In evaluating the nutrition science of front-of-package (FOP) systems and symbols, the committee adopted four guiding principles to set the stage for the nutritional assessment of FOP systems and symbols. These guiding principles were intended to assist the committee in identifying the systems and elements of systems most important to assisting American consumers in making healthier food choices and the system criteria that could be implemented in the current food environment. The guiding principles are:
1. A well-balanced, high-quality diet consistent with the recommendations of the Dietary Guidelines for Americans is essential for the health of Americans, and FOP labeling is one tool among many geared toward helping Americans make healthful choices. Other such tools include MyPyramid,a the Nutrition Facts panel (NFP), and health and nutrient content claims.
2. FOP systems will focus on nutrients or food components that are most strongly associated with diet-related health risks affecting the greatest number of Americans.
3. The information highlighted in FOP systems will be consistent with the NFP.
4. FOP systems will apply to as many foods as possible.
aMyPlate replaces MyPyramid as the primary federal government food group symbol and directs consumers to Choose MyPlate.gov to learn how to apply the Dietary Guidelines.
THE COMMITTEE’S TASK AND APPROACH
At the direction of Congress, the Centers for Disease Control and Prevention (CDC) asked the Institute of Medicine (IOM) to undertake a study to examine and provide recommendations regarding FOP nutrition rating systems and symbols. The FDA, and later the USDA Center for Nutrition Policy and Promotion, provided support. The study comprised two phases. The Phase I committee focused on evaluating current systems and nutritional criteria and resulted in a report in 2010. The Phase II committee was tasked to:
• consider the potential benefits of a single, standardized, front-label food guidance system regulated by the FDA,
• assess which icons are most effective with consumer audiences, and
• develop conclusions about the systems and icons that best promote health and how to maximize their use.
The committee drew on the guiding principles (Box S-1), assessment, findings, and conclusions from Phase I (shown in Box S-1) as a starting point. The committee conducted a comprehensive review and analysis of evidence from several sources directly relevant to its charge. In order to be comprehensive, the committee considered a wide range of material from academic peer-reviewed literature and publicly available industry, government, and marketing sources as well as evidence and perspectives from a wide range of disciplines. The committee acknowledged the potential shortcomings of any FOP system that were identified during Phase I, and explored whether and how consumers might use the information provided by an FOP symbol system. Although not tasked with making recommendations about food preparation and consumption practices after purchase, the committee recognized that these practices have implications for health. Finally, the committee evaluated only the potential benefits of a single, standardized, front-label, food guidance system regulated by FDA and not the regulatory or related considerations of universally implementing such a system.