Understanding the need for the Food Labeling Modernization Act of 2021

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By Sally Greenberg, NCL Executive Director

Many of us are trying to follow the advice of health authorities to cut back on sugar consumption, and food companies are responding with new versions of products promising “less,” “reduced,” and even “zero” amounts of added sugars.

But in the spirit of reducing added sugars — not surprisingly — more and more food producers are turning to artificial and synthetic substances, sugar alcohols, and new-fangled substances many people have never heard of like Luo Han Guo Extract (also known as “Monk Fruit”). This situation with artificial sweeteners has gotten more complicated since we last took a look at this issue.

Today more label claims are implying that the reformulated product is healthier than the original, without disclosing that the sugar content has been reduced by replacing it with artificial sweeteners. One reformulated oatmeal is labeled “Apples & Cinnamon Lower Sugar” and claims it has “35 percent less sugar.” That may sound like a good thing, but the new version is actually higher in calories than the original. Similarly, the reduced sugar version of one peanut butter brand has 1/3 less sugar, but has more calories per serving than its original counterpart.

Senior Members of Congress, including Representatives Frank Pallone (D-NJ) and Rosa DeLauro (D-CT), who chair the committees that have jurisdiction over the FDA and its budget, have introduced legislation to fix the problem, namely the Food Labeling Modernization Act of 2021, H.R. 4971 (FLMA). The FLMA, S. 2594, is sponsored in the Senate by Richard Blumenthal (D-CT), Ed Markey (D-MA), and Sheldon Whitehouse (D-RI).

The measure includes provisions aimed at increasing transparency, encouraging responsible product reformulation, and countering misleading claims. For example, the FLMA would require that a food containing any artificial or natural non-caloric sweeteners must prominently disclose the presence of such ingredients on the front labels of food packages. This would help ensure that food manufacturers do not simply replace sugar with questionable alternatives like artificial sweeteners, sugar alcohols, and other sweetening agents, making “new and improved” food products appearing to be more healthful than their regular versions.

The FMLA would also require the FDA to establish a program for front-label symbols indicating a food is high in sugar. NCL supports that effort, but consumers deserve the full story. We don’t want to see unintended consequences of sugar warning labels leading food companies to seek ever more alternative sweeteners; if they are going to be used, those alternatives should be clearly disclosed on the front label, as the FLMA would provide, so consumers can make fully informed purchasing decisions.

The FMLA also directs the FDA to improve food labels in other ways:

  • The bill improves transparency by mandating that caffeine levels be listed. Consumers who are pregnant, have certain health conditions, or take certain medications or supplements often need to limit or avoid caffeine. At the present time, there is no way of knowing how much caffeine is in many foods. The bill would address that problem by requiring prominent disclosure of caffeine content.
  • The bill would require that FDA establish clear and consistent standards for popular marketing terms like “natural” and “healthy.” That’s a welcome requirement.

In sum, the FLMA would bring food labeling into the 21st Century. The National Consumers League supports these important reforms and hope that this legislation gets the full support of Congress.

Vaccines to protect all

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By Sally Greenberg, NCL Executive Director
With co-author Marla Dalton, Executive Director and CEO, National Foundation for Infectious Diseases

COVID-19 has had profound implications on individual health and well-being and the U.S. healthcare system at-large. During the pandemic, we have seen routine vaccination rates decline significantly across all populations, putting individuals at risk of contracting vaccine-preventable diseases. The pandemic has also brought significant public attention to vaccines and now, perhaps more than ever before, many see the value of life-saving vaccines as one of the most effective public health prevention tools available to keep us safe and help end the pandemic.

The National Foundation for Infectious Diseases (NFID) and the National Consumers League (NCL) are committed to educating people about how to live healthier, safer lives. NFID is focused on educating the public and healthcare professionals about the burden, causes, prevention, diagnosis, and treatment of infectious diseases across the lifespan, and the mission of NCL is to protect and promote social and economic justice for consumers and workers in the United States and abroad.

