Until now, an orange couldn’t be called healthy, according to U.S. Food and Drug Administration. The fruit has 70 calories, three grams of fiber and more than 100 percent of the recommended daily value for vitamin C. Yet the whole fruit can’t qualify for a “healthy” label based on existing FDA guidelines for use of the term. Water can’t do so either—along with pistachios, bananas and many other fresh foods.
But what’s labelled “healthy” is about to change. A revised FDA rule, just announced this month, would allow whole foods such as oranges, in addition to fish such as salmon, to qualify as healthy. What can no longer use the word? Foods that have higher amounts of added sugar or saturated fats than the rule allows.
This change—the first in 30 years— could stop a lot of companies that call their breakfast cereals “healthy” from using the word on the box. The agency is working on a logo symbolizing “healthy” that manufacturers can use only if they meet new standards, but that may take a while.
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The old rule for using the word healthy on a food label was that the grocery item must contribute at least 10 percent of the established daily value of certain vitamins, calcium, iron, protein or fiber and not go over specific limits for saturated fat, total fat, sodium or cholesterol. The nutrients didn’t have to occur in the product naturally.
“The current rule is dangerously outdated, focusing on 1980 dietary priorities around fat and saturated fat, and so on,” says Dariush Mozaffarian, a cardiologist and director of the Food Is Medicine Institute at the Friedman School of Nutrition Science and Policy at Tufts University. He says the rule needed to change to focus on the FDA’s 2020–2025 Dietary Guidelines recommendations, which no longer accept adding nutrients in most foods as a replacement for a naturally occurring nutrient. Thus, an orange that has 100 percent of the recommended daily value of natural vitamin C is now preferred to most orange juices, which drain the nutrient-rich pulp from the juice, in a healthy diet.
The revised rule for adding healthy labels promotes eating whole foods—foods that have not gone through a process that could remove nutrients such as fiber—and also low-sugar and low-saturated-fat foods that include enough protein, oil, grains, vegetables or fruit by volume.
The previous rule did not require a product to be low in added sugar to be labeled healthy. But the new rule does. For instance, a food that meets the standards for protein—meat, seafood, beans, eggs, nuts or seeds—can’t have more than two percent of the recommended daily amount of sugar. This automatically eliminates, for example, chicken sausage with maple that may be otherwise healthy. Vegetable and fruit products must have no added sugar, and dairy and grain products can have up to five percent of the recommended daily value. Saturated fat content also is subject to sharp limits: five or 10 percent of the daily value depending on the type of protein.
Why did the FDA choose to limit added sugar? The agency consulted the Scientific Report of the 2020 Dietary Guidelines Advisory Committee, the same report that the Dietary Guidelines for Americans are based on. A scientific committee analyzed 23 studies, and found that added sugar could increase overall caloric intake without a nutritional benefit like the ones you would get from a vegetable or whole grain.
The 2013–2016 data from the National Health and Nutrition Examination Survey (NHANES) that influenced the report showed that the average added sugar consumption contributed at least 200 calories to daily diets across all age and sex groups. At the same time, most people did not eat in a way that met food group and nutrient requirements.
Food companies object to the sugar standards, however, and argue they could actually induce consumers to buy products with more fat. Sarah Gallo, senior vice president of product policy and federal affairs at the Consumer Brands Association, which represents most companies selling packaged foods, says that if foods currently able to describe themselves as “healthy” are barred from using the word because of sugar content, “consumers may migrate to full-flavor offerings that contain more saturated fat, added sugars and sodium.” In other words, why get one lasagna over another if the fuller-fat one doesn’t have a healthy label either?
Gallo adds that “the FDA’s proposed added sugars limit may reflect an inaccurate understanding of the products available in the marketplace and how truly restrictive FDA’s proposed added sugars thresholds are.”
Indeed, very few cereals and yogurts that you see on grocery shelves meet the added sugar limits. After reviewing a draft version of the new rule, the Consumer Brands Association noted in response that one of its member companies applied the FDA’s proposed criteria to its 195 yogurt products and 104 cereals. Only three cereals and 24 yogurts had sugar levels that qualified as healthy.
Nutrition experts are more optimistic about the new standards, because the “healthy” label offers people an easy way to find some healthy foods. “I can tell my patients that foods with a healthy label are a safe bet. It takes time, 15 to 20 minutes, [to] learn how to read a nutrition label,” and not everyone will take the time, says Courtney Pelitera, a registered dietitian specializing in sports nutrition and wellness nutrition. “Any shortcuts are helpful.”
Unfortunately, the label leaves no room for foods that may not go all the way to meeting the standards but come close. For instance, a Trader Joe’s Chicken Burrito Bowl has 22 grams of protein, nine grams of fiber and three kinds of whole grains. It seems like a nutritionally solid choice among frozen food options for nutrients and balance among food groups. In part because it uses full-fat cheddar cheese, however, it has 4.5 grams of saturated fat, or 23 percent of the total recommended daily value. That is slightly above the 20 percent (four-gram) recommended daily value required to qualify as healthy. Someone who has a meal within that limit could easily make up for the 0.5 gram extra of saturated fat by eating a low-fat cheese or yogurt in another meal. And even if all three of their meals that day had 23 percent of the recommended daily value, that would still be under the daily total; they could get up to 31 percent of their daily value of saturated fat from snacks and still meet the guideline.
Consumer brands are finding other ways to show consumers which options are healthier than others, Gallo says. It’s not unusual to see a package advertise the number of grams of whole grains a product has or the lack of added sugar, even though it might not meet the healthy label. Front-of-package labels often show fiber, protein, saturated fats, and so on. “I can tell my patients to look for certain saturated fat, fiber and protein numbers on labels,” Pelitera says.
While Mozaffarian supports the new healthy label requirements, he recommends the FDA take a different approach to encourage products to change to healthier recipes. “Imagine a front-of-package label that showed the actual servings of fruits, vegetables, whole grains, beans and legumes and nuts and seeds in a package,” he says. That would give companies an incentive to start to increase those ingredients.
Another option is a graded system, and the Food Is Medicine Institute is testing one. “We’ve done a randomized control trial for our Food Compass label, which is our more graded system that goes from 1 to 100” to rate how healthy a food is, Mozaffarian says. While the results aren’t published yet, he says, “we found that the Food Compass works even better [for] most people to [make] healthier shopping decisions.”
There is an overarching question about the new FDA rule: Will it pass muster with the incoming Trump administration, which has professed antipathy toward certain regulations? Some experts in food policy think it will be fine. “I don’t see the next administration fighting it. It’s a voluntary label claim,” says David Joy, a partner of international regulatory law firm Keller and Heckman, who worked for 15 years in the Office of Regulatory Policy in the FDA’s Center for Drug Evaluation and Research. “FDA is updating the criteria for ‘healthy’ claims on food labels in line with current dietary guidelines, and this isn’t a big regulatory burden for the food industry,” he says.
But Emily Lyons, a food regulatory attorney and partner of the law firm Husch Blackwell, believes the Trump administration might make changes because the food industry does have concerns with parts of the rule. She also notes that Robert F. Kennedy Jr., Trump’s choice to run the Department of Health and Human Services, may want to make his own changes, such as banning certain food dyes. The FDA policy “could be subject to the Congressional Review Act, which means that when Republicans take control of both the House and Senate, they could potentially repeal it,” Lyons says.
Even if the rule stands as written now, new labels could take at least two years to change on products in the grocery store. But if they do, people will be able to walk supermarket aisles and see that water, whole fruit, lean protein and a wider variety of whole grains are healthy to eat.
