What to Look for in the New Nutrition Labels

Shopping for healthy food just got a whole lot easier.
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As a youngster, breakfast was always a favorite time of day. My siblings and I would convince Mom to buy all kinds of cereal, often based on the prize inside or the Saturday cartoon commercials. The kitchen table would be cluttered with boxes and, after we poured our selections, I’d build a small fortress around my bowl, where I’d read up on the games and offers on the back of each box.

One thing we didn’t do was read the nutritional label.  Actually, there wasn’t one in those days.

Nutritional labeling began in the early 1970s, when the Food and Drug Administration (FDA) proposed a format that would appear on packaged foods. Compliance was voluntary, except when the manufacturer made nutrition claims or added nutrients.

The Nutrition Facts we know today debuted in 1993 after the passage of the Nutrition Labeling and Education Act (NLEA) of 1990. The law gave the FDA authority to mandate packaged foods labeling and require that certain claims be consistent with regulations.

Consumers paid attention. In a study conducted about a year after the law went into effect, nearly half of participants said they changed their minds about buying a certain food because they read the nutrition label.

Still, certain diet-related health problems, like obesity and diabetes, have continued to grow worse. The food industry is often blamed as contributing to unhealthy eating.

Since many grocery shoppers look to nutrition labels for guidance (in the FDA’s 2014 Health and Diet Survey, 77% of Americans said they checked nutrition labels at least some of the time when buying a certain food), updating the labels became a focal point for change. In May 2016, the FDA unveiled a revised Nutritional Facts panel, which food companies will roll throughout 2017; nearly all manufacturers will need to comply by late July 2018.

Look for changes in these areas:

Clearer design

  • Calorie information, serving size, and servings per container are all emphasized in big, bold print.
  • An explanation of Daily Value, the percentage one serving provides of how much you need each day of a given nutrient to stay healthy

Updated nutrition information

  • “Added Sugars” are called out in both actual amounts and Daily Value
  • Nutrient lists include Vitamin D and potassium, in addition to the already required iron and calcium
  • “Calories from Fat” is gone, but total fat, saturated fat, and trans fat remain
  • Updated daily values for sodium, dietary fiber, and vitamin D
  • Actual amounts of Vitamin D, calcium, iron, and potassium, in addition to the Daily Value

More realistic serving sizes

  • Servings sizes are changing based on how people actually eat, rather than how they should. For instance, a serving size of soda is changing from 8 ounces to 12 ounces, and ice cream from 1/4 pint to 1/3 pint.
  • For packages that contain between one and two serving sizes, calories and other nutritional information will be displayed as one serving, since most people are likely to consumer the entire portion in one sitting
  • Dual column labels will reflect both the “per serving” and “per package” values on some products that can be eaten in one sitting, but contain more than one standard serving (think a large bag of chips or box of cookies).

Bottom line: There’s a lot to know about smart nutrition, and reading food labels is one important part. Eat a variety of foods and know your basic food facts: what to avoid, what to have in small portions, and what to enjoy more frequently.

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Frank Hone is a consumer marketing strategist who focuses on the business impact of engagement strategy for health and well-being improvement... read more 

Program Spotlight: Smart Use Insurance Education

The University of Maryland Extension's Unique Program Is Helping Increase Insurance Literacy
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The University of Maryland Extension had developed a unique program designed to deliver health insurance education to consumers. Just as Americans were beginning to understand how to work with Obamacare, congress is working on a replacement, the American Healthcare Act. It’s not surprising that health insurance is confusing to most people. In fact, nearly half of all adults say they can’t understand or act on the health information they get, and that includes information on how to find and use health insurance.

Now it it’s third year, trained educators have delivered the program through workshops in seven states. And the results show that the program is really making a difference.

  • Participants saw a 25% increase in their confidence in making good health insurance decisions
  • Participants saw a 15% increase in the likelihood they would take a positive action – like comparing insurance plans or researching if they could get cheaper medications

After review of the pre- and post-surveys and other data, the program administrators crafted a strong hypothesis:

“If confusion could be reduced and confidence and capability increased, consumers would be able to make Smart Choice health insurance decisions.”

