NYHealth submitted the following comments in support of the FDA’s proposal to develop a mandatory, interpretive Front-Of-Package labeling system for nutrients to limit (i.e., saturated fat, sodium, and added sugars) and urged the agency to require labeling only when a product is high in these nutrients.
May 16, 2025
Docket Management Staff
Department of Health and Human Services
Food and Drug Administration
5630 Fishers Lane, Rm 1061, Rockville, MD 20852
Docket ID: FDA-2024-N-2910
Re: Food Labeling: Front-of-Package Nutrition Information
Dear Docket Management Staff:
The New York Health Foundation (NYHealth) appreciates the opportunity to comment on the Food and Drug Administration’s (FDA’s) proposed rule regarding front-of-package (FOP) nutrition information. NYHealth is a private foundation that works to improve the health of all New Yorkers, especially people of color and others who have been historically marginalized.[1] Our Healthy Food, Healthy Lives program seeks to advance policies and programs that connect New Yorkers with the food they need to thrive.[2] Our work has provided us with in-depth knowledge of how dietary diseases linked to saturated fat, sodium, and added sugars harm New Yorkers, as well as ways the proposed rule could help to improve dietary health in New York and across the country.
We support the FDA’s proposal to develop a mandatory, interpretive FOP labeling system for nutrients to limit (i.e., saturated fat, sodium, and added sugars). We urge the agency to require labeling only when a product is high in these nutrients.
- FOP Labeling Could Help to Reduce Dietary Disease in the United States
Dietary diseases are the leading cause of death in the United States. Poor diet, high blood pressure, and obesity are three of the four top risk factors for morbidity and mortality across the country.[3] New York is no exception; nearly two-thirds of all adults are obese, and approximately one-third have hypertension.[4],[5] For Black, Hispanic, and low-income individuals, these rates are typically higher.
Nutrition facts labeling systems could help to reduce dietary disease by promoting healthier consumer choices and industry reformulation.[6] But to realize these potential benefits, consumers must actually use the labels, and use of the current labeling system is not consistent. Less than half of U.S. adults regularly consult the Nutrition Facts Panel when purchasing a product.[7] And individuals with lower incomes and lower educational attainment—individuals more likely to suffer from dietary disease—are less likely to use the Nutrition Facts Panel.[8],[9] Evidence from countries that have implemented FOP labeling systems suggests that a mandatory, interpretive system that focuses on nutrients to limit and only requires labeling for products that are “high-in” these nutrients could better support consumer choice.[10],[11]
FDA Must Mandate FOP Labeling
For the proposed FOP labeling system to be useful, it must be mandatory. Many food and beverage companies are unlikely to adopt FOP labeling if the system is voluntary. Inconsistent adoption by food companies would likely undermine understanding and use of the system, as consumers would not be able to consistently compare products. And most likely, the companies that consumers are most likely to want more information from—companies with products that are high in saturated fat, sodium, and added sugar—would be least likely to adopt the scheme, if voluntary.
Unsurprisingly, in countries that have voluntary policies, uptake has been low. For example, less than half of the eligible products in Australia and only 50% of sales in France, both countries with voluntary schemes, included FOP labeling. Low uptake in countries with voluntary policies has prompted the World Health Organization to recommend that these countries “explore ways to overcome issues with uptake of the FOP [labeling] system in the marketplace, including through mandatory implementation.”[12] NYHealth agrees with the FDA that the U.S. should learn from other countries’ experiences and mandate FOP labeling.
To Help Consumers Avoid Unhealthy Products, FOP Labeling Must be Interpretive
NYHealth also agrees with the FDA that an interpretive labeling system is necessary. Labels that help consumers translate numbers from the Nutrition Facts Panel—for example, labels that indicate when foods are high in saturated fat, sodium, and added sugars—can help consumers make better choices at the point of purchase. The FDA’s food labeling literature review, its focus groups, and a National Academy of Medicine review all confirm this.[13],[14],[15]
FOP systems that do not help consumers make sense of Nutrition Facts Panel numbers do not typically influence consumer behavior.[16],[17] Research shows consumers are much less likely to identify healthier products using FOP systems like Facts Up Front than stoplight or other warning systems.[18],[19] To ensure that the new FOP system is as effective as possible, FDA must ensure that the system is interpretive, as the agency has proposed.
An FOP System Should Only Include Nutrients to Limit
As the FDA has proposed, limiting FOP labeling to saturated fat, sodium, and added sugars should help consumers distinguish healthy from unhealthy products. The U.S. Dietary Guidelines for Americans encourages individuals to reduce intake of these three nutrients, yet consumption far exceeds recommended values.[20] At the same time, individuals’ consumption of many positive nutrients falls short of recommended values. But, including positive nutrients in an FOP system, as some companies might suggest, would be confusing and duplicative. Participants in the FDA’s focus groups struggled to make sense of a system that included both, and the agency already allows companies to advertise health-promoting aspects of food through nutrient-content claims.[21]
FDA Should Employ a “High In” Style FOP Label
To further reduce confusion, the FDA should only require FOP labeling when a nutrient to limit is “high.” The FDA has proposed a label to disclose whether a product was high, medium, or low in saturated fat, sodium, and added sugar. Under this system, a product like Coca-Cola that was high in added sugar but low in saturated fat and sodium might appear healthier than it is: consumers might misinterpret the two “lows” and one “high” as canceling each other out. In contrast, a single warning for added sugar under the “high in” labeling system would better reflect the nature of the product. Studies of the countries that have instituted “high in” systems suggest this more straightforward approach can improve the healthfulness of foods consumers purchase. Research also suggests that “high in” FOP labeling schemes can encourage reformulation, as companies seek to avoid labeling.[22] The FDA should adopt this tried-and-true approach and require disclosure only when a product is high in a nutrient to limit.
