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FDA Can Make Us Healthier Than 'Healthy'

— Voluntary labels will only take us so far

MedpageToday
A photo of the exterior of the headquarters of US Food and Drug Administration in Silver Spring Maryland.

There's been a lot of over FDA's move to redefine what can be labeled a "healthy" food. In a proposed rolled out on the morning of the historic last month, FDA made some hefty claims about this initiative. The agency predicted that redefining which food products could use a "healthy" label on their packaging would help consumers select more healthful foods, improve people's overall diet quality, reduce all-cause morbidity and mortality, and yield $12 million in annual net benefits. But is updating the guardrails around a voluntary marketing claim really the best FDA can do for our nation's health?

Let's be clear: It's a good thing that FDA has taken this step to rein in sometimes about the healthfulness of foods. The proposal includes new limits on added sugars and stronger limits on sodium, while maintaining the existing limits on saturated fats, if a manufacturer wants to make a "healthy" claim. All three of these nutrients are by the vast majority of Americans. It also establishes that "healthy" foods must have minimum levels of ingredients from food groups that make up the core of a , including fruits, vegetables, whole grains, dairy, and proteins. And it removes the limit on total fats, in alignment with the latest nutrition science. But voluntary labels can only take one so far.

By FDA's own calculus, only 14% of foods qualify for the existing "healthy" claim, and even fewer (5%) currently choose to make the claim. As with any voluntary label, companies will use it if they believe it will enhance their products' appeal; otherwise, they will forgo it, leaving consumers to guess whether the product is actually less healthy or if the manufacturer just opted not to use the claim. That's why labels intended to promote public health must be mandatory, not voluntary.

FDA can do more. In recent years, , including our neighbors to the north and south, have pressed forward with simple, standardized labels -- called front-of-package nutrition labels -- aimed at nudging consumers towards healthier choices. Evidence suggests that front-of-package labels that only highlight a product's positive attributes are less effective than other forms of front-of-package labeling (for example, "traffic light" labeling) at of food selections and . Experiences from other countries also indicate that mandatory labeling policies are than voluntary ones. This means that even if FDA continues to to develop a voluntary front-of-package symbol to represent the "healthy" claim, the agency should also develop a more comprehensive, mandatory label that communicates to consumers not only which products are "healthy," but also which products are less healthy or are high in over-consumed nutrients, like salt, sugar, and saturated fat.

Mandatory front-of-package nutrient warning labels have a proven track record. After Chile adopted mandatory front-of-package nutrient warning labels in 2016, there were in purchases of calories (-3.5%), sugars (-10.2%), saturated fat (-3.9%), and sodium (-4.7%). Producers reacted to the labels by overhauling their products; the proportion of foods meeting the criteria for warnings about sugar . In contrast, voluntary front-of-package labeling initiatives in other countries have been less successful, with by industry.

FDA can do even more to ensure that a larger proportion of a food is nutritious enough to qualify as "healthy." In 2021, FDA released for the food industry, which were first proposed in 2016 in response to a 2005 petition from the Center for Science in the Public Interest and subsequent litigation. But FDA has yet to announce longer-term targets that are needed to fully achieve safe levels of sodium in the food supply. Furthermore, FDA can undertake a parallel initiative to reduce added sugars in the food supply. The (a partnership of local, state, and national health organizations convened by the New York City Department of Health and Mental Hygiene) and have commenced similar sugar reduction efforts.

All these proposals are included among the "" the Biden-Harris administration proposed in its just-released National Strategy on Hunger, Nutrition, and Health. By redefining and making moves on "healthy," perhaps FDA has started with the lowest-hanging fruit. But in order to tackle our nation's ballooning rates of chronic disease, the agency will have to reach higher. We hope to see FDA put some muscle behind its words and take bolder action to improve diets and health.

is a senior science policy associate at the Center for Science in the Public Interest. is president and executive director of the Center for Science in the Public Interest.