[Federal Register Volume 59, Number 89 (Tuesday, May 10, 1994)] [Unknown Section] [Page 0] From the Federal Register Online via the Government Publishing Office [www.gpo.gov] [FR Doc No: 94-11145] [[Page Unknown]] [Federal Register: May 10, 1994] _______________________________________________________________________ Part III Department of Health and Human Services _______________________________________________________________________ Food and Drug Administration _______________________________________________________________________ 21 CFR Part 101 Food Labeling: Nutrient Content Claims, Definition of Term: Healthy; Final Rule DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration 21 CFR Part 101 [Docket No. 91N-384H] RIN 0905-AD08 Food Labeling: Nutrient Content Claims, Definition of Term: Healthy AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. ----------------------------------------------------------------------- SUMMARY: The Food and Drug Administration (FDA) is amending its food labeling regulations to establish a definition for the term ``healthy'' under the Federal Food, Drug, and Cosmetic Act (the act). This final rule will provide a definition for this implied nutrient content claim and provide for its use on the food label. This action is in response to the Nutrition Labeling and Education Act of 1990 (the 1990 amendments). DATES: This regulation is effective May 8, 1994. Before January 1, 1998, the sodium content of individual foods, main dish, and meal products shall be consistent with Sec. 101.65(d)(2)(ii)(A), (d)(2)(ii)(B), (d)(3)(ii)(A), (d)(3)(ii)(B), or (d)(4)(ii)(A), as appropriate. After January 1, 1998, the sodium content of individual foods, main dish, and meal products that bear the claim ``healthy'' shall be consistent with the requirements in Sec. 101.65(d)(2)(ii)(C)(1), (d)(2)(ii)(C)(2), (d)(3)(ii)(C)(1), (d)(3)(ii)(C)(2), or (d)(4)(ii)(B), as appropriate. FOR FURTHER INFORMATION CONTACT: Felicia B. Satchell, Center for Food Safety and Applied Nutrition (HFS-158), Food and Drug Administration, 200 C St. SW., Washington, DC 20204, 202-205-5099. SUPPLEMENTARY INFORMATION: I. Introduction In the Federal Register of January 6, 1993 (58 FR 2302), FDA published a final rule entitled ``Food Labeling: Nutrient Content Claims, General Principles, Petitions, Definitions of Terms; Definitions of Nutrient Content Claims for the Fat, Fatty Acid, and Cholesterol Content of Food'' (hereinafter referred to as ``the general principles final rule'') that, among other things, provided for the use of implied nutrient content claims on the labels and in the labeling of individual foods and meal-type products. While the agency recognized that, as provided by section 403(r)(1)(A) of the act (21 U.S.C. 343(r)(1)(A)), a food is prohibited from bearing an implied nutrient content claim on its label or in its labeling unless the claim is defined by FDA by regulation, it was unable to adopt a comprehensive set of definitions for implied nutrient content claims in the general principles final rule because of resource constraints and the strict timeframes under which that rulemaking was accomplished. Although the agency did not establish a comprehensive set of definitions, it did determine, among other things, that the term ``healthy'' is an implied nutrient content claim when it is used on the label or in labeling in a nutritional context, for example, when it appears in association with an explicit or implicit claim or statement about a nutrient (58 FR 2302 at 2375). The agency said that, for example, in the statement ``healthy, contains less than 3 g of fat,'' ``healthy'' is an implied nutrient content claim. Because of the complex nature of this term, the agency concluded that it was not possible to arrive at a final regulation for a definition of the term ``healthy'' as part of the general principles final rule (58 FR 2302, January 6, 1993). However, in that same issue of the Federal Register, FDA published a proposal entitled, ``Food Labeling: Nutrient Content Claims, Definition of Term: Healthy'' (hereinafter referred to as ``the healthy proposal''), to establish a definition for the implied nutrient content claim ``healthy'' for individual foods, main dishes, and meal products (58 FR 2944, January 6, 1993). The agency tentatively concluded that foods labeled with the term ``healthy'' could be used with a variety of foods to assist consumers in maintaining healthy dietary practices, that is, to achieve a total diet that conforms to current dietary guidelines. In other words, FDA tentatively concluded that foods bearing a ``healthy'' claim should be those that, based on their nutrient profile, would assist consumers in achieving dietary recommendations. Consequently, the agency proposed to permit the use of the term ``healthy'' as an implied nutrient content claim on products that meet the definitions for ``low fat'' and ``low saturated fat'' and that do not exceed the disclosure levels for sodium and cholesterol (proposed Sec. 101.65(d)(2) (21 CFR 101.65(d)(2))). (Disclosure levels are defined as levels of total fat, saturated fat, sodium, and cholesterol in a food above which a referral statement is required when the food bears a nutrient content claim (see Sec. 101.13(h) (21 CFR 101.13(h))). The agency further stated that when ``healthy'' is not used as an implied nutrient content claim, it would be subject to the general misbranding provisions of section 403(a) of the act (58 FR 2944 at 2945). The agency advised that it intended to make any final rule that derived from the proposal effective on the date of applicability of the general principles final rule and the final rule on mandatory nutrition labeling (i.e., May 8, 1994) (58 FR 2944). However, FDA stated that if for some reason a final rule had not been issued by that date, ``healthy'' would be subject to the general nutrient content claim requirements for implied claims or the general misbranding clause (58 FR 2944). In a companion document in the January 6, 1993 issue of the Federal Register (58 FR 688), the Food Safety and Inspection Service (FSIS) of the U.S. Department of Agriculture (USDA) proposed a definition for ``healthy'' or any other derivative of the term ``health'' on meat and poultry products. FSIS proposed to permit ``healthy'' to be used on the label or in labeling of a meat or poultry product that contains less than 10 grams (g) of fat, less than 4 g saturated fat, less than 95 milligrams (mg) of cholesterol, and less than 480 mg of sodium per 100 g and per reference amount customarily consumed (RACC) for individual foods and per 100 g and per labeled serving for meal-type products. FSIS further proposed that any use of the term ``healthy,'' whether in a brand name or in conjunction with a nutrient, must meet this definition. FDA received approximately 50 letters in response to the ``healthy'' proposal. Each letter contained one or more comments. The letters were from a wide range of sources, including consumers, consumer organizations, professional associations, State and local government agencies, industry, and industry trade associations. Some of the comments supported various provisions of the proposal. Other comments suggested modifications, revisions, or revocations of various provisions of the proposal. A summary of the comments, the agency's responses to the comments, and a complete discussion of the agency's conclusions with respect to use of the term ``healthy'' follow. II. Comments and Agency Response A. Purpose in Defining ``Healthy'' The agency views the term ``healthy'' as a unique nutrient content claim. This term not only characterizes the level of the nutrients in a food but implies a judgment about the food itself, based on its nutrient profile. Polls and surveys discussed in the comments that FDA received on the ``healthy'' proposal show that consumers have many ideas about what this term means. Some believe that it means that the food is low in fat and low in sodium; others believe that the term means that the food is low in cholesterol; while still others believe that the term means that consumption of the food would lead to a healthy diet. Taken together, however, these comments establish not only that ``healthy'' conveys a strong message about the nutrient content of a food, but that consumers associate it with the nutrient levels that have generally been recommended over the past few years. The agency finds, therefore, that the fundamental purpose of a ``healthy'' claim is to highlight those foods that, based on their nutrient levels, are particularly useful in constructing a diet that conforms to current dietary guidelines. As stated in the ``healthy'' proposal (58 FR 2944 at 2946), and supported by the comments, foods labeled with the term ``healthy'' should be those that can be consumed to assist consumers in maintaining healthy dietary practices, that is, in achieving a total diet that conforms to current dietary recommendations. Thus, ``healthy'' is different from other nutrient content claims that FDA has defined in that, while the other nutrient content claims characterize only the level of the nutrient (or, in the case of ``light,'' nutrients) that is the subject of the claim, ``healthy'' characterizes both the level of the nutrient in a food and, derivatively, the food itself. 1. One comment stated that in order for a definition of ``healthy'' to be meaningful, unique nutrient criteria should be developed for each food category. The agency disagrees with this comment. Although the agency would consider it inappropriate if the definition of ``healthy'' were to exclude an entire category of foods that is recommended in dietary guidelines, FDA believes that to establish different criteria for each food category would not be helpful to consumers. Not only would consumers have to learn that the meaning of the term varied from food type to food type, but they would have to learn what the term meant in each food category if they were to use it in structuring a diet that conforms to dietary recommendations. Such a situation would defeat the purpose of the claim. Instead of being able to rely on the term as one that highlights foods that are particularly useful in structuring a healthy diet, consumers would be left to judge each food's place in the overall diet that they were consuming. For example, if the agency took into account the fact that some dairy products have a higher fat content than some other foods, and that some cheeses have a higher saturated fat content than some other foods, and so forth, consumers would be left with a situation in which even if they ate a significant number of foods labeled as ``healthy,'' they could have no confidence that their intake of these nutrients would be within dietary guidelines. The agency believes that the definition of ``healthy'' that it is establishing in this final rule will permit a sufficient number and variety of foods in all food categories to bear the term to help consumers achieve a total diet that is consistent with current dietary recommendations. Thus, the agency is not establishing a definition of ``healthy'' that is based on unique nutrient criteria for each food category. 2. A few comments stated that the definition of ``healthy'' should include alternative criteria that the product may meet to be able to bear the term. The comments argued that any product that can bear an approved health claim should be able to bear the term ``healthy.'' These comments asserted that for a food to make a health claim about one of its nutrients, it cannot contain levels of other nutrients that exceed disclosure levels. Thus, a food that can bear a health claim will not contain levels of a nutrient that will increase the risk of diet-related disease to the general population and in that regard represents a healthy food. The agency rejects these comments. A health claim is based on the relationship of a substance to a specific disease or health-related condition. While the provisions governing health claims do not permit such claims on products that contain nutrients at levels above the disclosure levels (see Sec. 101.14(e)), a product that bears a health claim may not be helpful in assisting consumers in lowering their daily intake of those nutrients that are not the subject of the claim, but of which reduced daily intake has been recommended. While the agency recognizes that Congress anticipated that health claims can be used to reinforce the Surgeon General's recommendations and to help Americans maintain a healthful diet (H. Rept. 101-538, 101st Cong., 2d sess., 9- 10 (June 13, 1990)), the fundamental concerns that underlie a health claim are different from those that underlie the definition of ``healthy.'' FDA's goal in defining ``healthy'' is to define the term in such a way that it will highlight foods that, because of their nutrient content, will be most helpful to consumers in constructing a diet that is consistent with dietary recommendations. The purpose of a health claim, on the other hand, is to make consumers aware of scientifically valid nutrient-disease relationships and of foods that have a level of the nutrient in question such that consumption of the food may help to affect the risk of developing the disease in question. In some circumstances these purposes overlap. In others they do not. For example, a woman in her 20's may wish to consume foods that are good sources of calcium, even though the levels of fat in such foods would not qualify them to bear a ``healthy'' claim. Thus, simply because a food qualifies to bear a health claim does not mean that it should also qualify to bear the term ``healthy.'' Consequently, the agency is not granting the comments' request to permit the term ``healthy'' on foods that qualify to bear a health claim, unless, of course, the product also meets the definition of ``healthy.'' 3. Some comments argued that ``healthy'' is not an absolute claim but a relative claim, and that it should be regulated as such. These comments stated that when foods in a given product line have been reduced in fat, saturated fat, sodium, or cholesterol, and an appropriate reference food exists, the product should be able to make a ``healthy'' claim. For instance, according to these comments, if a particular type of fat or oil, such as canola oil, has a lower amount of saturated fat than another type of oil, then the canola oil represents a healthier choice and should be able to bear the ``healthy'' claim. The agency disagrees with these comments. As fully discussed above, the purpose of the ``healthy'' claim is to highlight those foods that, because of their nutrient profile, are useful in assisting consumers in structuring their diets to conform to dietary guidelines. The usefulness of a food labeled ``healthy'' is not based on how it compares to a similar food, but on how it contributes to achieving a total diet consistent with dietary recommendations. In contrast, the purpose of comparative claims is to distinguish those foods that contain modified levels of the specified nutrient when compared to the level of that nutrient in an appropriate reference food. Thus, the purpose of a ``healthy'' claim is significantly different from that of a comparative claim. While both types of claims can be beneficial to consumers in structuring their diets, they do different things. Therefore, the agency considers it inappropriate to define ``healthy'' as a comparative claim. However, the agency advises that products that bear a comparative claim such as ``reduced'' and ``less'' and meet the requirements for a ``healthy'' claim can bear both terms. B. Need for Definition 4. A few comments asserted that FDA did not have the authority under the 1990 amendments to define ``healthy'' because the statute did not set forth an intent or direction to regulate words and expressions that do not relate to the absence, presence, or quantity of nutrients in a food, preventive claims, or curative claims, all of which are subject to scientific verification. The comments further asserted that the 1990 amendments did not authorize FDA to extend express or implied nutrient content claim regulations in a manner that would prohibit words or descriptive free speech that may be useful to consumers in selecting foods that are helpful in achieving a total diet consistent with current dietary recommendations. One comment from a foreign government advised that its policy is to not allow food products to be described as ``healthy,'' although their labeling may bear statements that the food can be consumed as part of a healthy diet. Thus, the comment argued that such a provision would be a barrier to free trade with the United States. Other comments supported the agency's position to establish a definition for ``healthy.'' These comments stated that if the term were not defined, products that had the term in their brand names before October 1989 would be permitted