The committee therefore makes the following recommendation:

Recommendation 1

FDA and USDA should develop, test, and implement a single, standardized FOP system to appear on all food and beverage products. The system should have the following eight characteristics:

•   One simple, standard symbol translating information from the NFP on each product into a quickly and easily grasped health meaning, making healthier options unmistakable;

•   Displaying:

ο Calories in common household measure serving sizes (shelf tags to be used on bulk items such as fruits and vegetables as well as packaged goods), and

ο Zero to three nutritional “points” (for saturated and trans fats, sodium, and added sugars);

•   Appearing on all grocery products, allowing consumers to compare food choices across and within categories (universal implementation must be preceded by consumer testing and conducted in conjunction with an education and promotion program);

•   Appearing in a consistent location across products;

•   Practical to implement by being consistent with nutrition labeling regulations;

•   Integrated with the NFP so that the FOP symbol system and the NFP are mutually reinforcing;

•   Providing a nonproprietary, transparent translation of nutrition information into health meaning; and

•   Made prominent and useful to consumers through an ongoing and frequently refreshed program of promotion integrating the efforts of all concerned parties.

Implementation of this system will require modifications of and/or exemptions to current FDA regulations and development of both new regulations and food group specifications for establishing evaluative criteria. Because the NFP does not declare added sugars, the total sugars declaration could be footnoted with a statement such as “Contains no added sugars” or “Contains a qualifying amount of added sugars.” A single, standardized FOP symbol system should be the only FOP system appearing on products. For products not meeting the evaluative criteria for an ordinal indicator symbol, the FOP label should still display calorie and serving size information. Examples of symbol systems that are consistent with these recommendations are presented in Chapter 7.

RECOMMENDATIONS FOR MONITORING, EVALUATION, AND FUTURE RESEARCH

Based on its review of existing public health campaigns, the committee concluded that implementation of an effective FOP system must be a well-funded, sustained effort that is dynamic, refreshed on a regular basis, and carried out by a public-private partnership. The committee further concluded that, in order to be successful, federal agencies and interested stakeholders, including private and nongovernmental organizations, should support the FOP symbol system, emphasizing its impact on consumer purchase and consumption behavior.

Research should be conducted to assess the needs and preferences of target audiences to better understand factors that influence consumer food choice and purchase behavior. In addition, formative research is necessary to test and refine messages and to determine the best approaches and channels to promote an FOP system. Monitoring through both process and outcome evaluation is needed to assess the effectiveness and impact and to refine and strengthen program components. Placing special emphasis to nutritionally at-risk subpopulations such as those with low incomes, low literacy/numeracy skills, or low levels of education, is an important component of the evaluation process. However, the committee recognizes that any FOP system is likely to have a narrow influence on food purchase decisions of consumers whose access or resources to purchase healthier foods is impacted by economic and/or geographic limitations. An evaluation of the impact of the FOP symbol system on product reformulation is also necessary. Ongoing research will help to guide and strengthen implementation efforts and help inform corrective actions where necessary. Lastly, research should measure success at each stage of the process



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