Food Labelling to keep NCDs at Bay

Surfing through the grocery stores, most of us have been drawn towards products labelled as organic, natural, trans-fat-free, and gluten-free. But how many consumers understand these labels and their importance well? A research conducted in October 2019, revealed that the consumer’s understanding of the various kinds of food labelling like Nutrition Facts Table, Front-of-Package Labelling, Health Star Rating, Guidelines Daily Amounts, Multiple Traffic Lights and Warning Labels, is variable and unclear.

Very few consumers realize that a good grasp of food labelling on the foods that they consume regularly can help them maintain good health and keep non-communicable diseases (NCDs) at bay.

The evolving system of food labelling

Codex Alimentarius Commission is the body that establishes international food labelling standards. The Food and Agricultural Organization of United Nations (FAO) works closely with WHO to help this body on technical and policy matters. The Codex labelling standard is used by all countries as guidance for uniformity and harmonisation and has also been used as the basis for the development of new food labelling policies.

Each country has their own set of regulations when it comes to food labelling. For this reason, food regulatory agencies in the Southeast Asia region have evolved regulations to govern food and nutrition labelling in their countries. Most countries have followed the Codex Guidelines in preparing their regulations, namely Indonesia, Singapore, Malaysia, Brunei Darussalam, Laos, Vietnam, and Cambodia. Conversely, to some extent, Thailand and Philippines have adapted the U.S. nutrition labelling guidelines.

Across the globe, regulators and scientists are evaluating and developing newer modes of communicating food composition to the consumers and this system of food labelling is still evolving. The latest amendment by U.S. Food and Drug Administration on food labelling included compliance requirements for fermented and hydrolysed foods that bear the “gluten-free” claim. Individuals suffering from celiac disease, a hereditary, chronic inflammatory disorder are advised to avoid all sources of gluten in their diet. China saw amendments in health food packaging warning labels and Australia is looking for major overhaul in regulations for sports nutrition this year. Thailand amended their regulatory requirements for CBD and hemp in herbal products in 2019.

Why the fuss?

According to the WHO, 71% of all deaths are due to NCDs and its rise has been driven primarily by four major modifiable behavioural risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets.

Nutrition labelling is considered a population-based approach, and if well designed, can potentially have a positive influence on the diet of consumers, and therefore contribute to the achievement of public health objectives. Food and nutrition education too is globally recognised as the most efficient tool for reducing the risks of NCDs. According to researchers from the American Journal of Preventive Medicine, specific food labelling has helped reduce consumers’ intake of calories by 6.6%, total fat by 10.6% and other unhealthy food options by 13%. The prevention of obesity and chronic diseases can be supported by choosing nutritious diets. Therefore, most governments have made it mandatory to include at least one type of food labelling system on packaged foods to promote healthy eating.

Highlighting “calories” and “servings”, declaration of “added sugar” grams, and calorie and nutritional information for both “per serving” and “per package” are of immense help in making consumption decisions. The inclusion of updated daily values for nutrients such as sodium, dietary fibre and vitamin D, as well as separate listing of “total fat”, “saturated fat” and “trans-fat” is beneficial too. The health-conscious community is increasingly looking for information about the food they are buying and food labels are an immediate source. In most countries, if companies adhere to the basic, desired composition of fat, saturated fat, sodium, cholesterol and beneficial nutrients like protein, fibre, vitamin A, vitamin C, calcium, or iron, they can label their food as “healthy”.

HCPs as credible sources of advice

Consumers in general tap onto multiple resources to learn about nutrition. However, nutritional labelling can provide consumers with invaluable information at the point of purchase. Healthcare practitioners (HCPs) too can play a significant role in educating clients on nutrition labelling, and how to utilise this information to make healthier food choices. Most consumers are also unaware about the authentic sources of getting right information on food and nutrition labelling. HCPs can refer and share a few standard and credible sources with their health-conscious consumers.

Each country has its own list of credible sources. Singapore, for instance has very high standards of food safety and makes the information about Food and Nutrition labels available on their government websites like the Singapore Food Agency, Health Promotion Board and Health Hub by the Ministry of Health Singapore. The American Food Sure Summit also releases global food law update reports annually.

Most governments and regulators are still structuring their food and nutrition labels for better consumer comprehension and therefore, there will be ample opportunity for continued debate on this topic. The current pandemic has brought back immense focus and attention to NCDs, as the affected people are considered more susceptible to complications. The global rise of diet-related NCDs plus the double burden of obesity and malnutrition means that it is imperative that all HCPs provide at least basic, evidence-based nutrition advice. This also implies that HCPs can help consumers in their journey of keeping NCDs at bay by educating consumers on food labelling.

How HCPs can play a larger role?

Time is one of the factors that is a critical enabler for imparting any form of advisory; in this case about nutrition labels and food safety. The current pandemic has resulted in more work hours and pressure for many doctors in the frontline and limited their ability to be available for such counsel. Here are a few quick tips to help HCPs utilise interaction opportunities with their consumers in a more effective manner:

Start talking about nutrition:

• Your patients may not know that you are available for giving nutrition advice. So, speak about nutrition in general when engaging with patients and encourage them to ask questions
• Empower your patients with tips to identify healthy foods, and nutrition labels can be one way to do it
• Have nutritional information available at your clinic and on your website. Provide links to fact-based sites for information
• Encourage your patients to bring in their labels so you can know what they are consuming and can discuss this with them

Include a nutrition checklist:

• Create a checklist that can be a part of your consultation papers and can be filled up by the patient while in the waiting
• Try and capture the awareness of patient on various aspects of nutrition including nutrition labels
• Apps and online tools too can be used to capture the nutritional awareness and needs of the patients

Create a community:

• Communities are a great way to stay connected with like-minded people and those who share a passion or a common goal. Communities can be on the digital platform too like WhatsApp, Facebook, and blogs. With social media being the most frequently used channel for consumers seeking nutrition information, HCPs can use this wisely to share more accurate sources of information.

As a doctor myself, I understand the challenges that HCPs are facing. These are challenging times. HCPs are in an important position as a trusted advisor and we have an opportunity to adopt the “whole person” approach where, the patients are treated holistically – catering for their physical, mental, and social needs. Attempting to better understand not only the patients’ sickness, but also their social, cultural and economic profiles and, above all, their expectations can greatly help doctors improve the lives of their patients.