FDA health labeling needs to do more

Many of us have witnessed the personal and emotional toll of diet-related illnesses such as diabetes and kidney disease on our family, friends and co-workers. As a Registered Dietitian, I’ve also seen food insecurity and confusion over food labels compound this toll.

The Food and Drug Administration (FDA) has been challenged to do better and recently proposed a revision of the “healthy” food labeling criteria, but they don’t go far enough. The revisions are a chance for a big win for nutritional health, but the agency’s proposal falls short of advancing the healthy eating that people and the planet need.

First enacted in 1994, the “healthy” label is designed to help the public easily understand dietary guidelines for Americans in retail grocery stores such as grocery stores. But as our still extremely low intake of healthier foods over the years attests, the “healthy” label wasn’t effective. Meanwhile, the epidemic of chronic diet-related diseases has continued to worsen.

More than 37 million people in the US now have diabetes, and another 96 million have prediabetes — totaling more than 1 in 3 Americans. Over 108 million people have high blood pressure and at least 37 million have chronic kidney disease. More than 20 million Americans suffer from heart disease, the leading cause of death nationwide.

Fortunately, good nutrition has been shown to play a key role in preventing or treating these conditions. There is strong evidence that good nutrition is based on eating foods like whole grains, fruits, vegetables, nuts, seeds, soy, and beans, peas, and lentils—foods that the average American doesn’t eat very much. There is also evidence that overhauling “healthy” labeling has the potential to influence consumer understanding, change purchasing behavior, improve dietary habits, reduce the burden of disease and improve diet’s impact on sustainability.

Unfortunately, the FDA’s myopic vision of healthy eating limits the proposal’s potential due to the agency’s myopic emphasis on helping Americans “maintain” healthy eating habits and prevent chronic disease.

But only a tiny fraction of the population currently has any healthy eating habits at all, such as consuming the foods mentioned above. The FDA needs to stay on the ball and contain the already endangered epidemic of chronic diseases in the majority of the population, which means establishing healthy eating habits first.

The good news is that the agency is now proposing its new health label, which focuses on food groups, rather than repeating the mistake of the past of focusing on isolated nutrients, which appears to have done little to improve public health. But it also seems stuck in the past to regard all food groups as equally important.

It’s true that foods from the protein group are just as important for promoting health as fruits, vegetables, and whole grains. But “protein deficiency is almost unheard of in the United States,” according to the Physicians Committee for Responsible Medicine, due to generalized excess intake and gross imbalances between food groups, leading to high disease rates.

Additionally, the FDA proposal only grants automatic “healthy” status to raw fresh produce. And this creates a fairness problem. To break down barriers related to cost, access and storage of healthy food in resource-poor communities, frozen or canned products should also be able to carry the “healthy” label. And if plant-based dairy products that meet nutritional criteria qualify for healthy labeling, consumption of nutritious products could be increased for those who cannot digest animal-based dairy products, which is common among people of color.