NFID's Marla receiving her vaccine

NFID’s Marla Dalton receiving her flu vaccine.

Both organizations recognize the tremendous benefits that vaccination provides for both individuals and entire communities. While fall and winter raise the need for annual vaccination against influenza (flu), and the current pandemic has led to the need for COVID-19 vaccines and boosters, we must not overlook the importance of routine vaccines that may have been missed during the pandemic. Vaccines are for people of all ages and there are specific vaccines recommended for children, adolescents, adults, and older adults 65+ to protect against serious and potentially deadly diseases.

NCL and nearly 150 other partner organizations are proud to participate in the NFID Keep Up The Rates campaign, to share messages to encourage all individuals to receive recommended vaccines that may have been delayed during the pandemic. Since the campaign launched in 2020, Keep Up The Rates has engaged national experts and leading public health organizations to reach populations most at risk of delaying vaccinations or experiencing complications from vaccine-preventable diseases.

Sally Greenberg getting vaccinated.

Keep Up The Rates recently released resources to educate healthcare professionals and consumers about vaccine coadministration—receiving multiple vaccines at the same time. When you bring your car in for an oil change, a good mechanic takes care of other routine maintenance to make sure your car runs safely. Protecting your health is not much different, so when you receive a COVID-19 vaccine or a flu vaccine, we encourage you to make sure that you are protected against other serious but preventable diseases. A new PSA and infographics are available to help share that messaging with all relevant audiences.

The COVID-19 pandemic has demonstrated that protecting public health is more important than ever. Just as we must always protect the rights of consumers and workers, we must also encourage measures that promote better health and a safe environment for all.

During ‘Striketober,’ standing up for a USPS that benefits consumers and workers

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By Eden Iscil, Public Policy Associate

Workers across America are taking action to hold employers accountable for low pay and poor working conditions. In what’s being called “Striketober,” 10,000 John Deere employees, 14,000 Kellogg’s workers, and 24,000 Kaiser Permanente staff have gone on strike. Additionally, 60,000 film and television workers belonging to IATSE threatened to withhold their labor, resulting in a deal for more favorable contracts. At NCL, we support workers advocating for better conditions and compensation. 

While it is generating fewer headlines, the actions of US Postal Service employees are just as important for consumer and worker welfare. Recent postal worker employee protests in Minneapolis highlight the indispensable public service these workers provide to millions of Americans daily. Those protests were prompted by a visit from Postmaster General Louis DeJoy, who is infamous for his 2020 attempt to degrade mail services at the same time that COVID-19 necessitated mail-in voting for millions of Americans. Importantly, DeJoy has come under renewed scrutiny for his 10-year plan, which would lead to significantly delayed mail deliveries. 

Given the importance of delivering mail promptly, we urge Congress and the Biden Administration to take a more active role in preventing Postmaster General DeJoy’s continued attacks on the Postal Service. Millions of Americans rely on the Postal Service for delivery of life-saving medication, receipt of their veterans and Social Security checks, and other important mail. Unfortunately, the impacts of DeJoy’s 10-year plan are likely to disproportionately affect rural communities and older Americans.   

We know such policies are harmful to everyday Americans from the many times they were previously attempted. Following DeJoy’s plans for a mail slowdown in 2020, veterans were forced to find alternative access to their medications and 350 million pieces of mail were delayed. We need to challenge such regressive policies that are implemented at an enormous cost to consumers. 

The threat that DeJoy’s recommendations pose to efficient U.S. mail delivery has been known since the summer of 2020. Congress and the Administration must act to get USPS back on the right track. 

Diverse research for a diverse America: The value of equitable, real-world research

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By Sally Greenberg, NCL Executive Director

While the COVID-19 pandemic has led to hardship for all Americans, it is clear that people of color have been disproportionately burdened. Across the health care continuum, addressing this disparity has become part of the broader conversation about the history of systemic racism and the underlying social determinants of health that negatively affect the mental, physical, and economic health of individuals and entire communities.

