After FDA proposed new requirements for what foods can include a "healthy" label on their packaging, stakeholders across the food industry have spoken out against the proposed rules, arguing that "hardly anything would qualify" under the new guidelines, Nicholas Florko writes for STAT.

FDA's 'healthy' proposed rule

In September, FDA proposed new rules regarding what foods can be labeled as "healthy" on their packaging. Under the proposal, food manufacturers can only label their products "healthy" if they meet certain criteria, including:

• Containing a meaningful amount of food from at least one food group or subgroup (fruit, vegetable, dairy, etc.) recommended by current dietary guidelines

• Meet specific limits for certain nutrients (sodium, saturated fat, added sugar) based on a percent of the daily value for the nutrient

For example, a cereal would need to contain three-fourths of an ounce of whole grains and no more than one gram of saturated fat, 230 milligrams of sodium, and 2.5 grams of added sugar per serving to be eligible for a "healthy" label.

According to FDA, the proposal "would align the definition of the 'healthy' claim with current nutrition science," including the current Dietary Guidelines for Americans.

Under FDA's proposal, grains and dairy products can only contain 2.5 grams of added sugar per serving, while other products, including fruits, vegetables, meats, nuts, and eggs cannot contain any added sugar.

Food industry pushes back on FDA's proposed 'healthy' label requirements

Following FDA's proposal, stakeholders across the food industry have spoken out against the new requirements for "healthy" food.   

SNAC International – an organization that represents companies like chip makers Frito-Lay and Utz – said FDA's restrictions around added sugars and salt are too restrictive.

Meanwhile, brands represented by the National Pasta Association, including Barilla and De Cecco, maintain that noodles are healthy because people who consume pasta often have higher-quality diets with higher vegetable intake.

Under FDA's proposed rules, Pickle Packers International noted that pickles will not be considered healthy because they are too salty, even though "pickles have a role to play in a healthy diet because they are predominantly comprised of vegetables and serve as a delicious condiment to other nutrient-dense foods."

Conagra, the maker of Healthy Choice frozen meals, said it cannot follow FDA's new guidelines "without alienating consumers."

"If the food does not taste good, people will not buy it, and Healthy Choice® — and the health benefits it has conferred for over 30 years — may disappear from the market," Conagra said.

The Consumer Brands Association (CBA), which represents corporations like Hostess, Mondelēz, General Mills, Pepsi, and Coca-Cola, has indicated that it may sue FDA over the rules. In a 54-page comment, CBA said the regulation infringes on food companies' First Amendment rights.

"Manufacturers have the right to label foods that are objectively 'healthy' as such, based on a definition of 'healthy' that is truthful, factual, and non-controversial," the group wrote. "We are concerned that limiting the truthful and non-misleading use of the word 'healthy' in product labeling could harm both the consumer and the manufacturer."

Meanwhile, the National Confectioners Association, which represents companies like Hershey's, Haribo, and Tootsie Roll, said it does not have a problem with FDA's proposal overall, but asked FDA to loosen the sugar proposal, and instead to "meet people where they are."

According to CBA, FDA may not have the legal authority to place such a strict limit on added sugar "given the lack of scientific consensus on the relationship between sugar intake and diet-related disease."

"The swift backlash from the food industry is a clear exemplification of the challenges the FDA has faced trying to more closely regulate nutrition in the United States," Florko writes. "It took the FDA nearly six years to come up with its proposed 'healthy' guidelines."

Health groups weigh in

The American Heart Association praised the sugar limits, saying, "Added sugars are a significant source of excess calories and are associated with greater overall calorie intake and higher body weight [and are] also linked to several metabolic abnormalities, a shortfall of essential nutrients, and increased risk of high blood pressure, high cholesterol, diabetes, and inflammation in the body."

In addition, while FDA's proposal received positive feedback from nutrition experts, including the American Society for Nutrition, the Association of State Public Health Nutritionists, and the Robert Wood Johnson Foundation, many of those groups have asked the agency to further tighten the rules, noting that some of the rules could be manipulated to allow unhealthy foods to qualify for the "healthy" label.

However, even supporters of more stringent nutrition policies have acknowledged that most foods Americans consume will not qualify for a "healthy" label.

"Hardly anything would qualify, so of course food manufacturers don't like the idea," said Marion Nestle, an emeritus professor of nutrition and public health at New York University, who noted that FDA's regulation "automatically excludes the vast majority of heavily processed foods in supermarkets, as well as a lot of plant-based meat, eggs, and dairy products," from bearing the "healthy" label.

Among food manufacturers, FDA's added-sugar requirement is likely the most controversial, Florko notes.

"Some of the backlash is to be expected," Florko writes. "The FDA's previous rules around healthy labeling placed similar limits on saturated fats and salts, but did not include any limits on allowable added sugar."

Ultimately, "[t]he backlash could have a real impact on the FDA's push to update food labels," Florko notes. (Florko, STAT, 2/21)