NCHR Comments on FDA update to “healthy” food label criteria

February 16, 2023

The National Center for Health Research (NCHR) appreciates the opportunity to comment on the US Food and Drug Administration’s (FDA) proposed update to the requirements for the use of the “healthy” claim on food labels. We support the FDA’s efforts to help consumers adopt healthier dietary patterns that conform to the latest nutrition science and Federal nutritional guidance.

The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.

NCHR agrees with FDA’s focus on nutrient-dense foods and eating patterns rather than specific nutrients. We believe updating these criteria is essential in helping consumers understand the nutritional value of the foods they purchase and consume.

We agree with the proposal that foods that are labeled healthy must limit added sugars to less than five percent of total calories. Every day, the average American adult, teenager, and child consumes about 17 teaspoons of added sugar – which amounts to more than ten percent of calories in a 2,000-calorie diet.1 Well above the amount recommended by Dietary Guidelines for Americans 2020-2025,2 this excess sugar consumption is linked to obesity, type 2 diabetes, and heart disease.1

In addition to criteria limiting added sugars, NCHR urges the FDA to prohibit foods containing sugar substitutes from being labeled “healthy.” Low- or no-calorie sweeteners are not considered added sugars and are not addressed in this proposal. But, several studies raise questions about the risks of sugar substitutes. For example, in draft guidelines released in 2022, the World Health Organization (WHO) warned against using sugar substitutes to lose weight or improve health. While the WHO acknowledges that more research is needed to determine a definitive connection, the organization says long-term harm from sugar substitutes is possible, including increased risk of obesity, type 2 diabetes, heart diseases, and mortality.3 Some of these sweeteners may also alter the normal flora of the gut – which can lead to changes in metabolism.4  For these reasons, we do not support labeling any food or drinks containing these sweeteners as “healthy.”

The proposed guidelines recommend limiting saturated fats in general but allow a “healthy” label for foods with a higher percentage of saturated fat if they are considered “core elements of healthful dietary patterns.” This includes a higher baseline limit for dairy products, game meats, seafood, eggs, oils, and oil-based spreads and dressings. We disagree with this proposed adjustment. While these foods can be part of a healthy diet, they contain a higher percentage of saturated fats and should not be labeled “healthy” because of the potential negative health impact. The American Heart Association recommends limiting saturated fats to help maintain a normal cholesterol level. Research shows that replacing saturated fats with unsaturated fats can help lower cholesterol and reduce the risk of heart disease and stroke. 5,6 To support a healthy diet, the label “healthy” should encourage the consumption of foods that confer health benefits, including fish and plant-based foods such as vegetable oils, nuts, and seeds.

We also encourage the FDA to eliminate any loopholes that would allow manufacturers to alter foods to meet the criteria for the “healthy” label. For example, highly-processed foods may be low in sugar and sodium but contain chemicals to improve the product’s taste, color, and texture.7 Many food additives have not been tested and deemed safe by the FDA.8 According to studies by the American Institute for Cancer Research (AICR), eating a diet high in processed foods is associated with a higher overall chance of getting cancer.9 Additional studies have found a direct association between diets high in processed foods and obesity, hypertension, and high cholesterol.10,11

Finally, we urge the FDA to launch an educational campaign to promote the new guidance. Such a campaign will help consumers make informed choices and enhance the FDA’s efforts to reduce the prevalence of nutrition-related diseases.

We appreciate the opportunity to comment on the FDA’s proposed update to the requirements for the use of the “healthy” claim on food labels. While we are encouraged that the FDA is updating the guidelines to better fit current nutrition science, we hope the agency will consider our recommendations since they would improve the impact of the proposed guidance on public health.


  1.     CDC. Know Your Limit for Added Sugars. Centers for Disease Control and Prevention. Published November 28, 2021. Accessed February 13, 2023.
  2.     Dietary Guidelines for Americans, 2020-2025.
  3.     Rios-Leyvraz M, Montez J. Health Effects of the Use of Non-Sugar Sweeteners: A Systematic Review and Meta-Analysis. World Health Organization; 2022:210.
  4.     Artificial Sweeteners: Are They Helping You Lose Weight or Gain it? National Center for Health Research. Published November 2, 2020. Accessed February 15, 2023.
  5.     Hooper L, Martin N, Jimoh OF, Kirk C, Foster E, Abdelhamid AS. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst Rev. 2020;2020(5):CD011737. doi:10.1002/14651858.CD011737.pub2
  6.     Facts about polyunsaturated fats: MedlinePlus Medical Encyclopedia. Accessed February 14, 2023.
  7.     Fox N. The Many Health Risks of Processed Foods. LHSFNA. Published April 1, 2019. Accessed February 14, 2023.
  8.     How Processed Foods Wreak Havoc on Your Health. Accessed February 14, 2023.
  9.     Fiolet T, Srour B, Sellem L, et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ. Published online February 14, 2018:k322. doi:10.1136/bmj.k322
  10.   Monteiro CA, Cannon G, Moubarac JC, Levy RB, Louzada MLC, Jaime PC. The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutrition. 2018;21(1):5-17. doi:10.1017/S1368980017000234
  11.   Are Processed Red Meats More Unhealthy than Other Red Meats? What About Other Processed Foods? National Center for Health Research. Published May 25, 2018. Accessed February 15, 2023.