Surprising ways food labels are misleading, according to experts

By Linda M. Richmond
Published May 5, 2021

Key Takeaways

Eating habits are one of the most significant modifiable risk factors for disability and premature death in the United States. 

In fact, a poor diet is responsible for more deaths than any other risk globally, including cigarette smoking, according to a landmark study spanning three decades and 195 countries published in the Lancet. Authors noted that the leading dietary risk factors for mortality are diets high in sodium and low in whole grains, fruit, vegetables, omega-3 fatty acids, and nuts/seeds.

Still, many of the most important facts about foods don’t appear on the nutrition label. Some of the worst foods consumed have no label at all because they’re eaten outside the home.

Here's a look at some of the important facts that don’t appear on labels.

‘Fake fiber’

Most adults only eat about half of the minimum recommended daily allowance for dietary fiber, which is set at 28 grams a day for a 2,000 calorie diet. Increasing intake of dietary fiber can help lower blood pressure, glucose, and cholesterol levels; aid bowel function; and promote a feeling of satiety, which may lead to eating less and weight loss.

But due to recent changes in food labeling rules, manufacturers can now count a slew of additives known as synthetic or isolated nondigestible carbohydrates as part of a food’s total fiber count. Some of these additives are known as alginate, guar gum, polydextrose, phosphorylated starch, and even something called hydroxypropyl methylcellulose. 

These may make foods appear to be more healthy than they are. “Food manufacturers are taking advantage of FDA’s definition of fiber to count ingredients that blur the distinction between sugar and fiber,” said Eva Greenthal, MS, MPH, senior science policy associate with the Center for Science in the Public Interest (CSPI), in an exclusive interview with MDLinx. Manufacturers can add fibers like these to dress up junk food as health food, she added.

Your best bet? Stick to the advice of the WHO, which recommends consuming foods that contain intact, naturally occurring fiber such as whole grains, beans, nuts and seeds, or vegetables and fruit.

Watch out for ‘wheat’ products

Healthy adults on an average 1,800 calorie diet should eat at least 3 one-ounce servings of whole grains a day. Whole grains include the bran, germ, and endosperm of a whole grain kernel and are associated with a reduced risk of heart disease, diabetes, and digestive problems.

But manufacturers may add molasses or colorants to breads, crackers, and other grain products to make them appear as if they’re made with whole grains, Greenthal said. The word “multigrain” on packaging may seem wholesome, but it simply means the food is made from several different grains, all of which may be fully refined and stripped of their health benefits. The same goes for other variations of the term, such as seven-grain, 21-grain, or even “wheat bread,” she said. 

“The term ‘made with whole grain’ may denote a very small amount of whole grains compared to the amount of refined grain,” Greenthal added. “We’re advocating to see products’ percentage of whole grains displayed prominently on the front of the package.” Since that’s not the case now, scan the ingredient list. Instead, choose products for which whole grain or whole wheat is listed first in the ingredient list, she said. “Don’t be fooled by the words ‘wheat flour.’ Look for 100% whole wheat bread. The word ‘whole’ is key.”

Hidden trans fats

Once marketed by the food industry as a healthy alternative to butter and lard, partially hydrogenated oils (PHOs)—found in foods like margarine, coffee creamer, chips, and more—are loaded in dangerous trans fatty acids. These are known to raise LDL (bad cholesterol), lower HDL (healthy cholesterol) levels, and increase risk for heart disease and diabetes. The FDA declared them no longer safe to consume, which greatly reduced their use. 

However, they’re not gone from the food supply. FDA spokesperson Dani Schor explained in an interview with MDLinx that some PHOs are approved as food additives, and food manufacturers may still obtain approval for certain uses of PHOs in foods. Furthermore, foods with less than 0.5 grams of trans fat per serving are listed on the nutrition label as “trans fat, 0 grams.”

Furthermore, all liquid vegetable oils that have been “deodorized” during the refining process—to give them their bland taste that consumers want—contain some trans fat, according to a blogpost by Guy Crosby, PhD, a food chemistry researcher and adjunct associate professor of nutrition at Harvard T.H. Chan’s School of Public Health. These trans fats are not included on the product’s labeling. These oils include the four most popular ones consumed in the United States—soybean, corn, canola, and palm.

Eating foods with even small amounts of trans fat on a regular basis can add up to a dangerous amount over time. What’s the best way to avoid trans fat? When choosing oils, select extra virgin, first cold-pressed oils from reputable, high quality sources. Scan the ingredient lists from other foods for the words “shortening,” or “hydrogenated” oils. When eating outside the home, avoid deep-fried foods.

Pay special attention to the ingredients lists and labels of the most common food sources of PHOs:

  • Shortening/margarine 

  • Microwave popcorn 

  • Packaged snacks like chips 

  • Baked goods or doughnuts 

  • Ready-to-use dough or frozen pizza 

  • Fried foods, including french fries and chicken 

  • Coffee creamer 

Read These fats are actually good for you on MDLinx.

The lie of ‘decaf’

Caffeine is the most widely used drug in the world and coffee is among the biggest dietary sources of its intake. At the same time, various medical conditions necessitate caffeine-restricted diets, and caffeine is contraindicated for patients taking certain medications. In addition, the NIH is advising pregnant women to limit or forgo even moderate caffeine consumption. Their recent NIH study published by JAMA found that consuming even small amounts of caffeine—equivalent to half a cup of coffee per day—was associated with lower birth weight. Despite caffeine’s addition to many popular foods and soft drinks, the food industry is not required to clearly list the amount of caffeine per serving on the nutrition label. 

“Decaf” doesn’t mean caffeine-free and cups can quickly add up: The Starbuck website lists the caffeine content of its decaf coffee at 25 mg per 16 oz cup. Furthermore, in espresso drinks, each decaf espresso “shot” can contain up to 16 mg of caffeine, according to a study published in the Journal of Analytical Toxicology. Most espresso drinks use at least 2 shots, meaning a decaf espresso drink can have as much caffeine as a can of regular Coca-Cola (34 mg for a 12-ounce can). Mocha syrup, a popular add-in, adds significantly more caffeine. 

The best way to avoid caffeine? Choose iced or hot herbal tea. Find out How much caffeine is too much? on MDLinx.

Fruit or ‘veggie’ snacks that aren’t

Another concern is questionable drinks or snacks with misleading references to fruits or vegetables in their names or on the front of packaging, such as vegetable chips or straws and fruit rolls or drinks. “They’re especially concerning considering these are foods that parents might serve their kids,” Greenthal said. “The form of vegetable they provide is a powder that may be stripped of the nutrients and fiber that make vegetables healthy.”

Serving these highly processed foods may make people less likely to eat whole intact fruits and vegetables. In fact, a study of children participating in after-school programs showed that they seldom choose fruit when it is served alongside sugar-sweetened or salty flavored grain-based snacks, according to the article published in the Journal of the Academy of Nutrition and Dietetics.

Find out about 10 ‘healthy’ snacks you should avoid on MDLinx.

Bottom Line 

According to CSPI’s Greenthal, “the United States is falling behind many other countries when it comes to front-of-package nutrition labeling that allows consumers to cut through the food industry’s noise about a given product and quickly identify healthier foods.” Until such changes are made, keep a watchful eye for tricks that make foods seem healthier than they are.

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