Remember back in the ‘90s, when we were all obediently swapping butter for margarine and picking low-cal Snackwells instead of enjoying the square of dark chocolate we were actually craving? To be fair to our past selves, we made these choices based on what experts told us was “healthy,” an elusive term the U.S. Food and Drug Administration (FDA) first tried to define back in the early ‘90s.
Since then, consumers have continued to reckon with one question: what is a healthy diet, really? Are eggs healthy for you or are they too high in cholesterol? Does eating low-fat snacks make a difference? Is yogurt a nutritious breakfast or is it better left as an occasional indulgence?
In December, the agency finally updated its recommendations with new guidance to suit what we now know about nutrition1 — and not a moment too soon, according to experts like Lauren Harris-Pincus, MS, RDN, and author of The Protein-Packed Breakfast Club and The Everything Easy Pre-Diabetes Cookbook. “With so much rampant misinformation about food in the media, a standard definition of ‘healthy’ that addresses today’s population needs can be helpful to consumers,” she says.
The New Definition of Healthy
So what is the new standard definition of “healthy”? The FDA guidelines notably no longer demonize healthy fats, and the focus is now on a whole foods diet rather than an alphabet soup of nutrients. According to pediatrician Dr. Joel “Gator” Warsh, author of Parenting at Your Child’s Pace: The Integrative Pediatrician’s Guide to the First Three Years, these changes were “long overdue.”
“The shift towards a more holistic view of nutrition reflects decades of evolving science that now emphasizes the balance and types of fats, the inclusion of whole food groups, and limits on added sugars, rather than just isolated nutrients,” he explains.
Here’s what you need to know about the FDA’s new definition of healthy food.
Fats Are No Longer the Devil
Low-fat options long dominated diet protocols, so much so that they were pretty much synonymous with the “healthy” options in grocery store aisles. But more recently, nutrition science has proven that eating fat doesn’t make you fat, nor does it reduce the likelihood of developing heart disease, as experts claimed in the ‘70s. In 2015, TIME reported that these claims were not made based on adequate research2.
On the contrary, one 2017 study compared more than 135,000 people on low-fat and low-carb diets around the world and found that the low-fat diet was far more likely to be linked to death, heart attacks, and heart disease3. Similarly, a 2012 study in Food & Nutrition Research showed that weight gain was actually more likely to be linked to diets high in refined grains and sweets than healthy fats and fiber-rich whole grains4.
One 2017 study compared more than 135,000 people on low-fat and low-carb diets around the world and found that the low-fat diet was far more likely to be linked to death, heart attacks, and heart disease.
The FDA’s new dietary guidelines have finally caught up with these truths, shifting recommendations away from limiting fat in general in favor of limiting saturated fat specifically. These fats, which are solid at room temperature, include butter, cheese, red meat, and coconut oil. A 2022 study found that these fats were more likely to be associated with increased body weight, body fat, and insulin resistance5.
Limit Added Sugars
The new guidance has rightfully shifted its attention away from the perceived dangers of dietary fat and onto recommended limits on added sugars, something that reflects contemporary nutrition science. A 2019 study showed that added sugars contributed to increased risk of early death6, and a 2018 study in the American Journal of Clinical Nutrition linked them to increased frailty in old age7. It’s no wonder Dr. Warsh is so effusive in his praise of this particular modification.
“The change I appreciate most is the adjustment on foods high in added sugars, such as certain yogurts and snack bars,” he says. Registered Dietitian Harris-Pincus agrees. “When the original content claim was developed in the early 90s, fat and cholesterol were the focus of restriction, and added sugars were replacing them in foods. Think Snackwell cookies and fat free Entenmann’s cake,” she says.
Foods that were once considered “healthy” (like sugary yogurts and breakfast cereals) packed with added sugar, have been sidelined in favor of whole foods pairing natural sugars with fiber, (like fresh or frozen fruit).
And that’s not all. If so many unhealthy foods slipped through the cracks in the old guidelines, it’s largely due to their frequent fortification in an alphabet soup of added nutrients. “Foods that were fortified with vitamins such as vitamin C but with significant added sugars, like fruit snacks or fruit punch, counted as healthy under the old guidelines,” explains Registered Dietitian Harris-Pincus, “as did fortified white bread without any whole grains, or fortified cereals with excessive added sugar.”
She’s “very pleased” that foods that were once considered “healthy” (like sugary yogurts and breakfast cereals) packed with added sugar, have been sidelined in favor of whole foods pairing natural sugars with fiber, (like fresh or frozen fruit).
