Eating healthy foods has long been linked to living longer and reducing one’s risk of obesity, heart disease, type 2 diabetes and other serious chronic conditions. It’s why the public health community focuses not just on food security, or ensuring that all people have enough to eat, but also on nutrition security — providing consistent access to nutritious foods.
The Food and Drug Administration is pivotal to improving diet quality. The agency recently has demonstrated its commitment to this goal in three important ways: prioritizing the development of front-of-pack nutrition labeling, setting sodium reduction targets to reduce heart disease and health care costs and updating the definition of “healthy” food to reflect the latest nutrition science.
Each of these efforts could significantly improve the quality of food consumed in this country. Together, they could mark a sea change in the impact of diet quality on improving health and reducing health care costs for communities nationwide.
The FDA’s influence over diet quality cannot be overstated: The agency regulates nearly 80 percent of America’s food supply, which extends to 35,000 produce farms, 300,000 restaurant chain establishments and 10,500 vending machine operators. That’s why the FDA is central to the national strategy announced by the White House last September to end hunger and increase healthy eating and physical activity by 2030.
The agency could make major gains well before that target date by taking the following actions:
Establishing front-of-pack nutrition labeling. For people who use the Nutrition Facts label (created by the FDA) to inform their food purchases, the label works as intended; those individuals buy more fruits, vegetables and whole grains, and they consume fewer sugary drinks. The problem? About two-thirds of consumers don’t frequently use the label, in part because the numbers can be confusing and the label appears on the back of packages rather than the front. Front-of-pack labeling, when done consistently and correctly, will solve both problems — and national surveys show a strong majority of U.S. consumers support making it mandatory.
Other countries that have implemented front-of-package labeling successfully use easy-to-understand symbols such as grades, star ratings or stoplight colors to show a product’s health score or communicate warnings about certain components such as saturated fat or added sugars. Studies show these tactics increase consumer understanding and prompt healthier purchases by consumers and healthier product formulations by food companies. The FDA launched a consumer research effort last year to determine a proposed front-of-package framework for U.S.-based products, and the agency’s spring 2003 Unified Agenda indicated a proposal could come by the end of this year. The FDA should move swiftly to meet that goal.
Setting sodium reduction targets. The average adult should consume no more than 2,300 milligrams (mg) of sodium per day, but people in America consume an astounding 3,400 mg of sodium per day. Elevated sodium intake can raise blood pressure and increase the risk for heart disease and stroke, which disproportionately affect people of color, including Asian, Black and Hispanic communities.
With most sodium intake coming from packaged and restaurant foods, the FDA released voluntary short-term sodium reduction targets for food manufacturers in 2021. These targets were a welcome step forward, but they were designed only to reduce average daily sodium intake to 3,000 mg. That target is insufficient. Lowering daily sodium intake to 2,300 mg for adults could prevent an estimated 450,000 cases of cardiovascular disease and save approximately $41 billion in health care costs over a 20-year period. We urge the FDA to release long-term sodium reduction targets that reflect that goal and use every tool at its disposal to encourage manufacturers to swiftly implement changes necessary to meet them.
Along with reducing sodium intake, lowering the consumption of added sugars also would result in significant public health benefits. We are pleased the FDA is exploring strategies to reduce added sugar consumption and will hold a public meeting and listening sessions this fall.
Updating the definition of “healthy.” Certain nutrient criteria must be met for a food or beverage to be labeled as “healthy.” However, these criteria have not been updated since 1994 — an eternity when it comes to nutrition science. The FDA’s proposed rule to update the definition of “healthy” would rightly focus on nutrient-dense foods recommended by the Dietary Guidelines for Americans, and would limit the amount of saturated fat, sodium and added sugars.
Taking this step would increase awareness of what comprises a healthy dietary pattern. The FDA should move aggressively to get it done — while pairing it with a robust consumer education and outreach campaign.
The FDA’s ambitious and science-based agenda to improve diet quality has the support of stakeholders across the public health community. It also should have bipartisan backing in Congress. Unfortunately, lawmakers have shown a willingness to use the annual appropriations process to tie the FDA’s hands in this important work. Lawmakers should support the agency’s efforts in both word and deed — ensuring the agency has the resources it needs and defeating legislative efforts to undermine its authority.
Through strong front-of-pack nutrition labeling, sodium and added sugar consumption reductions and an updated definition of “healthy” food, the FDA will help usher in a healthier future our nation’s communities need and deserve.
Nancy Brown is chief executive officer of the American Heart Association. Twitter: @NancyatHeart.
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