What Makes a Food 'Healthy'? Here's How the FDA Wants to Change the Definition

The Food and Drug Administration on Wednesday proposed a new definition of the word “healthy” when it comes to food packaging claims, in hopes of reducing the burden of chronic disease and advancing health equity in the United States.

The proposed rule is the first change to the term since 1994, and will now better align with the most current nutrition guidance, as well as the updated Nutrition Facts label and the latest Dietary Guidelines for Americans.

The updated definition also comes at a time when more than 80% of Americans aren’t eating enough vegetables, fruits, and dairy, and instead are opting for saturated fats, added sugars, and sodium-rich foods—all of which can help contribute diet-related chronic diseases.

“Too many people in the U.S. eat a diet that is low in whole grains, vegetables, nuts, seeds, and legumes; and high in saturated fats, processed grains, sugar, and sodium,” Dana Ellis Hunnes, PhD, MPH, RD, a clinical dietitian, assistant professor at UCLA Fielding school of public health, and author of Recipe for Survival, told Health. “The purpose of this redefining the word ‘healthy’ for the purposes of packaging is to make it easier for the consumer to choose foods that are overall of higher nutrition quality.”

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A New Definition for a Hard-to-Define Term

According to the FDA, using the term healthy on a food label allows consumers to easily identify healthier choices in the store—but in order to put the word on a label, the food must meet specific standards.

The label is also voluntary, meaning manufacturers can decide if they want to use the term healthy on packaging, if it meets the specific standards.

The current standards, put in place nearly two decades ago, include limits on total fat, saturated fat, cholesterol, and sodium. To qualify as healthy, foods must also provide at least 10% of the Daily Value for vitamin A, vitamin C, calcium, iron, protein, fiber, or a combination of those nutrients.

The proposed rule, however, adds stricter limits on some ingredients or nutrients, and lessens the focus on others.

To qualify as healthy under the new rule, foods must have a meaningful amount of food from at least one of the main food groups or subgroups—fruits, vegetables, dairy, dairy, whole grains, etc.

The foods must also now have limited amounts of added sugars—which were not previously included in the standards—and sodium: generally speaking the FDA suggested no more than 230 milligrams of sodium, and 2.5 grams of added sugars.

And rather than focusing on the total fat included in food items, the new rules will assess the type of fat, with a focus on limiting saturated fat. Because of this change, healthy, high-fat food—like avocados, nuts, seeds, and fish—that previously didn't qualify as healthy, now will.

The newly-proposed guidance also means that other foods previously given the healthy stamp—like white bread, sweetened yogurt, and certain cereals—may no longer be deemed as such. The FDA gives an example of cereal, which will now need to contain three-quarters of an ounce of whole grains and less than 1 gram of saturated fat, 230 milligrams of sodium and 2.5 grams of added sugars to be considered healthy.

Keep in mind, though, that this rule is still technically a proposal. The public is allowed to comment on the proposed rule until December 28, 2022. After that, the FDA will review the comments, finalize the guidance, and publish the final rule—and then food manufacturers will have three years to comply with that new definition, according to Angela Spivey, a partner on Alston & Bird’s Food & Beverage Industry Team.

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Taking Action to Improve Health in the U.S.

The proposed rule—unveiled to go along with the White House’s Conference on Hunger, Nutrition, and Health—is part of the FDA’s national strategy to end hunger, improve nutrition, and prevent diet-related chronic diseases, which pose a major public health problem for Americans.

Updating the nutritional standards is a step in the right direction in helping people improve their knowledge on what healthy amounts of sodium, sugar, and saturated fats look like. But confusion over what is and isn't healthy is only part of the problem.

In the U.S., convenience often drives people’s food choices, according to Christopher Gardner, PhD, a nutrition scientist, professor of medicine at Stanford University, and chair of the American Heart Association’s Nutrition Committee.

Rather than taking the time to purchase healthy ingredients and prepare a balanced meal, "the more common practices in America are to open a box or package and eat out of the box, or microwave the ingredients and then eat," Gardner told Health.

Of course, other factors influence food choices too, like cost, personal taste, access, education, and time. “A lot of it has to do with equity, costs of healthy, unprocessed foods, time to prepare these foods, access to these foods in disproportionately minority and lower-income neighborhoods,” said Hunnes.

While the new healthy label may motivate some people to grab healthier food items, these other barriers must also be addressed to successfully improve nutrition for all.

According to Gardner, the overall impact of this proposed rule will likely be minimal, in regards to people's food choices.

If anything, he said, the new guidance will likely have more of an impact on food manufacturers, who may tweak their ingredients in order to meet the criteria—which may, in turn, cause more confusion about the healthfulness of some foods.

"I still think much more needs to be done to encourage an appreciation [of] and [an] incorporation of simple, whole, yummy foods into the U.S. diet," said Gardner.

To that end, the FDA has several other projects promoting nutrition in the works. The agency recently released new guidance to reduce sodium in processed, packaged, and prepared foods, and tweaked the nutrition facts label on packaged foods and drinks.

It’s also working on reducing toxic elements in baby foods, setting safety standards for online grocery shopping, and improving how foods are identified and labeled.

"The FDA aims to help create an environment where people in the U.S. have greater access to healthier foods and nutrition information to help them make healthier choices more easily," an FDA spokesperson told Health, "as well as help ensure all children learn healthy habits early."