choices. For example, studies conducted by FDA during the design of the Nutrition Facts box found that while consumers preferred to have both % DVs and absolute amounts on the label, they did a better job using the label that contained % DVs alone (NIN, 1999). In addition, studies have repeatedly shown that when some consumers see large numbers next to a nutrient, they conclude that there is a large quantity of that nutrient in the food, regardless of the units of measure or the relative amount compared to the DV (FDA, 1993a).
However the overall conclusions that have been drawn based on earlier research typically reflect consumers’ use of nutrition labeling without experience, education, training, or guidance. Recent studies have focused on the education of special populations. Training programs and studies with children and adults with diabetes (Baylor College of Medicine and Texas Children’s Hospital, 2001; Kessler and Wunderlich, 1999; Miller and Brown, 1999; Miller et al., 2002), patients with chronic heart failure (Neily et al., 2002), and clinically obese patients seriously striving for weight loss (Fishman, 1996) have demonstrated success in teaching patients to use the Nutrition Facts box to make appropriate food choices. With diabetes education in particular, the focus of training sessions, in priority order, is on: (1) serving size, (2) grams of total carbohydrate, and (3) grams of fat. For those diabetic patients who are trained to count carbohydrate grams, there is an added emphasis on grams of dietary fiber in nutrition labeling. For diabetic patients with renal complications, the training also includes a focus on grams of protein, total calories, and milligrams of sodium. In the United States most diabetic training, especially with children, does not use the % DV, but rather has the absolute amount as its focus (Personal communication, B. Schreiner, Baylor College of Medicine and Texas Children’s Hospital, 2003).
The decision to add absolute amounts of micronutrients to the Nutrition Facts box should be based primarily on the information that will enable consumers to make healthy food choices. If making healthy food choices is the primary goal of the Nutrition Facts box, then adding absolute amounts should help achieve that goal. Therefore, the committee recommends that absolute amounts of micronutrients be added to the Nutrition Facts box because this addition has significant potential health value to the consumer.
Over time the scientific understanding of micronutrients has grown and the units of measure for expressing micronutrient quan-