The pandemic has underscored persistent health disparities, and there is growing recognition that representation in research and clinical trials can have a profound impact on health outcomes. A lack of representation from racially and ethnically diverse groups in research and clinical trials have typically led to gaps in data, missing the opportunity to assess the full impact of various treatments and drugs across a range of populations. The collection and use of real-world research and data to inform the potential use, risks, and benefits of medical products and treatments can ultimately lead to better health outcomes, particularly for those who have been underrepresented in the past.

Existing efforts to improve inclusion

Efforts to expand diversity and representation in medical research are underway in Congress. Policymakers are encouraging the incorporation of Real World Evidence (RWE) in drug development through the recent Cures 2.0 draft legislation released by Reps. Diana Degette (D-CO-1) and Fred Upton (D-MI-6). While the status quo limits us from effectively reaching underserved populations, the proposed legislation would allow studies that include RWE for some drugs after they have been approved. At the heart of this issue is a growing appreciation that the same therapy can affect different populations in different ways, which is why Cures 2.0 supports collecting data that more accurately reflects the unique experiences and needs of patients across diverse populations.

Recognizing the potential for RWE in maternal health

The lack of representative research in the field of maternal health is undeniable, and its implications are staggering. The dismal state of maternal care in the United States reflects how our health care system has failed women of color, including by not adequately studying treatment options to prevent maternal morbidity and mortality. The need for RWE is clear when you consider the persistent disparities in health outcomes that plague minority communities.

Preterm birth and its disproportionate impact on women of color is a stark illustration of the need to make progress on representative research in maternal health. Preterm birth is the second-largest contributor to infant death in America today. Despite the tremendous physical, emotional, and financial toll that preterm birth continues to take on our country — disproportionately so on women and families of color — not enough therapeutic tools currently exist to prevent it.

Today, “17P,” the only FDA-approved treatment to help reduce the likelihood of spontaneous, recurrent preterm birth in the United States is at-risk of being withdrawn from the market in all its forms, including the branded product and five generic versions. Unfortunately there is conflicting evidence from two different clinical trials, one representative of a diverse U.S. population and another studied in a largely white population in Europe. It’s not a straightforward comparison. If 17P is withdrawn, the women most affected by preterm birth, predominantly women of color, would be left without an FDA-approved treatment option.

The FDA is considering the path forward, including additional data collection through leveraging RWE from past patient use. The success of the first (approval) trial for 17P in the impacted communities signals the importance of RWE. Continued access to 17P is, at its core, a matter of health equity. Black women must not yet again be left vulnerable to a system that historically has overlooked them.

Finally, Juneteenth is declared federal holiday

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By Sally Greenberg, NCL Executive Director

Juneteenth, or June 19, is now a federal holiday, thanks to an overwhelming Congressional vote and President Biden’s signing it into law in the past two weeks. And it’s a long time coming. The day marks the emancipation of the last enslaved people in America in Galveston, Texas in 1865, over two years after the Emancipation Proclamation was signed by President Abraham Lincoln.

I’ve heard Juneteenth called Emancipation Day, Freedom Day, and the country’s second Independence Day. It surely is one of the most important anniversaries in our nation’s history.

As a Jew who has observed Passover my whole life, the holiday based on the Book of Exodus celebrating the liberation of Jews from Egypt after 400 years of enslavement, I also celebrate Juneteenth.

As I listened to the radio during a road trip, I heard stories about the newly declared federal holiday. I think most importantly, it’s gotten people talking about a conversation America has never really had: truth and reconciliation about the despicable institution of slavery in the United States and its vestiges: a century and a half of Jim Crow segregation, violence, and rampant, entrenched discrimination against African Americans.

