What Is “Healthy” Food?

Terms and phrases on food labels used to connote the healthfulness of products are ubiquitous. In the US, the term “healthy” was first defined by the Food and Drug Administration (FDA) but the term is also regulated by the United States Department of Agriculture (USDA) for use on the labels of most meat, poultry, and egg products. FDA defined the term in 1993, shortly after Congress enacted the Nutrition Labeling Education Act (NLEA) (an amendment to the Food, Drug, and Cosmetic Act, or FDCA). The NLEA reflects a common regulatory approach to diet- related disease: provide consumers with more information about certain aspects of the nutritional composition of food products so they can make healthier and more nutritious choices. Unfortunately, this approach fails to account for eaters that have varying degrees of, if any, choice. Additionally, it reflects a set of assumptions about consumers’ ability to understand the myriad information included on a food label and its relationship to health.

According to the Centers for Disease Control and Prevention’s (CDC) most recent data, diet-related chronic health conditions are the leading cause of death in the United States. These chronic diseases—obesity, diabetes, cardiovascular disease, and cancer—are largely preventable through healthy diet and good nutrition. Nutritionally inadequate diets exacerbate the risk of chronic diet-related disease. However, all Americans do not have equal access to healthful and nutritious foods. Diet-related chronic disease disproportionately impacts certain racial and ethnic groups and people with lower socioeconomic status. Since the start of the COVID-19 pandemic, these inequities have only increased, particularly because communities of color experienced far worse health outcomes from COVID due to underlying chronic disease.

Health claims can incentivize competition in the marketplace and influence product improvements. According to one market research firm, 60 percent of consumers look to food and beverage products to support their overall health. However, the same survey found “widespread confusion” as consumers try to decipher what is and is not healthy. Because health claims are proving to be profitable for business, manufacturers are creating new products or adapting existing products to be healthier. However, advocates have long pushed for front-of-package label statements or rating systems to replace or supplement the current back-of-package Nutrition Facts label to provide a full nutritional picture and minimize the impact some health claims may have on consumers.

Given the severity of diet-related disease and its continued increase in the US population, it has become clear that strategies to provide limited nutrition information to consumers at the point of sale are not achieving their intended consequence of improving public health. And, for the purpose of inducing a sale, many foods with labels containing claims related to health and nutrition are high in other unhealthy nutrients. For example, a food product label might include a front of package claim stating that the product is “high fiber,” leading a consumer to conclude it represents a healthy and nutritious option, when in fact, it may also contain a high amount of added sugars. Research shows that consumers rely heavily on food packaging claims when making purchasing decisions—particularly those related to what they perceive as the “healthfulness” of a product. Given the importance of this issue from both a public health and a consumer protection perspective, this issue brief explains how use of the term “healthy” on food products is regulated.