Features of the program include:

  • Explaining key terms that may be confusing to consumers, such as “copayment”, “deductible”, “HSA” and “PPO”
  • Showing consumers how to make “good guesses” on what their out-of-pocket health expenses may be so they can better prepare and plan
  • Detailing how consumers can save for health expenses using Flexible Spending Accounts and Health Savings Accounts
  • Helping consumers understand the benefits and advantages of different types of insurance plans and choose the right plan for them
  • Educating consumers about where to get reputable health insurance information and which sources shouldn’t be trusted

New opportunities are being explored to expand the program even further. Through technology even more consumers could benefit from the education.

For more information, visit the University of Maryland Extension web site.

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Jerry Gulley currently serves as EdLogics’ Chief Content Officer. He trained at the Culinary Institute of America in Hyde Park, New York and has held positions with Cooking Light, Health, and AllRecipes. 

Improving Health Literacy On A Global Scale

International Health Literacy Association Coordinating Global Efforts
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More and more people are talking about health literacy across the globe. Experts in medicine, government and public policy are continuing to expand their understanding of the incredible opportunity that increasing health literacy can have in improving health and health outcomes.

Some of the many challenging characteristics of global low health literacy populations include:

  • An inability to access information about medical or clinical topics
  • An inability to understand, evaluate and follow medical information
  • An inability to make good decisions about their health
  • An inability to locate and understand information about risk factors
  • An inability to follow basic instructions on treatments and care.

At the recent Health Literacy Conference presented by Wisconsin Literacy in Madison, Wisconsin, luminaries and academics in the area of health literacy met to discuss how to better address the global challenges and costs associated with low health literacy. In a panel led by the International Health Literacy Association (IHLA), the organization shared its goals and tactics for addressing this global issue.

“The International Health Literacy Association (IHLA) is a member-based association for professional development within the health literacy field. IHLA serves a diverse range of stakeholders, medicals, public health professionals, educators, as well as many others engaged in health literacy, research, policy, education and practice.”

While research is being conducted across the globe, there is currently little coordination of these efforts or even the sharing of critical data and findings. Not surprisingly, much of this research is carried out within very homogenous populations. This makes the global relevancy of any accumulated data a relatively complex topic.

The IHLA seeks to help in a number of ways:

  • Author and publish peer reviewed journals on the subject of health literacy research
  • Become the go-to aggregator of health literacy activities, projects and practices worldwide
  • Encourage cross-national collaboration
  • Become the “keeper” of health literacy’s best practices
  • Advocate for global health literacy awareness
  • Raise public awareness about the need to increase health literacy

The IHLA launched with meeting in North America, Asia and Europe. They are currently developing a schedule for upcoming meetings and initiatives. They are also forming work groups and creating a more formal organizational structure. Health professionals who wish to become involved can visit for more information.

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Jerry Gulley currently serves as EdLogics’ Chief Content Officer. He trained at the Culinary Institute of America in Hyde Park, New York and has held positions with Cooking Light, Health, and AllRecipes. 

Are We Asking the Right Questions?

Experts weigh in on why patients don't always get the right care – and what we can do about it
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We’ve all been there. Sitting in a cold exam room, tense and nervous, perhaps embarrassed in one of those awkward gowns. Not understanding what the doctor is saying—or even knowing what to ask.

Not knowing how to make informed healthcare choices can take a toll—physical, financial, emotional—even professional.

And the numbers don’t lie. Compared to people with higher health literacy, patients with low health literacy have:

  • 40% higher risk of going to the ER
  • 55% higher risk of hospitalization from asthma
  • 3 times more heart failure hospitalizations
  • 3 times higher odds of needing to go back to the hospital in patients over age 64
  • Higher risk of early death from heart failure and other causes
  • Low health literacy costs the US up to $238 billion a year.