to continue to use the term under the ``grandfather'' provision (Sec. 101.13(q)(1) implementing section 403(r)(2)(C) of the act) and thus continue to mislead consumers. The comments contended that unevenly restricting usage of the term would allow one company to use ``healthy'' in a brand name and preclude other manufacturers with equivalent or superior products from using the term. The agency does not agree with the comments that argued that it does not have authority to define ``healthy.'' Nor is it persuaded by those comments that argued that by establishing a definition for this term, FDA would be prohibiting words or descriptive free speech that could be useful to consumers. Establishment of a definition for ``healthy'' when it is used in a nutritional context is required by section 403(r)(1)(A) of the act itself. When used in such a context, ``healthy'' is making an implied claim about the levels of the nutrients in the food; that is, that these levels are such that the food would be useful in achieving a total diet that conforms to current dietary recommendations (56 FR 60421 at 60423, November 27, 1991). Such a claim, under the terms of section 403(r)(1)(A), would misbrand a food unless it is made in accordance with a definition of the Secretary (and, by delegation, FDA) or with one of the other provisions in section 403(r)(2) of the act. The agency has no intention of depriving consumers of information that may be useful to them in selecting foods that are helpful in achieving a total diet that is consistent with current dietary recommendations. The whole purpose of this rulemaking is to ensure that ``healthy'' is defined in a way that enables consumers to have confidence that the foods that bear this term will in fact be useful for the purpose highlighted by the comment. The agency also points out, as pointed out by some of the comments, that because ``healthy'' is an implied nutrient content claim that was in use in the brand names of some foods before October 25, 1989, the term could continue to be used in the brand names of those foods if FDA did not define the term. A survey of those brand names shows, however, that ``healthy'' means one thing on one product and something else on another (58 FR 2944 at 2946). Thus, it would in fact be contrary to the interest of consumers for FDA not to define this term because continuing use of the term would be in a confusing and inconsistent manner. It would also mean that foods that came onto the market after October 25, 1989, including those that are as, or are even more, useful than those that bore the term before the October 1989 date, would be unable to bear the term. Such a situation makes no sense. FDA fully considered the question of whether the nutrient content claims regime established by the 1990 amendments interfered with free speech in the nutrient content claims final rule (58 FR 2302 at 2392). The agency concluded that it did not. The discussion of this issue in the nutrient content claims final rule is incorporated herein. The comments that argued that defining ``healthy'' would prohibit descriptive free speech did not provide any basis for questioning the agency's earlier conclusion. Thus, FDA rejects these comments. FDA notes that preventive claims and curative claims, mentioned in some of these comments, were not the subject of the 1990 amendments. These claims are drug claims, not food claims. The 1990 amendments addressed only foods. In response to the comment from the foreign government, the agency recognizes that as a consequence of its decision to define ``healthy,'' some manufacturers may have to maintain dual label inventories for products that are exported to countries that do not permit ``healthy'' on the label. While it is not FDA's intent to hamper free trade, FDA concludes, based on the considerations that it has set out above, that it is necessary for it to define this term. 5. A few comments urged FDA to regulate the term ``healthy'' as an implied nutrient content claim regardless of whether it is used in a nutritional context. The comments asserted that such a regulatory approach would provide consistent treatment of the term between USDA and FDA because USDA had not proposed a contextual basis for the use of the term ``healthy.'' Further, the comments argued that to do otherwise could confuse consumers, who are not likely to recognize that the meaning of the term may vary when it appears on different food labels. One of these comments contended that if use of the term is not subject to regulation as an implied nutrient content claim when the use is not in a nutritional context, e.g., when it is used as part of a brand name without accompanying nutrient content claims, FDA will be creating a substantial loophole to the new regulations. The comment argued that this loophole will result in misleading uses of the term in food labeling. Another of these comments stated that the agency's proposed definition recognizes that the term is, in essence, a nutrient content claim for multiple nutritional characteristics, and that therefore, the agency should not require that there be other statements that create a nutritional context before a ``healthy'' claim is treated as an implied nutrient content claim. This comment stated that the use of ``healthy'' in a brand name should also be regulated as an implied nutrient content claim because companies whose products cannot meet the agency's criteria for the term as an implied nutrient content claim will simply place it in their products' brand names and not make any other nutrient claim, as a means of avoiding the agency's definition. The agency is not persuaded by these comments that ``healthy'' should be regulated as an implied nutrient content claim when not used in a nutritional context. The comments have not provided the agency with information on which to conclude that consumers would not be able to discern the context in which the claim appears on the label. The agency does not believe that the term ``healthy'' inherently implies the absence or presence of a nutrient in a particular amount, or that the food that bears the term necessarily has a nutrient profile that would be helpful to consumers in structuring a diet that conforms to dietary guidelines. Rather, such inferences are likely to be drawn only if the term ``healthy'' is accompanied by additional language or graphic material or is otherwise presented in a context that explicitly or implicitly suggests that the food has a particular nutrient profile. FDA believes that when ``healthy'' is used in a context in which it is not an implied nutrient content claim, the consumer will be able to understand that fact. For example, in the statement ``eat lots of fruits and vegetables for a healthy diet,'' the term ``healthy'' does not imply the absence or presence of a nutrient in a particular amount, nor does it imply that the food bearing the term is particularly useful in achieving dietary recommendations. Instead, the term is used to provide general dietary guidance. Thus, such a statement would not be a claim subject to the requirements of section 403(r) of the act. The determination as to whether the use of the term alone or in a brand name conveys a message about the usefulness of the food in achieving dietary recommendations because of its nutrient content is appropriately made on a case-by-case basis. Simply moving ``healthy'' from a claim elsewhere on the label to the brand name does not necessarily change the context in which the claim is made or cause the term not to be an implied claim. For example, the statement ``low in fat'' on the label of a food with the brand name ``Healthy Bites'' would place the term ``healthy'' into a nutritional context and subject it to the provisions of section 403(r) of the act. Likewise, the statement ``high in oat bran,'' that implies that the food is high in fiber, on the label of a food bearing the term ``healthy'' in the brand name would place the term into a nutritional context. Additionally, there may be instances when the use of a vignette on the label of a food bearing ``healthy'' would place the term in a nutritional context. Furthermore, the term ``healthy'' in a brand name may be placed in a nutritional context, even in the absence of other label claims, statements, or vignettes, for example, when the brand name covers a variety of products that are advertised and marketed as ``healthy'' because of their nutrient profile. The agency advises that in such circumstances, the use of the brand name itself is conveying a message to consumers about the nutrient profile of the product. The product line is represented as including foods that are useful in assisting consumers in structuring a diet that is consistent with current dietary recommendations. Thus, the agency is establishing in this final rule a definition for ``healthy'' when it is used in a nutritional context on the label, in the labeling, or in the advertising for a food product. Such a context is established when ``healthy'' appears in association with an explicit or implicit claim or statement about a nutrient, or when the term appears in a brand name that by virtue of its use implies that the product is useful in achieving dietary recommendations. Even when ``healthy'' is not used in a nutritional context, however, as fully discussed in the ``healthy'' proposal (58 FR 2944 at 2945), the agency would have significant reservations about the use of this term if it appears on a product that has nutrients at levels that exceed their disclosure levels as established in Sec. 101.13(h). It seems highly unlikely that the use of this term on a product that contains a nutrient at a level that would not assist consumers in maintaining healthy dietary practices would not be misleading. Consequently, the agency concludes that it is possible that ``healthy'' could be used in food labeling in a way that would not subject its use to regulation as a nutrient content claim, and the agency's regulatory approach appropriately must recognize that fact. Nonetheless, FDA finds that under section 403(a) of the act, it has ample authority to ensure that ``healthy'' is not used in a misleading manner, even when it is not used in a nutritional context. 6. In its January 6, 1993, proposal, FDA solicited comment on whether it should adopt a regulation using its authority under the general misbranding sections of the act, sections 201(n) (21 U.S.C. 321(n)), 403(a), and 701(a) (21 U.S.C. 371(a)), to provide further guidance on the circumstances under which use of ``healthy'' in a context that is not nutritional might be false or misleading and thus misbrand the product. The agency stated that if comments supported adopting such a regulation, FDA would consider doing so in this final rule. In response, two comments stated that FDA should provide further guidance on the circumstances under which use of the term ``healthy'' might be false or misleading but did not provide suggestions on how such circumstances should be defined. The majority of comments, however, did not ask FDA to provide further guidance. Many comments stated that the guidance in the preamble to the proposal is sufficient to regulate use of the term when it is not an implied nutrient content claim. In addition, some comments stated that it is appropriate to determine on a case-by-case basis whether the term, when not used in a nutritional context, violates the requirements of section 403(a) of the act and thus misbrands the product. The agency has concluded that the comments have not supported adoption of regulations under section 403(a) of the act on ``healthy'' when this term is not used in a nutritional context in labeling. Thus, FDA is not establishing additional regulations but will make a determination as to whether the use of the term is false or misleading under section 403(a) of the act on a case-by-case basis. C. Terms Subject to Definition 7. Several comments requested that FDA extend the definition of ``healthy'' to terms like ``health,'' ``healthful,'' and other derivatives of ``healthy'' to be consistent with the use of the term proposed by USDA. A few of these comments asserted that unless the definition of ``healthy'' applies to the derivatives of this term, consumers will be confused by the use of the derivatives on the labels of products that do not qualify for the ``healthy'' definition. The agency finds merit in these comments and concludes that the definition of ``healthy'' should also apply to the use of any of its derivatives in a nutritional context. The agency believes that derivatives of ``healthy'' have the same general meaning and connotation as this term and, thus, when used in food labeling may be construed by consumers to imply that the products on which they appear will be helpful in maintaining healthy dietary practices. Therefore, the agency concludes that it is appropriate to require that when any of the derivatives of ``healthy'' are used in a nutritional context in food labeling, their use be in accordance with the definition of ``healthy'' in Sec. 101.65. FDA finds that providing for the use of derivatives of ``healthy'' in the definition of that term is the logical outgrowth of the proposal. As stated above, USDA proposed this action, and FDA asked in its proposal whether its regulations should be consistent with USDA's. These comments urged that the coverage of the two agency's definitions should be consistent. FDA has concluded that it is appropriate to include the derivative terms in its definition because doing so will promote consistent use of these terms in the marketplace on both FDA and USDA regulated products. Accordingly, the agency is revising proposed Sec. 101.65(d)(2) to include derivatives of ``healthy'' in the definition of that term when they are used to characterize the level of a nutrient in a food. The derivatives of ``healthy'' include, but are not limited to, the terms ``health,'' ``healthful,'' ``healthfully,'' ``healthfulness,'' ``healthier,'' ``healthiest,'' ``healthily,'' and ``healthiness.'' 8. A few comments urged FDA to extend the definition of ``healthy'' to terms like ``wholesome,'' ``nutritious,'' ``good for you,'' and ``food for today's diet.'' One of these comments further stated that if FDA adopts a stringent definition for ``healthy,'' and fails to apply it to synonymous terms, the food industry might simply replace ``healthy'' with these other terms. While the agency recognizes that terms such as ``nutritious,'' ``wholesome,'' and ``good for you'' can be implied nutrient content claims when they appear in a nutritional context on a label or in labeling, the agency does not believe that they are necessarily synonymous with ``healthy.'' FDA has concluded, as stated in the general principles final rule (58 FR 2302 at 2375), that it does not have sufficient information to determine whether definitions for the terms mentioned in these comments are needed, and what those definitions should be. The comments to the ``healthy'' proposal have not provided the agency with the information that it would need to develop definitions or to establish these terms as synonyms for the term ``healthy.'' Thus, the agency is not extending the definition of ``healthy'' to these terms. However, the agency advises that when these terms appear in association with an explicit or implicit nutrient content claim or statement about a nutrient, they will be implied nutrient content claims and subject to the provisions of section 403(r) of the act. Thus, the use of such claims, if they are not defined by the agency, or if they are not exempted through the ``grandfather'' provision, would cause the product to be misbranded and subject to regulatory action. Furthermore, when these terms appear on the label other than in association with an explicit or implicit nutrient content claim or statement about a nutrient, they are subject to regulation under the general misbranding provisions of section 403(a) of the act. Therefore, if a firm is considering using such terms on its label or in its labeling in a nutritional context, it should petition FDA to define the term under section 403(r)(2)(A)(i) of the act. D. Covered Products 9. Some comments opposed FDA's proposal to define ``healthy'' on the grounds that this term is more appropriately applied to overall diets that include fresh fruits, vegetables, low fat dairy products, and grains than to an individual food, main dish, or meal product. These comments urged FDA to prohibit the use of the term on food labels because it describes the total diet, is misleading to consumers, reinforces the ``good food-bad food'' concept, and could easily lead a consumer to overconsume those products labeled as ``healthy'' rather than consuming a variety of foods. These comments further stated that consumers may rely on the claim rather than on specific information on the food label to determine the place of the food in