FDA announces new definition of what’s ‘healthy’

The Food and Drug Administration announced new rules Wednesday for nutrition labels that can go on the front of food packages to indicate that they are “healthy.”

Under the proposal, manufacturers can label their products “healthy” if they contain a meaningful amount of food from at least one of the food groups or subgroups (such as fruit, vegetable or dairy) recommended by the dietary guidelines. They must also adhere to specific limits for certain nutrients, such as saturated fat, sodium and added sugars. For example, a cereal would need to contain three-quarters of an ounce of whole grains and no more than 1 gram of saturated fat, 230 milligrams of sodium and 2.5 grams of added sugars per serving for a food manufacturer to use the word “healthy” on the label.

The labels are aimed at helping consumers more easily navigate nutrition labels and make better choices at the grocery store. The proposed rule would align the definition of the “healthy” claim with current nutrition science, the updated Nutrition Facts label and the current Dietary Guidelines for Americans, the FDA said.

The agency also is developing a symbol that companies can voluntarily use to label food products that meet federal guidelines for the term “healthy.”

The announcement came ahead of Wednesday’s White House Conference on Hunger, Nutrition and Health. The conference was the first of its kind since 1969, when a summit hosted by the administration of President Richard M. Nixon led to major expansions of food stamps, school lunches and other programs that have been credited with reducing hunger nationally and providing a critical safety net during the pandemic.

Once finalized, the FDA’s new system will “quickly and easily communicate nutrition information” through tools such as “star ratings or traffic light schemes to promote equitable access to nutrition information and healthier choices,” the White House said in a statement this week. The system “can also prompt industry to reformulate their products to be healthier,” it said, by adding more vegetables or whole grains or developing new products to meet the updated definition.

The stakes are high.

Six in 10 American adults have chronic lifestyle-related diseases, often stemming from obesity and poor diet, according to the Centers for Disease Control and Prevention. The CDC says these diseases are the leading cause of death and disability and a leading driver in the nation’s $4.1 trillion of annual health-care costs.

And the obesity epidemic is not moving in the right direction: Studies show that obesity, especially among children, rose significantly during the pandemic, with the greatest change among children ages 5 to 11, who gained an average of more than five pounds. Before the pandemic, about 36 percent of 5- to 11-year-olds were considered overweight or obese; during the pandemic, that increased to 45.7 percent.

In some Latin American countries, governments have instituted stricter food labeling laws, pushing back against sugary beverages and ultra-processed foods in an effort to escape the obesity epidemic that has overtaken the United States. In Chile, for instance, foods high in added sugar, saturated fats, calories and added sodium must display black stop signs on the front of their packages. Nothing with black stop signs can be sold or promoted in schools or included in child-targeted television ads.

Groups such as the Center for Science in the Public Interest have long petitioned the FDA to adopt mandatory, standardized and evidence-based front-of-package labeling. Front-of-package nutrition labeling, they say, will reach more consumers than the “Nutrition Facts” on the backs of packages, helping them quickly choose more-beneficial foods and spurring companies to reformulate products in a more healthful direction. According to nutrition experts, Americans generally consume too much sodium, added sugars and saturated fat in their packaged foods, so to be able to quickly identify foods that are high or low in those nutrients would be a significant public health benefit.

The Biden administration has endorsed the FDA’s efforts to crack down on sodium intake, strengthening the agency’s announcement last year that it would have food companies and restaurants reduce sodium in the foods they make by about 12 percent over the next 21/2 years. In a parallel effort, the administration suggests the FDA reduce Americans’ sugar consumption by “including potential voluntary targets” for food manufacturers’ sugar content.

New labeling language is sure to be controversial among food manufacturers that have sought to capitalize on Americans’ interest in more-healthful food.

“The FDA’s ‘healthy’ definition can succeed only if it is clear and consistent for manufacturers and understood by consumers,” Roberta Wagner, a spokeswoman for the industry organization Consumer Brands Association, said Tuesday.

But what constitutes “healthy” food is a thorny topic among nutrition experts. Would foods high in what many nutrition scientists call “good fats,” such as those that contain almonds or avocados, be deemed “unhealthy,” whereas artificially sweetened fruit snacks or reduced-fat sugary yogurts might be considered “healthy”?

The proposal is far from final and likely to be met with some resistance from food manufacturers, which have sought in recent years to capitalize on the increasing desire among consumers to eat healthier.

“In reality, FDA’s proposed rule will need to undergo significant review and revision to ensure it does not place the politics of food above science and fact,” said Sean McBride, founder of DSM Strategic Communications and former executive at the Grocery Manufacturers Association. “The details are critical because the final rule goes well beyond a simple definition by creating a de facto nutrition profile regulatory scheme that will dictate how food can be made for decades to come.”

Peter Lurie, executive director of the Center for Science in the Public Interest, said that front-of-package labeling shows real promise but that it must be mandatory, simple, nutrient-specific and include calories. He said that such labeling does change consumer purchasing behaviors and forces companies to reformulate their products to attain more favorable ratings. He said that unless a healthy definition and label is very specific, some companies will try to game the system by “health-washing” their less healthy products to appear healthy.

The FDA started a public process to update the “healthy” nutrient content claim for food labeling in 2016. But critics have said the dietary guidelines have often failed to focus on the right things. During the Trump administration, for instance, the 2020 dietary guidelines committee was forbidden to consider the health effects of consuming red meat, ultra-processed foods and sodium.

Federal nutrition guidance has experienced some significant pendulum swings. For many years, recommendations were based on intuitive, but incorrect, thinking: Eating fat makes us fat. Consuming large quantities of cholesterol gives us high cholesterol.

First defined by the FDA in 1994, “healthy” was initially focused on fat content. In 2015, the agency sent a warning letter to snack bar maker Kind about the company’s “healthy” label. At issue? The bars, mostly nuts, were too high in saturated fat. Nutrition experts and Kind submitted a formal petition to the FDA “to update its regulations around the term healthy when used as a nutrient content claim in food labeling,” to reflect current science.

In 2016, the FDA reversed its position, allowing Kind to use the term “healthy” and announcing that the agency would reconsider the definition of the word.

The new FDA guidance announced this week would automatically allow whole fruits and vegetables to bear the claim of “healthy,” and prepared food products would have to meet criteria for nutrient requirements and percentage limits for added sugars, sodium and saturated fats.

“Seven years after filing our Citizen Petition, Kind is celebrating that the FDA has proposed an updated regulatory definition of ‘healthy,’ ” Kind chief executive Russell Stokes said Wednesday. “A rule that reflects current nutrition science and Dietary Guidelines for Americans is a win for public health – and that’s a win for all of us.”

Recent dietary guidelines put an emphasis on eating a plant-based diet, including vegetables, fruits, whole grains, legumes, nuts and seeds. They maintain a hard line about limiting your intake of salt and saturated fat, but they state simply that cholesterol is “not a nutrient of concern,” doing away with the long-standing 300-milligram-per-day limit.