As a step toward determining how FOP systems should be used in the future, in FY 2009 the Congress directed the Centers for Disease Control and Prevention (CDC) to undertake a study with the Institute of Medicine (IOM) that would examine and provide recommendations regarding FOP nutrition rating systems and symbols.4 In FY2010 the Congress directed the CDC to continue the study.5 The first phase of the study, described in this report, was undertaken with support from CDC and FDA. An ad hoc committee was convened to review systems being used by manufacturers, supermarkets, health organizations, and governments in the United States and abroad and the overall merits of front-label nutrition icons, the advantages and disadvantages of various approaches, and the potential benefits of a single, standardized front label food guidance system regulated by the Food and Drug Administration. The charge to the committee was directed to FOP nutrition rating systems and symbols on labels of FDA-regulated food products. The committee recognizes that FSIS has responsibility for labels on packaged meat and poultry products using a prior label approval process. While the emphasis in this report is on FDA-regulated foods, the committee anticipates that its conclusions also will be pertinent to food products regulated by USDA.

In accordance with the IOM committee process, a committee was appointed to undertake the study. The statement of task for the study is in Box 1-1. A second phase, begun in September 2010, will draw from the Phase I report and consider (1) which icons are most effective with consumer audiences, (2) systems and icons that best promote health and how to maximize their use, and (3) the potential benefits of a single, standardized front-label food guidance system regulated by the FDA.

The members of the Phase I committee had expertise in the areas of nutrition sciences, dietary assessment and dietary reference intakes, nutrition and health communication, consumer education, and nutrition labeling. Biographical sketches of the committee are in Appendix E.

In accordance with the IOM’s contractual agreements with the sponsors, the committee met over a seven-month period for this first-phase activity to consider its scope of work, review the nutrition science behind FOP systems, and develop its findings and conclusions. Four in-person meetings were held, along with several committee conference calls. One meeting included a public workshop to which experts on FOP systems were invited to make presentations and discuss topics of relevance. A public comment period was held during the workshop, and interested individuals and organizations were invited to present both oral and written comments to the committee. Questions posed to developers and administrators of a number of FOP systems during preparations for and as part of the Phase I public workshop are shown in Box 1-2. The names of workshop speakers and their presentation topics can be found in Appendix D.

In addressing its task, the committee reviewed a number of publicly available materials including journal articles and reports related to nutrition labeling and FOP rating systems and symbols; materials submitted to the committee’s public access file; and information on existing systems from system websites, promotional materials, and public statements. The committee also reviewed the detailed algorithms of the Guiding Stars and NuVal rating systems, which are considered proprietary by Guiding Stars and NuVal. Finally, the committee gained additional insights on the development of certain existing programs during phone conversations between a few committee members and FOP system developers and administrators that were held in preparation for the public workshop. The process of identifying the systems to review began with internet searches using search terms including, but not limited to, “front-of-pack label,” “nutrition rating system,” “front panel symbol/system,” and “shelf tag system/symbols.” It was augmented by suggestions from committee members and others and grocery store visits to search for existing systems. The process found a number of systems from the United States and abroad. As details of systems were examined, the committee found that the systems fell into three distinct categories. The 20 systems highlighted in this report represent the varied systems both nationally and abroad. The committee found that differences in types began to diminish as additional systems were evaluated, providing little or no new information to be gained. The committee did not undertake original research. For simplicity, sources for each system’s nutrient criteria are listed at the beginning of Appendix C.


Explanatory Statement Submitted by Mr. Obey, Chairman of the House Committee on Appropriations, Regarding HR 1105, Omnibus Appropriations Act, 2009. Division F—Labor, Health and Human Services and Education, and Related Agencies Appropriations, p. 1398.


House Report 111-366, Conference Report to accompany H.R. 3288, ordered to be printed December 8, 2009.

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