Lilian White, MD
Posted on January 6, 2025
It has been estimated more than 80% of the US population are not eating enough of key health-supporting food groups, including vegetables, fruits, and seafood. In an initiative to encourage more healthy food consumption, the US Food and Drug Administration (FDA) has announced an update to the “healthy” label placed on foods.
For a food to be labeled as healthy, products must meet two criteria. The food must (1) contain a specified amount of a designated healthy food group and (2) meet limits for added sugars, saturated fat, and sodium. Previously, foods labeled as healthy were required to have specific amounts of nutrients (e.g., iron, vitamin A). Replacing this requirement with food groups (e.g., vegetables, fruits, whole grains) may encourage a wider variety of nutrients.
However, the general decline of nutritionally dense foods over the past few decades brings into question whether this new recommendation will improve the nutritional status of the population. Common produce (e.g., apples, potatoes) has lost 25%–50% of its nutritional density since the 1940s due to a variety of factors. This has led to an epidemic of overfed and undernourished populations.
Limitations on added sugar replace previous limitations on total fat and dietary cholesterol because nutrition science has generally moved toward emphasizing increasing unsaturated fat in diets. Notably, eggs (which previously did not make the cut for the healthy food label) may now be designated as healthy according to the new guidelines because of their rich protein content and the removal of low dietary cholesterol from the recommendation. Foods that were previously designated as healthy but no longer meet these guidelines include foods with high amounts of added sugar (e.g., breakfast cereal, yogurt, fruit drinks).
The new guidelines removed the previous limitation on total fat consumption but maintains a limit on saturated fats. Oils higher in unsaturated fats are encouraged in place of saturated fats. Based on a recent study, evidence for adverse health effects related to the consumption of seed oils (categorized as unsaturated fats) appears to be growing, but there is no specific recommendation regarding seed oils at this time. The recommendation limiting saturated fat has historically been due to the apparent relationship between saturated fat consumption and the risk of cardiovascular disease. A recent meta-analysis of randomized controlled trials evaluated unprocessed beef consumption and cardiovascular disease risk. The study did not demonstrate a relationship between the two, adding to the evidence that saturated fat consumption of itself may not necessarily be unhealthy.
Nutrition recommendations continue to evolve with increased study, and the new recommendations for the healthy label by the FDA appear promising for improving the nutrition of the US population. Products currently labeled as healthy have 3 years to conform to the new rules. Offering patient education in the meantime is key to supporting a healthy diet. A nutritional history is a reasonable place to begin and may be facilitated by support health care professionals using tools such as the Rapid Eating Assessment for Participants. Additional articles on the topic of nutrition are available from American Family Physician.
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