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This article examines nutrition labeling history as well as the findings of nine research studies of nutrition labeling formats. Nutrition labeling regulations were announced in 1973 and have been periodically amended since then. In response to requests from consumers and health care professionals for revision of the labeling system, the Food and Drug Administration initiated a three-phase plan for reform of nutrition labeling in 1990. President Bush signed the Nutrition Labeling and Education Act in November 1990. Literature analysis revealed that only nine studies with an experimental design have focused on nutrition labeling since 1971. Four were conducted before 1975, which was the year that nutrition labeling was officially implemented, two were conducted in 1980, and three were conducted after 1986. Only two of the nine studies supported the traditional label format mandated by the Code of Federal Regulations, and one study partially supported it. Four of the nine studies that evaluated graphic presentations of nutrition information found that consumer comprehension of nutrition information was improved with a graphic format for nutrition labeling: three studies supported the use of bar graphs and one study supported the use of a pie chart. Full disclosure (ie, complete nutrient and ingredient labeling) was preferred by consumers in two of the three studies that examined this variable. The third study supported three types of information disclosure dependent upon socioeconomic class. In those studies that tested graphics, a bar graph format was significantly preferred and showed better consumer comprehension than the traditional format.

This study estimated the effects of changing multiple levels and combinations of nutrition information format, load, expression, and order on consumers' perceptions of label usefulness in purchase decisions using adaptive conjoint analysis. A shopping mall intercept survey, which was administered by a marketing research firm, assessed consumer preferences for 12 label alternatives produced on Campbell's soup cans to portray nutrition information realistically; 252 of 258 respondents completed the computer interactive interview. Consumers significantly preferred the bar graph format to the bar graph/nutrient density and traditional label formats. Consumers considered the bar graph/nutrient density format to be as useful as the traditional label format. There was a highly significant difference among the three levels of information load; the most information load was preferred regardless of nutrient importance. Consumers significantly preferred nutrition information stated in absolute numbers and percentages vs in absolute numbers only in traditional, or in percentages only expressions. There was a significant difference between consumer preferences for the two types of information order. The findings indicate that consumers clearly preferred the nutrition label that displayed all nutrient values using a bar graph format, offered the most information load, and expressed nutrient values using both absolute numbers and percentages. Consumers also preferred nutrition information rearranged in an order that grouped nutrients that should be consumed in adequate amounts on the top, calories in the middle, and nutrients that should be consumed in lesser amounts on the bottom of the label.

On the basis of an analysis of three-day food records, food comsumption by major segments of the U.S. population was examined for 65 food groups and subgroups. This study indicates that demographic factors, particularly age, race, and region, can affect both the percentage of persons using certain foods and the mean frequency of their use. Both the similarities and the differences on these parameters are of interest when food usage is examined by demographic variables.

Seventeen lactating women who delivered preterm infants (between 28 to 34 wk of gestational age) and 26 nursing mothers of term infants participated in the study. Each term mother kept a record of 2-day dietary intakes, collected urines for 2 days, and provided fore and hind milk samples and a fasting blood sample at 2 and 12 wk postpartum. Each of preterm women provided fore and hind milk samples once a week for 16 wk starting 2 wk postpartum. The method of determining pantothenic acid content in milk samples was validated, and the vitamin was quantitated by the radioimmunoassay. The average pantothenate levels in fore and hind samples of preterm milk (3.31 and 3.72 micrograms/ml, respectively) were significantly (p less than 0.05) higher than those of term milk (2.64 and 2.48 micrograms/ml, respectively). No significant change was observed in pantothenic acid content within a feeding or with the progress of nursing in both groups. The vitamin content of human milk was compared with the minimum requirement of the Infant Formula Act of 1980. The pantothenate level in term milk was significantly (p less than 0.05) correlated with the vitamin level in maternal circulation and with that of the dietary intake and urinary excretion.

Seventy-five foods in a ready-to-eat state were analyzed for pantothenic acid using a new radioimmunoassay. Meats, potatoes, oat cereals, tomato products, and whole grains were among the better sources of pantothenic acid, supplying from 2 to 9 mg. per 1,000 kcal. Fruit products and corn-based and presweetened cereals were among the poorest sources of the vitamin. Results of the study suggest a need for careful selection of foods for pantothenic acid content by individuals on a low-energy diet.

