Food Labeling Should Not Be This Hard

Knowing what’s in your food or whether what you’re about to eat comports with a medically prescribed diet can be difficult. There’s no reason why the government should make it harder. But that’s exactly what the United States Department of Agriculture and Food and Drug Administration are doing when they prohibit companies from conveying information about FODMAP content on food labels.

Although not inherently harmful to most people, FODMAPs are a broad category of short-chain carbohydrates and sugar alcohols believed to trigger gastrointestinal symptoms in individuals living with irritable bowel syndrome and possibly several other functional gastrointestinal disorders.

In technical terms, FODMAPs are fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. More practically, people with IBS might want to be careful around most standard dairy items, honey, several cereals and artificial sweeteners, and a cornucopia of fruits, vegetables, legumes, and spices.

When consumed, these items can lead to luminal distension by causing increased amounts of water to enter the gastrointestinal tract and increased gas production by bacteria living in the colon. In some individuals with IBS and other functional gut disorders, this may trigger or exacerbate certain symptoms of their condition (e.g., intense pain and changes in intestinal motility), possibly through neurons in the gut responding abnormally to these physiological responses to FODMAP consumption. 

Hence, some patients with these conditions choose to limit their FODMAP intake or are encouraged to do so by their health care provider. Some go on strict low-FODMAP diets long term. Others temporarily do so for two to eight weeks then work to reintroduce specific FODMAP-containing foods into their diet to determine what they can tolerate. Broadly speaking, a lot of patients with relevant conditions find that the diet helps alleviate their symptoms.

Low-FODMAP diets though are generally considered sort of bland. They also tend to require a certain amount of time and education to be effective. Looking at a table of high- and low-FODMAP foods to make decisions about what to eat may not require an advanced degree in nutrition, but it is not difficult to imagine how having to break out such a table to evaluate every item you consider purchasing at the grocery store could become rather burdensome, especially if you’re new to the diet.

Fortunately, there are organizations and companies out there to help. Monash University, for example, has labs that both study the effectiveness of low-FODMAP diets and test food items for FODMAP content. Monash also offers several resources to help those on low-FODMAP diets make informed meal choices and works with companies that wish to offer low-FODMAP food options. If a company wants to submit a product to Monash for evaluation and Monash determines the item is low in FODMAP content, the company can then use a trademarked label to convey this information to consumers.

However, as one US company learned, even if one of the world’s leading FODMAP research facilities tells you your food is low in FODMAPs, this isn’t exactly the kind of thing you can just put on a label in the United States.

In 2018, Ketan Vakil, after dealing with his own digestive issues involving FODMAPs, saw an opening in the market to cater to customers on low-FODMAP diets by offering diet-compatible broths and spice blends that could safely add some flavor to this notoriously bland diet. Hence, he founded Gourmend Foods, and, after getting a chicken broth and some spice blends low-FODMAP certified by Monash, Vakil and Gourmend proceeded to sell those items online and in retail using Monash’s trademarked label.

However, in 2022 when Vakil expanded Gourmend’s product line with a low-FODMAP beef broth, he learned from the USDA while going through a pre-approval process for the beef broth’s label that it would be illegal for him to include FODMAP info on the label of his low-FODMAP beef broth. He also learned he shouldn’t have been putting this information on his low-FODMAP chicken broth or spice blends either, but only discovered this in 2022 because the labels for these items were not subject to the same pre-approval process on account of what are basically quirks in American food labeling regulations that determine whether an item’s labeling is the purview of the USDA or FDA and differences in how those agencies enforce compliance with labeling regulations. Furthermore, he found out other terms like “Gut Loving” or “Deliciously Digestible” were similarly verboten.

Now, in fairness to the government (a phrase I never enjoy writing), some restrictions on food labeling are probably worthwhile. We don’t want companies putting false or misleading claims on a food label. We can’t just assume all companies will be truthful in their labels out of fear that any dishonesty inevitably will be found out. Nor can we assume the presentation of inaccurate information will be punished even if discovered.

Furthermore, scientifically speaking, there hypothetically could be room for debate about whether Monash is defining or measuring FODMAPs properly (although, if there is such a debate, it is not very prominent in the scientific literature). Also, I suppose one also could argue that someone on a low-FODMAP diet might potentially misinterpret the term “low-FODMAP” as “No FODMAPs” and overeat a low-FODMAP food to the point of making themselves ill. 

Keeping my scientist hat on, I might actually agree with the government about not letting Vakil use the terms “Gut Loving” or “Deliciously Digestible.” These terms are far more nebulous. Also, perhaps such labeling could lead people suffering from other gastrointestinal issues (or no GI issues at all) to believe low-FODMAP items or diets are broadly beneficial to gut health when, in reality, these items probably offer little to no health benefit to those without specific gastrointestinal conditions. Also, there is some reason to believe long-term adherence to a low-FODMAP diet may lead to nutritional deficiencies and other downsides, especially when maintained without consultation with a nutritionist.

However, the government’s reasoning for preventing the use of terms like “low-FODMAP” is not based in scientific quibbles about definition and measurement, nor does it appear to be about concerns over how the labels might be misinterpreted or complications from the diet itself. 

No, instead the reason Gourmend cannot label its products as low-FODMAP seems to be a purely bureaucratic one. Food labels in the US can only contain nutritional claims found on a list of claims defined and approved by the government. The government does not have a definition for FODMAP. Therefore FODMAP is not on the list of government-approved nutritional claims. And thus companies in the US cannot make claims about FODMAP content on a product’s label regardless of their accuracy.

Subsequently, Vakil understandably has rethought plans to develop and sell more low-FODMAP products given the illegality of labeling them as such and has refrained from using the claim on at least some items. Also, he has teamed up with the Institute for Justice and one of his customers to take the government to court over the matter, claiming that the government is chilling his speech by not allowing him to provide verifiably true descriptions of lawful products to customers and that this is their best avenue to address the issue.

Justin M. Pearson, an attorney with the Institute for Justice, told me in an email that administrative routes would have been beyond Gourmend’s resources and ultimately futile.

Whether the case will be successful remains to be seen. It was previously dismissed by a federal district court, but was recently revived at the federal appellate level and will be back in a district court as of September 24. 

However, the fact that, due to purely bureaucratic reasons, years of litigation are required to attain permission from the government to note on a label that a food item meets a scientifically accessible definition for a medically-recommended diet just seems absurd. (Almost as absurd as a state government saying pasteurized skim milk doesn’t count as skim milk unless it contains some extra additives, as Florida tried to do a little while back). 

Even more absurd though is the fact that this is happening in an era in which so much focus is placed on food freedom and so much attention is given to the relationship between what we eat and chronic disease. Furthermore, it makes one wonder what other information food manufacturers are not allowed to tell people simply due to government red tape.