Sadly, this is a conversation too many Americans don’t want to have. Oklahoma passed a law outlawing the teaching of “Critical Race Theory” in state schools. In 2020, President Donald Trump issued an executive order excluding from federal contracts any diversity and inclusion training interpreted as containing “Divisive Concepts,” “Race or Sex Stereotyping,” and “Race or Sex Scapegoating.”

What even is Critical Race Theory? The textbook definition is that CRT acknowledges that the legacy of slavery, segregation, and the imposition of second-class citizenship on Black Americans and other people of color continue to permeate the social fabric of this nation.

Half a dozen other states are considering bills similar to Oklahoma’s. Fox News and other right wing media outlets have tried to use phony scare tactics to discourage discussion of slavery and its generations-long aftermath. The problem is that unless we have those discussions, we will never reckon with the reality that so much of our nation was built on the backs of enslaved people, including the White House. Refusing to discuss this our history of enslavement has a term too: “White Fragility,” defined as white Americans feeling discomfort and defensiveness when confronted with information about racial inequality and injustice. So despite Oklahoma’s law, Biden’s declaring Juneteenth as a federal holiday got people talking—and that’s a good thing.

I liked hearing about Civil Rights Activist Opal Lee, who long advocated for the celebration that started in Galveston to be made a federal holiday.

It was also interesting to learn that there’s a growing discontent within the African American community with symbolic gestures like declaring a federal holiday marking the end of slavery.

On that theme, NCL has endorsed HR 40, a U.S. House bill to set up a commission to study the history of enslavement and reparations to families whose relatives were enslaved. Consider these facts about the legacy of slavery:

We thank President Biden for recognizing that Juneteenth needs to be a federal holiday and was long overdue. Equally important is HR 40, which will provide a way forward for this country akin to the Truth and Reconciliation Commission body established by the South Africa in 1995 to help heal the country and bring about a reconciliation of its people by uncovering the truth in the aftermath of Apartheid.

Slavery is a legacy that all Americans, no matter your racial or ethnic background or when your family arrived in the United States, need to confront. We must not let anger, fragility, backlash, or denial prevent us as Americans from taking the time to really learn about and understand slavery, the Jim Crow laws that followed it, and practices, including lynching, that were used as a tool of terror and white supremacy, and the many lasting repercussions of that terrible history.

A step forward on privacy legislation

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By Sarah Robinson, Public Policy Manager

Earlier this month, NCL joined other consumer advocates and industry stakeholders in an event to highlight our consensus that Congress must act to create strong federal consumer privacy rights urgently. We joined colleagues at the 21st Century Privacy Coalition, the Business Software Alliance, and Common Sense Media in calling on Congress to commit to passing comprehensive privacy legislation by the end of the 117th Congress. In a virtual press conference, the groups, along with Rep. Jan Schakowsky (D-IL), Rep. Gus Bilirakis (R-FL), and Sen. Richard Blumenthal (D-CT) agreed that Congressional action to strengthen consumers’ privacy rights is long overdue.   

The Washington Post Editorial Board highlighted our event stating, “the surprising degree of consensus around not only the general necessity of nationwide data protections but also the particulars” makes taking action a “no-brainer.” A recent poll from Morning Consult revealed 80 percent of both Democrats and Republicans said Congress should make privacy a “top” or “important” priority in 2021.

There is bipartisan consensus and agreement from organizations across the spectrum that Congress must act. NCL’s message at the event is that it is now time to craft legislation that gives consumers back control over their personal data. At the event, Rep. Schakowsky, the chairwoman of the House Subcommittee on Consumer Protection and Commerce, announced her intention to hold a series of bipartisan roundtable discussions to examine ways to pass comprehensive privacy legislation. NCL is ready and eager to participate in those conversations to help ensure that a comprehensive bill gives all consumers strong, enforceable privacy rights.  