the total diet. Finally, the comments contended that a ``healthy'' claim would undermine terms like ``low'' and ``reduced,'' and that selecting foods labeled ``healthy'' does not necessarily lead to a healthy diet. Other comments supported the use of ``healthy'' on individual foods and meal-type products. These comments asserted that there is no sound reason to limit the use of the term to meals or main dishes. These comments contended that if properly defined and regulated, the claim can be useful in assisting consumers in achieving current dietary recommendations. A few comments recommended the use of ``healthy'' only on meal-type products. One comment further stated that the 1990 amendments do not contain language indicating that nutrient content claims may be limited to meals or main dishes. FDA rejects the comments that argued that ``healthy'' is more appropriately applied to overall diets than to individual foods, main dishes, or meal products (main dishes and meal products may be referred to collectively as ``meal-type products''). As stated in the ``healthy'' proposal, FDA believes that foods labeled with the term ``healthy,'' whether they are individual foods, main dishes, or meals, can be used with a variety of foods to assist consumers in maintaining healthy dietary practices (58 FR 2944 at 2946). The comments have not provided convincing information to the contrary. In fact, polls and surveys that are discussed in other comments have shown that depending on the context in which the term is used, many consumers perceive ``healthy'' in food labeling as describing some aspect of the nutrient content of the product. Because consumers perceive the term as describing the nutrient content of the food, the agency concludes that, if accurately defined, the term can be useful in helping consumers select those foods that will promote a diet consistent with dietary guidelines. Thus, the agency concludes that it is appropriate to establish regulations governing use of ``healthy'' as an implied nutrient content claim when it is used in such a context. As stated above, the polls and surveys discussed by the comments show that, in a nutritional context, ``healthy'' conveys a strong message about the nutrient content of a food. One of the goals of the 1990 amendments was to encourage manufacturers to provide a wider selection of foods with improved nutrient content to facilitate diets that conform to guidelines. The agency believes that defining ``healthy,'' particularly in the manner that FDA has done in this final rule, will encourage such innovation. The term will be reserved for those products that, based on their nutrient profile, will be useful in assisting consumers in structuring diets that conform to current dietary recommendations. The agency recognizes, as stated in one comment, that consumers may tend to rely on the ``healthy'' claim rather than reading specific information on the label. Thus, the agency accepts that it must define ``healthy'' in a way that ensures that, even if consumers do not read the full label, foods that bear the term will be useful in structuring a healthy diet. FDA believes that such a definition can be crafted, and that it has in fact done so in Sec. 101.65(d). The agency further concludes that ``healthy'' should be permitted on both individual foods and meal-type products. Given the fact that both types of foods make significant contributions to the overall diet, FDA is aware of no reason why consumers should not be appropriately advised about the usefulness of individual foods, as well as of meal- type products, in achieving a healthy diet. If the agency permitted the claim only on foods packaged as meal-type products, those consumers who chose to construct their diet primarily from foods packaged as individual foods would not have the same benefit of assistance in selecting foods that are useful in achieving a total diet that is consistent with current dietary recommendations. FDA finds, in deciding to define ``healthy,'' that such assistance can be appropriately given. Therefore, the agency is rejecting the comments that the use of ``healthy'' should be limited to meal products. 10. One comment suggested that if the term ``healthy'' is allowed on meal-type products, FDA should require label statements that state that additional foods such as lowfat milk, fruit, or whole grain bread or rolls be served with the meal, so that at least one serving of all five food groups suggested by the Food Guide Pyramid are included in the meal. The agency rejects this suggestion. The comment did not provide any information on which FDA could make a finding that the type of label statement suggested by the comment is necessary to ensure that consumers understand the proper place in the diet of a product labeled ``healthy'' or how the food's use conforms to the recommendations of the Food Guide Pyramid. Consumers who follow the Food Guide Pyramid will have on the label, through the product's statement of identity, the Nutrition Facts declaration, and the ingredient statement, the information necessary to determine the components and nutritional profile of the product, and where the product fits into the Food Guide Pyramid. The agency believes that by using the information available on the label, consumers will be able to determine the basic food groups that are represented among the product's ingredients and the number of servings of each of these food groups that the product contributes. Consequently, the agency believes that consumers will be able to determine the types of food that should be used to supplement the ``healthy'' product in order to meet the recommendations of the Food Guide Pyramid without any additional information in the labeling. Thus, FDA is not granting the request that additional label statements be required on products that meet the ``healthy'' definition. However, the agency will not object if manufacturers choose to offer guidance as to how their product may be used to achieve a diet that conforms with the Food Guide Pyramid, as long as the guidance is not false or misleading. 11. One comment argued that the proposed definition for ``healthy'' was not appropriate for foods for babies, toddlers, and children. It stated that the nutrients included in the proposed definition (fat, saturated fat, sodium, and cholesterol) may not necessarily be undesirable for infants and young children. This comment urged FDA to establish separate criteria for the use of ``healthy'' on foods for babies, toddlers, and children. However, the comment did not offer any suggestions on how the claim should be defined. FDA recognizes that the definition for ``healthy'' that it is adopting in this final rule is not appropriate for foods for infants and children less than 2 years of age, in part because it is inconsistent with the guidance provided by various health authorities that fat and cholesterol should not be restricted in the diets of infants (Ref. 1). The regulation on general provisions for nutrient content claims provides in Sec. 101.13(b)(3) that nutrient content claims may not be made on foods intended specifically for use by infants and children less than 2 years of age unless a regulation specifically provides for such a claim on such foods. The agency finds that there is nothing in the record of this rulemaking that would support a conclusion that a ``healthy'' claim should be defined for foods intended for infants and children less than 2 years of age, nor would anything in the record allow the agency to decide what such a definition should be. Accordingly, the agency is not establishing separate criteria for the use of ``healthy'' on foods for infants and children less than 2 years of age. The agency notes, however, that interested persons may submit a petition under Sec. 101.69 (21 CFR 101.69) with appropriate information that would provide a basis on which the agency could determine that a ``healthy'' claim would be appropriate on foods for infants and children less than 2 years of age. 12. One comment stated that the proposed regulation governing the use of the ``healthy'' claim would be inappropriate for restaurant foods because restaurant foods differ markedly from foods sold at retail. The comment asserted that because the portion size of a restaurant food may be adjusted to meet the criteria for the claim, the definition of ``healthy'' should be on a per ounce basis. If the definition is not established on a per ounce basis, the comment continued, 10 ounces of food in a meal may not be able to bear the term, whereas a 5 ounce portion of the same food would qualify to bear the term. The comment recommended that different criteria be established for restaurant foods so that the larger portions of food served in restaurants would be able to qualify. It suggested that to bear a ``healthy'' claim, one composite ounce of the main food in the meal should not contain more than 30 percent of its calories from fat and not more than 10 percent of calories from saturated fat. The comment stated that, thus, the overall meal would meet the proposed requirement for ``healthy.'' The agency advises that there is no basis for the concern expressed in this comment. While FDA recognizes that restaurant foods differ from packaged foods in the manner in which they are prepared and sold, it has determined that the differences between restaurant foods and packaged foods are not so great as to preclude restaurants from making claims based on the same criteria that apply to other foods (58 FR 2302 at 2387). A restaurant food may bear a ``healthy'' claim if the restaurateur has a reasonable basis on which to believe that the food that bears the claim meets the definition of ``healthy'' established in this final rule. (Claims made on menus are currently exempt from the requirements of this final rule and are being addressed in an ongoing rulemaking (58 FR 33055, June 15, 1993).) The reasonable basis can be provided in a number of ways. The restaurateur could show, for example, that he or she relied on a trustworthy cookbook that gave values for the specified nutrients in the finished food, and that such levels comply with the requirements for the ``healthy'' claim. A restaurateur could also use recognized data bases for raw and processed foods to compute nutrient levels in the foods or meals and then not use methods of preparation that violate the appropriate use of those data bases (e.g., uncontrolled addition of ingredients or inappropriate substitutions of ingredients). Thus, the agency is not providing a different basis for the definition of ``healthy'' for restaurant foods. Claims on restaurant foods that are individual foods must be based on the reference amount customarily consumed regardless of the portion size. For restaurant foods that are main dishes or meals, the claims are made on a per 100 g basis for the entire amount of food offered as a portion or a meal. These requirements should preclude the kind of misleading adjustments in serving size described in the comment. E. The Definition The agency proposed in the Federal Register of January 6, 1993 (58 FR 2944 at 2949), that the term ``healthy'' be permitted on products that meet the definitions for ``low fat'' and ``low saturated fat'' and that do not exceed the disclosure levels for sodium and cholesterol. The agency specifically solicited comment on whether the proposed definition of ``healthy'' was appropriate, or whether the definition should include a requirement that the food be ``low'' in a third nutrient i.e., sodium or cholesterol, or if the food should also be ``low calorie.'' In addition, FDA asked for comment on whether a definition that may not permit lean meat and poultry to bear the claim would help consumers to achieve a total diet that is consistent with current dietary recommendations. Finally, the agency solicited comment on whether a product labeled ``healthy'' should supply a certain amount of specified essential vitamins, minerals, or other nutrients (e.g., protein). 1. Fat and Saturated Fat 13. Many of the comments supported the ``low fat'' and ``low saturated fat'' requirements in the proposed definition of ``healthy.'' These comments agreed with the agency's position that a product labeled ``healthy'' should have restricted amounts of fat and saturated fat, so that the product will be helpful to consumers in structuring a diet that conforms to dietary guidelines. Other comments argued that the proposed fat and saturated fat criteria are too stringent. A few of these comments contended that a food may be healthy if it has a moderate amount of fat or saturated fat and is low in other nutrients that also are of public health significance, such as cholesterol or sodium. A few comments suggested that the definition of ``healthy'' should be revised so that a product would be allowed to bear the term ``healthy'' if the amounts of fat and saturated fat do not exceed the disclosure levels for these nutrients. A similar comment suggested that in addition to the disclosure levels as limits for fat and saturated fat, one of these nutrients should meet the ``low'' criterion. The comment contended that such a definition would provide greater flexibility for manufacturers to educate and assist consumers in maintaining healthy dietary practices. Another comment recommended that a food should be able to qualify to bear the term ``healthy'' if it contains one half the disclosure levels for fat and saturated fat. According to the comment, the definition would then be 10 percent daily value (DV) for individual foods, 15 percent DV for main dishes, and 20 percent DV for meals. The agency disagrees with the latter group of comments and concludes that the ``low fat'' and ``low saturated fat'' requirements in the proposal are appropriate for the definition of ``healthy.'' The agency rejects the comment that recommended using one half the disclosure levels as limits for fat and saturated fat. Aside from the fact that the comment did not provide a rationale for why such a definition would assist consumers in achieving diets consistent with dietary guidelines, the agency concludes that such a level would not sufficiently limit the amount of fat and saturated fat in a product labeled ``healthy'' to assist consumers in achieving dietary recommendations while giving them the flexibility of selecting a variety of other foods. Thus, such a level would defeat the purpose of the ``healthy'' claim. As for the use of disclosure levels, FDA finds that such levels cannot be used to limit or lower the daily intake of these nutrients. The disclosure levels established for fat and saturated fat, as well as other nutrients, were not intended to be used to limit or lower the daily intake of these nutrients but rather to ensure that a food that bears a nutrient content claim does not contain a nutrient at a level that may increase the risk of a diet-related disease (56 FR 60537 at 60543). The agency's intent in defining the term ``healthy'' is to identify those foods that are particularly helpful in constructing a total diet that is consistent with dietary recommendations. FDA considers it likely that individuals will make an array of food choices, and tying the term ``healthy'' to the disclosure levels would mean allowing this term to appear on foods that will not contribute to achievement of the recommended levels. Such a result would not be consistent with the agency's purposes in defining this term. The agency finds that the requirements that fat and saturated fat levels meet the ``low'' definition are appropriate because these restrictions recognize the need to reduce dietary intake of fat and saturated fat as recommended by the Surgeon General and the Food and Nutrition Board (Refs. 2 and 3). Therefore, they will assist consumers in constructing a total diet that is consistent with dietary recommendations. Accordingly, the agency is not revising the criteria that it proposed with respect to the levels for fat and saturated fat in the definition of ``healthy.'' 