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Living Well : Nutrition

Food Labels

When it comes to nutrition labels, sometimes what you read isn't what you get

READING NUTRITION LABELS

A Nutrition Facts label can be found on the side panel of most food packages. The title “Nutrition Facts” lets you know that the label meets federal regulations. The top part gives information about the food in the package, including serving size, total calories, calories from fat, and other information that varies by food product. The bottom part of the label is called a footnote; it appears only on larger packages and gives general information about how much the body needs of some nutrients. Let’s take a closer look at a Nutrition Facts label.

  1. Serving size information: Pay attention to the serving size, including the total number of servings in the food package. The size of the serving listed on the food label determines the nutrient amounts listed on the remainder of the label. If you eat a portion size different than the one indicated, you should calculate the values of the nutrients to determine what you have consumed.
     
  2. Calories: The calories listed on the label are for one serving. Make sure you understand how many servings are in the entire food package. If you eat a serving size different than the one indicated, you should calculate the calories you have consumed. For example, 8 ounces of milk is one serving and provides 90 calories. If you drink 16 ounces of milk (2 servings), multiply 90 calories by 2, which means you have consumed a total of 180 calories.
     
  3. % of daily value: The % DV is based on recommendations for a 2000-calorie diet. For labeling purposes, the FDA set 2000 calories as the reference amount for calculating % DV. You may require more or less than 2000 calories per day as an individual.
     
  4. Nutrients to limit: Eating too much fat, saturated fat, trans fat, and cholesterol may increase your risk of many diseases including heart disease and cancer. In addition, excess sodium intake can worsen hypertension (high blood pressure) in sensitive individuals and should be limited in the general population to avoid future chronic diseases. Look at the percentage of Daily Value (% DV) column to get an idea of how much of these nutrients a food contains. If the % DV is greater than 20%, the food is considered “high” in that nutrient while 5% or less is considered “low.”
     
  5. Total carbohydrates: The % DV for total carbohydrates is based on a general guideline that a 2000-calorie diet should contain 300 grams of carbohydrates. You may require more or less than this amount. The % DV shows you how much of the recommended daily amount of a nutrient is in a serving of food. By using the % DV, you can tell if this amount is high or low. If the % DV is greater than 20%, the food is considered “high” in that nutrient while 5% or less is considered “low.” The % DV of the Nutrition Facts panel tells you whether the nutrients in a serving of food contribute a lot or a little to your total daily intake. The chart below details the DVs and % DVs for a 2000 calorie diet.

     
  6. Nutrients to emphasize: Most people do not consume an adequate amount of fiber, iron, calcium, and vitamins A and C. Look at the food label to identify foods that contain high amounts of these nutrients. Look at the % DV column to get an idea of how much of these nutrients a food contains.
     
  7. Footnote: You may have noticed that there is an asterisk (*) after the words “% Daily Value.” This asterisk means that the values are based on a 2000-calorie diet. This statement must appear on all food labels. The footnote section remains the same for every package because it is not based on the actual food in the package but simply shows the recommended dietary advice for Americans based on a 2000- and 2500-calorie diet.

HOW ACCURATE ARE FOOD LABELS ON PREPARED MEALS?

Reading the nutritional information about the food you eat is important, but you may not want to believe everything you read. If the information on a food label seems too good to be true, it may be so!

Commercially prepared foods may have more calories than what the label says. In one study, 10 frozen meals were tested; the results showed that calorie contents averaged 8% more than what was stated on the labels. Furthermore, the calorie contents of 29 quick-serve and sit-down restaurant foods averaged 18% more than what the label said, and some foods had 200% more calories!

What can this mean for you? It can be frustrating that calorie counts are not always accurate. However, now that you’ve started to learn about appropriate serving sizes and how many calories are in common foods, you can use this information to determine the approximate calorie content of restaurant meals.

Here’s a practical example. Diane is at a sandwich shop to buy a turkey sub. The menu says a turkey sub with lettuce, tomato, and onion is 280 calories. Diane thinks this makes sense based on what she knows about the calories in turkey, bread, and vegetables. Along with the unsweetened iced tea and apple back at her desk, Diane thinks the turkey sandwich will make a good lunch.

When Diane gets her sub, it’s much larger than she expected; it seems to have about 10 slices of turkey. Diane knows from using her food planner and tracker that a thin slice of turkey has about 20 calories. This sub has 200 calories in the turkey alone. so the estimate of a total of 280 calories may not be realistic. Have you been in a situation like this? It’s important to stay alert when ordering food. Added mayonnaise, cheese, or other condiments can also add calories.

What can you do about it?

  • Read the "fine print" in the menu. What does the calorie count include? The menus often show pictures of foods with side dishes and drinks, but give a calorie count for the entrée only
  • When you place your order, be specific. If you don’t want mayonnaise or cheese, say so! Consider ordering condiments and dressings on the side and then use just a small amount
  • When you get your meal and see that it’s bigger than you thought it would be, take some home for later or offer to share with a friend

Eating out is convenient and fun, but consider what you are ordering. Start with a healthy order in line with your healthcare provider's recommendations and then make sure you got what you expected. You may be getting more than you asked for!

