New FDA rules aim to redefine what’s considered ‘healthy’

William Brangham:

The Food and Drug Administration has issued new rules for food labels for the first time in three decades. It's an update the agency says will help empower consumers to make healthier choices in the grocery store.

Under the new guidelines, items previously denied the healthy label, like nuts and seeds, salmon, and other high-fat fish, would be included. But some staples, like white bread and heavily sweetened yogurt and cereals, will no longer qualify.

To help us understand this evolution, I spoke recently with Lindsey Smith Taillie. She's a nutrition epidemiologist at the University of North Carolina's Gillings School of Global Public Health.

Lindsey, welcome back to the program.

The FDA is updating this definition of — quote, unquote — "what is a healthy food," three decades since they have last done this. What is the new criteria they're using to determine what's healthy and what's not?

Lindsey Smith Taillie, Nutrition Epidemiologist, University of North Carolina: Sure.

So the new criteria are that foods need to be under the thresholds for added sugar, which is new and didn't exist at the time that the initial ruling was released back in the '90s, as well as sodium and saturated fat. And so the idea is that this is really in line with the current dietary guidelines for Americans.

And then the other change is that the foods have to have some amount of food groups that are recommended, so things like fruits and vegetables, nuts, legumes, and things like that. And that previously was not part of this rule.

William Brangham:

Do you think any of this is going to matter? Do you think someone standing in the grocery store and holding an item of food in their hands is going to say, oh, the FDA says this is not healthy and put it back?

Lindsey Smith Taillie:

So, that's a really interesting question.

And the reality is that they're looking for this healthy icon label. And so it's not so much about what's not healthy. It's about what's maybe the healthiest. And we have evidence from other countries that have similar label types. And there's really no data to suggest that this type of label has a meaningful impact on consumer purchasing behavior.

And then the other thing is that many of our food products are already covered in health and nutrition claims. And so it's unclear whether this FDA healthy label will really stand out from all of these other claims that are already on the packages and really affect consumer purchases.

William Brangham:

Yes, my understanding is that only about 5 percent of products have those labels. And all those other labels that you're describing that say all-natural, low-sodium, all these things that can be incredibly misleading for consumers.

So what does help people realistically decide what is the right thing to eat and the right thing to avoid?

Lindsey Smith Taillie:

So I think what we have seen from the global evidence from what other countries have done, as well as experiments that we have done here in the U.S., is that there are a couple of things.

The first is plain packaging and a regulation that would actually remove those nutrition and health claims from products that don't meet these standards. So instead of just adding that healthy label, you would also remove all of the other confusing and potentially misleading marketing that's on these packages, because it creates a lot of noise that's hard for consumers to sift through when they're only making these decisions in about 10 to 12 seconds.

The other thing that the FDA could do — and this rule is actually under consideration right now — is to put on labels about what's unhealthy. So, thinking about the foods that are the biggest drivers of our current epidemics of obesity and type 2 diabetes, we could use clear front-of-package labels to signify what a food is high in sugar, high in sodium, high in saturated fat.

We do have a strong evidence base that that type of label works, that consumers understand it, and that it does reduce their purchases of products with those labels.

William Brangham:

We know that there was a Johns Hopkins study that showed that half of all calories consumed at home by American adults come from these ultra-processed foods.

Again, can you just remind us of the dietary and health impacts that that kind of a diet has?

Lindsey Smith Taillie:

Yes, absolutely.

So we have a pretty large body of observational evidence to show that diets high in ultra-processed foods are linked to an array of health problems, everything from adverse mental health outcomes, to weight gain, which is probably the strongest evidence that we have, to increased risk of cancer, cardiovascular disease, and type 2 diabetes.

William Brangham:

Another issue, the FDA is also considering banning the use of red dye No. 3, which is in a lot of our foods. What is the science? What's the argument for why we should take that out of our food supply?

Lindsey Smith Taillie:

So there are a couple of arguments for why we might take it out of our food supply. I think one argument is that it's not beneficial to us. It doesn't really add any nutrient value, in — except that it makes our foods look pretty and more bright.

In terms of the health concerns with red dye No. 3, it was banned for use in cosmetics decades ago when studies show that high amounts in rats led to cancer. Now, I don't believe that there's strong evidence to show that ingesting this leads to cancer in humans.

However, when you see that kind of mechanism, it might raise these kinds of questions, which is what the FDA wants to review. The piece of evidence that we do have is that there are some kind of studies that show that consumption of red dye in children increases hyperactivity.

So it's a little bit unclear exactly what's going on with this red dye No. 3, but it does seem like this is something that's not necessarily good for us and it could be harmful. And so it's worth a further review by the FDA.

William Brangham:

All right, that is Lindsey Smith Taillie of the University of North Carolina.

Thank you so much for being here.

Lindsey Smith Taillie:

Thank you.