14. One comment recommended that in addition to the requirement that fat and saturated fat meet the ``low'' definition, FDA should further limit the amount of these nutrients in main dishes and meal products that qualify to bear the term ``healthy.'' The comment proposed caps of 10 g of total fat and 4 g of saturated fat. In support of the suggested criteria, the comment stated that these caps would serve two purposes: (1) They would be consistent with USDA's proposed definition of ``healthy,'' thereby avoiding confusion over the different levels of fat and saturated fat that may be in FDA-regulated products labeled ``healthy'' and USDA-regulated products labeled ``healthy''; and (2) They would assure consumers that ``healthy'' foods are among the lowest in fat and saturated fat in the marketplace. The agency has not been persuaded by this comment that further limitations are necessary or appropriate for meal-type products labeled ``healthy.'' As stated in response to the previous comment, FDA believes that the ``low'' criteria for fat and saturated fat recognize the need to reduce dietary intake of fat and saturated fat. FDA further believes that the ``low'' criteria are sufficient to assist consumers in restricting their fat and saturated fat intake, without being so restrictive that it would preclude a sufficient number and variety of foods from bearing the claim. Furthermore, FDA believes that the underlying intent of the comment in recommending caps was really to urge FDA and USDA to establish consistent and uniform definitions to minimize consumer confusion. In fact, the two agencies have consistent definitions of ``healthy.'' Elsewhere in this issue of the Federal Register, USDA is establishing a definition of the term ``healthy'' and its derivatives, as applied to meat and poultry products, that is consistent with the definition that FDA is establishing in this document. 15. Another comment, which also recommended additional criteria for meal-type products, stated that in addition to the ``low fat'' and ``low saturated fat'' requirements, foods labeled with the term ``healthy'' should contain no more than 30 percent of calories from fat and less than 10 percent of calories from saturated fat. The agency advises that, as discussed in the ``healthy'' proposal (58 FR 2944 at 2947), the definitions for ``low fat'' and ``low saturated fat'' for meal and main dish products, include a second criterion that requires that the food bearing the claim contain no more than 30 percent of calories from fat and less than 10 percent of calories from saturated fat respectively. Consequently, no changes in Sec. 101.65(d) are necessary in response to the comment. 2. Sodium 16. Several comments that supported the proposed requirement that a food bearing the term ``healthy'' be ``low fat'' and ``low saturated fat'' urged the agency to also require that the product meet the definition for ``low sodium.'' One comment cited the results of a national survey conducted by the National Consumers League (NCL) that showed that 81 percent of the respondents thought that a food labeled as ``healthy'' was low in fat and sodium. The comment contended that, thus, a definition for ``healthy'' that does not require the food to be low in sodium is inconsistent with consumer perception. Other comments also cited the NCL survey as well as other surveys that showed that consumers view the term ``healthy'' as a claim for sodium. Some comments stated that levels for sodium proposed by FDA are not consistent with the Dietary Guidelines' recommendation of limiting sodium intake to 2,400 mg a day. The comments argued that at the proposed levels for sodium, a packaged meal-type product, which typically provides 250 to 450 calories, could provide up to 40 percent of the DV for sodium. This amount of sodium from one meal could easily cause a consumer to exceed 2,400 mg of sodium per day. Other comments recommended that FDA adopt USDA's proposed limit of 480 mg sodium. Several comments expressed the belief that sodium is a nutrient that is as closely associated with diet-related disease as either fat or saturated fat. They argued, therefore, that ``healthy'' should represent a substantially reduced level of sodium. Other comments stated that individual foods should meet the ``low'' definition for sodium (140 mg or less per reference amount), and that meal-type products should contain no more than 480 mg of sodium. One of these comments asserted that a level of sodium above 480 mg may not be helpful to consumers who will consume meal-type products labeled ``healthy'' frequently as a way of achieving recommended DV's. Other comments on this issue supported the agency's proposal to permit the term ``healthy'' on products that did not exceed disclosure levels for sodium. These comments stated that a ``low sodium'' requirement would disqualify many products that are helpful in assisting consumers to meet recommended dietary goals. One comment argued that the proposed levels for sodium were too low, and that the agency should not regulate the amount of sodium in products permitted to bear the term ``healthy.'' The comment asserted that sodium is used in food as a necessary processing agent and preservative (e.g., for binding protein, for developing flavor profiles, and for retarding spoilage). This comment argued that there is not yet sufficient research to determine a precise ``minimum'' or necessary sodium content to guarantee safety against microbiological contamination. In addition, the comment asserted that sodium is used not only to assist in preservation but also for taste. It added that, if the sodium in a product is so low as to render the product tasteless or even bad tasting, consumers will not eat the product or will add salt at the table, which could result in greater sodium intake. The comment asserted that the goal should be to reduce the current overall dietary intake of sodium and not to set a specific sodium requirement that must be met before a product could bear the claim. During the comment review period, this respondent submitted a supplemental comment, restating the concern that the proposed sodium levels were inappropriate. However, the supplemental comment recommended that FDA revise its proposal to permit any product that contained 600 mg or less of sodium and that otherwise met the requirements to bear the claim ``healthy.'' The comment stated that this recommendation was based in part on information that food with lower salt levels may not behave the same as foods with at least 600 mg of sodium with regard to moisture retention, flavor profile, and shelf life. However, the comment did not provide data to support its position. The agency has considered all of the comments and is persuaded that it is not appropriate to allow individual foods or main dish or meal products that contain amounts of sodium equal to the disclosure level to bear the term ``healthy.'' Based on information received in the comments, FDA finds that consumers expect ``healthy'' to be a claim for sodium in addition to other nutrients. FDA's proposal to use the disclosure levels as the limit for sodium and cholesterol was premised on its tentative view that to help consumers to comply with dietary recommendations, it was most important to highlight foods with low fat and saturated fat levels, and that it would be adequate to ensure that the amounts of sodium and cholesterol in foods that bore a ``healthy'' claim did not exceed disclosure levels. Having been persuaded that consumers will be using foods labeled as ``healthy'' to limit their sodium intake to achieve current dietary recommendations, the agency finds it appropriate to restrict the amount of sodium in a product that qualifies to bear the term. Foods that contain sodium at the disclosure level will not be useful for this purpose. (FDA will discuss cholesterol in the next section of this document.) While FDA agrees with the comments that argue that ``healthy'' should only be permitted on products that help the consumer in reducing sodium intake to meet dietary recommendations, FDA has not been persuaded that the best approach in achieving this goal is to incorporate a ``low sodium'' requirement in the definition of ``healthy.'' FDA concludes that a definition that requires ``low'' sodium would be too restrictive because such a requirement would disqualify many products that would be useful in maintaining a diet that conforms to current dietary guidelines. Foods such as raw beet greens, canned white corn, canned carrots, many breakfast cereals, legumes, low fat dairy products, and other foods that are useful in following dietary guidelines would be disqualified with a ``low sodium'' requirement. While FDA recognizes that manufacturers will have to reformulate many of their processed products to meet the definition of ``healthy'' that it is adopting, the agency is concerned that many processed foods, as well as certain fresh foods, that would otherwise meet the definition would be disqualified with a ``low sodium'' requirement. The agency believes that for the claim to be useful, foods that are able to bear the term should be of a sufficient number and variety to help consumers achieve a total diet that is consistent with current dietary recommendations. Further, as stated in the comments, sodium plays an important role in consumer acceptance of a product. FDA believes that if, in addition to the ``low fat'' and ``low saturated fat'' requirements, it were to define ``healthy'' to include a ``low sodium'' requirement, the appeal of many products would be diminished because of an unacceptable flavor profile, especially in foods where sodium has been added as a flavoring agent to compensate for the removal of fat. Thus, if consumers abandon the product or add salt to taste at the table, the food would lose its usefulness in assisting consumers in achieving dietary recommendations with respect to sodium intake. Thus, the agency has concluded that while the disclosure level is too high for sodium in a food bearing a ``healthy'' claim, a ``low sodium'' criterion is not a viable option. The agency considered the recommendation by one of the comments that the sodium criterion for ``healthy'' be no more than 600 mg of sodium. It concluded that such a level for individual foods would be inappropriate because it exceeds the disclosure level and would not assist consumers in maintaining healthy dietary practices. Furthermore, such a criterion could cause frequent use of foods labeled ``healthy'' to result in an overall diet inconsistent with current dietary guidelines. If, for example, an individual at one of four eating occasions were to consume at least four individual foods that were labeled ``healthy,'' and each contained 600 mg of sodium, he or she would have reached the Reference Daily Intake (RDI) for sodium (i.e., 2,400 mg) in that one eating occasion. Because of the ubiquity of sodium in the food supply, it is unlikely that at the remaining eating occasions all of the foods consumed would be free of sodium. Thus, in the course of a day, the person's overall sodium intake would exceed the RDI and result in an overall diet inconsistent with recommendations. With regard to meal-type products, a requirement that the food contain no more than 600 mg would be more helpful in meeting dietary guidelines than the disclosure levels of 720 mg and 960 mg for main dishes and meals, respectively. However, 600 mg of sodium in meals and main dishes would not provide consumers with the flexibility of eating other foods that do not restrict the amount of sodium but that can help in other ways to achieve current dietary recommendations. Although the comment that suggested a level of 600 mg raised a concern that lower sodium levels could affect the viability of some products, the agency is not aware of data that establish a threshold level of sodium needed for a wide variety of foods, and the comment did not provide any data to support its claim. While 600 mg sodium may be necessary to produce and distribute certain foods, FDA believes that there is a wide variety of foods for which such a level is not needed. There are currently many individual foods and meal-type products on the market that contain less than 600 mg sodium (Ref. 4). Based on the comments, the agency is persuaded that a mealtype product bearing the term ``healthy'' should contain no more than 480 mg of sodium per labeled serving. This level is the level for sodium that USDA is adopting in its definition of ``healthy'' for meal-type products. Such a requirement is appropriate because it is low enough to ensure that foods that comply with it will be helpful in assisting consumers in achieving current dietary goals and will also give consumers who eat such foods the flexibility to consume foods whose sodium content is not restricted, such as breakfast cereals and some dairy products. At the same time, the agency believes that, based on the sodium levels of products currently available, this level is not so low that it would significantly affect the appeal of meals or main dishes that contain this level of sodium. Thus, the agency is revising its definition of ``healthy'' in Sec. 101.65(d)(4)(ii)(B) to provide that if the food is a main dish or meal product the level of sodium in the product cannot exceed 480 mg. With regard to individual foods, the agency has scrutinized the comments in seeking an appropriate level for sodium. As previously discussed, the agency considers it inappropriate to include a ``low sodium'' criterion in the definition of ``healthy.'' It is not the agency's desire to so narrowly define the term ``healthy'' that it would disqualify many foods that are recommended to be included in the diet and that could assist consumers in meeting dietary goals. Nor is it the agency's desire to have a definition that permits nutrients at levels that would not be helpful in assisting consumers in achieving current dietary goals. While FDA has been persuaded that the definition of ``healthy'' should restrict the level of sodium so that foods bearing the claim will be helpful in reaching dietary goals, the agency does not believe that the levels suggested in comments represent appropriate sodium levels for individual foods. To fulfill the purposes of a ``healthy'' claim, FDA has concluded that the sodium criterion for ``healthy'' must be significantly less than the disclosure level that it proposed in the January 6, 1993, issue of the Federal Register (58 FR 2944 at 2949) and yet higher than ``low sodium.'' In trying to arrive at such a level, FDA decided to examine the dietary effects of 25 percent and 50 percent reductions from the disclosure level. The agency has determined, as stated in the general principles final rule (58 FR 2302 at 2346), that a reduction of at least 25 percent in the level of the nutrient from the level of the same nutrient in an appropriate reference food is a significant reduction. Applying a 25 percent reduction to the disclosure level for sodium in individual foods, the agency arrived at a level of 360 mg (i.e., 480 mg x .25 = 120; 480 - 120 = 360). Likewise, applying a 50 percent reduction to the disclosure level for sodium in individual foods, the agency arrived at a level of 240 mg. In evaluating the appropriateness of these levels as a sodium criterion for the term ``healthy,'' the agency found that a level of 240 mg of sodium would, like ``low'' sodium, disqualify many foods that are recommended to be included in a healthy diet. Thus, the agency rejected this level. However, in evaluating a level of 360 mg of sodium the agency found: (1) That this level will assist consumers in constructing a diet consistent with dietary guidelines; (2) That it is an amount of sodium that could be reasonable for a wide variety of foods to use the ``healthy'' definition without compromising the appeal of the food (Ref. 4); (3) That the level is not so restrictive that it is likely to disqualify many foods that are recommended to be included in a healthy diet; and (4) That this level is consistent with the requirement that is being adopted by USDA elsewhere in this issue of the Federal Register. Because this level satisfies the criteria for an appropriate sodium level, FDA decided to adopt it. The agency notes that these factors distinguish the use of a percent reduction from the disclosure level for sodium from the use of a similarly derived level for fat, which the agency refused to do. As stated above, use of a level for fat that is derived from a percent reduction of the disclosure level would not adequately serve the purposes that are to be achieved by a ``healthy'' claim. However, for sodium, such reduction provides an appropriate level. Thus, the agency is revising its proposed definition of the term ``healthy'' in Sec. 101.62 (d)(2)(ii) and (d)(3)(ii) to require that individual foods bearing the claim ``healthy'' contain no more than 360 mg of sodium per reference amount customarily consumed (reference amount) and per labeled serving. The agency is concerned, however, that this approach will not effectively control misleading claims on nutrient-dense foods with small serving sizes. The agency has addressed a similar concern in the definition of ``low.'' As fully discussed in the general principles final rule (58 FR 2302 at 2317), the agency concluded that in order to prevent misleading ``low'' claims on nutrient-dense foods with small serving sizes, a weight-based criterion should be applied to these foods. Thus, the agency adopted a per 50 g requirement for foods with a reference amount of 30 g or less or 2 tablespoons or less. The agency believes that a similar approach is warranted in the definition of ``healthy.'' Without a weight-based criterion for foods with small serving sizes, foods such as rye wafers would be able