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The FDA’s New Definition of ‘Healthy’

Jonathan Ferng, MD, MBA, MS
Jonathan Ferng is an internal medicine physician who has a wide range of interests spanning healthcare, business, consulting, research, and music. He enjoys meditating, learning new skills, and sharing positivity with the world.
Published: October 1, 2022
The FDA has changed the definition of healthy to include avocados, seeds and nuts, and even fish.
Updates to the voluntary “healthy” claim on food packages in the U.S. have been met with mixed feedback from both consumers and experts. (Image: Jane Doan via Pexels)

Poor nutrition is one of the key lifestyle risks for chronic disease, along with tobacco use, alcohol use, and lack of physical activity. According to the Centers for Disease Control and Prevention (CDC), 6 in 10 adults in the U.S. have a chronic disease, and 4 in 10 have two or more chronic diseases.

The leading drivers of 4.1 trillion U.S. dollars in annual healthcare costs include heart disease, cancer, chronic lung disease, stroke, Alzheimer’s disease, diabetes, and chronic kidney disease. Most people in the U.S. consume excessive amounts of sodium, saturated fats, and sugars, increasing their risk of these chronic diseases.

On Sept. 28, the U.S. Food and Drug Administration (FDA) proposed updated rules for the nutrient content claim “healthy” on food packages. While the “healthy” claim is voluntary, and there is not yet an official symbol that can be placed on packaging, some companies will still try to comply with new guidelines to appease health-conscious consumers.

New framework

The FDA’s new nutrition guidelines were announced ahead of the White House Conference on Hunger, Nutrition and Health the same day. More than 50 years had elapsed since the first and only previous conference in 1969. 

The Biden Administration promised to commit $8 billion towards a stated goal to, “End hunger and increase healthy eating and physical activity by 2030, so that fewer Americans experience diet-related diseases like diabetes, obesity, and hypertension.”

In a statement released by the White House, the front-of-package (FOP) labeling system was touted as a way to “quickly and easily communicate nutrition information,” and “empower consumers to make healthy choices.”

Recommendations are based on current nutrition science and may include tools such as “star ratings or traffic light schemes.”

The new framework aims to provide consumers with nutrient-dense foods. Food products are required to have a meaningful amount of food from at least one food group or subgroup, such as fruits, vegetables, grains, dairy, and protein foods.

Specific limits for added sugars, saturated fats, and sodium vary based on the type of product, including if the product contains more than one food group or is a main dish and meal. 

According to the FDA, “Examples of foods currently ineligible to bear the ‘healthy’ claim based on the existing regulatory definition, but that would qualify under the proposed definition are water, avocados, nuts and seeds, higher fat fish, such as salmon, and certain oils.”

In contrast, “Products that currently qualify for ‘healthy’ that would not under the proposed definition include white bread, highly sweetened yogurt and highly sweetened cereal.” 

Raw whole fruits and vegetables would automatically qualify as “healthy” due to their nutrition profile and benefit towards a healthy diet.

Expert opinions

According to The Washington Post, Sean McBride, founder of DSM Strategic Communications and a former executive at the Grocery Manufacturers Association, said, “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.”

“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,” McBride added.

Peter Lurie, Executive Director of the Center for Science in the Public Interest, told the newspaper that the labeling shows promise but should be mandatory, simple, and specific.

Eva Greenthal, also from the Center for Science in the Public Interest, told CNN, “The potential impact as we see it is fairly limited.”

She pointed out how the voluntary healthy claim is currently only carried by a few food products, and that the updated standards may make the number shrink further. She said the healthy claim would not help people understand which foods are nutritious.

Nutrition labels

To allow consumers to make more informed food choices, the FDA previously updated the Nutrition Facts label on packaged foods in 2016. The serving size and calorie count fonts were enlarged, and serving sizes were modified to better reflect what people normally eat and drink in a day.

The percent Daily Value (% DV), which shows how much each nutrient contributes to the total daily diet, was adjusted so that 5% DV or less of a nutrient per serving is considered low, while 20% DV or more of a nutrient per serving is considered high. 

Additionally, nutrition labels were no longer required to list calories from fat due to research showing the amount of fat is less important than the type of fat consumed. Vitamins A and C do not need to be listed because deficiencies are rare nowadays.

Calcium and iron remained on the labels, while Vitamin D and potassium were added because diets high in these nutrients can reduce osteoporosis and high blood pressure risk, respectively.

Added sugars were included in labels because sugars from food processing, syrups, honey, and concentrated fruit or vegetable juices made it difficult to stay within calorie limits while meeting nutritional goals.