In our 2016 webinar, “Why Health Literacy Matters to Your Business,” leading experts Cynthia Baur, PhD, Endowed Professor and Director of the University of Maryland’s Horowitz Center for Health Literacy, and Dr. Russell Rothman, MD, MPP, Director of the Center for Health Services Research at Vanderbilt University, discussed with EdLogics moderator and population health expert Fred Goldstein how, by focusing on statistics, we may be missing the bigger picture.

Here’s just a small part of what they had to say:

Looking at the wrong problem

Fred Goldstein: Given all of the statistics, what are some of the key reasons patients with lower health literacy experience poorer health and require more care?

Dr. Baur: One of the things I like people to think about is even the framing of that question. Because you are right about the data that’s been collected on people’s experiences and outcomes with getting healthcare services. But that approach of looking at people’s health literacy levels and the use of emergency services and what-not—many times, that approach puts the blame on them. Because it makes them seem like they’re doing things that are inappropriate or costing the system or themselves more money.

Systems on top of systems

Dr. Baur: The reality is that we live in a very complex set of health systems. There are multiple healthcare systems. There’s the public health system. There’s the educational system which influences people’s knowledge and skills about health. So all of those different systems are part of that larger environment in which people are trying to get information and services. …

Health literacy has really been an issue that’s been out there for a while. The data have been accumulating about these costs. We’re at a point where people are taking a step back and saying, if you want patient-centered or person-centered health and healthcare, you really have to look at what people’s experiences with these systems are. You have to look at the challenges they face and the demands being placed on them to try to get information and services. And that will lead us toward looking at organizational practices, system redesign, and ways that will make it easier for people to get what they need.

Lost in the maze

Dr. Rothman: Poor health literacy is a common problem. We know that over 90 million Americans have basic or below basic skills and over 110 million have only basic or below basic quantitative skills, which can make it very challenging in our very numbers-focused healthcare environment.

Even people with good health literacy skills can now struggle to navigate what’s become a very complex healthcare system. Trying to figure out how to take their medicines, how to follow a good diet, how to follow up specific recommendations from providers—even just navigating

where to go in the hospital, or how to get to appointments, or how to navigate insurance—it’s all become very complex. The amount of time patients have to interact with their doctors or other clinicians whether it’s at a clinic or even in the hospital—it’s very short.

The bottom line

Dr. Rothman: There are real opportunities for us to improve how we provide health information to patients and families to help them to improve their health.

Watch the entire webinar for more from other experts, including  former US Health and Human Services Secretary, Governor Tommy Thompson

The information and opinions attributed to Drs. Baur and Rothman are their opinions only and do not necessarily represent the views of their affiliated organizations, including the University of Maryland, Centers for Disease Control and Prevention, and Vanderbilt University Medical Center.

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Thomas M. Chamberlain, PharmD, is Founder and CEO of EdLogics, an education-based consumer engagement company that provides innovative health education and learning management solutions to employers, health plans, healthcare providers, and government more

Win-Win: How Healthcare Gamification Helps Companies and Employees

Playing to learn is one path toward improved health literacy—and lower healthcare costs.
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In 2012, Tom Chamberlain, PharmD, founded EdLogics, our gamified health education platform. Recently he shared how he first got the idea from working with patients, and the results so far.

Let’s start with your background. You began your career as a pharmacist, right?

Right. As a PharmD and an entrepreneur, I’ve been involved in starting and growing a number of companies, all of them focused on healthcare education and improving the utilization of healthcare services. My primary objective has always been to improve clinical outcomes and reduce healthcare costs for consumers and payors of healthcare services.

And how did you get the idea for EdLogics?

I was fortunate to have had the opportunity to manage my own patients during my doctor of pharmacy program and residency training. Having firsthand experience treating patients with chronic conditions like diabetes, high blood pressure, and COPD, I knew the challenges of educating and engaging patients in the self-management of their conditions. Traditional educational strategies such as pamphlets and printouts weren’t effective in teaching patients what they needed to know to improve their conditions.

