What exactly should the word “healthy” mean on food labels?

The United States Food & Drug Administration (“FDA”) asked that same question on Thursday, March 9, 2017. In an all-day public meeting in Rockville, Maryland, the FDA opened the floor to interested parties, asking for input on its ongoing effort to redefine what “healthy” means and which food products can be labeled as such.  The meeting began with opening remarks from FDA representatives, followed by presentations and panel discussions from food companies and health experts, break-out sessions on various topic areas, and a public comment session.

As a starting point, the FDA has indicated that “[r]edefining ‘healthy’ is part of an overall plan to provide consumers with information and tools to enable them to easily and quickly make food choices consistent with public health recommendations and to encourage the development of healthier foods by the industry.”[1]  Accordingly, it is important for the definition of “healthy” to be updated as science and dietary patterns evolve.

The FDA’s current decision to consider redefining “healthy” was prompted by two developments. First, there was a recognition that Americans are under-consuming certain important nutrients the FDA should be encouraging them to eat.  Second, there was a recognition that some previously-held beliefs regarding what constitutes a healthy diet are now outdated.

By way of example, there has been considerable focus on limiting total fat consumption without regard to the type of fat consumed. As a result, nuts, avocados, fatty fish and other foods are not considered “healthy” under the current guidelines because they contain more than 3 grams of fat per serving.  Science has evolved, however, and the prevailing view is that not all fats are created equal – i.e., monounsaturated fat (found in nuts) and polyunsaturated fat (found in fatty fish) can lower blood cholesterol levels and decrease the risk of cardiovascular disease.  Thus, one of the issues discussed during the public meeting was whether “healthy” should be redefined in such a way that would permit such foods to carry the “healthy” claim.  On that point, the Vice President and General Counsel of KIND, LLC, Justin Mervis, noted that there is something wrong with the definition of “healthy” when low-fat pudding qualifies, but avocados and almonds do not.

During the meeting’s break-out sessions, the discussions centered, in part, on whether “healthy” should be a nutrient-based claim, a food-based claim, or a hybrid of the two, with most participants favoring a hybrid approach. In so doing, however, many participants advocated for a broader array of nutrients to be considered “healthy.”  Those participants argued that, if a health benefit can be demonstrated, it should make the list.  Other participants advocated for the inclusion of more food groups – such as nuts, fatty fish and eggs.

Specific concerns were voiced over the option of defining “healthy” based solely on nutrient content. In addition to the previously-mentioned debate over fat content, there also was a great deal of discussion surrounding the difference between natural sugar (such as that in bananas) and added sugars.  Additionally, there was concern that being overly-focused on a particular nutrient may have unintended consequences.  For example, focusing on reducing sugar may lead to the addition of artificial sweeteners, which may have detrimental health consequences.

There also were concerns with defining “healthy” based solely on food groups. Specifically, which food groups should be included, what should the selection criteria be, and should foods be required to have a certain nutrient profile in order to qualify as “healthy”?  Some participants noted that the health benefits can vary, even within a particular food group – for example, the health benefits of broccoli are very different from the benefits of celery.  Additionally, there was concern expressed whether certain food groups, such as fruits and nuts, which in limited quantities are viewed as healthy, but in large quantities may not be because of the natural sugar and fat levels, should be included in the definition.

Regardless of the definition, some participants questioned whether a food label should be permitted to simply claim that it is “healthy” without saying why it is healthy, such as “healthy because it provides 100% of the recommended daily value of Vitamin C.”

Finally, an over-arching concern among the participants was how the FDA intended to keep the “healthy” definition up-to-date with science, and whether it intended to revisit the definition on a pre-determined regular basis. The FDA did not answer those questions, but instead invited the public to provide its thoughts on those topics.

The FDA concluded the meeting, advising that it will continue to receive written comments until April 26, 2017. After that, the FDA will review all of the information and decide whether the definition should be redefined, and if so, how and when.  The FDA expressed a desire to continue the dialogue, but expressed no date for when any decisions would be made.

[1] https://www.fda.gov/food/guidanceregulation/guidancedocumentsregulatory information/labelingnutrition/ucm520695.htm.