Public Health

What does the label say? Physicians seek transparency

It is difficult for patients to make choices that affect their health and well-being when essential information is inaccessible or misleading. At the 2018 AMA Interim Meeting in National Harbor, Maryland, the AMA House of Delegates (HOD) took action on several fronts to address that problem in the packaging and labeling of food and medical products.

Many front-of-package (FOP) labels on food products feature nutrient claims that suggest or imply nutritional properties related to its content of energy, proteins, fats, carbohydrates, dietary fiber, vitamins or minerals, according to a resolution presented by the AMA Medical Student Section.  

“Studies of responses to nutrition-related claims in food advertising have found that consumers over-generalize a product’s healthfulness based on narrower claims,” says the resolution.

The FDA regulates FOP claims by enforcing qualifying criteria that food products must meet for use of each individual nutrient claims. But there are no requirements that food products labeled with nutrient claims that can be generalized to imply healthfulness adhere to specific macronutrient claims. 

To limit the amount of added sugar a food product can contain if it carries any FOP label advertising nutritional or health benefits, delegates adopted new policy that encourages the FDA to:

  • Develop front-of-package warning labels for foods that are high in added sugars based on the established recommended daily value.
  • Limit the amount of added sugars permitted in a food product containing front-of-package health or nutrient content claims.

“The AMA believes that food packaging should include more transparent information about the contents within our food so the healthy choice can be the easy choice for consumers,” said Albert J. Osbahr, III, MD, a member of the AMA Board of Trustees.

“When consumers have access to the amount of sugar they are consuming they may choose foods with less sugar—which can help prevent debilitating chronic medical conditions, such as type 2 diabetes and heart disease which affect millions of Americans.”

Allergen labels on food packaging

“There has been a documented fatal anaphylactic food reaction in a teenager who unsuspectingly ate from packaging that resembled packaging of other, nonallergenic, food products,” says a resolution presented by the Indiana delegation, which notes that potentially fatal anaphylactic food allergies continue to rise in prevalence.

Delegates directed the AMA to "encourage food manufacturers to pursue more obvious packaging distinctions between products that contain the most common food allergens identified in the Food Allergen Labeling and Consumer Protection Act and products that do not contain these allergens." 

Animal-derived medical products

Several medications and surgical products contain ingredients that are derived from animal sources. Because patients may have strong religious convictions, cultural beliefs or vegetarian and vegan diets, it can lead them to object to using medical products with animal-derived ingredients (ADIs), according to an AMA Board of Trustees report whose recommendations were adopted.

Individuals who want to avoid animal-derived products may inquire about the origin or source of the ingredients in their medications. However, 70 percent of physicians were unaware that several medications contain ADIs because the information is inconsistently reported, difficult to obtain and sometimes incorrect, says the report. Seventy percent of physicians also thought it was important to inform patients who might object if such medications are prescribed.

Manufacturers are not required to declare on the label how an ingredient is sourced, which means it is not present in drug databases and clinical decision-support systems for physicians.

To increase awareness of animal-derived medical products, delegates adopted new policies to:

  • Urge manufacturers to include all ingredients and components present in medical products on the product label, including both active and inactive ingredients, and denote any derived from an animal source.
  • Encourage cultural awareness regarding patient preferences associated with medical products containing active or inactive ingredients or components derived from animal sources.