Nutritional Information: The Best Way to Judge the Health Value of Foods

Nov 01, 2010 | Updated May 25, 2011

In judging the nutritional quality of foods, there is a strong case to make for not just the truth, but the whole truth. A product may be fat-reduced, but not better for us because fat was taken out, but sugar and salt were added. Or salt reduced, but not better for us, because fiber was taken out. Or sugar reduced, but not better for us ...

There is also a strong case to make for disclosing the good, the bad and the ugly. However, a committee of the Institute of Medicine (IOM), convened to review the whole issue of "front of pack" nutrition guidance, settled on the latter two only: the bad and the ugly.

Specifically, the IOM committee recommends that front of pack guidance be about calories, saturated fat, trans fat and sodium. Period.

Let's start with what might be good about only considering the bad and the ugly. At present, food companies, which own the front-of-pack real estate, emphasize the positive there. And, they do so in a way that can be very misleading. A breakfast cereal may well be a source of vitamins and minerals because those are added to the mix, but be made primarily from sugar. A fat-reduced peanut butter will tell you on the front of its jar that it is fat-reduced, but fail to mention the copious additions of sugar and salt.

Perhaps the IOM committee members particularly wanted to help put a stop to this. If so, they were on to something. Consumers cannot choose better nutrition when industry practices directly undermine their ability to identify it.

But, frankly, it seems to me there is a whole lot more that is bad and ugly about just considering the bad and ugly, and doing it the way this IOM committee suggests. Among the more obvious problems with their proposal is that sugar is ignored. So, with this approach, products that take out saturated fat but add sugar -- a fairly common practice in the reformulation of processed foods -- would get to talk about the saturated fat reduction only. An excess of added sugar is widely recognized as one of the great liabilities of the modern American diet. The fact that not all saturated fat is created equal and not all is harmful -- a matter directly addressed by the current Dietary Guidelines Advisory Committee -- calls the IOM committee's conclusion further into question. Though limited to the bad and the ugly, the proposed approach does not appear to address these comprehensively.

But then, more fundamentally, there is the enormous distortion of ignoring the good. As far as I can tell, with the IOM's proposed approach, jelly beans would be better than almonds, walnuts, avocado or salmon (the latter all contain some saturated fat). Fat-free, artificially flavored ice cream, loaded with sugar, would look better than dark chocolate (which contains saturated fat), or lightly salted edamame, or tuna, or whole grain breakfast cereal. Chicken could not be distinguished from salmon, because omega-3 fat is not considered. Whole grain would not be distinguishable from refined grain, because fiber is not considered. A potato would not be distinguishable from spinach or kale, because phytonutrients are not considered. And on it goes.

I think nutrition guidance should be based on the very best knowledge we have of the truth, the whole truth and nothing but the truth. This can be done, by a system that is independent, objective, comprehensive and considers the good, the bad and the ugly.

A system that penalizes the bad and ugly, but rewards the genuinely good. A system that can distinguish between nutrients added, willy-nilly, through fortification and nutrients of actual value, intrinsic to a food. Such an approach exists, and has been shown to correlate strongly with the actual health outcomes we truly care about in a test involving over 100,000 people. We of course have no such evidence for the approach the IOM committee proposes.

The truth, nothing but the truth and the whole truth is a powerful and compelling concept, and the cornerstone of not just our approach to justice, but our ideals about approaching justice. It is relevant to making an informed judgment about anything.

Putting the IOM proposal about food in the context of the legal system may be a good way to close out the argument that considering just the bad and the ugly -- and doing even that selectively -- is oddly, distortingly and even dangerously inadequate: Under a system that tells only the bad and the ugly ... Nelson Mandela is an ex-con; period.