Conclusion
Thank you for the opportunity to provide comments on this rule. A mandatory, interpretive FOP labeling system has the potential to improve consumer choice and healthy product availability in New York and across America. For these reasons, the New York Health Foundation supports this proposed rule, and we look forward to supporting the FDA’s implementation efforts in the near future.
Sincerely,
Julia McCarthy, J.D.
Senior Program Officer
[1] New York Health Foundation. What we do. https://nyhealthfoundation.org/what-we-do/. Accessed January 2025.
[2] New York Health Foundation. Healthy food, healthy lives. Available from: https://nyhealthfoundation.org/what-we-fund/healthy-food-healthy-lives/.
[3] The US Burden of Disease Collaborators. The state of U.S. health, 1990-2016 burden of diseases, injuries, and risk factors among U.S. states. JAMA. 2018;319:1444-1472.
[4] New York Behavioral Risk Factor Surveillance System. Overweight and obesity: New York State adults, 2021. Available from: https://www.health.ny.gov/press/releases/2023/2023-06-20_obesity.html.
[5] New York Behavioral Risk Factor Surveillance System. High blood pressure: New York State adults, 2021. Available from: https://www.health.ny.gov/statistics/brfss/reports/docs/2023-11_brfss_high_blood_pressure.pdf.
[6] Food & Drug Administration. FDA’s nutrition initiatives. 2025, May 9. Available from: https://www.fda.gov/food/nutrition-food-labeling-and-critical-foods/fdas-nutrition-initiatives.
[7] Center for Science in the Public Interest. Front-of-package nutrition labeling: leveraging food labels to inform consumers and promote public health. 2023, January 10. Available from:https://www.cspinet.org/sites/default/files/2023-01/FOPNL%20Fact%20Sheet_1.10.23_final.pdf.
[8] Ollberding NJ, Wolf RL, Contento I. Food label use and its relation to dietary intake among U.S. adults. J Am Diet Assoc. 2010;110(8):1233-1237.
[9] Storz MA. Nutrition facts labels: who is actually reading them and does it help in meeting intake recommendations for nutrients of public health concern? BMC Public Health. 2023;23(1), 1947.
[10] Croker H, Packer J, Russell SJ, Stansfield C, Viner RM. Front of pack nutritional labelling schemes: a systematic review and meta-analysis of recent evidence relating to objectively measured consumption and purchasing. J Hum Nutr Diet. 2020; 33(4):518-53
[11] Song J, Brown MK, Tan M, et al. Impact of color-coded and warning nutrition labelling schemes: a systematic review and network meta-analysis. PLoS Med. Oct 2021;18(10):e1003765.
[12] Kelly B, Jewell J. What is the evidence on the policy specifications, development processes and effectiveness of existing front-of-pack food labelling policies in the WHO European Region? Vol. Report 61. 2018. Available from: https://www.euro.who.int/__data/assets/pdf_file/0007/384460/Web-WHO-HEN-Report-61-on-FOPL.pdf
[13] Verrill L, et al. Consumer reactions to front-of-package nutrition labeling schemes on foods versus beverages—2023 focus group findings. U.S. Food & Drug Administration. 2023. Available from: https://www.reginfo.gov/public/do/PRAViewIC?ref_nbr=202008-0910-021&icID=262002.
[14] Verrill L, et al. Front of package labeling literature review. U.S. Food & Drug Administration. 2023. Available from: https://www.fda.gov/food/nutrition-food-labeling-and-critical-foods/front-package-nutrition-labeling.
[15] Wartella EA, et al. Examination of front-of-package nutrition rating systems and symbols: promoting healthier choices. The National Academies Press. 2012. Available from: https://nap.nationalacademies.org/catalog/13221/front-of-package-nutrition-rating-systems-and-symbols-promoting-healthier.
[16] Neal B, Crino M, Dunford E, et al. effects of different types of front-of-pack labelling information on the healthiness of food purchases-a randomised controlled trial. Nutrients. Nov 24 2017;9(12).
[17] Ducrot P, Julia C, Mejean C, et al. Impact of different front-of-pack nutrition labels on consumer purchasing intentions: a randomized controlled trial. Am J Prev Med. May 2016;50(5):627-636.
[18] Deliza R, de Alcantara M, Pereira R, Ares G. How do different warning signs compare with the guideline daily amount and traffic-light system? Food Quality & Preference. 2020;80.
[19] Arrua A, et al. Warnings as a directive front-of-pack nutrition labelling scheme: comparison with the Guideline Daily Amount and traffic-light systems. Public Health Nutr. Sep 2017;20(13):2308-2317.
[20] U.S. Department of Agriculture, Health & Human Services. Dietary Guidelines for Americans, 2020-2025. 9th ed. 2020. Available from: https://www.dietaryguidelines.gov/ sites/ default/ files/ 2020-12/ Dietary_ Guidelines_ for_ Americans_ 2020-2025.pdf.
[21] Verrill L, et al. Consumer reactions to front-of-package nutrition labeling schemes on foods versus beverages—2023 focus group findings. U.S. Food & Drug Administration. 2023. Available from: https://www.reginfo.gov/public/do/PRAViewIC?ref_nbr=202008-0910-021&icID=262002.
[22] Rebolledo N, et al. Changes in the critical nutrient content of packaged foods and beverages after the full implementation of the Chilean Food Labelling and Advertising Law: a repeated cross-sectional study. BMC Medicine. 2025;23(1):46.
