Please read the label: Helping patients to improve their diet
Nutrition-related health problems, such as cardiovascular disease (CVD) and obesity, present a significant challenge to government and healthcare professionals alike. Despite a number of innovative and interesting programmes, obesity rates continue to rise at an alarming pace. This article will explore front of pack food labeling, an initiative designed to help consumers make more informed choices about the foods they’re eating.
The food label is one of the most important and direct means of communicating product information between manufacturers and consumers. However sometimes food labels contain so much information, it can be difficult to know what we should be looking for and what it all means.

To help improve diet and promote healthily eating, initiatives such as front of pack nutrition labelling and guideline daily amounts (GDA) have been introduced. The goal is to create better consumer knowledge about the nutritional composition of different foods, as well as an understanding of how this contributes to the overall diet, allowing the right food choices to be made.
Guideline Daily Amounts
Guideline Daily Amounts (GDAs) cover daily guidelines for calories, fat, saturated fat, carbohydrate, total sugars, protein, fibre, salt and sodium and can usually be found next to the nutrition information panel on food packaging. The GDA values were developed by the Institute of Grocery Distribution1, and are based on the recommendations made by the Committee on Medical Aspects of Food Policy (COMA)2 and the Scientific Advisory committee on Nutrition (SACN)3.
They are recommendations based for an average male and female adult of healthy weight and average activity level (i.e. someone who is not intending to lose or gain weight and moderate physical activity around 2-3 times a week). Because people vary in many ways, such as size and activity levels, health care professionals must be aware that GDAs cannot be used as targets for individuals. They simply provide a benchmark against which the contribution from these nutrients per serving of a food product can be roughly assessed.

Front of Pack Labelling
A number of food labelling schemes are currently used by manufacturers. One of which is front of pack nutrition labelling. Such labelling can supplement that already provided by nutrition panels on the back of food packaging. There are 2 main types currently seen– multiple traffic light labelling and GDA labelling.
Both concepts focus on the five key nutrients of most interest to UK consumers,– calories, sugars, fat, saturated fat and salt, presenting them on the front of packs.
Currently, these labeling schemes are optional but this situation could change as mandatory front of pack labeling is being proposed by the European Commission as part of a new regulation (Food Information for Consumers).
Multiple traffic light labelling
Food products with traffic light labels on the front of the pack show if the food has high, medium or low amounts of fat, saturated fat, sugars and salt and what amount of these nutrients it contains. It uses a colour coding of red, amber and green to enable consumers to see at a glance how appropriate that food is as part of their healthy diet and lifestyle.
How to use this labelling
Red light = the food is high in this nutrient and whilst it's fine to have the food occasionally, or as a treat, try to keep an eye on how often these foods are chosen, or try eat them in smaller amounts.
Amber light = this is an OK choice most of the time, but choosing green for that nutrient would be a better choice.
Green light = the food is low in that nutrient. The more green lights, the healthier the choice.
Patients should be choosing foods with mostly greens, a few ambers and hardly any reds for each nutrient.
Traffic lights are allocated according to criteria set by the Food Standards Agency. As a guide, high and low amounts for each nutrient are classed as follows:

GDA labelling

Multiple traffic light labelling is supported by retailers such as Waitrose, and Sainsbury and manufacturers such as McCain’s and Covent Garden Soup. Further information on this type of labelling can be found at www.eatwell.gov.uk.
Foods with Guideline Daily Amounts on the front of pack show information about the amount of calories, sugar, fat, saturates and salt in a stated portion of food and also gives what percentage of an adult’s GDA this is. The GDA percentages stated on front of packs is based on that for the average female adult- this is to prevent confusion over using two sets of GDA figures on labels. GDA labelling does not include traffic light colouring.
How to use this labelling
Guideline Daily Amounts are very simple to use and allow patients to see exactly how much each nutrient is contributing to their overall diet. Patients should be aiming to choose foods, where possible, with the lowest % GDA for each nutrient, making sure that as long as they are balancing their intakes of these nutrients throughout the day they should not exceed the guideline amount.
GDA labelling is supported by retailers such as Tesco and manufacturers such as Cadburys, Walkers and BENECOL®. Further information on this type of labelling can be found at www.whatsinsideguide.com
Achieving a healthy, balanced diet with front of pack labelling
It is important to always encourage patients to look at labels whenever making food choices, be it for specific health reasons or simply to follow a healthy diet and lifestyle.
Using front of pack labeling is important to any patient who needs to keep a close eye on a particular nutrient in their diet, be it calories, sugars, fat, saturates or salt. For example patients with high cholesterol who need to monitor their intake of saturated fat, can see at-a-glance how much of this particular nutrient will be contributing to their overall diet for that day. Allowing them to make informed choices over whether they should want to consume that food or drink item in their diet. Similarly, people with diabetes or high blood pressure, who are controlling intakes of sugar or salt, or those looking to lose weight can make quick comparisons between different products giving them the ability to chose healthier options.
It is well established that following a healthy diet and lifestyle is key to the maintenance of good health and government recommendations for a healthy diet include4:
1. Base your meals on starchy foods such as wholegrain bread, pasta and rice
2. Eat lots of fruit and vegetables -aim for at least five portions every day
3. Eat more heart healthy oily fish - such as salmon and mackerel
4. Cut down on saturated fat, sugar and salt
5. Increase exercise- aim for 30 minutes 5 times a week
Continuing to raise patient awareness on how they can use simple steps to achieve a healthy diet through sensible eating, exercise and understanding labels is vital for the reduction of health-related diseases in the UK population.
References
1. IGD ( 2005) Report of the IGD/PIC Industry Nutrition Strategy Group 2005
2. COMA (1991) Dietary reference values for food energy and nutrients for the United Kingdom: report of the Panel on Dietary Reference Values of the Committee on Medical Aspects of Food Policy. Reports of Health and Social Subjects 41. TSO, London
3. Scientific Advisory Committee on Nutrition (2003) Salt and health. TSO, London
4. Food Standards Agency www.eatwell.gov.uk
Published in partnership with the Royal College of Nursing's Practice Nurse Association
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