FDA’s healthy labeling needs to do more

Many of us have witnessed the personal and emotional toll of diet-related diseases like diabetes and kidney disease on our family, friends and coworkers. As a registered dietitian, I’ve also seen how food insecurity and confusion over food labels add to this toll.

Challenged to do better, the Food and Drug Administration (FDA) recently proposed “healthy” labeling criteria revisions for food, but they don’t go far enough. The revisions are a chance at a major win for dietary health, but the agency’s proposal fails to advance the healthy diets that people and the planet need.

First enacted in 1994, “healthy” labeling is supposed to help the public easily understand the Dietary Guidelines for Americans in retail food settings like grocery stores. But, as our still extremely low intake of healthier foods over the years attests, the “healthy” label hasn’t been effective. Meanwhile, the epidemic of chronic diet-related diseases has continued to worsen.

More than 37 million people in the U.S. now have diabetes, and another 96 million have prediabetes — more than 1-in-3 Americans in total. Over 108 million people have hypertension, and at least 37 million have chronic kidney disease. More than 20 million Americans have heart disease, the nation’s leading cause of death.

Fortunately, good nutrition has been shown to play a key role in preventing or treating these ailments. Evidence strongly indicates that good nutrition is grounded in eating foods like whole grains, fruit, vegetables, nuts, seeds, soy along with beans, peas and lentils —foods that the average American doesn’t eat very much. Evidence also suggests that revising “healthy” labeling has the potential to influence consumer understanding, change purchasing behavior, improve dietary habits, reduce disease burden and improve dietary impacts on sustainability.

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

But only a tiny fraction of the population currently has healthy dietary habits to begin with, such as the consumption of the foods mentioned above. The FDA needs to keep its eye on the ball and reduce the epidemic of chronic disease in the majority of the population that is already at risk, which means first establishing healthy dietary habits.

The good news is that the agency is now proposing its new healthy label, which is focused on food groups instead of repeating the past mistake of focusing on isolated nutrients, which appears to have produced little improvement in public health. But it also seems stuck in the past, viewing all food groups as equally important.

It’s true that protein group foods are just as necessary to promote 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.In contrast to deficiency diseases of the past (like scurvy from lack of vitamin C), the modern era’s “Western” diet is marked by a general excess of intake and gross imbalances among food groups, leading to high rates of disease.

From a new disease-prevention perspective, emphasizing the importance of consuming enough fruits, vegetables, whole grains and beans is far more important than continuing the outdated focus on protein. By highlighting this distinction and encouraging foods that contain active disease-prevention components, the “healthy” label could actually help improve health.

Additionally, the FDA’s proposal only grants automatic “healthy” status to raw fresh produce. And this creates an equity problem. To reduce barriers related to cost, access and storage of healthy foods in low-resource communities, frozen or canned produce should be able to carry the “healthy” label, too. And allowing plant-based dairy products that meet  nutritional criteria to qualify for healthy labeling could increase consumption of nutritious products for those unable to digest animal-based dairy, which is common among people of color.

It’s urgent that FDA revises the proposal to accurately reflect environmental impacts, too. Our food system drives multiple crises involving climate, biodiversity, food and water security, and it produces massive volumes of untreated animal waste — all of which affect nutrient density, food security and public health. Since food labels can shift consumer choices, label requirements that drive those choices could have direct, substantial impacts on the health of people and the planet.

The FDA has a chance to make a real impact on the American diet. I hope it takes that chance. 

Mark Rifkin is the senior food and agriculture policy specialist at the Center for Biological Diversity. He holds a master’s degree in health education and is a registered dietitian.