For people with diabetes, testing blood sugar is a routine part of managing their condition. If you’re injecting insulin or using a pump, you may have to test several times a day. Without accurate blood sugar tests, you might not get the right amount of insulin at the right times.

If you can’t measure your blood sugar, you can’t control it. And if you can’t control your blood sugar, you raise your risk of amputations, heart attacks, blindness, erectile dysfunction, and many other problems. One immediate risk is diabetic ketoacidosis, which comes on quickly and can be fatal. Even if you survive, your ER trip will cost thousands of dollars. And it all can be avoided with appropriate education.

Many patients seem to understand how to check their blood sugar once someone shows them. But it was clear to me that most of my patients had forgotten what they’d learned by their next visit. They still weren’t retaining the information needed to manage their diabetes.

This happened over and over again – and similar scenarios occurred with a number of patients with various chronic conditions. I realized we’d never be able to help our patients if we couldn’t find a better way to teach them what to do.

Is that where health literacy comes in?

Yes, but a lot of people aren’t familiar with the term. Here’s one definition:

“Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”

Or to put it more simply:

“Health literacy means you can find and understand the information you need to make good decisions about your health.”

Low health literacy is now recognized as a critical barrier to effective and efficient healthcare. It’s an enormous problem, and the consequences are far-reaching. For instance, did you know that compared to patients with adequate health literacy, patients with low health literacy have:

  • 40% higher risk of going to the emergency room
  • 55% higher risk of hospitalization from asthma
  • 3 times more heart failure hospitalizations
  • and 3 times greater odds of 30-day readmission for patients over age 64

In fact, the cost of low health literacy in the US is somewhere between $106 billion and $238 billion per year. It’s unreal!

If we want to improve health outcomes and lower healthcare costs, we need a way to reach consumers – a way that works for them long term.

So how does EdLogics help?

Since I started working in the healthcare industry, the concept of health literacy has matured into an academic discipline. Institutions like Vanderbilt University have devoted teams of talented experts and researchers—like Russell Rothman, MD, MPP, arguably one of the top health literacy experts in the world—to help healthcare providers, employers, payors, and the public understand the implications of low health literacy—and develop effective solutions to address this major healthcare issue.

At EdLogics, we’ve teamed up with many leading academic medical centers and Centers of Excellence (CoE), as well as industry thought leaders like Dr. Rothman and former US Secretary of Health and Human Services Governor Tommy Thompson, to identify specific ways to improve health literacy.

The first step is to make learning fun and engaging. To do this, we employ and work with experienced clinicians, developers, designers, and gamification experts to create stimulating, engaging games that educate users on important health topics, from diabetes to the Zika virus, all developed with the low health literate user in mind.

To keep users coming back, we’ve developed innovative gamification and unique incentive strategies where users earn rewards by playing games and completing educational activities.

Employers can purchase a customized version of the platform, enabling employees and their families to play, learn, and win. And the cost is minimal: roughly $20 a year per family.

What have you seen so far?

I’m very proud of our platform. It’s a product that educates consumers about chronic diseases, common medical conditions, general health, well-being, medications, and how to navigate the healthcare system. We’ve heard inspiring testimonials from employers and employees, and we have impressive statistics on knowledge improvement and consumer engagement. In fact, 100% of users improve their knowledge of a given condition after completing our learning activities, and 79% of users say they will change their behavior based on what they learned.

We’re continuously making enhancements, all with a focus on improving consumer engagement. That’s the key to being able to influence positive behavior change and deliver the most important, lifesaving knowledge. Not to mention the opportunity to reduce pain and suffering – both physical and financial.

Bookmark this blog and follow us on LinkedIn and Twitter. We’ll be publishing posts on the crisis of low health literacy and how to help address it. Want to learn more? Request a demo of the EdLogics platform.

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Thomas M. Chamberlain, PharmD, is Founder and CEO of EdLogics, an education-based consumer engagement company that provides innovative health education and learning management solutions to employers, health plans, healthcare providers, and government more