to bear the ``healthy'' term, even though they may contain as much as 880 mg of sodium per 100 g of food. The agency would consider a ``healthy'' claim on such a product to be misleading. Thus, to prevent misleading claims on nutrient dense foods with small serving sizes, FDA is adopting the per 50 g criterion for foods with small serving sizes, consistent with the approach used for ``low'' claims. Specifically, foods that have reference amounts of 30 g or less or 2 tablespoons or less may bear the ``healthy'' claim provided they contain no more than 360 mg of sodium per 50 g and meet all other requirements of the definition. Because section 403(r)(1)(A) of the act, which prohibits undefined nutrient content claims, is applicable May 8, 1994, and would preclude most ``healthy'' claims if that term is not defined, FDA has determined that it is essential that it provide a definition for that term by May 8, 1994. However, the agency recognizes that the revisions in the sodium requirements for individual foods and main dishes and meal products, while the logical outgrowth of the proposal, will significantly limit the amount of sodium a food may contain for it to bear a ``healthy'' claim as compared to the proposal. Further, results of an informal survey in Washington, DC of products currently available in the marketplace (Ref. 4) show that many individual foods, main dishes, and meal products that are labeled as ``healthy,'' and that otherwise meet the definition of ``healthy'' established in this final rule, would not qualify for use of the term because the sodium level in such foods exceeds 360 mg in individual foods and 480 mg in main dish and meal products. The agency does not wish to severely disrupt the marketplace by establishing a definition or effective date for ``healthy'' that would cause the majority of products that are currently labeled ``healthy,'' and that otherwise meet the definition, to be removed from the market. The agency, therefore, is providing time to give industry the opportunity to reformulate their products to meet the requirement that sodium not exceed 360 mg per reference amount and per labeled serving for individual foods and 480 mg per serving for main dish and meal products. While the effective date of the ``healthy'' definition is May 8, 1994, products currently on the market that otherwise meet the definition of ``healthy'' will not have to conform to the criteria of 360 mg sodium for individual foods and 480 mg sodium for meal-type products until January 1, 1998. However, while the agency believes that these requirements are appropriate, it is concerned that if, during this transitional period, FDA were to permit products currently on the market that contain uncontrolled levels of sodium to continue to bear the term ``healthy'' until January 1, 1998, such products would not be helpful in assisting consumers in reducing their sodium intake and would be inconsistent with current dietary recommendations. Therefore, the agency is establishing a requirement that will limit the amount of sodium allowed in individual foods, main dish products and meal products bearing the term ``healthy.'' In attempting to arrive at an appropriate level for sodium, the agency evaluated products that are currently available in the marketplace and that, with the exception of the sodium requirement, meet the definition for ``healthy.'' The agency also considered how these products are likely to be used in constructing overall diets that conform to current dietary guidelines. The agency determined that levels of 480 mg of sodium in individual foods and 600 mg of sodium in main dishes and meal products are appropriate levels during this transitional period. Such levels will assist consumers in reaching dietary goals by at least limiting their sodium intake, and they will not preclude products currently available and that otherwise meet the definition of ``healthy'' from continuing to bear the term while firms reformulate their products. Thus, individual foods that do not exceed 480 mg sodium per reference amount and per labeled serving and meet the other requirements of the ``healthy'' definition provided in Sec. 101.65(d) may bear the term until January 1, 1998. Likewise, main dishes and meal products that do not exceed 600 mg sodium per labeled serving and otherwise meet the ``healthy'' definition may bear the term until January 1, 1998. 3. Cholesterol 17. Some comments supported the proposal that foods that contain less than the disclosure level for cholesterol would be eligible to bear the claim. A few comments, however, urged the agency to require that a product bearing the term ``healthy'' meet the ``low cholesterol'' criteria. One comment cited the results of the survey by NCL cited in section II.D.2. of this document that showed that 79 percent of the respondents thought that a food labeled as ``healthy'' was low in cholesterol. Thus, the comment contended that a definition for ``healthy'' that does not require the food to be ``low'' in cholesterol is inconsistent with consumer perception. Another comment stated that foods labeled with the term ``healthy'' should contain no more than 60 mg or a significantly reduced amount of cholesterol. FDA has not been persuaded by the comments that the definition of ``healthy'' should include a ``low'' cholesterol criterion. FDA finds that a definition that requires that a food be ``low'' in cholesterol would be too restrictive because such a requirement would disqualify products, including some seafood and game meat containing products, that otherwise meet the ``healthy'' definition and that would be useful in structuring diets that conform to current dietary guidelines. Although the agency recognizes that consumers may perceive ``healthy'' to mean ``low cholesterol'' (as shown by the NCL survey) and, thus, select foods labeled ``healthy'' to restrict their cholesterol intake, the agency has not been convinced by the comments that a product labeled ``healthy'' must meet a ``low cholesterol'' requirement to assist consumers in achieving current dietary recommendations. Unlike sodium, cholesterol is not ubiquitous in the food supply. Dietary cholesterol is found mainly in egg yolks, certain shellfish, organ meats, and, to a lesser extent, other meats and dairy products (Ref. 5). Consequently, cholesterol is not likely to be present in significant amounts in many of the foods that are included in a healthy diet (e.g., fruits, vegetables, legumes, cereal grains). Furthermore, while the agency acknowledges that most dietary guidance recommends that serum cholesterol be lowered because of its relationship to cardiovascular disease, saturated fat is the major dietary determinant of total serum cholesterol levels in populations (Ref. 6). The definition for ``healthy'' that FDA is adopting in this final rule requires that the total amount of saturated fat in a product be low for it to qualify to bear the claim. Thus, the need to restrict the amount of dietary cholesterol is diminished in the presence of the ``low saturated fat'' criterion. The agency finds that this criterion will adequately assist consumers in structuring a healthy diet with respect to dietary factors that could affect serum cholesterol levels. Therefore, for single ingredient products that are not raw seafood or game meat, FDA is requiring in Sec. 101.65(d)(2)(iii) that the level of cholesterol not exceed the disclosure level. Although it believes that the proposed criterion for cholesterol is appropriate for meal-type products as well, FDA is concerned that by adopting the proposed criterion, it would be establishing a requirement that is not totally consistent with the criterion established for cholesterol by USDA. In its final rule on the definition of ``healthy,'' published elsewhere in this issue of the Federal Register, USDA is adopting a criterion that limits the amount of cholesterol in meal-type products to the disclosure level defined in Sec. 101.13(h)(3) permitted for main dishes, i.e., 90 mg per labeled serving. FDA examined the impact that such a requirement would have on meal products subject to its jurisdiction. (The disclosure level for meal products is 120 mg per labeled serving.) A survey of the local marketplace as well as a review of product composition data submitted to the agency (Refs. 4 and 7) has shown that meal products currently labeled ``healthy'' contain levels of cholesterol at or below 90 mg per labeled serving. Therefore, a requirement restricting the amount of cholesterol to 90 mg per labeled serving would not significantly affect FDA-regulated meals that currently bear the term ``healthy.'' Further, such a requirement would ensure that the meal products labeled ``healthy'' are among those most likely to assist consumers in achieving dietary recommendations. Thus, the agency does not consider it unreasonable to apply the cholesterol limitation for main dishes to its meal products as well. Accordingly, the agency is revising proposed Sec. 101.62(d) to require that main dish and meal products that contain less than 90 mg cholesterol per labeled serving, and that otherwise meet the definition of ``healthy,'' may bear the claim. 18. One comment suggested that, in the absence of requiring ``low'' for all nutrients, the agency should require a disclosure statement, as it has done for terms such as ``light/lite,'' that states ``See ______ panel for information on cholesterol and sodium,'' as appropriate. This statement would appear immediately adjacent to the most prominent appearance of the term on the principal display panel of the label. In response to this comment, the agency points out that it has established requirements for label statements about nutrients that are present in amounts that exceed the disclosure levels in a product that makes a claim about another nutrient (Sec. 101.13(h)). In order for consumers to use such information effectively, it should be used with consistent meaning. The agency is reluctant to require use of disclosure statements on a different basis unless there is a well justified need. The comment did not provide justification for why it should, and the agency is therefore not adopting the suggestion. Thus, for ``light'' claims, ``healthy'' claims, and all other nutrient content claims, a statement in accordance with Sec. 101.13(h) immediately adjacent to the claim is required if the food contains fat, saturated fat, cholesterol, or sodium in an amount that exceeds the disclosure level. F. Need for Additional Criteria In its January 6, 1993, proposal (58 FR 2944), FDA solicited comment on whether it should include additional requirements in the definition of ``healthy'' such as a ``low calorie'' criterion or a requirement that a food that bears a ``healthy'' claim supply a certain amount of specified essential vitamins, minerals, or other nutrients. 19. The majority of comments supported a requirement that a food must contribute certain essential nutrients to bear a ``healthy'' claim. They asserted that the definition of ``healthy'' is unbalanced without the requirement for a prescribed amount of these nutrients because a food labeled ``healthy'' should not only limit the amount of fat, saturated fat, cholesterol, and sodium but should also contribute certain essential nutrients. Thus, according to the comments, a claim that is to be used to assist consumers in achieving a healthy diet should include a requirement that the food provide certain essential nutrients. The comments further asserted that the proposed definition is a one dimensional approach because it fails to adequately account for current dietary recommendations as they relate to intake of certain nutrients, such as vitamins, minerals, and other essential nutrients. The comments contended that dietary guidelines stress the importance of essential nutrients, and that foods that fail to contribute essential nutrients, but that are permitted to be labeled as ``healthy,'' would likely mislead consumers. The comments supported their statements by submitting results from a recent poll in which 63 percent of respondents expected a product labeled ``healthy'' to be a good source of some important vitamins and minerals. One comment stated that without the requirement for inclusion of some nutrients, the definition would be trivialized or compromised by its use on products of little or no nutritional value, because foods like jelly beans, soda, and certain candies could qualify to bear the term. Another comment stated that such a requirement could assist consumers in identifying foods that are nutrient dense and at the same time contain a minimum of components that according to current dietary recommendations should be limited for healthy eating. Other comments opposed inclusion of any requirement that a product labeled with the term ``healthy'' provide certain nutrients in addition to limiting the amount of fat, saturated fat, sodium, and cholesterol in the product. These comments contended that the addition of a nutrient contribution requirement would limit a manufacturer's ability to formulate processed foods that have an increased nutritional quality, and such a requirement would take away an incentive to produce foods of this type. Another comment that was opposed to a requirement that a food supply certain nutrients to qualify to bear a ``healthy'' claim stated that foods that are widely viewed as healthy and that contribute needed variety to a healthy diet, such as apple juice, grape juice, and whole wheat bread, would not meet this requirement and therefore would not be able to bear the ``healthy'' claim. Although the agency recognizes that certain varieties of apple juice and grape juice may not be able to bear the claim, the agency disagrees that whole wheat bread will not be able to bear a ``healthy'' claim. Nutrient profile data analyses (Ref. 4) show that whole wheat bread will meet the 10 percent nutrient contribution requirement set forth in this final rule. The agency believes that the ``healthy'' claim should be reserved for those foods that are particularly helpful to consumers in achieving dietary recommendations. Conceptually, a healthy diet not only restricts nutrients that have been shown to be related to disease but also includes those nutrients that are important in sustaining body function and reducing the risk of disease. The agency would be concerned that without a requirement that a food that bears a ``healthy'' claim contribute at least one essential nutrient to the diet, consumers using ``healthy'' foods frequently might not consume enough of these nutrients. Thus, the agency agrees with those comments that stated that a product bearing the claim ``healthy'' should also contribute essential vitamins, minerals, or other nutrients to the diet. Accordingly, FDA is revising the definition of ``healthy'' to include a nutrient contribution criterion. 20. One comment suggested that the agency use the Index of Nutritional Quality (INQ) system as a mechanism to facilitate the definition of ``healthy.'' The INQ is a ratio that compares the percent of the Reference Daily Intake (RDI) or Daily Reference Value (DRV) of the nutrient in the food to the percent of the reference caloric intake that is contributed by the food. In other words, the INQ relates a food's contribution to nutrient allowances to its contribution to energy requirements. The comment stated that a positive nutrient contribution could be determined using this criterion. The comment proposed that a ``healthy'' food should have an INQ above 1 for at least four nutrients or an INQ above 2 for at least two nutrients. While the agency finds some merit to this comment, it believes that a less complex requirement would be more useful to consumers in understanding how to construct a total diet consistent with dietary guidelines. The use of the INQ system would also not be consistent with the approach used in defining other nutrient content claims and would likely confuse and mislead consumers regarding the nutrient profile of the food. Moreover, the RDI's of several of the essential nutrients that the comment recommended be included in the definition of ``healthy'' are not based on caloric density. Thus, the agency believes that it would be inappropriate to base a nutrient contribution requirement on the caloric contribution of the food. Therefore, FDA rejects the suggestion that it base a nutrient contribution requirement on the INQ system. 