BY THERESE REVITTE, MNT & TRACY McCUBBIN, MD, ABOIM, ABEM

Take a look at the front of any packaged item in the grocery store and what do you see?  Claims such as all natural, organic, low-calorie, low-fat, multi-grain, made with whole grain, light, fruit-flavored, non-GMO, cage-free, zero trans fats, gluten free and no added sugar catch our eye.  These seem to imply that these products are a healthy choice. But are they?  The answer to that question is much more nuanced than you’d think.

Packaging is a powerful marketing tool for food companies. They want to entice you to buy their products and their labelling is one way to accomplish this. If you take the labels at face value, you may be missing something. To be a savvy consumer, take the time to read the back of the package – the ingredients and the nutrition label.  

What should you look for on the label?  

Food companies typically use the perfect combination of sugars, salt and fats to make foods taste appealing, so you should look at those numbers on the label. When one of these is reduced, more of the others are often added. So those fat-free cookies are often made more palatable by adding more sugars and artificial flavors to compensate.   

Follow these guidelines for the healthiest choices:

• Added sugars should be low (or non-existent) per serving.  Challenge yourself to eat less than 20 grams per day. Remember, added sugars are different from the sugars found naturally in fruit and dairy.

• Salt should only be a small percentage of the daily recommended amount of <2300 mg.  

• Avoid industrial seed and vegetable oils such as corn, soy, canola, sunflower, safflower and cottonseed oil.  These contain free radicals. 

• Finally, choose products with fewer than 5 ingredients containing whole foods with names that you recognize.  

Label claims

To begin with, it helps to know what certain labels mean. To make the following claims, food companies must adhere to these guidelines.

• Calorie free: Less than five calories per serving

• Low calorie: 40 calories or less per serving

• Low cholesterol: 20 milligrams or less and 2 grams or less of saturated fat per serving

• Fat free/sugar free: Less than ½ gram of fat or sugar per serving

• Reduced: At least 25% less of the specified nutrient or calories

• Good source of: Provides at least 10-19% of the Daily Value of a particular vitamin or nutrient per serving

• Low sodium: 140 milligrams or less of sodium per serving

• High in: Provides 20% or more of the Daily Value of a nutrient

Beyond these, here are some tricks to watch out for:

Serving size 

Say you’re buying an energy bar.  At first glance, it looks ideal. As you read the label, you might see that the ingredients are healthy and the sugar, salt and fat contents are in the right range. But as you’re eating your last bite, you see that each bar contains 2 servings! You’ve now eaten a double serving of calories, sugar, salt and fat. Always look at the serving size information before diving in.

Hidden sugars

Did you know there are 4 grams of sugar in one tablespoon of ketchup? Food companies know that our palates are hard-wired to like sweetness, so they put hidden sugars in all sorts of foods that you wouldn’t expect. In addition, food companies know that consumers don’t want to see sugar listed as the first ingredient. Instead they will put smaller amounts of several sugars in the product so that they’re listed lower on the ingredient list. Read the total amount of added sugars.  Challenge yourself to eat less than 20 grams of added sugars per day.  Check out this list for hidden sugars:

• Sugars: beet sugar, brown sugar, buttered sugar, cane sugar, coconut sugar, date sugar, golden sugar, invert sugar, muscovado sugar, organic raw sugar, evaporated cane juice, and confectioner’s sugar.

• Syrups: maple syrup, high fructose corn syrup, honey, agave nectar, malt syrup, oat syrup, rice bran syrup, and rice syrup.

• Other added sugars: barley malt, molasses, cane juice crystals, lactose, corn sweetener, crystalline fructose, dextran, malt powder, ethyl maltol, fructose, fruit juice concentrate, galactose, glucose, disaccharides, maltodextrin, and maltose.

“All-natural”

We tend to think of something labeled all-natural as healthy. It conjures up images of small farms, happy animals, fresh air and puffy clouds. But “all-natural” is essentially a meaningless term. The FDA has considered the term “natural” to mean that nothing artificial or synthetic has been added to a food that would not normally be expected to be in that food, including artificial colors, artificial flavors and synthetic ingredients. Beyond that, any product can be labeled as “all-natural,” whether it’s healthy or not. 

Trans fat free

We all know that artificial trans fats are detrimental to our health, and the FDA required them to be removed from products in June 2018.  However, if a food has less than half a gram of trans fats per serving, the FDA allows the food company to label the food as trans fat free.  These can add up. If you read the ingredients and you see the word “hydrogenated,” the food has trans fats.

Multi-grain and whole grain

These two terms tend to confuse the consumer into thinking they are healthy choices. Multi-grain simply means that several types of grain flour is used in the product. Oftentimes, these flours are refined blood-sugar-raising white flours with the nutritional benefits stripped away.  

Whole grain means that the bran, germ and endosperm of the grain have not been removed from the flour. This leaves the beneficial nutrients and fiber intact. Food companies can label a food as whole-grain with very little whole grain included. As the consumer, you should be looking for the first ingredient to be whole grain, and look for 100% whole grain. Also look at the additional ingredients to be sure that they’re not stacking up sugars, salts or unhealthy fats to make it taste better, such as with sugar-laden cereals.

Free range or cage-free

It can be tricky to know which eggs to buy when so many labels abound. Cage-free, free-range, organic, pastured, farm-fresh…what to do? In an ideal world, you would get to know your egg-producing farmer so you could ensure that the laying hens are living their best life.  But, at the grocery store, there are stacks of egg cartons to choose from.  We don’t like the idea of animals being in tiny cages.  But be leary about cage-free and free-range labels. Food producers must be able to show that cage-free and free-range animals are allowed access to the outdoors. However, there are no guidelines for what this access looks like, and how long the animals are outside.  

According to the USDA, “eggs marked with the USDA’s National Organic Program label come from uncaged hens that are free to roam in their houses and have access to the outdoors. The hens are fed an organic diet of feed produced without conventional pesticides or fertilizers.”

Pastured eggs come from hens that are allowed to roam free, eating plants and insects along with some commercial feed.  Those fed flax seed have a higher omega-3 content.

Remember, foods can have many seemingly healthy labels, but still be a poor choice because of high sugar or salt, refined carbohydrates or unhealthy fats. Be a nutrition detective. If the first ingredients are forms of sugar, refined grains or processed/hydrogenated fats, you know it’s not a healthy choice. A good rule of thumb is to choose products with fewer than 5 ingredients.