In the battle of added sugars vs. natural sugars, the new guidelines make a clear distinction.
Indeed, the recommendation to embrace a whole foods diet is probably the most reflective of the evolution of nutritional science in the past three decades. Rather than encouraging Americans to focus on individual nutrients like vitamin A or calcium, the new guidelines embrace nutrient-dense whole foods, with a focus on including a variety of sub-groups like vegetables, fruits, and whole grains in our diets.
“I’m excited to see a focus on encouraging the consumption of nutrient-dense foods vs. solely vilifying bad foods to avoid,” says Harris-Pincus. For Warsh, this is one of the more exciting changes to the guidelines. “This approach encourages a more balanced and diverse diet,” he says, “which is crucial for promoting overall health and preventing chronic diseases.”
Rather than encouraging Americans to focus on individual nutrients like vitamin A or calcium, the new guidelines embrace nutrient-dense whole foods, with a focus on including a variety of sub-groups like vegetables, fruits, and whole grains in our diets.
What Are the New “Healthy” Foods to Embrace?
While it’s heartening to see new guidelines finally remove the “healthy” label from sugar-packed granola bars, it’s even more exciting that natural, whole foods once wrongfully omitted from the category can now own the term with pride.
Good-Quality Fats Have Benefits
One major change is that the guidelines acknowledge that foods rich in good-quality fats — like salmon, nuts, avocado, and olive oil — actually deserve to be called healthy. “This change helps to dispel the myths around total fat content being a marker of unhealthiness,” says Dr. Warsh. In fact, a 2011 study in Lipids found that the monounsaturated fats in these foods can protect against metabolic syndrome and cardiovascular disease8.
The Incredible Egg
Another food whose bad rep has finally been reversed is the incredible, edible egg. Eggs have long been vilified for their link to high cholesterol. However, recent research from DukeHealth not only found that fortified eggs had no effect on cholesterol in otherwise healthy patients — they actually have potential benefits for patients with diabetes9.
In a statement released by the FDA, Jen Houchins, Director of Nutrition Research for the American Egg Board’s Egg Nutrition Center, noted that eggs also contain nutrients that many Americans don’t get enough of, like vitamin D and choline. “This news makes eggs a clear healthy choice, vindicating them from outdated science,” she said. “The FDA announcement reaffirms the egg’s role in supporting the health of American families, with nutritional benefits for everyone.”
What Still Needs to Change?
While these new guidelines are a vast improvement, they are far from perfect. Experts note a couple of unfortunate oversights.
Processed Food Ingredients
One thing that nutrition experts would like to see more of is a focus on the quality of ingredients in processed foods. “Even foods that meet these new ‘healthy’ criteria can still contain preservatives, artificial colors, or flavor enhancers that might not align with a holistic health perspective,” says Warsh. Some of these additives have notably been linked to increased risk of endocrine disruption or even cancer10.
Artificial Sweeteners
For Harris-Pincus, the lack of guidance on artificial sweeteners is somewhat worrying. “The definition doesn’t address artificial sweeteners, which are a tempting swap given the added sugar limit,” she says. “And while there’s nothing fundamentally wrong with non-nutritive sweeteners that are generally regarded as safe by the FDA, It’s tempting to overuse them in food products to stay below the added sugar limit of 5 grams in a ¾ ounce serving of a whole grain equivalent product, or below 2.5 grams in a 2/3 cup serving of a dairy product like yogurt.”
A More Accurate Definition of “Healthy”
One major change is that the guidelines acknowledge that foods rich in good-quality fats — like salmon, nuts, avocado, and olive oil — actually deserve to be called healthy.
Overall, the new FDA guidelines offer a welcome change to the definition of healthy that Warsh and Harris-Pincus both see as progress. With this updated guidance, consumer brands will also be able to use the “healthy” label in a more accurate, responsible way — and in turn, it will make it easier for shoppers to easily identify food that’s good for us.
By embracing foods like whole grains, vegetables, fruits, dairy products, meat, and fish, the new guidelines are a huge step in the right direction.
Sources:
- https://www.fda.gov/media/184535/download?attachment
- https://time.com/3702058/dietary-guidelines-fat-wrong/
- https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/abstract
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3418611/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9312452/
- https://pubmed.ncbi.nlm.nih.gov/31479109/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11199687/
- https://pubmed.ncbi.nlm.nih.gov/21308420/
- https://corporate.dukehealth.org/news/fortified-eggs-did-not-raise-cholesterol-modest-sized-cardiology-study
https://www.cspinet.org/press-release/red-3-fda-petition