The Index of Nutritional Quality (INQ) is a method of quantitative and qualitative analysis of single foods, meals, and diets which has special significance in assessing clinical nutritional problems. The INQ is a ratio of the nutrient-to-calorie content of foods which may be calculated by computer and printed as bar graphs and tabular data. The number of nutrients and the nutrient standards used for analysis are flexible parameters which may be varied for each clinical situation. Illustrative examples include INQ analysis of simple foods, an institutional house diet, the diabetic Exchange list, and the diagnostic evaluation of the dietary intake of a hospitalized patient.

Past intervention efforts have not been effective in solving the nutrition problems in either industrialized or developing nations. While it may be intellectually stimulating, arguing over the subtleties of various strategies does not serve to improve the nutritional well-being of populations and may actually be detrimental. Whether we are concerned about an excess of calories or an inadequate supply of calories, the issue of calories is critical worldwide. A nutrient density approach provides a unified, scientifically justifiable, comprehensive approach to improving the nutritional status of populations in both developed and developing countries.

Using available food composition data, individual Exchange Lists within the revised Exchange Lists for Meal Planning were evaluated for calories; protein; fat; calcium; phosphorus; iron; sodium; potassium; vitamin A; thiamin; riboflavin; niacin; ascorbic acid; saturated, oleic, and linoleic fatty acids; cholesterol; and crude fiber. Mean values, standard deviations, and ranges are reported for the above nutrients. Mean values agreed well with those suggested in the booklet for grams of carbohydrates, protein, and fat and for calories for all lists except milk. However, a wide range in values exists for food within each Exchange List.

Information on human needs for pantothenic acid is limited and no recommended daily allowance has been established, although a safe and adequate level of 4-7 mg/day has been suggested for adults and adolescents. Pantothenic acid levels in urine, whole blood, and erythrocytes were determined by radioimmunoassay in 63 healthy adolescents. Dietary intakes were calculated and evaluated from 4-day diet records. Although 49% of the females and 15% of the males consumed less than 4 mg/day, average blood levels for both groups were in a normal range relative to other populations (411.9 +/- 102.8 ng/mL and 344.5 +/- 113.6 ng/mL, respectively). Dietary intake was highly correlated with urinary excretion (p less than 0.001). Levels of pantothenic acid in erythrocytes correlated well with dietary intake and urinary excretion. A model was developed to predict circulating levels of pantothenic acid from dietary intake and urinary excretion.

With data from the U.S. Department of Agriculture's nutrient densities of diets of 7,810 individuals more than 4 years old were evaluated by use of the Index of Nutritional Quality (INQ) and standard dietary allowances per 1,000 kcal. With the exception of vitamins A and C, the nutritional quality of food consumed by various sex-age groups was remarkably consistent, despite wide variations in total calories consumed. The average concentrations of calcium, iron, magnesium, and vitamin B6 were not sufficient to meet recommended allowances. The reasonableness of recommended standards and the utility of the nutrient density concept for improving food habits of the population are discussed in view of these new data.

Nutrietn density profiles, generated for the individual subgroups within the revised Exchange Lists for Meal Planning, are presented. The authors suggest that the profiles would be useful for educational purposes.

The pantothenic acid (PA) and coenzyme A (CoA) content of various organs of rats maintained on a PA-deficient diet were determined. The PA content of heart, kidney, gastrocnemius and testes of rats fed the PA-deficient diet was reduced by greater than 90%, and liver PA was reduced by 70%. However, these low PA levels were sufficient to maintain tissue CoA at control levels. Although CoA levels were maintained, the PA-deficient rats did not grow at normal rates suggesting that low PA may effect growth rate by mechanisms other than by depressed CoA. PA-deficient rats were subjected to fasting and alloxan-diabetes to determine if increased CoA synthesis occurred as in normal animals. Both fasting and diabetes resulted in elevations in myocardial and liver CoA, which were comparable in rats fed a PA-deficient diet or a regular diet. The source of the PA used for the increase in tissue CoA in PA-deficient rats has yet to be determined.

