Label-Reading Difficult for Many

Perhaps you do need to be a Rhodes scholar--or at least a food scientist--to comprehend the information provided on food nutrition labels, says a new study published in the November issue of the American Journal of Preventive Medicine.

The article, "Patient Understanding of Food Labels: The Role of Literacy and Numeracy" by researchers from Vanderbilt University Medical Center, Nashville, TN, found that the reading and math skills of a significant number of people might not be adequate to determine accurate nutritional information from the current labels.

The study surveyed 200 primary-care patients from a wide socioeconomic range using standardized and validated tests for literacy. Experts designed a Nutrition Label Survey (NLS) to evaluate patient understanding and measure comprehension of nutrition labels. The survey asked subjects to interpret food labels, such as determining carbohydrate or caloric content of a specific amount of food and to choose which of two foods had more or less of a certain nutrient. Half of the questions referred to products that were clearly labeled as "reduced carb," "low carb," or designed for "a low-carb diet."

Of those surveyed, 68% had some college education, and 77% had at least 9th-grade level literacy skills. However, 63% had less than 9th-grade math skills. More than 40% suffered from a chronic illness, such as diabetes, that needed dietary intervention, and 23% reported being on a specific diet plan.

The patients correctly answered 69% of the NLS questions. However, only 32% could correctly calculate the carbohydrate content of a 20-oz. bottle of soda that contained 2.5 servings. Only 60% could figure out the carbohydrates in half a bagel when the serving size was a whole bagel. The net carbs in 2 slices of low-carb bread were determined correctly by 22% of the subjects. The study determined the most-common reasons for mistakes in working out the correct amounts were misapplication of the serving size, confusion by extraneous material on the label, and incorrect calculations.

Lead researcher Dr. Russell L. Rothman, M.P.P., concluded: "The study showed that many patients struggle to understand current food labels, and that this can be particularly challenging for patients with poor literacy and numeracy skills. Poor understanding of nutrition labels can make it difficult for patients to follow a good diet. Of particular concern are situations that involve interpretation and application of serving size. There are also opportunities for the FDA to improve how food labels are designed in order to improve how patients take care of their nutrition."