The U.S. Food and Drug Administration (FDA) recently updated its criteria for foods labeled “healthy.” The proposed change is based on current nutrition science and prioritizes healthy dietary patterns, continuing from the FDA’s overhaul of the Nutrition Facts panel in 2016. Xaq Frohlich, assistant professor of history at Auburn University, explains why and how “healthy” food label criteria has changed over the years.
Frolich’s research focuses on the historical intersections of science, law and markets, and how they have shaped our understanding of food, risk and responsibility. His book, “From Label to Table: Regulating Food in America in the Information Age,” will be published by the University of California Press in 2023.
Q: Can you talk about the FDA’s new guidelines for “healthy” food and why they came about?
Frolich: The current FDA definition of “healthy” emphasizes reducing total fats and providing a minimum of certain key vitamins, reflecting the public health focus in the early 1990s on reducing fats in one’s diet to decrease their risk of heart disease. The FDA’s new proposed definition recognizes the current state of the art in nutrition science that says some fats, such as monounsaturated and polyunsaturated fats common in vegetable oils, nuts and fish, can be good for one’s health. The new definition also addresses growing concerns with added sugars and highly processed foods.
The FDA’s change in policy was more than six years in the making. The agency began to reconsider the “healthy” rule after it called out the Kind Snacks food company in 2015 for using “healthy” on its snack bars, which had a fat content above the FDA’s threshold. The fat content of those snack bars came from nuts, today generally seen to be a healthy source of fat. Critics pointed out the perverse logic of the current rule, which allows sugary ready-to-eat breakfast cereals and fat-free puddings to use “healthy” on their labels but doesn’t permit its use on healthy basics such as nuts, avocados or salmon, all of which are high in good fats. Nor could “healthy” be used for cooking oils such as olive oil, which didn’t meet the definition’s threshold of providing certain vitamins. The FDA issued a proposed rule change in 2016 and held hearings on the matter in 2016, but took the matter no further, until now.
Q: What is significant about the updated guidelines? Why have they taken so long to change?
Frolich: The FDA estimates that, in the current marketplace, about 5% of all packaged foods are labeled “healthy.” So, this rule change will have a significant impact on a lot of food products across America. Part of the slowness of updating these guidelines reflects the entrenched interests of the food industry, which has designed its food products for the current guidelines, and this results in a status quo bias for those rules.
Critics might make fun of the FDA’s efforts to define healthy, and it will not be the first time the agency has struggled to define such a broad term. In 1992, the FDA went after Florida orange juice makers for their use of the term “fresh” on frozen concentrated orange juice. How do you define “fresh” for industrial foods? In 2016, at the same time the FDA was exploring changes to “healthy,” it proposed rules to define “natural.” That initiative went nowhere, and “natural” continues to be used by food companies today without any clear meaning or consistency. Yet there is a need for the FDA to define “healthy” because, otherwise, food companies will do so and often at the expense of and great confusion for the consumer.
If these questions about what “healthy” food is of interest to you, you should take advantage of the opportunity to write the FDA now and submit your comments on the proposed rule before the Dec. 28 deadline.
Q: Historically, how have food labels changed through the years?
Frolich: At one time, the FDA didn’t allow any health claims on foods. This was because it was concerned about misinformation and fraud that was common in drug markets. In the early 20th century, it was common for many products we would now think of as food – exotic spices or olive oils – to be marketed as ingredients in patent medicines that made extravagant claims about their health-restoring properties. To crack down on these fraudulent markets, and to build the public’s confidence in legitimate, scientifically tested pharmaceuticals, in the 1930s the FDA began to seize food products that made specific health claims, arguing they were “misbranded” drugs.
Three new product markets changed the FDA’s no-health-labeling policy on foods. The first were vitamin-enriched foods. While the FDA disliked the growing “vitamania” in the 1940s and 1950s, and in particular advocates of vitamin mega-dosing, it came to accept and even endorse the role that vitamin enrichment could play in “restoring” vitamins to the food supply that had been lost due to industrial processing.
Second, by the 1950s, there were new food additives – in particular, artificial sweeteners – that companies wanted to market to weight-conscious dieters. While FDA officials remained skeptical of their safety, the popularity of these low-cal products proved difficult for the agency to deny politically.
Third, and perhaps most significantly for changing the FDA’s policy on healthy foods, medical associations in the 1960s became concerned about the health consequences of overeating and were endorsing the diet-heart thesis, which argued that changes to one’s diet, such as eating low-fat foods, would prevent future risk of heart disease. Producers of these different products found creative ways around the FDA limits on health claims to make implied claims that would attract this growing consumer market.
In the 1970s, the FDA shifted direction and introduced a “voluntary” nutrition label. Food companies that wanted to make health claims could now do so, as long as they put the FDA’s “Nutrition Information” label on their packages. The result was a dramatic explosion of new diet products, especially low-fat dairy substitutes and high-fiber cereals. The proliferation of health claims in the 1980s, and new diet foods that tested the boundaries between what is classified as a food versus drug, led to the passage of the 1990 Nutrition Labeling and Education Act, which charged the FDA with fixing the U.S. food labeling system. From 1990 to 1994, the FDA developed new guidelines, which included the hallmark change: a new Nutrition Facts label that now had to appear on all packaged foods. These guidelines also included the 1994 definition of “healthy” in place today.
Q: What does this most recent change signify about what the FDA would like to communicate to consumers?
Frolich: The turn to nutrition labeling has placed the FDA in the difficult position of arbitrating what kinds of health marketing on foods are legitimate or misleading. It recognizes consumers have a right to health information on food; yet it struggles to police the boundaries of what is advertising puffery, subject to consumer judgment and what is public health education, where the FDA seeks to standardize information.
The FDA’s latest proposed changes to the “healthy” label are a sign that it is taking its role seriously as a public gatekeeper for health information about food. This is good. However, there remains a long way to go in addressing the flood of inconsistent and contradictory health information Americans receive about food at the supermarket, whether food is labeled “healthy” or not.
This story originally appeared on Auburn University’s website.