The Controversy Surrounding Smart Choices

by Kelly Dumke and Rachel Zavala

Dean Eileen Kennedy keeps a 100-calorie box of Froot Loops perched on her desk, a Smart Choices “memento” from her infamous quote published in the New York Times.

“You’re rushing around, you’re trying to think about healthy eating for your kids and you have a choice between a doughnut and a cereal,’ Dr. Kennedy was quoted as saying, evoking a hypothetical parent in the supermarket. ‘So Froot Loops is a better choice.”

The notorious quote led to a firestorm of criticism regarding the Smart Choices Program, a front-of-package (FOP) label system based on the federal Dietary Guidelines for Americans developed by a conglomerate of food industry leaders, academia, nutritionists, and public interest organizations.

Health experts, government officials, and some nutrition academia questioned the program’s nutritional guidelines, first introduced in August, when the green checkmark denoting a “smart choice” appeared on pre-sweetened cereals, snacks, and sandwich spreads lining grocery store shelves. Critics also questioned the influence of private industry, the nutritional agenda’s of several public health institutions, and consumer confusion.

Dr. Marion Nestle, senior professor of nutrition at New York University, questions how the American Society of Nutrition (ASN) and other nutrition experts can objectively evaluate the nutritional merits of the Smart Choices Program (which she calls in her blog Food Politics the “Better than a Donut Program”) when private industry pays for the program.

“Kellogg’s and other participating companies pay up to $100,000 for that seal. No wonder the ASN and everyone else involved in the program wanted to set the nutrition standards so loosely…The more products that qualify for the Smart Choices logo, the more money the program gets. I’d call that a clear conflict of interest,” she writes in her blog.

Mark Bittman, a New York Times journalist, questions the impact of the Smart Choices Program on the program’s target audience – consumers. “When sugar is 40% by weight of the product…what is the product? The product is dessert! You could put vitamins and minerals in garbage and garbage would meet the nutritional requirements [of the Smart Choices Program] as long as the garbage is low in fat.”

Following the slew of public criticism, the Food and Drug Administration (FDA) issued a Guidance for Industry letter in late October in which the agency announced that it will analyze misleading food labels and intends to develop a universal FOP labeling system that all food manufacturers must follow. The FDA did not name the Smart Choices Program specifically, but the program subsequently decided to suspend the use of its logo.

Meanwhile, Connecticut Attorney General Richard Blumenthal announced in October he is launching an investigation into the research and selection measurements utilized in the Smart Choices Program, as well as the process and payments involved in administering the program.

Smart Choices and FOP labeling defined
The not-for-profit Smart Choices Program was developed in response to the need for a single FOP labeling system to help consumers make smarter food and beverage choices. The program’s standards were developed by a panel of scientists, academia, health and research organizations, food and beverage manufacturers and retailers across a two-year time span. There is a fee for food companies to participate in the labeling program based on annual sales and number of products enrolled.

The FDA regulates nutrition labels on food and beverage products. Therefore, they are a major player in the FOP labeling debate with the potential to mandate, abolish, or implement standardized practices for all food and beverage retailers.

In this case, the majority of accessible facts come directly from the dialogue between the Smart Choices Program and the FDA. Specifically, three public documents have been released – two from the FDA and one from the Smart Choices Program – that outline each institutions position on FOP labeling.

After the initial launch of the Smart Choices Program in August, government officials composed a letter to the managers of the Smart Choices Program regarding their concerns about the new program. The FDA Senior Advisor for Food Safety, Michael R. Taylor, and the Deputy Undersecretary of Food Safety, Jerold R. Mande, state that the FDA “recognizes the potential value of a standardized approach for FOP labeling.” However, the FDA “would be concerned if any FOP labeling systems used criteria that were not stringent enough to protect consumers against misleading claims; were inconsistent with the Dietary Guidelines for Americans; or had the effect of encouraging consumers to choose highly processed foods and refined grains instead of fruits, vegetables, and whole grains,” the letter states.