21. Many comments urged FDA to require that foods labeled ``healthy'' provide at least 10 percent of the RDI or DRV of the essential nutrients that are of sufficient public health significance to warrant their inclusion in the nutrition label. Specifically, the comments requested requirements for vitamin A, vitamin C, protein, calcium, iron, or fiber. These comments asserted that the number of these nutrients required should increase with the food's contribution to the total daily intake. Under this suggested approach, an individual food would have to contain at least 10 percent of the DV of one of the six nutrients mentioned above per reference amount and per labeled serving, a main dish would have to contain at least 10 percent of the DV of at least two of the six per serving, and a meal would have to contain at least 10 percent of the RDI or DRV of three of the six per serving. The agency agrees with the suggestion that the required nutrients should be those that are of sufficient public health significance to warrant their inclusion in the nutrition label. Thus, the agency is revising its definition of ``healthy'' in Sec. 101.65(d) to include a requirement that to bear the term, a product must provide a specified amount of vitamin A, vitamin C, protein, calcium, iron, or fiber, all of which have been highlighted by leading health authorities as being important to the public health (Refs. 2, 3, 5, and 8). In addition, the agency believes that it is reasonable to expect main dish and meal products to contribute more than one specified nutrient to the food because the contribution of a main dish and meal product to the total daily diet is greater than that of an individual food. The approach taken by the agency in defining nutrient content claims on main dish and meal products is generally that main dishes approximate two individual foods and meals approximate three individual foods. The suggestion in the comments that main dishes provide two nutrients, and that meals provide three is consistent with this approach. Thus, the agency is revising its definition of ``healthy'' to include a requirement that to bear the term, a product must provide a specified amount of one, two, or three (depending on the food, i.e., individual food, main dish, or meal) of the six nutrients mentioned above. The agency also finds merit in those comments that suggested that the definition of ``healthy'' include a requirement that a food bearing the claim contribute at least 10 percent of the DV of the nutrients it provides. The agency has long held that a food is not a significant source of a nutrient unless that nutrient is present in the food at a level equal to, or in excess of, 10 percent of the U.S. Recommended Daily Allowances (U.S. RDA) in a serving. In the general principles final rule (58 FR 2302 at 2414), FDA adopted regulations requiring that to bear a ``good source'' claim for a nutrient, the food must contain at least 10 percent of the RDI or DRV of the nutrient. Thus, FDA finds that it is appropriate to require that a food labeled ``healthy'' be at least a ``good source'' of the specified nutrients that it provides. Therefore, FDA is providing in Sec. 101.65(d) that for a food to bear the claim ``healthy,'' an individual food must contain 10 percent of the RDI or DRV of one of the following per reference amount--vitamin A, vitamin C, calcium, iron, protein or fiber; a main dish must contain 10 percent of the RDI or DRV of two of the six nutrients per serving; and a meal must contain at least 10 percent of the RDI or DRV of three of the six per serving. The agency points out that while the amount of the nutrient is the same as that required for a ``good source'' claim (i.e., 10 percent), the nutrient contribution provision for ``healthy'' for main dish and meal products does not require that the 10 percent of the RDI or DRV be contributed by a single food in the main dish or meal. (The provisions governing a ``good source'' claim require that a single food in the main dish or meal product contribute at least 10 percent of the RDI or DRV of the nutrient in question before the product can bear the claim.) The requirement for ``healthy'' would not be met, however, if the main dish or the meal contributed only a single nutrient at a level that is 20 percent or 30 percent of the RDI or DRV. The nutrient contribution requirement is met when the entire serving of the food provides at least 10 percent of the RDI or DRV of each of the number of nutrients required. 22. While many comments supported the addition of a nutrient contribution requirement in the definition of ``healthy,'' they were divided on the question of whether products could be fortified to meet the claim. Some comments argued that fortification should not be permitted because products like jelly beans, soda, or salad dressing could qualify if fortification were permitted. Other comments argued that products that have otherwise met the definition but do not contain the essential nutrients should be permitted to be fortified. The agency has carefully considered these comments. In the general principles proposal (56 FR 60421) and final rule (58 FR 2302), the agency considered the appropriateness of fortifying a food to meet the requirements for bearing the nutrient content claim ``more.'' Although the agency stated its concern that random fortification could lead to deceptive and misleading claims, it concluded that fortification in accordance with the policy on fortification of foods in Sec. 104.20 (21 CFR 104.20) would ensure that the fortification was rational, and that a ``more'' claim based on rational fortification would not be misleading. The agency believes that it is reasonable to take a similar approach in the definition of ``healthy.'' The agency is not persuaded by the comments opposing fortification that it should prohibit fortification of foods to meet the nutrient contribution requirement of the ``healthy'' claim. Such action would be inconsistent with the goal of encouraging manufacturers to improve the nutritional quality of foods to assist consumers in structuring a diet that conforms with current dietary recommendations. Thus, the agency is not prohibiting fortification of foods in the definition of ``healthy.'' However, the agency is concerned that random fortification of foods could result in deceptive or misleading ``healthy'' claims. Thus, consistent with the provisions governing the ``more'' claim, the agency believes that following the principles stated in its fortification policy as provided in Sec. 104.20, in fortifying a food to qualify to bear the term ``healthy'' will ensure that those foods are not indiscriminately fortified for the sole purpose of making the claim. The fundamental objective of the fortification policy is to establish a uniform set of principles that serve as a model for the rational addition of nutrients to foods. Accordingly, the agency is providing in Sec. 101.65(d)(2)(v), (d)(3)(iv) and (d)(4)(v) that a food may be fortified to meet the positive nutrient requirement in the definition of ``healthy,'' provided that the fortification is in accordance with the policy on fortification of foods in Sec. 104.20. Although, as fully discussed in the technical amendments document to the general principles final rule, (58 FR 44021 at 44026, August 18, 1993), the agency believes that the principles established in the fortification policy are appropriate in determining conditions for rational fortification, the agency notes that Sec. 104.20 was developed at a time when less technology was available for food formulation, and when food consumption behaviors and recommendations varied from those considered appropriate today. Thus, FDA is concerned that limiting fortification only to the nutrients that are explicitly mentioned in Sec. 104.20 would preclude beneficial nutrients from being used in food fortification. However, the agency does not consider it appropriate to establish a fortification policy for ``healthy'' that is different than the fortification policy established for ``more'' claims. As discussed in the technical amendments document (58 FR 44021 at 44026), the agency's intention is to initiate rulemaking to permit rational fortifications other than those described in Sec. 101.40 to qualify for ``more'' claims. At the time of such rulemaking, the agency will reconsider the provisions on fortification established in this final rule. 23. One comment stated that requiring a fruit or vegetable to meet the definition of ``good source'' for any of the six nutrients mentioned above would eliminate cucumbers, grapes, green beans, and iceberg lettuce from bearing a ``healthy'' claim. The comment argued that all fruits and vegetables that meet the proposed definition for ``healthy'' should be allowed to use the term without having to meet any nutrient contribution requirement. The comment contended that fruits and vegetables are inherently healthy and are the only food group for which such a general statement can be made. After considering this comment, the agency is providing one narrow exception to the requirement that foods be a good source of one of the six nutrients of public health significance to qualify to bear a ``healthy'' claim. Current dietary guidance emphasizes consumption of fruits and vegetables, and diets high in fruits and vegetables have been associated with various specific health benefits, including lower occurrence of coronary heart disease and some cancers (Refs. 2 and 5). Consistent with this guidance, FDA believes that increased consumption of raw fruits and vegetables can contribute significantly to a healthy diet and to achieving compliance with dietary guidelines, even if particular items, such as celery and cucumbers, do not contain 10 percent of the daily value of one of the six nutrients of public health significance. Precluding such foods from being termed ``healthy'' could confuse consumers and undermine an important element of current dietary guidance. FDA will therefore allow use of the term ``healthy'' in connection with raw fruits and vegetables that do not meet the nutrient content requirement, if the other elements of the ``healthy'' definition are met. FDA is not prepared at this time to extend this exemption to processed fruits and vegetables, however. When processed, these foods are exposed to substances and conditions, such as sodium, heat, and liquid packing media, that commonly affect their nutritional profile and may alter their inherent beneficial qualities. They are also subject to a range of processing techniques, including canning, cooking, and freezing, that may have various effects. FDA does not currently have an adequate basis to evaluate these effects and thus is not prepared at this time to extend this exemption to all fruit and vegetable products. Processed fruits and vegetables will be subject to the requirement that they be a good source of one of the six nutrients of public health significance specified above. FDA welcomes information on whether to propose changes in the nutrient content requirement for fruits, vegetables, or other food categories, in order to allow the use of the term ``healthy'' on other foods that would not otherwise meet this aspect of the ``healthy'' definition that may be useful in helping achieve compliance with dietary guidelines. 24. A few comments urged the agency to include an additional criterion that a product bearing the term ``healthy'' must be ``low'' in calories. Another comment suggested that such a product meet the ``low'' definition for sugars. However, these comments did not offer any information that was not considered by the agency at the time it issued the ``healthy'' proposal. The agency has not been persuaded by the comments that it is necessary to include a ``low calorie'' or ``low sugar'' criterion in the definition of ``healthy'' for the claim to be useful and not misleading to consumers. The information provided in the comments did not show that consumers expect ``healthy'' to be a claim about the caloric content of the food. Furthermore, the purpose of defining the term would be defeated if the term were defined so narrowly that it is appropriate only for people on weight-loss diets. Thus, the agency is not requiring that a food be ``low calorie'' or ``low'' in sugar to bear the term ``healthy.'' G. Treatment of Flesh Foods 25. Virtually all of the comments requested that FDA and USDA harmonize their definitions of ``healthy.'' One comment contended that if the agencies cannot agree on a single consistent definition of the word ``healthy'' for any category of products, they should simply prohibit use of the term on those products. Some comments recommended that FDA adopt USDA's definition. Those comments supporting the USDA definition argued that such a definition would permit certain fish, poultry, and lean meats to bear the term ``healthy,'' which is consistent with the current dietary recommendations of the Surgeon General and the Food and Nutrition Board (Refs. 2 and 3), which recommend consumption of fish, skinless poultry, and lean meats. The comments contended that FDA's proposed definition would permit very few, if any, fresh cut meats to bear the term. These comments urged that the two agencies coordinate their definitions so that consumers receive the assistance that they need to implement dietary recommendations. The agency agrees with the comments that requested consistency in the FDA and USDA definitions of ``healthy.'' Both FDA and USDA recognize that having different definitions for the same nutrient content claim could lead to consumer confusion and undermine the usefulness and credibility of the claim. FDA and USDA have jointly reached a decision to consistently define ``healthy'' as it applies to the foods regulated by the two agencies. Thus, elsewhere in this issue of the Federal Register, USDA is establishing a definition of the term ``healthy'' as it applies to meat and poultry products that is consistent with the relevant aspects of the definition set forth in this final rule. In their efforts to achieve a consistent definition, USDA and FDA are adopting regulations that: (1) Provide for the use of the term ``healthy'' on ``extra lean'' raw, single ingredient meats, poultry, fish, and game meats, (2) Require that all other products that bear the term be ``low'' in total fat and saturated fat and contain limited amounts of sodium and cholesterol, and (3) Require that there be minimum levels of certain essential nutrients in the product. In addition, consistent with USDA's approach, FDA has, as stated above, extended the definition of ``healthy'' to include any of the derivatives of the term, such as ``healthful'' and ``healthier.'' The agency believes that such an approach is appropriate because establishment of a consistent definition with USDA will ensure that the term is used in a credible, consistent, useful, and nonmisleading manner. Moreover, a consistent definition will help consumers identify products in all food categories that will be helpful to them in constructing a diet that is consistent with dietary recommendations. 