Reported normal concentrations for human whole-blood total pantothenic acid vary from 1.1 to 12 mumol/L. This wide range may partly arise from the various enzymes used for liberation of pantothenic acid from coenzyme A, particularly the source of pantetheinase. A purified pantetheinase from pig kidney had greater than 100 times the specific activity and less than 0.01 times the pantothenate content of other commonly used extracts. Endogenous pantetheinase activity in human plasma was identified (11.2 +/- 2.0 mumol pantothenate .min-1.L-1, n = 29) and found comparable to the activity usually added from exogenous sources for liberation of pantothenate from whole blood (1-13 mumol.min-1.L-1). Alkaline phosphatase alone liberated as much pantothenate from hemolyzed whole blood as did alkaline phosphatase with pantetheinase. Previous reports of total blood pantothenate may be elevated by pantothenate in the pantetheinase extracts, an unnecessary source of error. Whole-blood total pantothenate concentrations less than 4.6 mumol/L are normal and do not indicate deficiency, as is often currently quoted.

This study was designed to determine whether any difference in taste acuity exists between individuals with a diagnosis of Type I diabetes mellitus and control subjects. Detection and recognition thresholds were evaluated for sodium chloride, sucrose, citric acid, and quinine sulfate. The results indicate that diabetes or age can decrease an individual's ability to detect and recognize sweet, salty, and bitter solutions. Decreased taste acuity in individuals with diabetes may be an important factor in the perception of food.

Alcoholic beverage data from the U.S. Department of Agriculture's Nationwide Food Consumption Survey (NFCS), 1977-78, were compared with apparent consumption data from the U.S. Department of Health and Human Services (DHHS). NFCS data indicate that only one-fifth of the alcohol estimated to be consumed by DHHS is reported at the household level. For those individuals consuming alcoholic beverages, energy levels were higher than for non-drinkers. Average daily nutrient intake for most nutrients was similar for drinkers and non-drinkers. The nutrient density of diets of drinkers was significantly lower than that of non-drinkers with respect to protein, fat, carbohydrate, calcium, iron, phosphorus, vitamin A, and thiamin.

Recent human studies suggest rapid in vivo hydrolysis of the lipid-lowering drug, pantethine, to the vitamin pantothenic acid and the small aminothiol compound, cysteamine. To test whether the active agent is a hydrolysis product, we repeated three experimental models of pantethine's effect with pantothenate and cysteamine. In vitro experiments with human fetal fibroblasts showed equivalent modulation of cholesterol and methyl sterol synthesis by pantethine, cysteamine, or cystamine (the disulfide of cysteamine), but pantothenate had no effect. Similarly, in vivo experiments with 0.5% cholesterol-fed rabbits showed oral pantethine or equimolar cystamine significantly lowered plasma cholesterol, while pantothenate, cystine, and 2-hydroxyethyl disulfide did not. Lastly, diabetic male rats (40 mg/kg streptozotocin) fed 0.1% pantethine and lower plasma free fatty acids after 2 weeks than controls, an effect not seen with pantothenate and largely duplicated by cystamine. The efficacy of pantethine has previously been attributed to altered vitamin metabolism and increased coenzyme A concentration. Pantethine did increase CoA levels 45% in rat liver homogenates while equivalent amounts of cystamine or pantothenate did not. However, a causal relationship between CoA levels and pantethine's action as a hypolipemic agent has never been shown. At least in 3 independent experimental models, the lipomodulating effect of pantethine appears instead to be mediated by the hydrolysis product cysteamine.

