Information that consumers get on food packaging needs to be clear, brief and supported by science, attendees at a public meeting told Food and Drug Administration officials Thursday.

FDA held the meeting to gather input on its Nutrition Innovation Strategy, announced in March, which addresses nutrition claims such as whether a food is “healthy”; ingredient labels; the Nutrition Facts label and menu labeling; and reducing sodium.

“Leveraging nutrition to advance public health is one of my top priorities,” FDA Commissioner Scott Gottlieb told the audience gathered in Rockville, Md., for the all-day meeting.

One of the major topics was how to define milk. 

Gottlieb brought up the controversial subject, joking about his comment last week that almonds don’t lactate, which he made while discussing whether almond and other alternative “milk” products should be labeled as such.

FDA rules define milk as “the lacteal secretion, practically free from colostrum, obtained by the complete milking of one or more healthy cows.”

“I’m done now talking about the physical attributes of almonds,” he said to laughs. “I’ll just say they taste very good.”

But he wasn't done discussing the the milk topic. FDA released a statement from Gottlieb shortly after he left the meeting in which he said FDA would be looking closely at the use of “milk” on plant-based products such as almond milk and soy milk.

“Many of these plant-based foods use traditional dairy terms (e.g., milk, yogurt, cheese) in the name of the product,” Gottlieb said. “For instance, we’ve seen a proliferation of products made from soy, almond or rice calling themselves milk. However, these alternative products are not the food that has been standardized under the name ‘milk’ and which has been known to the American public as ‘milk’ long before the 1938 Federal Food, Drug, and Cosmetic Act was established. In addition, some of these products can vary widely in their nutritional content – for instance, in relation to inherent protein or in added vitamin content – when compared to traditional milk.”

Dairy groups at the meeting urged FDA to take action on the plant-based products’ claims, saying that consumers are confused by the labeling, with some thinking that they contain cow’s milk.

And Joe Reardon, assistant commissioner of the Consumer Protection Division of the North Carolina Department of Agriculture, said that “plant-based beverages do not meet the definition of milk – it’s that simple.” If the word “milk” is on the label, he said – echoing Gottlieb – the milk inside should be from a cow.

Shannon Campagna, a lawyer with Alston & Bird representing the Plant Based Foods Association, said consumers are sophisticated enough to know the difference between plant-based products and dairy milk, and cited a survey showing that 78 percent of cow’s milk drinkers believe “milk” is the right term for the plant-based products.

Meanwhile, attendees generally agreed that in order to call a food product “healthy,” FDA should analyze the claim in the context of a person’s overall diet, using the Dietary Guidelines for Americans (DGA) as a benchmark.

“Any claims need to be in line with the (2015) Dietary Guidelines,” said Jeannie Blankenship, vice president of policy initiatives and advocacy for the Academy of Nutrition and Dietetics.

FDA is in the process of developing a proposed rule on how foods can be labeled “healthy.”

One possibility being looked at – which received vocal support at the meeting – is to have an icon on the package represent whether a food is healthy.

“Consumers are confused about what is healthy,” said Harvard professor Anne Thorndike, representing the American Heart Association. “A standard 'healthy' icon will not only help consumers more easily identify those products but also encourage the food industry to make a wider variety of healthy options available.”

Kristi Reimers, a director at ConAgra Foods, urged FDA to finish writing its definition of “healthy” before launching an icon. She agreed that claims need to be made in the context of the DGA recommendations.

The Grocery Manufacturers Association, represented by Kristen Scott, director of health and nutrition policy, urged FDA to survey consumers on icons “to ensure they understand the icon’s meaning and trust that it provides useful information.”

Scott also said that a “healthy” definition that is “based on both nutrients and food groups has the potential to spur innovation and provide broader access to foods aligned with healthier dietary patterns.”

Laura MacCleery, policy director of the Center for Science in the Public Interest, pushed back against Gottlieb’s comment that food companies wait too long to get FDA approval for their health claims and that this impedes innovation.

But MacCleery said the problem is not a lack of claims on products, but that so many claims are meaningless and, as a whole, misleading or deceptive.

“We would therefore urge FDA to review the most frequently employed deceptive labeling claims with implications for public health, including ‘made with’ and ‘contains real fruit’ claims, the use of misleading images of whole fruits and vegetables when only minuscule amounts are in a serving, the use of misleading titles for categories of foods that are unhealthy or are minimally nutritious foods (i.e., ‘Veggie Sticks,’ ‘Fruit Snacks’), and so on,” according to the PowerPoint that accompanied a presentation she gave at the start of the meeting.

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