Truth AND Consequences — Health and Communications

If the purpose of food package nutrition labels is to enable consumers to make better decisions about their health, then those labels should highlight not just the nutritional contents, but also the consequences of consuming any specific food or its components.

Most countries now have some requirement for nutrition labeling of packaged food. In the US, the labels list items like cholesterol, sodium, protein, calories, and various vitamins and minerals, all coupled with percent daily values (DVs). But this information alone isn’t sufficient to make health decisions. The consumer is left to translate the contents and DVs into meaningful healthy practices.

In the example of a redesigned label below [ * ], consumers can now see facts about both nutrition and consequences. Information has been added to communicate the risks and benefits (highlighted in yellow) of the various ingredient components. With this addition, a consumer who exceeds the DA for sodium now knows that they haven’t just crossed some magic line but actually increased their risk for hypertension. That’s a real and understandable consequence.

Mock-up of a Nutrition Facts label modified to show consequences.

There are even some precedents for such consequence labeling. In the US, wine must contain this warning:

(1) ACCORDING TO THE SURGEON GENERAL, WOMEN SHOULD NOT DRINK ALCOHOLIC BEVERAGES DURING PREGNANCY BECAUSE OF THE RISK OF BIRTH DEFECTS. (2) CONSUMPTION OF ALCOHOLIC BEVERAGES IMPAIRS YOUR ABILITY TO DRIVE A CAR OR OPERATE MACHINERY, AND MAY CAUSE HEALTH PROBLEMS. [ 1 ]

And cigarette packages, for example, must contain one of these warnings:

WARNING: Cigarettes are addictive.
WARNING: Tobacco smoke can harm your children.
WARNING: Cigarettes cause fatal lung disease.
WARNING: Cigarettes cause cancer.
WARNING: Cigarettes cause strokes and heart disease.
WARNING: Smoking during pregnancy can harm your baby.
WARNING: Smoking can kill you.
WARNING: Tobacco smoke causes fatal lung disease in nonsmokers.
WARNING: Quitting smoking now greatly reduces serious risks to your health. [ 2 ]

Of course, given the interests of food producers and processors, it’s highly unlikely that such labels would ever be required by the government. That said, one group that might especially benefit from such labeling are teens, a cohort with a notorious inability to calculate consequences [ 3 ] and a predisposition to eating unhealthy foods [ 4 ].

But if consequence labels for packaged foods are never going to happen, what is the point? Simply this: that just as health communicators have an obligation to report results and not just activity, reporting on consequences can also be a powerful way to clarify and frame a situation.

Take, for example, universal childhood vaccination. Beyond the obvious consequences of reduced infant deaths, suffering, and wasting, there are also outcomes like these:

Higher child survival rates will lead to lower fertility rates
Which will mean fewer premature births and fewer women dying in childbirth
Which will lead to more stable families, higher total-family incomes
etc.

Chains of consequences like this, showing the health, economic, and social benefits of an action, help to make compelling and persuasive arguments for initiatives like vaccinations. In other words, sharing consequences can have consequences.

NOTES

[ * ] This label design is just an example for purposes of this dicusssion. The exact wording of the consequences sections would have to be carefully crafted to convey that quantities of some nutrients, like sodium, are essential for life while lower or higher quantities can contribute to severe negative health outcomes.

[ 1 ] https://www.ttb.gov/pdf/brochures/p51901.pdf

[ 2 ] https://www.fda.gov/downloads/tobaccoproducts/labeling/rulesregulationsguidance/ucm276631.pdf

[ 3 ] https://www.npr.org/templates/story/story.php?storyId=124119468

[ 4 ] https://www.sciencedirect.com/science/article/pii/S2211335516300857