On October 26, 2010, the Institute of Medicine held the first meeting of its Phase II “Examination of Front-of-Package Nutrition Rating Systems and Symbols.” As discussed in our client advisory regarding IOM’s Report on Phase I of the “Examination of Front-of- Package Nutrition Rating Systems and Symbols,” Phase II will focus on consumer understanding and use of front-of-package systems and symbols. IOM is charged with considering which icons are the most effective with consumer audiences, developing conclusions about the systems and icons that best promote health and how to maximize their use, and assessing the potential benefits of a single, standardized front-label food guidance system regulated by the Food and Drug Administration (FDA).

The public portion of the meeting was divided into two sessions. Session I, entitled “"Recent Consumer Research on FOP Systems and Symbols,” included presentations on the effectiveness of front-of-package (FOP) systems and symbols by FDA, Yale University's Rudd Center on Food Policy and Obesity, the Grocery Manufacturers Association, and the International Food Information Council Foundation. Alan Levy, a Senior Scientist in the Office of Regulations and Policy at FDA’s Center for Food Safety and Nutrition (CFSAN), and Chung-Tung Joi, a supervisory consumer science specialist at CFSAN, presented on behalf of FDA.

Session II, entitled “Additional Research Issues," included presentations regarding "Health Literacy and Population Subgroups," which was addressed by Christina Zarcadoolas of Mt. Sinai School of Medicine, "Consumer Use of Back of Panel (NHANES analyses)," which was addressed by John Kozup of Villanova University, and the "Relationship of Labeling to Product Reformulation," which was addressed by Christina Johnson of the New York City Department of Health and Mental Hygiene.

The IOM workshop demonstrates that more research is necessary to identify the most effective FOP labeling system for the United States. During his remarks, Alan Levy noted that FDA would like to position FOP labeling to obtain an "iconic" status, where FOP labeling "causes people to think about nutrition." According to Levy, FDA would like FOP labeling to become a "brand" similar to the Nutrition Facts Panel, in which consumers “look to [FOP labeling] for key health information.” When asked FDA’s position on establishing a mandatory FOP labeling system, Levy stated that the Agency has not taken a position on whether FOP labeling should be mandatory, but noted that without a widely used system “that appears on both obviously good and obviously bad products,” it would be difficult for FOP labeling to “achieve the iconic status it needs to become the go to place” for helpful nutrition information.

According to Christina Johnson of the New York City Department of Health and Mental Hygiene (NYC DHMH), the NYC DHMH believes that FDA should take an aggressive approach in establishing a FOP labeling system, and recommends, among other things, that FDA establish a mandatory FOP labeling system and a national nutrient database for food products to monitor compliance. The NYC DHMH also recommends use of a system that was not developed by industry.