An Updated Definition of “Healthy” Foods in the United States: How Do They Measure in Nutrient Density, Cost, and Frequency of Consumption?

Abstract

Background

In 2024, the Food and Drug Administration (FDA) finalized an update to the definition of the term “healthy” as used on food labels, to align with current dietary guidelines. A holistic understanding of food choice is vital for socially- and economically-conscious food programs and policies.

Objectives

This study applied the new “healthy” criteria to a nationally-representative database of foods and beverages and compared qualifying items to those that failed to qualify, in terms of nutrient density, monetary cost, and frequency of consumption.

Methods

Nutrient profile scores based on the Nutrient Rich Foods Index 9.3 model and weighted frequency of consumption data from the Food and Nutrient Database for Dietary Studies were linked to data for monetary cost, based on national food prices.

Results

The analysis included 3062 foods and beverages in 12 food groups, of which 14% qualified as “healthy.” Many foods did not qualify due to excess sodium and saturated fat. Overall, qualifying foods and beverages had a higher median nutrient density and frequency of consumption (P < 0.001) and lower median cost per serving (P < 0.001) compared with items that failed to qualify. Among food groups, qualifying plant protein foods, consisting primarily of nuts and seeds, were significantly lower in nutrient density and more expensive than not qualifying plant proteins. Qualifying mixed dishes were also significantly more costly than those that failed to qualify.

Conclusions

Foods and beverages that would qualify as “healthy” under new FDA criteria were more nutrient dense. Overall, qualifying items may be less expensive and consumed more frequently than not qualifying items, although results differed for individual food groups. To increase the availability of foods and beverages qualifying as “healthy,” industry reformulation of packaged and processed nutrient-dense foods should be considered to reduce the addition of sodium, sugar, and saturated fat.