Decoding Food Labels: A Guide for Healthcare Professionals to Teach Patients

Understanding food labels is vital to optimize nutrient intake. Food labels provide necessary information to help patients make informed nutrition choices, which is crucial to managing chronic conditions like diabetes, hypertension, dyslipidemia, and obesity. A 2018 study found that 57% of adults reported “not understanding” the content on food labels, so educating patients on food labels is crucial.

Because food labels contain complex terminology and small print, they can be difficult to understand. Additionally, misleading marketing claims can cause confusion. This article aims to provide an in-depth guide to decoding food labels and illustrates the role of healthcare professionals in teaching patients how to read food labels.

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Understanding Food Label Components

Nutritional Facts Panel

Serving Size and Servings Per Container

Near the top of the food label are two key pieces of information: the serving size and the number of servings per container. This information is the basis for all of the nutrition facts on the rest of the panel. If one serving is 3/4 cup of cereal and contains 150 calories, if someone eats 1 1/2 cups of cereal, they consume 300 calories. Often, the serving size may be smaller than anticipated, leading to an underestimation of the calories and macronutrients eaten. Be sure to check the serving sizes of the foods you eat and measure them for precise information.

Calories Per Serving

Calories represent the total amount of energy a food provides. This is a key factor for balancing energy intake with energy expended, helping to manage weight. Because different foods contribute different amounts of energy, the listed calories per serving explain the energy density of the food, specific to the serving size listed. The calories per serving is the sum of the energy provided by each of the three macronutrients: carbohydrates, proteins, and fats.

Macronutrients

Carbohydrates

Total carbohydrates include not only the carbohydrates but also the dietary fiber, natural sugars, added sugars the food contains. Sugars are defined as the total amount of sugar the product contains, including sugars naturally occurring (as in fruits and vegetables) and added sugars (as in processed foods).

Proteins

Proteins are important for a number of different functions in the body, such as muscle strength and repair, neurotransmission, cellular functions, and metabolism. The amount of protein that each person needs varies depending on existing chronic medical problems or health risks, age, sex, activity level, and personal health goals.

Fats 

On the nutrition facts panel, you will see several different types of fats listed: total fat, saturated fat, trans fat, and cholesterol. Total fat includes the total grams of all types of fats. Saturated fats come almost exclusively from animal sources. 

• Trans fats are created by hydrogenation of liquid oils, making them shelf-stable, solid fats at room temperature. However, these are linked to a number of health diseases, so the Food and Drug Administration (FDA) requires that trans fats be specifically listed under the Fats section of the nutrition facts panel to inform consumers of what is in their food.

• Cholesterol is another type of fat from animal products, and it is a key component of cell membranes and other structures. However, high levels of cholesterol are known to cause coronary artery disease, so it is important to know the cholesterol content of the foods in our diet. It is listed in milligrams in the fats section of the nutrition facts panel.

Micronutrients: Vitamins and Minerals

In addition to macronutrients, the nutrition facts panel also lists four main micronutrients: vitamin D, calcium, iron, and potassium. In addition to the amount of these four micronutrients per serving, the label also lists the percentage of the recommended daily allowance (RDA) that this amount provides. These are the minimum micronutrients listed, so many panels will include others.

Percentage of Calories Per Macronutrient

Each macronutrient provides a specific amount of calories (energy) per gram. Carbohydrates provide 4 calories per 1 gram of carbohydrates. Multiplying the total grams of carbohydrates by 4 calories per gram results in the total number of calories from carbohydrates. Dividing the total calories from carbohydrates by the total calories per serving and then multiplying the result by 100 gives the percentage of calories provided by carbohydrates in one serving.

• For example, if a food has 15 grams of carbohydrates per serving, 15 grams of carbohydrates x 4 calories per gram is 60 total calories from carbohydrates. If each serving of the food contains 120 calories, 60 ➗120 equals 0.5, which when multiplied by 100, equals 50%. This means that 50% of the calories in each serving of the food come from carbohydrates.

Like carbohydrates, proteins also provide 4 calories per 1 gram of protein. Follow the same calculation demonstrated above for carbohydrates to determine the total calories from protein and the percentage of total calories from protein.

While carbohydrates and proteins provide 4 calories per gram, fats are more energy-dense, containing 9 calories per gram. To know how many calories in a serving of food are from fats, multiply the number of grams of total fat per serving by 9. To determine the percentage of calories per serving from fat, divide the total number of calories from fat by the number of calories per serving and then multiply that result by 100.

Ingredients List

The ingredients list on the nutrition facts panel lists the ingredients in descending order by weight, meaning the ingredients at the beginning of the list make up more of the food product than those listed last. 

Below the ingredients list, you will find the eight common food allergens required to be listed, if any of them are present in the food item: 

• Wheat
• Milk
• Soy
• Eggs
• Fish
• Shellfish
• Tree nuts
• Peanuts

Many foods contain additives and preservatives, like artificial colors, flavors, and other compounds. While added to provide visual appeal, taste, or preservation, these substances can cause health concerns and should be minimized.

Percent Daily Values (%DV)

Percent daily values (%DV) are listed next to each nutrient on the nutrition facts label. The percent daily values are based on a 2,000-calorie diet, aiming to provide a general recommendation of what that food supplies, as compared to overall daily needs. In general, 5% or less is a low nutrient composition over the day, which is not a good food source for a given nutrient. On the other hand, 20% or more indicates a food source that supplies a high source of that particular nutrient. 

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This allows a person to identify foods that contribute high amounts of nutrients that should be limited, such as saturated fat, sodium, and added sugars. Similarly, it can help encourage patients to consume more significant amounts of foods that are high in dietary fiber, vitamins, and minerals. However, it is important to remember that the 2000-calorie reference diet may not be appropriate for everyone, so these percentages need to be increased or decreased based on individual needs.

Practical Tips for Educating Patients

Reading and Comparing Labels

Reading labels thoroughly is crucial to identifying healthful food options. Remember that the 2000-calorie reference diet may not apply for everyone. Patients should discuss their specific nutrition goals with their health care provider or a dietician. Comparing similar products allows patients to make healthier choices based on better nutrition profiles, like less added sugars, lower sodium content, or the absence of trans fats.

Identifying Healthy Options

By prioritizing whole foods and minimally processed items, it is easier to consume a nutrient-dense diet. Following a nutrient-dense diet has been shown to reduce the risk of many chronic illnesses, such as hypertension, type 2 diabetes mellitus, and obesity. This requires opting for foods with fewer ingredients that are minimally processed, as well as being able to recognize whole foods on labels. Certifications like USDA Organic and Non-GMO Project Verified, plus the ingredients list, offer insights into the degree of processing and the amount of added ingredients.

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Key Takeaways

• Food labels are critical for making informed dietary choices.
• Healthcare professionals play a key role in educating patients about food labels.
• Understanding how serving sizes, calories, macronutrients, and micronutrients are presented is essential.
• Using the percent daily values can help identify how much of a nutrient each food provides.
• Being able to compare the nutrition facts labels of similar items allows patients to make healthier choices.
• Identifying healthier food options helps patients adhere to a nutrient-dense diet.