Meanwhile, continued negative press coverage of the Smart Choices Program prompted another FDA memo. In mid-October, the FDA’s “Guidance for Industry: Letter Regarding Point of Purchase Food Labeling,” addressed the food industry as a whole.
The FDA is concerned that the numerous FOP labeling systems all rely on different nutrient criteria, leaving consumers confused about the nutritional content of foods. As a result, the FDA intends to determine what should be on a FOP label; evaluate whether the label effectively reaches consumers; and standardize FOP labeling criteria—but not necessarily the symbol.

The FDA is aiming to work with the food industry, nutrition experts, the United States Department of Agriculture (USDA), and the Institute of Medicine (IOM), with the goal of “develop[ing] an optimal, common approach to nutrition-related FOP and shelf labeling that all Americans can trust and use to build better diets and improve their health.”

The Smart Choices Program issued a press release on October 23 in response to the FDA’s “Guiding Industry” letter. The release stated that the program would postpone “active operations and not encourage wider use of the logo at the time.” Smart Choices program officials stated that they welcomed the FDA’s interest in the FOP labeling system.

Despite the controversy Dean Kennedy still believes in Smart Choices.  “It is an important program that has gotten skewed coverage. It is not just about one product; it is about an overall dietary pattern that adheres to the Dietary Guidelines.”

The Future of Smart choices and FOP
According to the program’s press release, Smart Choices is no longer actively recruiting companies or encouraging enrolled companies to continue to use the logo. The FDA has scheduled hearings and research panels, including the IOM, with the ultimate goal of producing a standardized nutrient criteria and label that effectively reaches consumers at the point of purchase, green check or not. The FDA intends to publish the mandate by the end of 2010.

According to Dean Kennedy, the Smart Choices program still exists, and was designed to be “flexible as new science comes out to modify [the program’s] criteria.” Dean Kennedy is unsure if all eight food manufacturers will continue to participate in the program once the FDA issues its FOP mandate at the end of 2010, but hopes that more manufactures will join.

“It will make it easier once there is a government mandate to entice more companies to participate,” she adds. “There is a lot of momentum from the FDA to get this done quickly.”

The Smart Choices Program continues to hold board calls, and is scheduled to meet with the FDA in December. The program will most likely meet with the USDA as well, but no date is scheduled thus far.

Despite the torrent of criticism surrounding her involvement in the program, Dean Kennedy never thought of stepping down.  “I don’t think intimidation tactics work for science discourse. This has been two- and-half years of serious discussion, and did not emerge out of thin air.”

Friedman Student’s Response
In response to the Smart Choices Program fallout, a Friedman School student forum has emerged to develop a nutrition-labeling blueprint that it hopes to present at the FDA’s public hearings.

Two major forces drive Friedman student involvement in this debate:
1.) A desire to alleviate consumer confusion about nutrition labels,
2.) An undeniable link, intentional or not, between the Friedman School as a nutritional authority and the Smart Choices Program controversy involving the school’s dean.

Although the latter point is secondary to the students’ concern about nutritional labeling, students question how the controversy has effected the school’s reputation. The informal student forum’s main focus is to address the problem of consumer confusion and nutritional labeling from a public health perspective rather than a profit-driven industry perspective.

“People don’t know what they’re buying…foods are more complex and health messages are confusing. There is a definite conflict of interest when the same people who put these products into the market are the one’s trying to come up with a [nutrition label] solution,” states Vlad Kustanovich, one of the founders of the student discussion forum.

The forums hopes to parallel IOM efforts by drafting several recommendations and possibly participate in early 2010 FDA hearings on FOP labeling. Mandates from the FDA have been vague and students are hoping to gain a clearer understanding of the FDA goals in order to have a real impact. “Until we know what we can contribute…we are trying to keep it [the discussion] broad,” says Kustanovich.

Dean Kennedy lends support to the forum stating, “I think the students are being very thoughtful. They come at it from a lot of different perspectives, which is helpful. No point of view has emerged yet, they are just trying to synthesize complex information,” Dean Kennedy has agreed to fund two students to travel to Washington, DC to present their findings.

Jesse Roberts, another founder of the student forum, says “The thing is…we all care, but the question is…what can we do?”
If you are interested in being part of the ongoing discussion and producing actual results to address the ongoing FOP labeling debate contact Vlad (vladimir.kustanovich@tufts.edu) or Jesse (jesse.roberts@tufts.edu).

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