Colleen Sloan, PA-C, RDN

One of the most underutilized tools in patient education is the Nutrition Facts label.

Instead of focusing the conversation on restrictions—like “cut back on sugar” or “limit soda” —teaching teens to read nutrition labels encourages awareness and better decision-making. By middle school, kids are making more independent food choices, and many are interested in health and fitness. Learning to spot added sugars, compare portion sizes, and recognize misleading marketing claims gives them a practical tool to take ownership of their health. Let’s look at how to incorporate this into our patient encounters.

What's on the Nutrition Facts label?

The Nutrition Facts label includes¹:

• Serving size and servings per container
• Calories per serving
• % Daily Values (%DV)
• Macronutrients: fat, carbohydrates (including fiber and added sugars), and protein
• Other key nutrients: cholesterol, sodium, vitamins, and minerals

Food labels also list ingredients, which is essential for individuals with food allergies, and may include regulated claims like "healthy," "low fat," or "USDA Organic."

Breaking down the label for patients

1. Start with serving size

The serving size determines all information on the label. This is the best place to start. Many products seem like single portions but may contain multiple servings. If a patient eats more than 1 serving, they must multiply all listed nutrients accordingly.

Encourage patients to:

• Always check the servings per container
• Compare their actual portion to the listed serving size
• Understand that serving size is not a recommendation, just a reference

2. Understanding % Daily Value (%DV)

The % Daily Value helps determine if a food is high or low in a particular nutrient (based on a 2,000-calorie diet)¹. If you eat 1 serving of a food and it provides 10% DV of dietary fiber, then for that day, you have eaten 10% of your dietary fiber daily goal.

• 5% DV or less = Low
• 20% DV or more = High

3. Nutrients to limit vs prioritize

Encourage patients to limit foods high in saturated fat, trans fat, sodium, and added sugars; and to prioritize fiber, protein, vitamins, and minerals.²

Nutrient of concern: Added sugars

A key area for nutrition education should focus on added sugars since children and adolescents in the United States consume approximately 17 teaspoons of added sugar daily—far exceeding recommendations.³

Recommended guidelines for added sugar

• Children under 2: Avoid added sugars entirely
• Children 2 years and older: Limit to 25 grams (6 teaspoons) per day³
• Sugary drinks: Should be avoided
• 100% Fruit juice:⁴
• Ages 1-3: No more than 4 ounces per day
• Ages 5-8: No more than 4-6 ounces per day
• Ages 9-13: No more than 6-8 ounces per day
• Ages 14-18: No more than 8 ounces per day
• Infants under 1 year should not consume fruit juice

How to teach patients to use the label

Teaching kids about added sugar can be simple, interactive, and empowering—without using fear tactics or labeling sugar as "bad." The focus should be on awareness and better choices—not guilt, fear or obsession.

Use their favorite foods

• Ask what snacks or drinks they love and look up the food label together.
• Teach them to check the serving size first. Are they eating more than what’s listed?
• Next, look at the grams of added sugar per serving.
• Explain that 4 grams of sugar equals 1 teaspoon. Older kids can divide the total grams of added sugar by 4 to determine how many teaspoons they are consuming. (It’s easier to visualize a teaspoon, rather than a gram)
• Provide a target of 25 grams per day and discuss how this food fits into that limit.

Fun exercises at home

Label scavenger hunt:

• At the grocery store, give kids a list of things to find, such as:
• A snack with at least 3 grams of fiber
• A drink with zero added sugar
• A food with 20% DV of protein

At-home sugar awareness activities:

Have kids guess how much sugar is in their favorite drink, then measure out the teaspoons of sugar to visualize their intake. Remember: 4 grams equals 1 teaspoon.

Serving size exercise:

• Ask kids to pick a box or bag of cereal, chips, cookies, crackers, or pretzels from the pantry.
• Have them measure out how much they would usually eat for a snack into a bowl.
• Next, check the serving size on the label and measure out the actual serving size in another bowl.
• Compare the 2 portions. Were they surprised by the difference?

Strategies to lower sugar intake

The easiest way to cut back on added sugar is by swapping out sugary drinks, which are the biggest contributor to excess sugar in kids' diets. Encouraging parents to replace soda, sports drinks, juice, and sweetened teas with water, milk, or sparkling water can significantly reduce a child's sugar intake with just 1 simple change.

Another effective strategy is limiting processed snacks, which often contain hidden sugars. Instead of reaching for flavored yogurts, granola bars, and sweetened cereals, parents can offer fresh, whole-food alternatives like fruit, nuts, cheese, or whole-grain crackers.

Small, consistent swaps like these can build healthier eating habits without making kids feel restricted.

Key takeaway

When teens learn to read between the lines of food marketing and are armed with the valuable skill of reading nutrition labels, they take ownership of their nutrition and are more likely to develop lifelong healthy habits—a win for both them and their health care providers.

References:

1. Program HF. How to understand and use the Nutrition Facts Label. U.S. Food And Drug Administration. Published March 5, 2024. Accessed March 2, 2025. https://www.fda.gov/food/nutrition-facts-label/how-understand-and-use-nutrition-facts-label

2. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Accessed March 2, 2025. DietaryGuidelines.gov

3. Muth ND, Dietz WH, Magge SN, et al. Public policies to reduce sugary drink consumption in children and adolescents. PEDIATRICS. 2019;143(4). doi:10.1542/peds.2019-0282

4. Ages 5-18 Beverage Recommendations | Healthy Eating research. Healthy Eating Research. Published January 29, 2025. Accessed March 2, 2025. https://healthyeatingresearch.org/tips-for-families/ages-5-beverage-recommendations/