date. In 2010, according to the FDA, the average American consumed 5.8 grams of trans fat per day (2.6% of energy intake). Monoglycerides and diglycerides are not considered fats by the FDA, despite their nearly equal calorie per weight contribution during ingestion. On 11 July 2003, the FDA issued a regulation requiring manufacturers to list trans fat on the Nutrition Facts panel of foods and some dietary supplements. The new labeling rule became mandatory across the board on 1 January 2006, even for companies that petitioned for extensions. However, unlike in many other countries, trans fat levels of less than 0.5 grams per serving can be listed as 0 grams trans fat on the food label. According to a study published in the Journal of Public Policy & Marketing, without an interpretive footnote or further information on recommended daily value, many consumers do not know how to interpret the meaning of trans fat content on the Nutrition Facts panel. Without specific prior knowledge about trans fat and its negative health effects, consumers, including those at risk for heart disease, may misinterpret nutrient information provided on the panel. The FDA did not approve nutrient content claims such as "trans fat free" or "low trans fat", as they could not determine a "recommended daily value". Nevertheless, the agency is planning a consumer study to evaluate the consumer understanding of such claims and perhaps consider a regulation allowing their use on packaged foods. However, there is no requirement to list trans fats on institutional food packaging; thus bulk purchasers such as schools, hospitals, jails and cafeterias are unable to evaluate the trans fat content of commercial food items. Critics of the plan, including FDA advisor Dr. Carlos Camargo, have expressed concern that the 0.5 gram per serving threshold is too high to refer to a food as free of trans fat. This is because a person eating many servings of a product, or eating multiple products over the course of the day may still consume a significant amount of trans fat. Despite this, the FDA estimates that by 2009, trans fat labeling will have prevented from 600 to 1,200 cases of coronary artery disease, and 250 to 500 deaths, yearly. This benefit is expected to result from consumers choosing alternative foods lower in trans fats, and manufacturers reducing the amount of trans fats in their products. The American Medical Association supports any state