26. In the ``healthy'' proposal, as stated above, FDA solicited comment on whether the proposed definition of ``healthy'' would assist consumers in achieving a total diet consistent with dietary recommendations given that under the proposed definition, lean meat and seafood would not be able to bear the claim. Many comments requested that FDA revise its proposed definition so that lean meats and seafood would be able to bear the claim or, in the alternative, to establish additional criteria for those foods. The comments stated that such action was consistent with current dietary recommendations to include fish and lean meats as part of a healthy diet. The comments further stated that to not provide a definition for ``healthy'' that would permit seafood and game meats to bear the term would create an inequitable situation in the marketplace between comparable FDA- regulated and USDA-regulated products because access to the term would depend on whether the product is under FDA or USDA jurisdiction. The agency agrees with the comments. As previously discussed, the agency believes that the fundamental purpose of the ``healthy'' claim is to highlight those foods that are particularly useful in constructing a diet that conforms to current dietary guidelines. The agency would consider it inappropriate if the requirements in the definition of ``healthy'' precluded use of the claim for an entire category of foods that play an important role in the diet and that dietary guidelines recommend be included in a healthy diet. Thus, FDA concludes that the definition of ``healthy'' should permit use of the term on those seafood and game meats that can be used to assist consumers in constructing a diet consistent with dietary recommendations but that do not meet the ``low'' fat and ``low'' saturated fat criteria. Therefore, FDA is making provision in the definition of ``healthy'' for certain seafood and game meat products (Sec. 101.65(d)(3)). In arriving at a definition for ``healthy'' on seafood and game meats, the agency considered whether to limit the definition to raw, single ingredient seafood and game meats or to extend it to foods such as processed seafood and game meat products and multiple ingredient products. The agency took the latter approach in establishing definitions for the nutrient content claims ``lean'' and ``extra lean'' and provided for claims about the fat and saturated fat content of a product that could not meet the ``low fat'' and ``low saturated fat'' criteria. In the nutrient content claims final rule (58 FR 2302 at 2423), FDA adopted provisions permitting the ``lean'' and ``extra lean'' claim on nonflesh foods as well as flesh foods. (The agency notes, however, as fully discussed in the August 18, 1993, issue of the Federal Register (58 FR 44028) pursuant to that rulemaking, the agency has reconsidered both definitions and is now less certain than before that the definition for ``lean,'' and possibly ``extra lean,'' that it developed from data on flesh foods is appropriate for food products that do not contain flesh foods as ingredients. The agency will consider additional rulemaking to reexamine how the term ``lean'' and ``extra lean'' should apply to nonflesh foods.) With respect to ``healthy,'' however, because FDA believes that seafood and game meat products, whether individual foods, main dishes, or meals composed of more than one ingredient, can be formulated to be low in fat and low in saturated fat, it is not making special provision for formulated products. FDA finds that special provision is warranted only for raw, single ingredient seafood and game meats. The latter products do not have the advantage of being subject to reformulation to reduce the fat, saturated fat, and cholesterol levels inherently in these foods, yet they are recommended by the Surgeon General and the Food and Nutrition Board as foods to include in a healthy diet. Use of the ``healthy'' claim will highlight the foods in this category that are particularly useful in constructing a diet that is consistent with dietary recommendations. Finally, the agency agrees that precluding the use of ``healthy'' on raw, single ingredient seafood and game meats would likely confuse consumers, who would see the claim on USDA regulated products but not on comparable FDA regulated products that could be used interchangeably in a healthy diet. Thus, the agency has concluded that providing for use of the term ``healthy'' on the labels of raw, single ingredient seafood and game meat products would be of value to consumers in maintaining healthy dietary practices. Accordingly, FDA is revising its definition of ``healthy'' so that certain raw, single ingredient seafood and game meats may bear the claim. 27. Several comments recommended that FDA use USDA's proposed definition of ``healthy'' (i.e., the product contains less than 10 g of fat, less than 4 g saturated fat, less than 95 mg of cholesterol, and less than 480 mg sodium per 100 g and per reference amount to define when the term may be used on seafood and game meat products. One comment suggested that the fat limitation should be 5 g per 100 g. A similar comment suggested that products meeting the ``extra lean'' definition should be allowed to use the term ``healthy.'' These comments asserted that establishing criteria in the definition of ``healthy'' that would permit its use on lean seafood and game meats would provide uniformity among regulations governing competitive products (i.e., comparable products that are regulated by USDA and FDA). The comments argued that such a provision would avoid unfair competition in the marketplace, as well as provide alternative choices for foods that are recommended to be included in a healthy diet. In deciding to establish a definition for ``healthy'' on raw, single ingredient seafood and game meats, the agency carefully considered these comments. The agency recognizes that, because foods in this category inherently contain relatively high levels of fat, saturated fat, and cholesterol, and cannot meet the ``low fat'' and ``low saturated fat'' criteria, the definition of ``healthy'' for raw, single ingredient seafood and game meats will necessarily permit higher levels of fat and saturated fat in these foods than in other foods. However, the agency is not persuaded that the most appropriate approach is to adopt the definition proposed by USDA. The agency concludes that a more appropriate approach is to adopt criteria that will permit raw, single ingredient seafood and game meat products that meet the ``extra lean'' definition for fat, saturated fat, and cholesterol, and otherwise meet the definition of ``healthy'' that is established in this final rule for other individual foods, to bear the ``healthy'' claim. Such action is consistent with FDA's basic conclusion that foods labeled as ``healthy'' should be useful in assisting consumers in achieving a total diet consistent with dietary recommendations. Products meeting the ``extra lean'' criteria will better meet the goal of minimizing fat and saturated fat intake than products that meet the ``lean'' criteria. Accordingly, the agency is including the definition of ``healthy'' for raw, single ingredient seafood and game meats in Sec. 101.65(d)(3). Under this provision, raw, single ingredient fish and game meat that contain, per reference amount and per 100 g, less than 5 g of fat, less than 2 g of saturated fat, less than 95 mg of cholesterol, and otherwise meet the requirements established in this final rule, may bear the term ``healthy.'' FDA recognizes that the definition of ``healthy'' for raw, single ingredient seafood and game meats allows the claim to be used when the level of cholesterol in the food exceeds its disclosure level (i.e., 60 mg cholesterol per reference amount and per labeled serving). The agency considered whether to prohibit the claim when the product contained more than 60 mg cholesterol. However, the agency concluded that it would be of benefit to consumers to permit the claim on raw, single ingredient seafood and game meat products that have a cholesterol content exceeding the disclosure level because the claim identifies the foods in this category that are particularly useful to consumers in structuring diets consistent with dietary guidelines. When the cholesterol level in a food labeled ``healthy'' exceeds FDA's disclosure level, the food is subject to the requirement in Sec. 101.13(h) that requires a disclosure statement referring the consumer to the nutrition information panel for additional information about cholesterol content. III. Effective Date As discussed above, in response to comment 16, FDA is adopting May 8, 1994, as the effective date of this regulation to establish the definition of the term ``healthy.'' Section 403(r)(1)(A) of the act, which prohibits undefined nutrient content claims, is applicable May 8, 1994. Thus, FDA has determined that it is essential that the agency provide a definition for the term ``healthy'' that is effective on that date. If ``healthy'' were not defined by May 8, 1994, products currently on the market that bear the term and that are not ``grandfathered'' would be misbranded and subject to regulatory action. The agency also recognizes, however, that many of the products that are marketed with a ``healthy'' claim do not meet all of the requirements established in this final rule, and that because of the timeframes in which this final rule is being issued, will not have sufficient time to reformulate their products. The agency has no desire to cause the significant market disruption that would result from either not defining ``healthy'' or vigorous enforcement of the definition that FDA is adopting. Accordingly, the agency intends to exercise its enforcement discretion judiciously with respect to products that bear this term. Over the next 18 months, the agency is unlikely to object to products that currently bear ``healthy'' in their labeling, so long as their manufacturers are making good faith efforts to bring their products into compliance with Sec. 101.65(d) and their labeling is otherwise in full compliance with the law. The agency advises, however, that it expects that new products that come onto the market during this period will fully comply with the definition of ``healthy.'' The agency expects that by January 1, 1996, all products that bear the term ``healthy'' will comply fully with Sec. 101.65(d). The agency notes that the period between publication of this final rule and January 1, 1996, is comparable to the amount of time that manufacturers were given to comply with the requirement of the general principles final rule (58 FR 2302). The agency notes, however, that Sec. 101.65(d)(2), (d)(3), and (d)(4) will be in effect, and that it retains the right to take action on a ``healthy'' claim before January 1, 1996, if it concludes that the facts of the particular case warrant such action. With regard to the two-tier sodium requirement, before January 1, 1998, individual foods that contain more than 480 mg sodium per reference amount and per labeled serving, and main dish and meal products that contain more than 600 mg sodium per labeled serving, may not bear the ``healthy'' claim. After January 1, 1998, products bearing a ``healthy'' claim must comply with the 360 mg sodium per reference amount and per serving and 480 mg sodium per labeled serving requirement for individual foods and main dish and meal products, respectively. IV. Economic Impact FDA has examined the economic implications of the final rule on the definition of ``healthy'' as required by Executive Order 12866 and the Regulatory Flexibility Act (Pub. L. 96-354). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health, and safety effects; distributive impacts; and equity). The Regulatory Flexibility Act requires analyzing options for regulatory relief for small businesses. FDA finds that this final rule is not an economically significant rule as defined by Executive Order 12866. In accordance with the Regulatory Flexibility Act, the agency certifies that the final rule will not have a significant impact on a substantial number of small businesses. A. Regulatory Options 1. No Definition FDA could choose not to define the term ``healthy.'' However, in the general principles final rule, FDA determined that the term ``healthy'' is an implied nutrient content claim. If FDA does not define the term, its use in labeling except on those products using the claim in their brand name prior to October 29, 1989 or in a nonnutritional context, would misbrand the food. This option would result in large costs, including labeling costs, and a valuable signal used by consumers to alert them to foods that may assist them in meeting dietary goals would be lost. FDA could alternatively decide to propose to reverse its previous determination that the term ``healthy'' is an implied nutrient content claim. However, FDA could only make such an amendment if the agency was persuaded that its original determination was in error. FDA has received no information that would support such a conclusion. Further, such an action would require separate rulemaking and could not take effect until well after the May 8, 1994 deadline. Thus, until FDA published a final rule, this alternative would have the same impact as not defining the term ``healthy.'' 2. Different Definition of ``Healthy'' FDA could determine that an alternative definition of the term ``healthy'' would be appropriate. The major difference between the proposed rule and the final rule in the definition of ``healthy'' is in the prescribed levels of sodium. FDA originally proposed to set the allowable sodium levels at the disclosure levels for individual foods and meal-type products. However, as described earlier in this document, comments stated that the disclosure levels are too high and would result in ``healthy'' claims that are of little help to consumers trying to meet dietary goals. Alternatively, FDA could determine that ``healthy'' products must meet FDA's definition for ``low sodium'', and some comments suggested that approach. However, this option would result in significant costs because very few products now labeled as ``healthy'' would be able to make the claim. Also, comments indicated that the technology to reduce sodium levels to ``low sodium'' levels does not currently exist for many products because sodium functions as a protein binder, a preservative, and as flavoring. Such a reduction in sodium would cause most products to be unpalatable to consumers. B. Costs of the Final Regulation FDA believes that the costs of the final ``healthy'' regulation will not be substantial, as many products currently using the term already meet the definition, are very close to doing so, or can satisfactorily reformulate their product over the time period the agency is permitting for implementation of this regulation. There are at least 35 brands that include the term ``healthy'' in the brand name. FDA does not know how many products or labels are sold under these brands. Nor is FDA able to estimate the number of products with labels using the term ``healthy'' other than in the brand name. FDA has specific information, including nutrition information, on the products of four brands. Two of these brands do not include products regulated by FDA (i.e. all of the brands' products are regulated by USDA). The remaining two brands have approximately 44 FDA regulated products sold with ``healthy'' in the brand name. After examining the nutritient content of these foods, FDA has determined that at least 12 products will not meet FDA's interim definition of ``healthy,'' and that an additional 5 products will not meet the final definition of ``healthy.'' The primary disqualifier is the sodium content of the products. In addition, a few products do not meet the ``low fat'' requirement. The manufacturers of products not meeting the definition of ``healthy'' have three options for bringing their products into compliance: Reformulate the products to meet the definition, cease marketing the products, or relabel the product. 1. Reformulation Whether or not a firm will choose to reformulate their products will depend on the relative cost of reformulation compared to dropping the product, and on whether the product will continue to be palatable to consumers. FDA has very little information on the cost of reformulation, which will depend on the extent of reformulation that is necessary. Of the 17 products identified as not meeting the definition of ``healthy,'' FDA estimates that four have sodium contents so close to the defined level that these products can be easily modified. The cost of reformulating these products is expected to be small. However, the cost of reformulating several other products are expected to be higher because the current sodium or fat content significantly exceeds the defined amount, or because modifications are required in more than one nutrient (i.e. reductions in both fat and sodium content). The longer compliance period will allow firms extra time to develop the technology to reduce the sodium content of their foods and will provide consumers with time to adjust their tastes to lower sodium levels. 