Case Study  

Disclosing Nutritional Information to Reduce Chronic Diseases

When Congress mandated nutrition labels in 1990, it was hailed as the biggest change in food policy in fifty years — standardized facts on every can and package, for the first time letting shoppers compare what they were actually eating. But the label that promised transparency also carved out exemptions covering nearly half of what Americans buy, and the science it reported lagged years, sometimes decades, behind what scientists already knew. Now online grocery and delivery apps are opening a new gap.

Microscope of a nutritional label

The Nutrition Labeling and Education Act of 1990 (NLEA) required food processors to label products with amounts of key nutrients as a public health measure. Chronic diseases such as heart ailments, cancer, and diabetes were the largest causes of preventable deaths in the United States, killing more than 1.5 million people each year. Scientists agreed that the single most important factor in preventing and minimizing the effects of such diseases was improved diet. Before Congress acted, however, consumers had no way to assess the healthfulness of most packaged foods. Supporters of the law hoped that it would create new incentives for Americans to eat healthier foods and for manufacturers to improve their products.

Consumer groups combined with organizations such as the American Cancer Society and the American Heart Association to promote nutritional labeling as a public health measure rather than simply a right-to-know cause. Entrepreneurial members of Congress, led by Representative Henry Waxman (D-Calif.) and Senator Howard Metzenbaum (D-Ohio), pressed for the new labeling law. The food industry supported disclosure both as preferable to conflicting state requirements and as a means to reap profits from marketing healthy products.

The new law required food processors to label in standardized formats amounts in each serving of total fat, saturated fat, cholesterol, sodium, total carbohydrates, complex carbohydrates, sugars, dietary fiber, and total protein, in the context of amounts recommended for consumption as part of a daily diet. Companies also had to list total calories and calories from fat in each serving. Serving sizes were standardized to conform to amounts customarily consumed. Products that were not labeled accurately and completely could be deemed misbranded by the federal Food and Drug Administration (FDA) and removed from the market. In 1994, when the law took effect, interested shoppers could compare nutrients in virtually every can, bottle, or package of processed food for the first time. The law was appropriately heralded as the most important change in national food policy in fifty years.

However, Congress also gerrymandered the labeling requirement to satisfy powerful interests, exempting nearly half of consumers’ food purchases. Fast-food outlets, full service restaurants, fresh meats and seafood, deli items, and dietary supplements all escaped labeling.

Nutritional labeling did improve over time—but only slowly and sporadically. Often labeling failed to keep pace with new science. Scientists had known since the 1970s that trans fatty acids were the most health-threatening fats, for example. The FDA, however, did not require their listing on food labels until 2006. Major food allergens (from tree nuts to shellfish) were not clearly labeled until 2006. And labels continued to group together all carbohydrates despite evidence that complex carbohydrates were healthier than simple carbohydrates. The risks and benefits of dietary supplements remained largely undisclosed. In the late 2000s several industry groups launched private front-of-package labels, some of which were flagged by the FDA for being misleading and unfounded.

A notable expansion of labeling requirements took effect in 2018. After a number of state and local governments mandated that chain restaurants report calorie information on their menus, Congress made the requirement national in 2010 for chains with 20 or more locations selling standardized products. Chains were also required to provide nutritional information on request. The Food and Drug Administration (FDA) issued implementing rules that became effective in 2018. Many restaurant chains welcomed the national rules as preferable to a patchwork of location requirements.

The FDA updated nutritional labels on processed foods in 2020 and 2021 to reflect advances in science. Proposed in 2014 and finalized in 2016 but delayed while food companies prepared to comply, the new rules included a controversial requirement for listing separately sugars that were added in manufacturing to enhance taste, a requirement aimed at helping consumers reduce obesity. They also presented calorie information and serving size in larger and bolder type to make it easier for shoppers to spot. They updated serving sizes to reflect consumption patterns. And they required listing of Vitamin D and potassium, often lacking in American diets.