While passing legislation this Congress is a priority, NCL made clear that we are not going to simply bargain away long held principles on data privacy. NCL believes that in order to protect the privacy and security of consumers’ personal data, the legislation must not preempt stronger state laws, must include strong enforcement provisions, including a private right of action and provide consumers with strong substantive privacy rights. The right legislation will include effective enforcement mechanisms that safeguard privacy rights for consumers and enshrine rules of the road for businesses.  

We applaud Reps. Schakowsky and Bilirakis, and Sen. Blumenthal for their leadership and their commitment to continue fighting for comprehensive privacy legislation. We hope to continue to cooperate with this esteemed group as we work to achieve our shared goal. 

Giving a voice to women facing preterm birth

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By Sally Greenberg, NCL Executive Director

Born out of our historical focus on reducing health inequities in the United States, and a nearly year-long movement to preserve access to approved therapies that fight premature birth, NCL supported the launch of the Preterm Birth Prevention Alliance (PBPA), which brings together a coalition of 15 patient advocacy organizations who share concerns about the grave state of preterm birth in the United States and its disproportionate impact on Black, Indigenous, and women of color.

For the past decade, hydroxyprogesterone caproate, commonly called “17P,” has been the only available FDA-approved treatment option to reduce the risk of recurrent preterm birth. Patients and the healthcare providers who serve them currently have access to one branded and five generic versions of the prescription product. However, in 2020, the FDA proposed withdrawing all forms of 17P, based on conflicting efficacy data from two studies composed of vastly different populations — one inclusive of women in the U.S. most vulnerable to preterm birth and one not. Both studies showed that this class of treatment is safe for both mother and baby.

Despite multiple formal requests to consider additional data and alternate ways to study the efficacy of this class of drugs before effectively depriving women of access, FDA made its recommendation without engaging the most important stakeholders—patients who are at the highest risk and their providers. And even after a recently published meta-analysis showed that 17P injections reduced the risk of preterm birth before 34 weeks in high-risk women with singleton pregnancies, FDA persisted in its recommendation.

The Alliance was formed to stand up for the needs of moms and babies of every race and ethnicity and urge regulators to hear directly from women facing prematurity and their providers about their real-world experiences — in a public hearing — before making a decision on withdrawal.

We believe that evidence of efficacy for Black, Indigenous, and women of color in the United States — who are at highest risk of adverse outcomes — should be more determinative than a lack of demonstrated treatment efficacy on primarily white women from other countries. And we believe that more inclusive studies and data are needed, across more racially and ethnically diverse patient populations, to better understand the causes and impact of disparate outcomes in preterm birth.

Alliance partners currently include:

  • 1,000 Days
  • 2020 Mom
  • American Association of Birth Centers
  • Black Mamas Matter Alliance
  • Black Women’s Health Imperative
  • Expecting Health
  • Healthy Mothers, Healthy Babies Montana
  • HealthyWomen
  • Miracle Babies
  • National Birth Equity Collaborative
  • National Black Midwives Alliance
  • National Consumers League
  • National Partnership for Women & Families
  • Sidelines High-Risk Pregnancy Support
  • SisterReach

Organizations or advocates concerned about the needs of women facing prematurity — whether you are a healthcare professional, maternal and infant health advocate or a health equity champion — are invited to join us and add your voice to this effort.

Learn more and join the Alliance: https://nclnet.org/pbp/

Consumers face an unfair disadvantage at the pharmacy counter

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By Sally Greenberg, NCL Executive Director

Everywhere we turn these days, we find ourselves wondering if we are getting a fair deal. Americans continue to suffer the economic consequences of a year-long global health pandemic, and many of us are trying to stick to the essentials and stretch our dollars where we can. As COVID-19 has reminded us, there aren’t many issues families face that are more significant than access to health care.

Families can’t go without essential prescriptions and often wonder why the price seems to go up each time they go for a refill. In fact, we are likely paying more than necessary at the pharmacy counter, but we don’t often know — or even think to ask — why.

