Touting the Nutrition Keys front-of-pack nutrition labeling program as “the most significant modernization of food labels since the Nutrition Labeling and Education Act of 1990,” executives at the Grocery Manufacturers Association (GMA) and retailer trade group Food Marketing Institute said they were taking aim at childhood obesity and shoppers’ demands for more nutrition information when introducing the program in January. But months before the system was scheduled to appear on grocery shelves this fall, Nutrition Keys was stirring criticism from multiple fronts.

Nutrition Keys follows a similar trade association effort in 2009 called Smart Choices, a front-of-pack checkmark meant to steer shoppers to good-for-you food products. Soon after Connecticut’s then-Attorney General Richard Blumenthal requested information about the nutrition claims for products displaying the Smart Choices label such as Froot Loops and Cocoa Krispies from their manufacturers, the program was abandoned.

Smart Choices did succeed in raising awareness of the many systems that deliver at-a-glance information on nutritional content. FDA Commissioner Margaret Hamburg and the Centers for Disease Control and Prevention convened an independent expert committee of the Institute of Medicine (IOM) to review the issue and make labeling recommendations. The first phase was completed in October 2010, with final recommendations due this fall.

The IOM panel reviewed a sampling of 20 label programs created by manufacturers, retailers and other groups. Some were classified as nutrient-specific, similar to Kellogg’s Nutrition at a Glance and General Mills’ Nutrition Highlights and Goodness Corner. Calories per serving and other key nutrients are flagged in those programs. A similar approach is taken with Nutrition Keys.

The IOM committee’s Phase 1 report suggests including information on trans fats, saturated fats and sodium in front-of-pack callouts but excludes sugar per serving, citing insufficient evidence linking sugar to health issues such as obesity, hypertension and stroke. The GMA program excludes trans fats but includes sugar. It also gives manufacturers the option to include two additional callouts for other nutrients.

Criticism of Nutrition Keys was leveled in June in the New England Journal of Medicine. In a column  headlined “Front-of-package nutrition labeling-an abuse of trust by the food industry?” the authors, Drs. Jeffrey Koplan and Kelly Brownell, criticized Nutrition Keys as confusing and lacking “a science-based, easily understood way to show consumers whether foods have a high, medium or low amount of a particular nutrient.” The doctors also questioned the program’s timing, which coincides with the release of the IOM committee’s final recommendations.

Support for their conclusions has come from within the industry. In a statement released in July, Irwin D. Simon, CEO of Hain Celestial Group Inc., said Nutrition Keys “may disguise the true character of a product in order to induce purchase …. This seems similar to the Smart Choices program introduced last year by an overlapping group of companies.” Simon urged industry to wait for the IOM report “or risk being perceived as untrustworthy and inviting further government intervention.”

GMA did not respond to telephone and e-mail requests for comment.

Front-label nutritional information has expanded across many food categories in recent years, including fresh meat and poultry (see story on page 22). Despite the expansion, a third of the 1,200 shoppers who participated in a survey cosponsored by Sealed Air Corp.  indicated they want more health and nutrition information when purchasing fresh meat and poultry.