and Bassuk, 2003). The current Nutrition Facts box that appears on food labels was conceived as an important public health tool to reduce diet-related disease. Since 1941 nutrition labeling in the United States has reflected the current scientific knowledge on the relationship between diet and health. For example, the changes reflected in nutrition labeling regulations promulgated by the Food and Drug Administration (FDA) in 1973 required that both positive and negative aspects of the nutrient content of food appear on the label to emphasize the relationship between diet and health (Hutt, 1981). The Nutrition Facts box and the related nutrition information on the label continued this effort to encourage healthier food choices. To achieve this health goal, the 1993 version of nutrition labeling included a new tool—the percent Daily Value (% DV)—that enables consumers to rapidly and efficiently understand how a particular food fits in the context of a healthy diet (FDA, 1993a).
The science underlying the % DVs in the Nutrition Facts box in the United States and Canada is not the most current. As explained further in Chapter 2, in the United States the majority of the nutrient reference values are based on the 1968 Recommended Dietary Allowances (RDAs) (NRC, 1968); for the reference values for which there were no RDAs at the time, FDA developed Daily Reference Values, which were based on the then current scientific information on reduction in risk of chronic diseases (FDA, 1993c). The new Canadian label values are based on the 1983 Recommended Nutrient Intakes (RNIs) (Canada, 1983b). In the United States and Canada, the Institute of Medicine’s (IOM) Dietary Reference Intakes (DRIs), which have replaced the former RDAs and RNIs as quantitative estimates of required nutrient intakes, were developed to be used as reference values for planning and assessing diets and for many other purposes, including serving as the basis for nutrition labeling (IOM, 1997). The DRIs include the RDA and three additional reference values—the Estimated Average Requirement, the Adequate Intake, and the Tolerable Upper Intake Level (UL)—that need to be considered when establishing the basis for reference values for nutrition labeling. To enable consumers to use the nutrition label in making informed dietary choices, the science underlying the Nutrition Facts box must be up-to-date. Thus the U.S. Department of Health and Human Services’ FDA, the U.S. Department of Agriculture’s Food Safety and Inspection Service, and Health Canada asked IOM to undertake a study of the use of the DRIs in nutrition labeling and fortification.