What do we really know about our food? Where was it produced? How was it produced? How has the fun been altered, processed, and prepared? What additives were put into the food? Every heard of the GRAS or EAFUS lists? Thousands of chemicals and non-food constituents are added to our food – yet most of these are not on the nutrition facts label or list of ingredients. Why? In this section, we will explore the issue of transparency in food, and provide some solutions to help you know more about what you eat.

“Everybody knows what transparency is, until asked to give a definition. Then it seems nobody knows.”
-Adapted from Oliver, R. (1997). Satisfaction: A behavioral perspective on the Customer.

In 1958 President Eisenhower signed the Food Additives Amendment to the Federal Food Drug and Cosmetic Act. The law presumed that a chemical intentionally added to food was potentially unsafe and required that no chemical be used without a “reasonable certainty in the minds of competent scientists that the substance is not harmful under the intended conditions of use.” Congress required food companies to file a “food additive petition” as the primary means by which to get an FDA approval of a chemical’s use in food. If the agency did propose to approve the chemical, it would inform the public and request comments before adopting a regulation allowing the use. The system was designed at a time when an estimated 800 chemical additives were in use, far fewer than the more than 10,000 allowed today.
NRDC Report – Generally Regarded as Secret: Chemicals Added to Food in the United States.

Generally Regarded a Safe (GRAS)

What does the food industry and our government consider safe to put in our food? You might be surprised! Check out what is in the GRAS list. Here is the main FDA page for GRAS. Here is the actual GRAS database.

“GRAS” is an acronym for the phrase Generally Recognized As Safe. Under sections 201(s) and 409 of the Federal Food, Drug, and Cosmetic Act (the Act), any substance that is intentionally added to food is a food additive, that is subject to premarket review and approval by FDA, unless the substance is generally recognized, among qualified experts, as having been adequately shown to be safe under the conditions of its intended use, or unless the use of the substance is otherwise excluded from the definition of a food additive.

FDA Nutrition Facts Label - From Dr. Uma Pisharody

As a pediatrician who takes care of children suffering from the metabolic harms of excessive sugar consumption, I was so happy to hear that the FDA has finalized its new Nutrition Facts labelAdded sugars will now be clearly marked.

The graphic below is a great summary of all changes we should start seeing in the next couple of years.  A previous blog reviewed all of the key changes, but today, I want to highlight a few reminders of why we still have to be vigilant when it comes to reading food labels, particularly when it pertains to the sugar content.

Free vs added sugar.

Even though the new label clearly identifies when sugar has been added to packaged food, we need to keep track of “free” sugar (i.e. sugar that has been removed or “freed” from its original source) too.  For instance, when sugar is found in nature, it’s usually in small quantities, often in combination with fiber, and this protects us from metabolic harm.  Sugar in juice is considered free sugar, although it may not have necessarily have been “added” in.

Example: an average orange contains about 9 grams of sugar and at least 4 grams of fiber, while a typical serving of orange juice contains five times the sugar with none of the fiber!

When calculating our sugar intake, we need to include both added as well as free sugars in our diet, aiming to keep the total to a minimum, which leads me to my second point.

Limits are still set relatively high.

The FDA’s label uses percentage limits as advised by the USDA’s guidelines which were published earlier this year.  As I had alluded to in a previous blog, the 10% limit for added sugar intake is still double that which is suggested by both the American Heart Association and World Health Organization.

Also, the FDA’s label is based off the average adult diet of 2000 calories/day.  Keep in mind that for children, maximum sugar intake should be about half of this.  Also remember that these labels set upper limits of intake.  It would be even better to consume as little added sugar as possible (zero grams would be ideal!). In other words, save the sugar for special treats on special occasions!  Here are the recommendations I use:

Foods without labels are even healthier!

While the new labels will help us make healthier nutrition choices when buying packaged foods, remember that the healthiest foods are those that come without packaging and labels.  While shopping for food, shop the perimeter of grocery stores, where you’ll find the fresh fruits, vegetables, meats and dairy.  Remember that roughly 90% of added sugar intake comes from ultra-processed foods, those found usually within the grocery store aisles.

I like the saying that “when a food has a label, consider it a warning label” and recommend that whenever possible, just “eat real food”.

Uma_PisharodyUma Pisharody, MD, FAAP is a Pediatric Gastroenterologist practicing at Swedish Medical Center in Seattle. She is a passionate patient advocate effecting change in the hospital and in her patients’ lives. Dr. Pisharody is a true champion for childhood metabolic health having led the initiative to take juice off the pediatric menu at Swedish. Dr. Pisharody is also a member of the board of the IRN.

Read more blogs by Dr. Pisharody at the Institute for Responsible Nutrition website:

Everything Added to Food in the U.S., according to the FDA. Check out the EAFUS database here. What is the difference between the GRAS list and EAFUS? Here is what the FDA says:

“The EAFUS list of substances contains ingredients added directly to food that FDA has either approved as food additives or listed or affirmed as GRAS. Nevertheless, it contains only a partial list of all food ingredients that may in fact be lawfully added to food, because under federal law some ingredients may be added to food under a GRAS determination made independently from the FDA. The list contains many, but not all, of the substances subject to independent GRAS determinations.”

Now, if you understand what this means, then you are smarter than we are. The list sounds pretty important though, doesn’t it?

Organizations working on Food Transparency