Pantothenic acid nutritional status was evaluated in 37 men (32 noninstitutionalized and five institutionalized) and 54 women (33 noninstitutionalized and 21 institutionalized) 65 yr of age or older. A fasting blood sample, a 24-h urine specimen and a food consumption record for 1 wk were obtained from each subject. Hematological, anthropometric, and dietary parameters indicated these 91 subjects were similar to elderly populations evaluated in other studies. Pantothenic acid was analyzed by both radioimmunoassay and microbiological assay. By combining methods it was possible to differentiate various forms and derivatives of pantothenic acid. Free pantothenic acid, but not the phosphoderivatives, was observed in urine. Microbiological and radioimmunoassay estimations of pantothenic acid showed good correlation (r = 0.91). Pantothenic acid excretion in the institutionalized subjects (7.5 +/- 1.3 (x +/- SEM) mg/g creatinine) was comparable to the excretion levels in the noninstitutionalized subjects (5.9 +/- 0.6 mg/g creatinine). Those consuming pantothenic acid supplements had significantly higher excretion levels. Blood pantothenic acid values between the groups, noninstitutionalized (537 +/- 27.4 ng/ml) and institutionalized (615 +/- 47.3 ng/ml), were comparable. The average dietary intake of pantothenic acid for the elderly population studied was 5.9 +/- 0.1 mg/day with the institutionalized and noninstitutionalized subjects having a similar intake of 2.9 mg/1000 kcal. Institutionalized elderly males and females were consuming 2237 and 1962 kcal, respectively, while their noninstitutionalized counterparts were consuming 2201 and 1887 kcal.

Mathematical clustering algorithms were used to classify foods within dairy, grain, and fat commodity groups on the basis of nutrients with limited availability in the food supply as well as those posing a possible health risk due to excess consumption. The procedure overcomes the problem that has made objective and accurate grouping, i.e., dealing simultaneously with 10 or more nutrients, difficult. The clustering routine classifies foods on the basis of similar nutrient content for any number of food attributes and assigns a degree of association to each food to indicate its compositional similarity to a prototype food for the cluster group. Foods within dairy, grain, and fat commodity groups were clustered on the basis of similar content of vitamin B-6, calcium, iron, magnesium, folacin, zinc, and added sugar, fat, cholesterol, and sodium. Whole milk and natural cheese clustered together on the basis of their moderate nutrient and relatively high fat and sodium content. Whole wheat breads, pumpernickel bread, and pancakes from mix constituted a grain subgroup with highest nutrient content, lowest cholesterol and sugar, lower fat, and higher sodium. Other subgroups based upon similarities in attributes were identified within food commodity categories. The result is an expansion of some food groups to incorporate concepts of both nutritional adequacy and moderation of food components of current nutritional concern.

Pantothenic acid nutritional status was evaluated longitudinally in 26 pregnant women (experimental group) during their third trimester of pregnancy and at 2 weeks and 3 months postpartum. Seventeen nonpregnant and nonlactating women (control group) participated at the same time intervals. All the women were assessed by the intake calculated from a reported 2-day dietary record and by fasted blood, plasma, and 24-hour urinary levels of pantothenate determined by a radioimmunoassay. Estimated daily mean dietary pantothenate intake and the vitamin density for the experimental group were not statistically different from those for the control group. The dietary pantothenate intake averaged 2.75 mg/1,000 kcal. Average pantothenate blood level of the experimental group was lower than that of the control group. No significant difference was found between the two groups in the pantothenate levels of fasting plasma and urinary excretion. When they did not take pantothenic acid supplements, members of the experimental group had intakes less than the Estimated Safe and Adequate Daily Dietary Intake and lower mean blood values than the members of the control group. This suggests that pregnant and lactating women need to consume more pantothenate to maintain a blood vitamin level similar to that of nonpregnant women. This may be achieved by an increased caloric intake, if desirable, or by more careful selection of foods high in the nutrient.

A review of the literature indicated a need for nutrition education materials to be current with prevailing scientific knowledge, using advanced instructional technology. Individuals need help in applying nutrition principles to their dietary practices. A nutrition education program utilizing the nutrient density concept and the dietary guidelines for use on videodisc with microcomputer interface was developed and evaluated. The evaluation of the program did not prove to be statistically effective, but learners did show an interest in the program and had positive feedback in regard to the information presented and the technology used.

The relative sweetness and acceptability of sucrose and fructose were determined at various levels in sugar cookies, white cake, vanilla pudding, and lemonade. Because of the reported increased sweetness of fructose and greater tolerance in individuals with diabetes mellitus for fructose, the study was designed to investigate its potential as an alternative sweetener. Results indicate that sucrose was both preferred and considered sweeter than fructose in sugar cookies, white cake, and vanilla pudding; however, the reverse was true in lemonade. On the basis of these results, the authors do not recommend the substitution of fructose for sucrose.