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INDICATION

Qsymia® should be used together with a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obese) or
  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol

Limitations of Use:

  • It is not known if Qsymia changes your risk of heart problems or stroke or of death due to heart problems or stroke
  • It is not known if Qsymia is safe and effective when taken with other prescription, over-the-counter, or herbal weight loss products

It is not known if Qsymia is safe and effective in children under 18 years old

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

Qsymia can cause serious side effects, including:

Birth defects (cleft lip/cleft palate). If you take Qsymia during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant. Women who are pregnant must not take Qsymia. Women who can become pregnant should have a negative pregnancy test before taking Qsymia and every month while taking Qsymia and use effective birth control (contraception) consistently while taking Qsymia. Talk to your healthcare provider about how to prevent pregnancy. If you become pregnant while taking Qsymia, stop taking Qsymia immediately, and tell your healthcare provider right away. Healthcare providers and patients should report all cases of pregnancy to FDA MedWatch at 1-800-FDA-1088, and the Qsymia Pregnancy Surveillance Program at 1-888-998-4887.

Increases in heart rate. Qsymia can increase your heart rate at rest. Your healthcare provider should check your heart rate while you take Qsymia. Tell your healthcare provider if you experience, while at rest, a racing or pounding feeling in your chest lasting several minutes when taking Qsymia.

Suicidal thoughts or actions. Topiramate, an ingredient in Qsymia, may cause you to have suicidal thoughts or actions. Call your healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: thoughts about suicide or dying; attempts to commit suicide; new or worse depression; new or worse anxiety; feeling agitated or restless; panic attacks; trouble sleeping (insomnia); new or worse irritability; acting aggressive, being angry, or violent; acting on dangerous impulses; an extreme increase in activity or talking (mania); other unusual changes in behavior or mood.

Serious eye problems, which include any sudden decrease in vision, with or without eye pain and redness or a blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma). These problems can lead to permanent vision loss if not treated. Tell your healthcare provider right away if you have any new eye symptoms.

Possible side effects of Qsymia include:

Mood changes and trouble sleeping. Qsymia may cause depression or mood problems, and trouble sleeping. Tell your healthcare provider if symptoms occur.

Concentration, memory, and speech difficulties. Qsymia may affect how you think and cause confusion, problems with concentration, attention, memory or speech. Tell your healthcare provider if symptoms occur.

Increases of acid in bloodstream (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will: feel tired, not feel hungry (loss of appetite), feel changes in heartbeat, or have trouble thinking clearly. Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Qsymia.

Low blood sugar (hypoglycemia) in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus. Weight loss can cause low blood sugar in people with type 2 diabetes mellitus who also take medicines used to treat type 2 diabetes mellitus (such as insulin or sulfonylureas). You should check your blood sugar before you start taking Qsymia and while you take Qsymia.

High blood pressure medicines. If you are taking medicines for your blood pressure, your doctor may need to adjust these medicines while taking Qsymia.

Central Nervous System (CNS) side effects. The use of prescription sleep aids, anxiety medicines, or drinking alcohol with Qsymia may cause an increase in CNS symptoms such as dizziness and light-headedness. Do not drink alcohol with Qsymia.

Possible seizures if you stop taking Qsymia too fast. Seizures may happen in people who may or may not have had seizures in the past if you stop Qsymia too fast. Your healthcare provider will tell you how to stop taking Qsymia slowly.

Kidney stones. Drink plenty of fluids when taking Qsymia to help decrease your chances of getting kidney stones. If you get severe side or back pain, and/or blood in your urine, call your healthcare provider.

Decreased sweating and increased body temperature (fever). People should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition.

Common side effects of Qsymia include:

Numbness or tingling in the hands, arms, feet, or face (paraesthesia); dizziness; changes in the way foods taste or loss of taste (dysgeusia); trouble sleeping (insomnia); constipation; and dry mouth.

Tell your healthcare provider if you have any side effect that bothers you or does not go away. These are not all of the possible side effects of Qsymia. For more information, ask your healthcare provider or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to VIVUS, Inc. at 1-888-998-4887 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Please read the Qsymia Medication Guide and Full Prescribing Information.

The Q and Me Patient Resources and Education site is based on the LEARN® Program provided under copyright license (September 15, 2010). All rights reserved.

IMPORTANT SAFETY INFORMATION

Do not take Qsymia if you are pregnant, planning to become pregnant, or become pregnant during Qsymia treatment; have glaucoma; have thyroid problems (hyperthyroidism); are taking certain medicines called monoamine oxidase inhibitors (MAOIs) or have taken MAOIs in the past 14 days; are allergic to topiramate, sympathomimetic amines such as phentermine, or any of the ingredients in Qsymia. See the end of the Medication Guide for a complete list of ingredients in Qsymia.

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