad and overconsumed nutrients, and good and under-consumed nutrients.
Such a system is already in place in Sweden, where low-fat and fiber rich foods are marked with a green keyhole symbol using food-specific criteria.
Critics of the labeling plan raise concerns, however, about the feasibility and effectiveness of assigning food labels, as well as the social and legal implications of the proposal.
Good Foods Versus Bad Foods
In 1970s, for instance, there were efforts to create objective criteria for nutritional value using nutrient density. That project ultimately failed.
"The [nutrient density] terminology didn't get anywhere so we settled for nutritional labeling on the package," explains Helen Ullrich, Berkeley, Calif.-based co-founder and former executive director of the Society for Nutrition Education, now retired. "The density label had too many ramifications to put on the foods. It began to say, these are good foods and these are bad foods, and people didn't want to say that."
Other experts question whether any food deserves to wear a scarlet J. The American Dietetic Association and many in the food industry, for instance, contend there is no such thing as good and bad foods. Instead, they say we should focus on good and bad diets.
"It's the overall nutrition package that provides the health benefit, not each food in isolation," maintains Robert Eckel, a professor at the University of Colorado Health Sciences Center in Denver.
But, claims Katz, "If we can rate the quality of the overall diet, we must be able to rate the quality of the building blocks."
"From a public health perspective, it is folly to not believe that some foods are better than others," agrees Dr. Kelly Brownell, director of the Yale Center for Eating and Weight Disorders, in his book Food Fight. "Before progress can be made on changing the American diet, there must be collective agreement that the population should be eating more of some foods and less of others."
Still, some nutrition experts worry the classification is overly simplistic.
Connie Diekman, director of nutrition at Washington University in St. Louis, points out that "nutritional needs vary" from person to person. "Some foods are high in nutrients and calories but they add significantly to healthy eating — meat, cheese or olive oil for example," she says.
Jackie Newgent, a New York-based culinary and nutrition communications consultant, suggests it's difficult to know where to draw the line with categories. "There are far too many variables," she says. "For instance, where would something like dark chocolate fit? It's packed with antioxidants, yet not ones that'll show up on a nutrition facts food label."
Will Labels Make a Difference?
Even if a classification system were agreed upon, many question the added value of yet another nutritional label. Newgent explains: "People generally already know what's more healthful and less healthful and … consumers still choose to purchase items based mainly on taste … People know that 10 grapes are a better choice than 10 cookies."
And Lisa Katic, a nutrition consultant for the Grocery Manufacturer's of America and the Snack Foods Association in Washington, D.C., says consumers may actually be confused by another layer to existing food labels.
Many in the food industry are reluctant to use additional labels, and experts wonder if companies might manipulate the protocol by fortifying otherwise unhealthy foods with vitamins and minerals.
"Might Hostess, for example, fortify Twinkies with added vitamins and narrowly avoid the Scarlet J?" asks Arthur Greenwald, Studio City, Calif.-based media consultant who works with bariatric surgeons. "Would higher-end treats such as Godiva Chocolates or imported fois gras lobby for a special gourmet-quality exemption?"
Still, Jacobson believes the primary benefit of an added label is that it is "symbolic, rather than detailed numbers. … A lot of people don't use [the nutrition facts labels], partly because [they are] complicated. They have been useful, but haven't had as great an impact as many of us wished."
Big Brother in the Kitchen?
A number of critics argue the labeling system underestimates the ability of Americans to make their own dietary choices.
"This is pushing the envelope, acting like people don't know which foods should be consumed in moderation," says Katic. "The industry is very committed to give consumers more choices. [We] think the key is education and helping people meet a balanced diet."
David Lineback, director of the Joint Institute for Food Safety and Applied Nutrition at the University of Maryland in College Park, argues "the proposal being made is a disservice to and an excuse from taking personal responsibility for one's eating habits."
Adds Newgent, "I want my handful of potato chips every now and then. I can't imagine feeling like my hand is being slapped every time I want a few."
While Katz acknowledges the potential downsides of labeling, he says he's"not trying to be anybody's nanny. … Giving people nutrition info they can use is empowering, then they can take personal responsibility."