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Experts: Nutrition Keys Program Ineffective

Six months after it was introduced, the Nutrition Keys program developed by the food industry is under attack in an editorial published in this week’s New England Journal of Medicine.

Kelly D. Brownell of the Rudd Center for Food Policy and Obesity at Yale University and Jeffrey P. Koplan, M.D., of Emory University penned the op-ed piece, saying the approach used by the industry in developing Nutrition Keys has “major flaws.”

“The Nutrition Keys label may confuse consumers by including so many symbols, especially when the nutrients listed can be changed at the food company's discretion,” the authors wrote. “Further confusion may be generated by the fact that a high number is considered bad for the mandatory components but good for the optional nutrients.”

Perhaps a bit of review is needed here. Nutrition Keys was unveiled by the Grocery Manufacturers Association and the Food Marketing Institute back in January. Four of the six “keys” are devoted to the recommended daily value for calories, saturated fat, sodium and sugars. Companies would have the option of using the two additional, open keys for nutrients they want to highlight. They can chose to feature any two of the following: Potassium, fiber, protein, vitamin A, vitamin C, vitamin D, calcium or iron.

The system replaced an earlier version called Smart Choices that was discredited for including high-sugar breakfast cereals aimed at kids. The industry pulled that program when the Food and Drug Administration took notice of public criticism and wrote an open letter threatening a thorough review of nutrition label programs.

At the same time, the FDA announced that it would launch its own effort to develop a standard front-of-pack labeling system for food products. That task was assigned to the independent Institute of Medicine — the same folks who reviewed the recommended daily allowance for Vitamin D. The group’s report is due out sometime this fall.

The editorial asks why GMA and FMI moved ahead of the FDA’s efforts. They describe Nutrition Keys as lacking a science-based, easily understood way to show consumers whether foods have a high, medium, or low amount of a particular nutrient. It is also too easy to confuse consumers with the interchangeable keys, they write.

“Why would the industry not simply wait for the recommendations of this group of objective experts? Perhaps so that it could lock in a system that would change food choices as little as possible and preempt the imposition of an alternative system that would be based on the available relevant science.”

The government is reviewing labeling systems from around the world, most notably, Great Britain’s “traffic light” system. This oft-praised program adds colors (green for good, yellow for caution, and red for excessive) that provide important context for consumers who might not know whether 14 grams of sugar per serving is OK or not. It would permit easier side-by-side comparisons at the point of purchase.

“The traffic-light system may permit such an assessment, allowing purchasers to consider how best to maximize the proportion of green- and yellow-stamped items in their food cart and minimize the proportion of packages with red stamps,” the pair writes.

The GMA and FMI are spending $50 million to educate U.S. consumers about Nutrition Keys. If the IOM comes out in favor of something more akin to a traffic light system, we wonder how much will be spent fighting that decision?