Do Food Packaging Health Claims Correlate with Healthiness Or Mislead our Patients?

Background. Primary care physicians regularly implore patients to buy and eat healthy foods. But as our patients stroll their grocery store aisles, can we count on food packaging health claims to show our patients the healthier foods? It has been asserted that health claims actually adorn the least healthy foods (Pollan, 2007). We performed a field study of the most commonly purchased foods and beverages in America to assess whether packaging health claims correlate with healthiness so that we can advise patients on whether and when health claims indicate actual healthy items.

Methods. Using the online website for the nation’s largest grocer, Walmart.com, we performed quota sampling in 122 categories of foods and beverages most commonly consumed by Americans according to the National Health and Nutrition Examination Survey (NHANES) 2017-2020 What We Eat in America (WWEIA) report. Promotional claims occur in three types: FDA-approved health claims, nutritional content claims, and functional claims. Each food item’s front packaging was assessed for quantity and type of promotional health claims independently by two researchers. Two researchers also independently assessed food items healthfulness by calculating their Nutri-Score raw nutritional score. Discrepancies between researcher findings were resolved by consensus.

Results. We found that the number and type of packaging promotional health claims do not associate with particularly healthy foods nor unhealthy foods at all. Even within 14 standard food and beverage type categories, we found no association with healthiness or unhealthiness. The only association found in our data was that food categories well-known for healthiness (fruits, vegetables, grains) are in fact healthier than food categories well-known for unhealthiness (snacks and sweets, fats and oils, and sugars).

Conclusion. We cannot recommend that our patients use food packaging health claims to identify food that is particularly healthy or unhealthy. We found support for physicians to advise patients instead to pursue foods from categories that they learned were healthy in grade school.