Nutrition Keys is ‘abuse of trust’: NEJM commentary

By Caroline Scott-Thomas

- Last updated on GMT

Related tags Grocery manufacturers association Nutrition Iom

The Nutrition Keys prototype
The Nutrition Keys prototype
The Nutrition Keys front-of-pack labeling system unveiled by the Grocery Manufacturers Association and Food Marketing Institute last year is an industry abuse of trust, claims a new commentary.

Writing in the latest issue of the New England Journal of Medicine​, Dr. Kelly Brownell of Yale’s Rudd Center for Food Policy and Obesity and Dr. Jeffrey Koplan of Emory University in Atlanta argue​ that there are major flaws in the voluntary labeling system, and that the timing of its launch is suspicious at best. It is ‘troubling’ that the Nutrition Keys scheme has been developed and introduced when the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) have already commissioned the Institute of Medicine (IOM) to issue recommendations on front-of-pack labeling, they write. The IOM’s second phase report is due in the fall.

“Why would the industry not simply wait for the recommendations of this group of objective experts?”​ Brownell and Koplan wrote. “Perhaps so that it could lock in a system that would change food choices as little as possible and preempt the imposition of an alternative system that would be based on the available relevant science.”


The Grocery Manufacturers Association (GMA) and Food Marketing Institute (FMI) represent the majority of food and beverage companies in the United States. They announced their intention to develop a front-of-pack nutrition symbol in the week following release of an IOM report that found front-of-pack nutrition labels would be most useful to consumers if they highlighted calories and nutrients that could be harmful when consumed in excess, such as trans fat, sodium, and saturated fat.

Nutrition Keys highlights calories, saturated fat, and sodium, and also adds sugars, which were not included in the IOM’s recommendations.

In addition, the label does not mention trans fats front-of-pack, as the IOM recommended, but allows food companies to highlight up to two ‘nutrients to encourage’ – specifically potassium, fiber, vitamin A, vitamin C, vitamin D, calcium, iron and protein.

‘No bad food’

Brownell and Koplan argue that so many symbols could confuse consumers, especially when the nutrients listed can be changed at a food company’s discretion, and suggest that a ‘traffic light’ system, as is used in the European Union, would better inform consumers as to whether a product contains a low, medium or high amount of a nutrient.

“A mantra of the food and beverage industry is that “there is no bad food.” Even if that were true, there still would be better and worse or more healthful and less healthful foods,”​ they wrote.

Mandatory labeling?

In conclusion, they urge industry to “show good faith by awaiting the IOM report and endorsing the best evidence-based approach to front-of-package labeling.”

“Otherwise, industry may have proven itself untrustworthy again and raised the risk of what it wishes to avoid — government’s exercising its authority to mandate some types of labeling and to restrict others,”​ they wrote.

The FDA announced its intention to scrutinize front-of-pack nutrition claims in 2009 amid concerns that a proliferation of labeling schemes could confuse the public about nutrition information.

Among the front-of-pack labeling schemes in use in the United States, some are endorsed by health organizations, while others have criteria devised by organizations like the Whole Grains Council, or by companies themselves. However none of the front-of-pack symbols is currently regulated by the FDA.

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