(P28-015-25) What Is “Healthy” Food? Evaluating Foods and Beverages Consumed by US Adults That Satisfy the US Food and Drug Administration’s Updated “Healthy” Claim Criteria

Objectives: Standardized, easy-to-understand nutrition labels can empower consumers to make healthier food choices. In 2024, the Food and Drug Administration (FDA) released updated criteria for the “healthy” claim that can appear on foods and beverages. To qualify, products must provide a minimum amount of at least one food group (e.g., whole grains), while not exceeding limits on saturated fat, sodium, and added sugar. However, it is unknown how criteria compare to the Nova classification of processing level and existing systems for evaluating nutritional quality of foods and beverages.

Methods: We coded items reported in the 2017-2018 National Health and Nutrition Examination Survey as meeting FDA “healthy” criteria (FDA-aligned/FDA-unaligned). We examined the proportion of FDA-aligned items across food categories and Nova categories using descriptive statistics, and used t-tests to compare mean nutrient content of FDA-aligned versus FDA-unaligned items stratified by food category and Nova category. We estimated correlations between FDA-alignment and other nutrient profiling systems (Food Compass, Nutri-Score, and Health Star Rating) using point-biserial correlation.

Results: Of 4,949 items, 14.9% meet “healthy” criteria. Most FDA-aligned items are minimally processed (85.6%). The majority of FDA-aligned items are fruits, vegetables, nuts, seeds, or legumes (63.7%). Only 2.1% of ultra-processed foods (UPFs) qualify for the “healthy” claim, with the majority (65.2%) of FDA-aligned UPFs classified as beverages or whole grain products. FDA-aligned foods do not consistently demonstrate more favorable nutrient profiles compared to FDA-unaligned foods, overall and across food categories. FDA-alignment is moderately correlated with Food Compass (0.56), Nutri-Score (0.46), and Health Star Rating (0.41).

Conclusions: Few items meet FDA’s “healthy” criteria, with the majority of these items classified as minimally processed foods. Though FDA-unaligned items are not considered unhealthy, findings suggest that few UPFs can form the foundation of a healthy dietary pattern, according to FDA criteria. Nevertheless, moderate correlations with other nutrient profiling systems underscore the challenge of classifying individual foods based on healthfulness.

Funding Sources: The presenting author was supported by a training grant from the NHLBI.