By 2022, another challenge to nutritional labeling emerged. Surveys suggested that more than two-thirds of consumers now bought some groceries online, with most planning to continue some online shopping after the COVID-19 pandemic receded. As food companies adapted, early research suggested that most grocery stores listed nutritional information on their websites for online ordering but that accessing nutritional information often required extra clicks or scrolling. Likewise, online ordering from chain restaurants increased during the pandemic. While the FDA required that digital menus, like print menus, list calories, the agency did not initially require independent delivery services that posted menus to list calories.

Updated March 2022

This case study is drawn from Full Disclosure, Fung, Graham and Weil, 2007.

A longer version of this case study appeared in Democracy by Disclosure, Graham, 2002

Related Resources

Raising Wages by Changing Norms: Work Policy for the Long Game
Protest for raising the minimum wage

Policy Brief

Raising Wages by Changing Norms: Work Policy for the Long Game

When Amazon announced a company-wide $15 minimum wage in 2018, the obvious assumption was that every competitor fighting for the same workers would have to match it or lose their workforce. They didn’t. Despite dramatic wage jumps at the companies that voluntarily raised their floors — and real cuts to turnover and hiring costs that made the move pay for itself — researchers find zero evidence of wage spillovers to the “poacher” and “feeder” companies competing in the very same local labor markets. The explanation turns out to say less about generosity than about just how much leverage employers hold over workers who have nowhere else to go.

What Do Workers Want and Need: Partisan Consensus on What it Takes to Make Ends Meet
McDonalds sign accepting job applications

Policy Brief

What Do Workers Want and Need: Partisan Consensus on What it Takes to Make Ends Meet

Survey nearly 10,000 hourly workers at 67 of the country’s largest service-sector employers — Walmart, Waffle House, Amazon — and you’d expect their politics to split them on everything. Instead, 78 percent of MAGA-identified workers and 96 percent of Harris voters back a $15 minimum wage, and across the board, workers converge on the same figure for what it would actually take to get by: $24 an hour, 40 hours a week. What they’re actually paid falls $7 short. The bigger problem may not be the wage gap at all — it’s who workers think is responsible for closing it.

“This Ancient Atrocity”: The Return of Child Labor in the United States: Why Now? What Should be Done?
Child labor illustration

Policy Brief

“This Ancient Atrocity”: The Return of Child Labor in the United States: Why Now? What Should be Done?

In 2023, federal investigators found nearly 5,800 children employed in violation of labor law — 2.5 times the number just five years earlier — cleaning “skull splitters” and “brisket saws” on meatpacking kill floors, running equipment in Hyundai and Kia supply plants, and working overnight shifts in bakeries supplying Frito-Lay and General Mills. Every case traces back to the same business model: major brands outsourcing labor through layers of contractors and staffing agencies, then professing outrage when children turn up on the factory floor. The Fair Labor Standards Act has banned this exact kind of work since 1938. So why is it the contractors, not the Fortune 500 names on the label, taking the blame?

More on this Issue

Do Social Media Platforms Make People Happier?

Video

Do Social Media Platforms Make People Happier?

Social media has become one of the primary ways that families, communities and societies stay connected. As its use becomes increasingly embedded in everyday life, opting out can feel difficult for those who want to remain connected to others. At the same time, critics argue that people may be better off using social media less, or perhaps not at all. Why, then, do people continue to use products they may believe are ultimately harmful to their well-being?

The Program on Democracy and the Informed Public hosted a seminar with Cass Sunstein, Robert Walmsley University Professor at Harvard University and founder and director of the Program on Behavioral Economics and Public Policy at Harvard Law School.

How Americans Navigate Voting Information Ahead of the 2026 Midterm Elections
Captiol building with trend graphic

Additional Resource

How Americans Navigate Voting Information Ahead of the 2026 Midterm Elections

The Shorenstein Center’s 2026 Voting Information Trends project—developed in collaboration with the National Internet Observatory at Northeastern University, the Ash Center for Democratic Governance and Innovation’s Program on Democracy and the Informed Public, and The Civic Health and Institutions Project—provides new insights into the voter information landscape in the United States ahead of the 2026 midterm elections.

Among the resources, an interactive dashboard maps where Americans are finding voting information and learning about key aspects of the voting process—from sourcing polling locations to voter registration. Also included are a series of trends reports gauging perceptions of voting in the lead up to the 2026 midterm elections.