A variety of factors drive drug costs, some of which are obvious: the cost of research and development, distributing the product, the pharmacies’ profits – but there is one far less known cause of price increases: PBMs, short for pharmacy benefit managers.

Most people have never heard of PBMs, and PBMs like it that way. They are billion-dollar companies that control more than 80 percent of the prescription drug formularies, (formularies are the lists of drugs that a health plan allows its members to access) — in the United States.

Because of their outsized role, too often PBMs determine how much consumers, businesses, government agencies, and others pay for medicines. As originally conceived, PBMs were meant to help ensure that patients get a fair deal by:

  • working with manufacturers to ensure rebates (or savings) for medications
  • working with insurance companies to determine which medications are covered
  • working with pharmacies to set the price points and help reimburse pharmacies for dispensing prescriptions.

In theory, PBMs should be lowering costs for everyone. However, as they have evolved and grown, they’ve become greedy and self-serving entities, scooping up discounts for themselves and throwing consumers under the bus. All the while, their profits continue to soar as they are all among the top Fortune 500 companies.

Sadly, PBMs have also found ways to manipulate the system and put their own profits first.

Insulin is a prime example. Diabetes patients who need their medication to survive are increasingly left with fewer options for treatment. When PBMs get involved, consumer costs increase.

One recent analysis found that the total value of rebates and discounts for insulin on an annual basis amounts to more than $5,000 per patient. Another report explained that the net price on one insulin product — what the company earns as revenue — declined by 53 percent since 2012, while the list price increased 141 percent. As the WSJ story explains, this is in part due to PBM middlemen meddling. In order to ensure formulary positions (which PBMs control), companies are paying more and more each year.

Consumers don’t know where high drug prices come from and they shouldn’t have to — the system needs to deliver affordable, accessible, safe and effective medications without any entities taking an unfair or hidden profit. The stakes are too high as we look ahead to the health challenges that millions face with the Covid pandemic.

NCL joins with many other groups, including America’s Agenda, United Food and Commercial Workers International Union, HMC Healthworks, Union of Bricklayers and Allied Craftworkers, National Community Pharmacists Association, National Alliance of State Pharmacy Associations, Diabetes Leadership Council, and Diabetes Patient Advocacy Coalition in helping to expose hidden, and frankly, indefensible profits being directed to the coffers of PBMs — money that should be redirected to bring drug prices down for patients and consumers.

Let’s all ask hard questions about PBMs’ role in our healthcare system and whether we can’t be using the profits they are taking to lower drug costs. Share this story with others. Talk with your friends and family. Ask your local pharmacist questions.

Consumers – not PBMs — should come first at the pharmacy counter. Stay tuned for more from us on this, and let’s continue the conversation.

Does your baby’s food contain toxic metals?

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By Nailah John, Program Associate

As a mother, I once fed my baby with baby food only to later be told that some baby foods contain toxic metals at levels that exceed what experts and governing bodies say are safe. Congressional investigators have found dangerous levels of toxic heavy metals in many popular baby food brands. The World Health Organization says that the top 10 chemicals of concern for infants and children include arsenic, lead, cadmium, and mercury.  This exposure to heavy metals in childhood is linked to permanent dips in IQ, an increased risk of future criminal activity, and damaged long-term brain function.

Some pediatricians and children’s health experts say that heavy metals are found in soil and contaminate crops grown in it. Heavy metals can also get into food during manufacturing and packaging processes. However, the amount that is allowed in baby food products exceeds the limit. The nonprofit Healthy Babies led a national investigation and found that 95 percent of baby foods tested contain toxic chemicals. Fifteen foods accounted for half the risk, with rice-based foods at the top. Making these food and lifestyle changes can help reduce toxic metal residue:

  • Choose rice-free snacks over rice-based ones. Try a frozen banana or a chilled cucumber instead of rice-based teething biscuits.
  • Opt for oatmeal over rice cereal.
  • Give tap water over fruit juice.
  • Rather than sticking strictly to baby food made from sweet potatoes and carrots (which contain higher levels of metals), opt for baby food made from other fruits and vegetables.
  • Make your own baby food by buying, washing, and blending your own fruits and vegetables.
  • Don’t get stuck in the baby food phase. Baby food is meant to be transitional, used only for a few months. Introduce your babies to sources of protein like fish—salmon, tuna, cod, whitefish, and pollock.
  • Visit the pediatrician often in the first two years of your child’s life. This can help to identify any developmental problems.
  • Limit heavy metal exposure in other ways. Heavy metals are also found in peeling or chipping paint in older homes built before 1978.
  • Don’t smoke or vape as secondhand and even thirdhand smoke (or residue from smoking on furniture or clothes) may expose children to metals like cadmium and lead.

While individuals can do their part, the most significant changes will have to come through enforced legislation and stronger regulations on baby food. According to the recent congressional report, toxic metals in tested baby food eclipse safe levels, “including results up to 91 times the arsenic level, up to 177 times the lead level, up to 69 times the cadmium level, and up to 5 times the mercury level.” The report recommended that the Food and Drug Administration require baby food manufacturers to test their finished products for toxic heavy metals and label products that contain them. One of the most powerful ways of creating change is by calling your Member of Congress and urging them to use their voice to address the issue of heavy toxic metals in baby foods. As a mother, I plan to do so and so should you.

The evolution of American alcohol policy — and what’s next

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By Nailah John, Program Associate

Alcohol is consumed by billions of consumers the world over. Humans drink alcohol for many reasons, including enjoying the taste or coping with stress while others consume alcohol because of social influences. More than 85 percent of people around the world consume alcohol. America’s alcohol policy has seen many ups and downs over many decades from prohibition in the 1920s to the end of prohibition in 1933, National Minimum Drinking Age Act in 1988, the Alcohol Beverage Labeling Act 1988 (ABLA), and the continued efforts for a “Nutritional Facts Label” on all alcoholic beverages by consumer advocacy groups.

Every other consumable product on the supermarket shelves is required to have a Nutritional Facts Label. That label has a list of required information about a food’s nutrient content, such as the calories, protein, vitamins, fat, sugar, sodium, and fiber. This is critically important consumer information for guiding healthy choices.

After Prohibition In 1935, the Federal Alcohol Administration governed alcohol regulation. In 2003, the Alcohol and Tobacco Tax and Trade Bureau (TTB) was formed, and alcohol continued to be regulated by this federal agency. Since the 1970s, consumer advocacy groups have worked for a comprehensive label on all alcoholic products. In 2003, the Center for Science in the Public Interest (CSPI) and the National Consumers League made a hard push for a nutritional facts label. Manufacturers asked for voluntary labels, making the argument that putting nutrition facts on all bottled of alcohol would make consumers think that alcohol was nutritious. In 2004, TTB sided with manufacturers and issued guidelines that allowed them to list calories, carbs, protein, and fat­—but only if they wished to do so voluntarily. In 2021, NCL and other groups are recommitting ourselves to this consumer information campaign.

The Dietary Guidelines 2020-2025 lay out the existing recommendations for sugar and alcohol, which recommend moderate alcohol consumption––up to one alcoholic drink per day for women and up to two per day for men. The CDC warns that alcohol consumption is associated with a variety of short and long-term health risks: high blood pressure, various cancers, motor vehicle accidents, violence, and sexually risky behavior. The CDC guidelines also note that pregnant women should refrain from alcohol consumption and that those with certain condition should avoid alcohol. That is true as well with certain medications.

More than half—55 percent—of Americans say they have had alcohol in the past month. An estimated 14.5 million American adults age 12 and older battled an alcohol use disorder, or 5.3 percent of this population. The bottom line is that if you drink, do so in moderation per the CDC and DGAC guidelines. And join with consumer advocates fighting for a nutritional facts label to be put on all alcoholic beverages.