Smart Choices Program Aiming to Improve Food Purchasing Decisions

Katherine Hobson

Going to the grocery store with the goal of buying the most healthful packaged foods can be tough. Very few of us have the know-how and the time to read the official nutrition facts label and list of ingredients on the back of the package, balance that with the marketing claims on the front, and make an informed decision. So over the past few years, grocery stores--including Hannaford and Food Lion, with the Guiding Stars program, as well as SuperValu's Nutrition IQ program--have rolled out their own rating systems aimed at making things easier for shoppers.

But there's a different kind of system rolling out this fall, and rather than on shelf tags, you can find it right on the packaging of foods manufactured by PepsiCo, Kellogg Co., Unilever, Kraft Foods, and other companies. The Smart Choices program puts a green check on the front of products produced by participating manufacturers as long as the foods meet certain nutritional standards. (It also shows calories and serving size.) The program replaces the individual guidance systems that some companies had used. It was created by the nonprofit Keystone Center, which facilitated conversations between scientists, consumer organizations, and the food industry, then handed it off to the American Society for Nutrition to administer. So should you start making your purchasing decisions based solely on that check?

In a word: no. There are pros and cons to Smart Choices, as there are with other food labeling systems, and unfortunately, you aren't going to be able to abandon skepticism and critical thinking when you walk through those automatic supermarket doors. The big caveat is that while the new program's nutritional standards are "derived from" the Dietary Guidelines for Americans (the government's pronouncement every five years on what foods and nutrients we should be consuming) and authoritative nutrition research, the recommended products aren't uniformly healthful. Cereals are a leading example. While foods in most product categories cannot qualify for a check if more than 25 percent of their calories come as added sugars, an exception was made for cereals, which can contain as many as 12 grams of sugar per serving. That allows for the inclusion of Froot Loops, Frosted Flakes, and Cookie Crunch, all of which clock in at roughly 40 percent sugar.

Joanne Lupton, science adviser to the Smart Choices Program and a nutrition professor at Texas A&M University, says the exception was based on a "call out" in the 2005 Dietary Guidelines that says adding small amounts of sugar to nutrient-dense foods like cereals may make them more palatable and therefore boost intake. (In other words, a spoonful of sugar makes the cereal go down.) Still, it's hard to believe that Froot Loops is truly one of the best alternatives in the cereal aisle, given that sugar is the first ingredient, it has just 3 grams of fiber per serving, and it also contains partially hydrogenated vegetable oil. When I wrote about how to pick the best breakfast cereal, nutritionists advised opting for those that have at least 5 grams of fiber per serving and do not list sugar as one of the top three ingredients . . . and there were a handful of cereals that fit the bill.

Marion Nestle, a nutrition professor at New York University, says that in addition to tolerating high cereal sugar levels, Smart Choices sets particularly generous sodium standards. She's also concerned about the involvement of the well-respected ASN, which she says is effectively endorsing those 40 percent sugar cereals through its participation in the program. Michael Jacobson, executive director of the Center for Science in the Public Interest, says he resigned from the original Keystone Center roundtable on front-label nutrition icons in part because of disagreements with several of the program's criteria, including: Grain products were not required to be at least 50 percent whole grain, and "functional fibers" were counted the same as naturally occurring fiber.

The standards aren't perfect, but the program is a good start, says Wendy Bazilian, a nutritionist and registered dietitian who supports Smart Choices. "It's a great way of narrowing the playing field." Families are going to buy packaged convenience foods, she says, so some kind of guidance as to more healthful options is incredibly helpful. (Bazilian was compensated for her time during Smart Choice's press launch but not for her ongoing support of the program.)

In a letter to the general manager of Smart Choices, representatives of the Food and Drug Administration as well as the Department of Agriculture said they'd be monitoring the products and their effect on food choices and perceptions and "would be concerned if any [front-of-the-pack] labeling systems used criteria that were not stringent enough to protect consumers against misleading claims; were inconsistent with the Dietary Guidelines for Americans; or had the effect of encouraging consumers to choose highly processed foods and refined grains instead of fruits, vegetables, and whole grains." (Since it's a voluntary system, not all foods will be rated; will consumers think that an unchecked apple is less healthful than a checked bag of chips?)

Smart Choices is not the only recent addition to the ratings game. Back in the supermarket aisle, a system called NuVal, available in chains including Hy-Vee, Meijer, and Price Chopper, uses a proprietary algorithm to crunch the pluses (including the presence of nutrients such as fiber, calcium, and omega-3 fatty acids) and the minuses (the presence of saturated and trans fats, sodium, sugar, and cholesterol) and come up with a score from 1 to 100. The higher the number, the better for you. "It's a GPS for food labels," says David Katz, the physician who conceived of NuVal and is the cofounder and director of the Yale Prevention Research Center, in a reference to the global positioning system. "It takes you where you want to go, but you still make the decision." He says it's a particularly useful tool when you're choosing within a category, say, between a Salerno butter cookie (NuVal score: 1) and a Health Valley oatmeal raisin cookie (NuVal score: 34). True, neither scores particularly high, but "I'd just as soon have the food I like love me back a little," says Katz. If a grocery store agrees to participate, all foods in the store must be scored, he says.

The Nutrient-Rich Foods Index, a 5-point scoring system, will also roll out online this fall, says Adam Drewnowski, professor and director for the Center for Public Health Nutrition at the University of Washington in Seattle, who is one of the developers of the index. (The Nutrient-Rich Food Coalition is a collection of commodity organizations, representing industries including eggs, citrus, beef, and potatoes.) "We do eat too many calories, too much sugar, and too many saturated fats, but we are now valuing foods by the absence of problematic nutrients," he says. "We've stopped caring about the good things. Let's think about protein, antioxidants, phytochemicals, and vitamins and bring back positive nutrition." The developers hope to place the system in supermarkets at some point.

A thousand ratings systems are blooming because it's going to be exceedingly tough to get nutritionists, the food industry, and activists to voluntarily agree on a single set of criteria, says Christopher Gardner, director of nutrition studies at the Stanford Prevention Research Center, who is nonetheless encouraged by all the activity on this front. But more research is needed to nail down the best system, he says After all, we really don't know what kind of program will work best--a single check, a range of zero to five stars or dots, or a 1-100 score? Or a "traffic light" system (red, yellow, and green symbols for levels of saturated fat, sodium, and other nutrients) like the one in Britain? While research suggests that these programs can affect purchases--skewing them toward the preferred items--we don't yet know how long such an effect would last or whether it would make a dent in the rates of obesity or other related diseases, which have multiple causes and aren't likely to be drastically changed by any kind of labeling system.

So if a Smart Choices check or NuVal score helps you pick a slightly better ice cream than you otherwise would, great. But they're not really essential. To eat what most nutritionists would agree is a healthful diet, a quick rule of thumb is to avoid the center aisles at the grocery store as much as possible and consume mostly foods in their least processed state, focusing on fruit, vegetables, whole grains, legumes, and fish. "We shouldn't expect the sky from any of these systems," says Jacobson.

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Health Nutrition: Smart Choices Program Aiming to Improve Food Purchasing Decisions