The Food and Drug Administration unveiled a new proposal on Wednesday that would change the criteria for which packaged foods the agency considers “healthy,” in an attempt to modernize its approach to nutrition and reduce the burden of diet-related diseases.
Currently, about 5 percent of all packaged foods are labeled “healthy,” according to the agency. The definition, which was set in 1994, allows for food manufacturers to add the word “healthy” to their products, as long as the products have limited amounts of total fat, saturated fat, cholesterol and sodium and provide at least 10 percent of the daily value of one or more of the following nutrients: vitamin A, vitamin C, calcium, iron, protein or dietary fiber. (Seafood, game meat and raw fruits and vegetables have slightly different criteria.) In 2016, the F.D.A. updated its guidelines to allow for some foods to contain more total fat and to include some that provide at least 10 percent of the daily value of vitamin D or potassium.
Crucially, there is currently no limit on added sugars under the current definition — an omission that the F.D.A. believes is inconsistent with today’s nutrition science.
“The old rule was really outdated — you could create any kind of Frankenstein food that met the nutrient criteria and label it as healthy,” said Dr. Dariush Mozaffarian, a cardiologist and professor of nutrition at the Tufts Friedman School of Nutrition Science and Policy in Boston. “This is a major advance.”
The proposed rule, which the agency announced to coincide with Wednesday’s White House Conference on Hunger, Nutrition and Health, introduces a new limit on added sugars — in general, no more than 2.5 grams per serving, although this can vary depending on the food. It also restricts the amount of sodium to no more than 230 milligrams per serving and provides limits for saturated fat, which can similarly vary depending on the food, the F.D.A. said.
A six-ounce serving of yogurt, for example, would not qualify as “healthy” under the new rule if it contained more than 2.5 grams, or 5 percent of the daily value, of added sugars; a frozen dinner of salmon, green beans and brown rice would not qualify as “healthy” if it contained more than four grams of saturated fat.
The new definition aims to encourage healthy eating by prioritizing a mix of vegetables, fruits, grains, dairy, proteins and certain oils, including vegetable oils. A “healthy” food would need to contain a minimum amount of at least one of those food groups and be under the proposed limits for saturated fats, sodium and added sugars. Raw whole fruits and vegetables would automatically qualify.
“Those criteria will eliminate vast swaths of the supermarket from being eligible for the healthy logo,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University.
Many sugary cereals, granola bars, highly sweetened yogurts and white breads, which might currently qualify as “healthy” under the existing definition, would be eliminated under the new rule.
Water, avocados, nuts and seeds, fatty fish like salmon, and certain oils — which do not currently qualify as “healthy” — could earn the distinction under the new guidelines.
The new definition of “healthy” emphasizes whether a food fits into a healthy dietary pattern overall, as opposed to just focusing on a food’s individual nutrients. Salmon, for example, which isn’t considered “healthy” under the current definition because it is high in fat, would earn the new “healthy” distinction because it is rich in beneficial omega-3 fatty acids and protein and low in saturated fat and cholesterol.
“The F.D.A. has been really behind the times when it comes to making stricter guidelines for these things,” said Dr. Selvi Rajagopal, an assistant professor of medicine at Johns Hopkins Medicine and a diplomat of the American Board of Obesity Medicine. “When I read this, I thought, OK, this is good. I was pleased.”
Typically, after the F.D.A. proposes a rule, the agency seeks commentary from outside health experts and the general public before the rule can go into effect, said Dr. Peter Lurie, executive director and president of the Center for Science in the Public Interest. The process can take a year or more, he added.
While he applauded some aspects of the proposed update, especially the limit on added sugars, Dr. Lurie stressed that there is a fundamental problem with the label, which as with the current label, would remain voluntary. Consumers might erroneously think that any foods without a “healthy” label are automatically unhealthy. “It’s not really helpful in that respect,” he said. “It allows the industry to decide what to convey to the consumer, as opposed to providing the consumer with what they would clearly want.”
Instead, Dr. Lurie and others in the nutrition field are pushing for new standardized, mandatory nutrition labels placed on the front of food packages, which the F.D.A. is currently looking into.
In the meantime, the agency hopes that an updated definition will help consumers make better dietary decisions, to help lower the incidence of “diet-related chronic diseases” like cardiovascular disease and Type 2 diabetes. More than 80 percent of people living in the United States aren’t getting enough vegetables, fruit and dairy in their diets, according to the F.D.A.
“There’s been so much mixed messaging on what’s healthy and what’s not,” Dr. Rajagopal said. “The average consumer just doesn’t have a baseline.”