2. Loss of Brand Names/Products Some manufacturers might not be able to reformulate their products or may determine that the costs of reformulation are prohibitive. The manufacturers may choose to market their products under a different brand name. New resources must also be expended in marketing the product and in informing consumers that the product has a new name. A brand name is an intangible asset representing capital just as a tangible asset is capital. Brand names act as signals that help consumers identify quality differences and shop more efficiently. Manufacturers invest real resources in developing and maintaining their brand identities. One comment to the proposal stated that one particular firm had ``hundreds of millions of dollars invested in the [brand] name.'' In order to calculate the value of a brand name lost to certain products, FDA compared average selling prices for 44 products sold under a ``healthy'' brand with prices of other non-``healthy'' branded products within the same product class. The average premium earned by products with the word ``healthy'' in the brand name is $0.57 per 16 oz. equivalent unit (all products regardless of package size are converted to 16 oz. units). Multiplying by the average sales volume of the ``healthy'' brands leads to an annual cost per discontinued product of approximately $800,000. FDA acknowledges that it could be a cost to the individual manufacturers of products currently branded ``healthy'' if the brand names were, in fact, removed from the market. The loss of a brand name to the extent that it does not convey false or misleading information is a societal loss, as is the loss of any productive asset. FDA is unable to calculate how much of the consumer surplus (the difference in the market price and the price consumers are willing to pay for the product) is due to consumer misinformation about the nutritional profile of products that have borne the term ``healthy.'' Although most of these products are nutritionally labeled on the nutrition panel, some consumers use the term ``healthy'' as a signal to buy the product and do not read the information on the nutrition panel on the back of the product. For those individuals, existing consumer surplus would be reduced with the better information that will be provided under the consistent science-based definition, established by this final rule. 3. Relabeling Manufacturers of those products that make ``healthy'' claims on products that are not sold under ``healthy'' brand names may choose to relabel products without the claim when reformulation is either too costly or not technologically feasible. In its regulatory impact analysis of the final rules to amend the food labeling regulations (58 FR 2927, January 6, 1993), FDA determined an average printing and redesign cost per product of $2,200 for an 18-month compliance period, the compliance period applicable to those products not meeting the interim definition of ``healthy.'' Those products that meet the interim definition but not the final definition will have approximately 3\1/2\ years to comply. The relabeling cost applicable to the longer compliance period is significantly less per product, approaching zero, because more products will be able to incorporate mandated label changes with regularly scheduled changes. As stated previously, FDA has no information regarding the number of products that make ``healthy'' claims but do not use the term in the brand name. Therefore, FDA cannot determine how many products would be relabeled as a result of this regulation. C. Benefits of the Final Regulation In its cost-benefit for the food labeling regulations in January 1993, FDA noted many significant benefits of improved nutrition labeling--including decreased rates of cancer, coronary heart disease, obesity, hypertension, and allergic reactions to food. The agency concluded that, as consumers are given more informative labeling, uncertainty and ignorance concerning the nutritional values of the foods they eat will decrease, and many consumers will select more nutritious, healthier foods. The improved health status of Americans expected to result from those rules was estimated to range from $4.4 billion to $26.5 billion over the next 20 years. FDA believes that the use of the term ``healthy'' will contribute substantially to those benefits. ``Healthy'' is a powerful term for consumers who are trying to construct diets that fit within the dietary guidelines and is also important for food manufacturers who wish to market foods to those consumers interested in improving their diets. The agency believes that this definition of ``healthy'' will ensure that consumers wishing to meet the dietary guidelines with respect to fat, saturated fat, cholesterol, and sodium will be greatly helped in doing so, and it will provide food processors anxious to produce products that can be labeled ``healthy'' with established nutrient levels that they can formulate their products to achieve. As products labeled as being ``healthy'' in compliance with this final rule appear on the market, they will substantially contribute to the overall goal of improving the diet and health of Americans. Thus FDA believes that the primary benefit of this definition will accrue to consumers who select these products based on a desire to meet the dietary guidelines, particularly with respect to fat, saturated fat, cholesterol, and sodium. It is possible that some products that are currently marketed as ``healthy'' but that do not fit the definition, and thus are not useful in achieving dietary goals, will be removed from the market, thus increasing benefits. It is also possible that a small number of products that could assist some consumers in reducing their consumption of fat, saturated fat, sodium, or cholesterol will be unable to bear the claim ``healthy,'' thus potentially reducing benefits. Some products may be reformulated to meet the requirements for the claim but may lose sales from lack of consumer taste satisfaction. It is likely, however, given the selling power of the term ``healthy,'' that this rule will increase the number of products bearing the term ``healthy.'' With a set definition for the term ``healthy,'' firms will see the advantage of making products that can bear the ``healthy'' claim without the potential for either federal challenge or competition from products that are less helpful in meeting dietary goals but are also marketed as ``healthy.'' Currently, products marketed as ``healthy'' have dramatically different nutritional profiles. For example, two very similar frozen entrees produced by two ``healthy'' brands have sodium contents per serving of 400 mg and 770 mg. Under FDA's new definition, the lower sodium product will not have to compete with higher sodium products that claim to be ``healthy.'' In addition, in defining the term ``healthy,'' FDA is reducing information costs to consumers. With a set definition, consumers will be assured that the claim signals reliable information about the nutritional content of the product. FDA is unsure of the size of the benefit derived from the specific levels of sodium required in the definition of ``healthy.'' All consumers have some probability of a benefit from reducing sodium levels. FDA's definition of ``healthy'' is intended to assist in meeting dietary goals that are based on the Surgeon General's recommendation that all Americans reduce their sodium intake. The 1988 Surgeon General's Report on Nutrition and Health states: Although not all individuals are equally susceptible to the effects of sodium, several observations suggest that it would be prudent for most Americans to reduce sodium intake. These include the lack of a practical biological marker for individual sodium sensitivity, the benefit to persons whose blood pressures do rise with sodium intake, and the lack of harm from moderate sodium restriction. (Ref. 2, p. 13). D. Regulatory Flexibility FDA is unaware of small firms marketing their products as ``healthy.'' It is unlikely that this definition will have a significant effect on small firms. E. Summary FDA has examined the costs and the benefits of the final rule and has determined that it is not an economically significant rule as defined by Executive Order 12866. Although many products currently marketed as ``healthy'' will not meet the definition, many will require only minor reformulation. The remaining products requiring more significant modifications of nutrient content will either undergo more costly reformulation, be relabeled, or will no longer be sold. In addition FDA has determined that the benefits of the regulation derive from an incentive to food manufacturers to produce more ``healthy'' products and from improved information to consumers that facilitates selection of foods that help consumers meet dietary goals. V. Environmental Impact The agency has previously considered the environmental effects of the action being taken in this final rule. As announced in its nutrition labeling proposed rules published in the Federal Register of November 27, 1991 (56 FR 60366 et al.), the agency determined under 21 CFR 25.24(a)(8) and (a)(11) that these actions are of a type that do not individually or cumulatively have a significant effect on the human environment. Therefore, neither an environmental assessment nor an environmental impact statement is required. VI. References The following references have been placed on display in the Dockets Management Branch (HFA-305), Food and Drug Administration, rm. 1-23, 12420 Parklawn Dr., Rockville, MD 20857, and may be seen by interested persons between 9 a.m. and 4 p.m., Monday through Friday. 1. National Heart, Lung, and Blood Institute, NCEP, ``Report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents,'' DHHS, Public Health Service, National Institutes of Health, April 7, 1991. 2. ``The Surgeon General's Report on Nutrition and Health,'' DHHS, Public Health Service Publication No. 88-50210 (Government Printing Office Stock No. 017-001-00465-1), U.S. Government Printing Office, Washington DC, 1988. 3. Committee on the Nutrition Components of Food Labeling, Food and Nutrition Board, IOM, NAS, ``Nutrition Labeling, Issues and Directions for the 1990's,'' Washington, DC, National Academy Press, 1990. 4. Satchell, F.B., Division of Programs and Enforcement Policy (HFS-158), Center for Food Safety and Applied Nutrition, memorandum to file; (a) ``Nutrient Profiles of Individual Foods, Main Dishes and Meal Products that Currently Bear the Term `Healthy,''' August 30, 1993; (b) Modification of USDA's Nutrient Data Base for Standard Reference Release 9, ``Effects of Disclosure, `Low,' and Essential Nutrient Requirements on Individual Foods,'' August 2, 1993. 5. Committee on Diet and Health, Food and Nutrition Board, Commission on Life Sciences, National Research Council, NAS, ``Diet and Health: Implications for Reducing Chronic Disease Risk,'' National Academy Press, Washington DC, 1989. 6. DHHS, PHS, ``Healthy People 2000: National Health Promotion and Disease Prevention Objectives,'' DHHS (PHS) Publication No. 91- 50213, DHHS, Washington, DC, pp. 112, 113, 117, 118, 120-125, 1991. 7. Satchell, F.B., Division of Programs and Enforcement Policy (HFS-158), Center for Food Safety and Applied Nutrition, memorandum to file, ``Nutritional Data of Products with `Healthy' in the Brand Name,'' August 30, 1993. 8. Life Sciences Research Office, Federation of American Societies for Experimental Biology, ``Nutrition Monitoring in the United States. An Update Report on Nutrition Monitoring,'' chs. 3 and 4, prepared for DHHS, Government Printing Office, Washington, DC, 1989. List of Subjects in 21 CFR Part 101 Food labeling, Nutrition, Reporting and recordkeeping requirements. Therefore, under the Federal Food, Drug, and Cosmetic Act and under authority delegated to the Commissioner of Food and Drugs, 21 CFR part 101 is amended as follows: PART 101--FOOD LABELING 1. The authority citation for 21 CFR part 101 continues to read as follows: Authority: Secs. 4, 5, 6 of the Fair Packaging and Labeling Act (15 U.S.C. 1453, 1454, 1455); secs. 201, 301, 402, 403, 409, 701 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321, 331, 342, 343, 348, 371). 2. Section 101.65 is amended by adding new paragraphs (d)(2) through (d)(4) to read as follows: Sec. 101.65 Implied nutrient content claims and related label statements. * * * * * (d) * * * (2) The term ``healthy'' or any derivative of the term ``healthy,'' such as ``health,'' ``healthful,'' ``healthfully,'' ``healthfulness,'' ``healthier,'' ``healthiest,'' ``healthily,'' and ``healthiness'' may be used on the label or in labeling of a food, other than raw, single ingredient seafood or game meat products, main dish products as defined in Sec. 101.13(m), and meal products as defined in Sec. 101.13(l), as an implied nutrient content claim to denote foods that are useful in constructing a diet that is consistent with dietary recommendations provided that: (i) The food meets the definition of ``low'' for fat and saturated fat; (ii)(A) The food has a reference amount customarily consumed greater than 30 grams (g) or greater than 2 tablespoons and, before January 1, 1998, contains 480 milligrams (mg) sodium or less per reference amount customarily consumed, per labeled serving; or (B) The food has a reference amount customarily consumed of 30 g or less or 2 tablespoons or less and, before January 1, 1998, contains 480 mg sodium or less per 50 g (for dehydrated foods that must be reconstituted before typical consumption with water or a diluent containing an insignificant amount as defined in Sec. 101.9(f)(1), of all nutrients per reference amount customarily consumed, the per 50 g criterion refers to the ``as prepared'' form); (C)(1) The food has a reference amount customarily consumed greater than 30 g or greater than 2 tablespoons and, after January 1, 1998, contains 360 mg sodium or less per reference amount customarily consumed, per labeled serving; or (2) The food has a reference amount customarily consumed of 30 g or less or 2 tablespoons or less and, after January 1, 1998, contains 360 mg sodium or less per 50 g (for dehydrated foods that must be reconstituted before typical consumption with water or a diluent containing an insignificant amount as defined in Sec. 101.9(f)(1), of all nutrients per reference amount customarily consumed, the per 50 g criterion refers to the ``as prepared'' form); (iii) Cholesterol is not present at a level exceeding the disclosure level as described in Sec. 101.13(h); (iv) The food, other than a raw fruit or vegetable, contains at least 10 percent of the Reference Daily Intake (RDI) or Daily Reference Value (DRV) per reference amount customarily consumed, per labeled serving of vitamin A, vitamin C, calcium, iron, protein, or fiber; (v) Where compliance with paragraph (d)(2)(iv) of this section is based on a nutrient that has been added to the food, that fortification is in accordance with the policy on fortification of foods in Sec. 104.20 of this chapter; and (vi) The food complies with definitions and declaration requirements established in part 101 of this chapter for any specific nutrient content claim on the label or in labeling. (3) The term ``healthy'' or its derivatives may be used on the label or in labeling of raw, single ingredient seafood or game meat as an implied nutrient content claim provided that: (i) The food contains less than 5 g total fat, less than 2 g saturated fat, and less than 95 mg cholesterol per reference amount customarily consumed and per 100 g; (ii)(A) The food has a reference amount customarily consumed greater than 30 g or greater than 2 tablespoons and, before January 1, 1998, contains 480 mg sodium or less per reference amount customarily consumed, per labeled serving; or (B) The food has a reference amount customarily consumed of 30 g or less or 2 tablespoons or less and, before January 1, 1998, contains 480 mg sodium or less per 50 g (for dehydrated foods that must be reconstituted before typical consumption with water or a diluent containing an insignificant amount as defined in Sec. 101.9(f)(1), of all nutrients per reference amount customarily consumed, the per 50 g criterion refers to the ``as prepared'' form); (C)(1) The food has a reference amount customarily consumed greater than 30 g or greater than 2 tablespoons and, after January 1, 1998, contains 360 mg sodium or less per reference amount customarily consumed, per labeled serving; or (2) The food has a reference amount customarily consumed of 30 g or less or 2 tablespoons or less and, after January 1, 1998, contains 360 mg sodium or less per 50 g (for dehydrated foods that must be reconstituted before typical consumption with water or a diluent containing an insignificant amount as defined in Sec. 101.9(f)(1), of all nutrients per reference amount customarily consumed, the per 50 g criterion refers to the ``as prepared'' form); (iii) The food contains at least 10 percent of the RDI or DRV per reference amount customarily consumed, per labeled serving of vitamin A, vitamin C, calcium, iron, protein, or fiber; (iv) Where compliance with paragraph (d)(3)(iii) of this section is based on a nutrient that has been added to the food, that fortification is in accordance with the policy on fortification of foods in Sec. 104.20 of this chapter; and (v) The food complies with definitions and declaration requirements established in this part for any specific nutrient content claim on the label or in labeling. (4) The term ``healthy'' or its derivatives may be used on the label or in labeling of main dish products, as defined in Sec. 101.13(m), and meal products, as defined in Sec. 101.13(l) as an implied nutrient content claim provided that: (i) The food meets the definition of ``low'' for fat and saturated fat; (ii)(A) Before January 1, 1998, sodium is not present at a level exceeding 600 mg per labeled serving, or (B) After January 1, 1998, sodium is not present at a level exceeding 480 mg per labeled serving; (iii) Cholesterol is not present at a level exceeding 90 mg per labeled serving; (iv) The food contains at least 10 percent of the RDI or DRV per labeled serving of two (for main dish products) or three (for meal products) of the following nutrients--vitamin A, vitamin C, calcium, iron, protein, or fiber; (v) Where compliance with paragraph (d)(4)(iv) of this section is based on a nutrient that has been added to the food, that fortification is in accordance with the policy on fortification of foods in Sec. 104.20 of this chapter; and (vi) The food complies with definitions and declaration requirements established in this part for any specific nutrient content claim on the label or in labeling. Dated: April 29, 1994. David A. Kessler, Commissioner of Food and Drugs. Donna E. Shalala, Secretary of Health and Human Services. [FR Doc. 94-11145 Filed 5-5-94; 10:27 am] BILLING CODE 4160-01-P