Pizza prawns, chewing gum and bottled water all play an important role in our diet: foods that can be described as healthy.
The US Food and Drug Administration is currently revising its definition of healthy to reflect our changing understanding of nutrition science. The push fueled the debate over eating habits and what the new standard should say.
Frozen food manufacturers are looking for special rules for "mini-meals" and name small pizza prawns and dumplings as examples that are suitable.
Chewing gum and mineral water companies say they should not exclude the term just because their products do not provide nutrients.
The FDA updates its definition of "healthy" to reflect nutrition science. Currently, it refers to low-fat products, but there are questions about healthy fats – and now about sugar
Advocacy groups and health professionals also weigh and raise concerns about ingredients such as sugar.
Some say the word healthy is inherently misleading when applied to a single product rather than an overall diet.
"The problem is that being healthy is relative," said Bruce Y. Lee, professor of international health at Johns Hopkins. For example, it would not be healthy to rely on broccoli alone.
The federal standards for the use of the word "healthy" on labels were established in 1994 and set limits for total fat and cholesterol.
Susan Mayne, director of the FDA Food Labeling Division, said the definition reflects the decades-long understanding of nutrition and needs to be updated.
With the revision, she said that people can trust that the word "healthy" is science based, unlike many other terms on packages.
"This is one the federal authorities will stand behind," she said.
The government's dusty definition of healthy was put to the test at the end of 2015. At that time, the FDA child warned that the snack bars were too fatty for the use of this term. Kind pushed back and said the fat came from nuts.
Since the introduction of the rule more than two decades ago, nutrition experts have made a greater distinction between "good fats" found in nuts and "bad fats" such as trans fats in oils that are partially hydrogenated, an industrial process, The food produces a longer shelf life.
The relationship between dietary cholesterol and heart disease is also no longer clear.
Separate US dietary guidelines, updated every five years, put no limits on total fat or cholesterol. They also recommend avoiding trans fats and reducing saturated fats such as those found in meat and milk. But the relationship between saturated fats and heart disease is now being called into question.
Now the sugar has become a concern. Some health experts said that our fear of fat has led people to devour low-fat, high-sugar products.
The changing views reflect the pitfalls of nutrition science. Most food studies are based on connections between what people say they eat and their health, leaving the door open for erroneous conclusions. Holding on to cause-and-effect relationships is more difficult.
Therefore, the effort to redefine "healthy" calls for such a debate. After the FDA was launched in late 2016, the FDA received more than 1,140 public comments on the subject.
The next step is for the FDA to propose a new definition that would be subject to another round of public comment. The agency will not say when it expects to establish a definitive rule with the new definition.
HOW MOMMA used to do
"Healthy" was once just another generic term for marketing, like "healthy" or "made like mom," said Xaq Frohlich, a professor of food history at Auburn University.
After a growing number of health claims and disease claims, the FDA has laid down ground rules for the word.
"The reason why" healthy "attention gets noticed is that a lot of the American public really wants their food to be healthy," Frohlich said.
Apart from the regulatory definition, what people consider healthy varies. Notable tribes of today include: paleo supporters, gluten-free, organic and vegan diets. Some of her views are reflected in comments to the FDA last year.
The Sierra Club wants to exclude "healthy" foods made with genetically modified and artificial ingredients. The National Pasta Association wants the option of calling gluten-free pasta healthy. At the moment it is said that some gluten-free pasta shy away from the need for nutrients.
In addition to limiting fat and cholesterol, the current standard requires the presence of a nutrient such as calcium, fiber, iron or vitamin C. One reason why companies say bottled water and sugarless chewing gum wrongly excludes the term.
Richard Mann, a lawyer with the International Chewing Gum Association, said sugar-free chewing gum does not have any of the nutrients that people are supposed to limit.
"It has no fat, it has no sugar, it has practically no calories," he said.
Some ask if an updated definition makes a difference. The American Academy of Pediatrics says businesses will likely only reformulate snacks to comply with the new rules.
Companies may have an additional incentive to do so: the FDA is also considering a symbol that would make it easier for people to identify products that meet the new definition.