Just over a year ago, KIND, a company I have long admired, with products my family has long enjoyed, received a reprimand of sorts from the FDA. The company was informed in a warning letter that their use of the word "healthy" on some of their product packaging was in violation of regulations, and thus inappropriate.
What a difference a year makes. FDA has now rescinded the warning, reversing their stance on the very statement the agency took issue with 13 months ago. FDA has concluded that use of "healthy" by KIND is permitted and appropriate after all, and that it's own, outdated regulations are what's inappropriate. They are quite right, and I applaud them. Saying mea culpa is hard enough for any of us, let alone a federal agency.
I was quite convinced that KIND was right. As noted, my family and I have long enjoyed KIND bars, including varieties caught up in the exchange with FDA. With all due respect to the agency, where I have many friends and colleagues, my own standards of "healthy" food are notoriously fussy, and reliably higher than theirs. The KIND bars in question met my criteria.
By way of reminder, the FDA concern about the bars pertained to their fat content. FDA regulations evolve at the speed of government, and so those currently on the books originated decades ago. Our thinking about dietary fat has certainly moved on since then, although the FDA regulations don't necessarily reflect enlightened thinking even from those days. Even at the peak of our preoccupation with dietary fat, most experts understood that almonds, walnuts, and avocado were not the problem. The regulations with which FDA is currently encumbered would preclude calling those foods, or a filet of wild salmon, "healthy" because of their content of total fat, saturated fat, or both.
That, then, was the basis for the rebuke to KIND. The bars exceeded specific threshold values for total or saturated fat. That fat, however, was coming almost entirely from wholesome, whole food sources, notably almonds.
The problem with such a stipulation is self-evident, but becomes even more so when the Dietary Guidelines for Americans are brought into the mix. The 2015 Dietary Guidelines for Americans, the far better 2015 Dietary Guidelines Advisory Committee Report, and for that matter the corresponding efforts back in 2010, all explicitly recommend routine intake of nuts and seeds in support of health, as well they should based on expansive evidence. So we had clearly maneuvered ourselves into a paradox of public health nutrition: eat nuts to be healthy, but don't call a product healthy ("healthful," actually, but let's agree to leave Strunk and White out of it) if it is made mostly of those very nuts, and thus delivers the fat they contain. The public is confused enough about good nutrition without that sort of help!
This obviously made no sense, and KIND might have decided to argue with the FDA. But, characteristically, they did a far kinder, and more constructive thing: they conferred, and collaborated.
I say characteristically not just because the company motto is "do the kind thing," but because I know this company and its leadership well. The CEO, Daniel Lubetzky, and I have been friends for many years, and I can say from that intimate vantage point that he is a man of laudable integrity. Even while running KIND, Daniel has continued to run a non-profit and invest in other philanthropic efforts to advance understanding, and peace, across cultures and around the world.
As for the company, which has been recognized as a paragon of corporate responsibility, I have seen its commitment to the kind thing, and public health, up close. Before serving as the company's Senior Nutrition Advisor for the past year, my lab had run two studies funded by KIND. Ironically, the research I proposed -- and which they agreed to fund -- had much to do with the nutrient composition of nuts.
Research has long suggested that nuts, though high in calories, are exceptionally satiating, meaning they help us feel, and stay full. In principle, if the ratio of satiety to calories is high enough, even very high-calorie foods could help control appetite and weight, and there is some evidence to support exactly that. I wanted to know if KIND bars, made principally of nuts and fruit, offered that same advantage. The idea they might do so actually originated with a parental admonition we all recall from childhood: don't snack between meals, it will spoil your appetite!
These days, snacks are implicated in epidemic obesity. I have long wondered how something that "spoils" appetite by suppressing it, could cause obesity. The answer almost certainly is: it can't. The snacks that contribute to obesity don't really suppress appetite, they stoke it. Snacks have changed since the days of our mothers' wagging fingers. I wondered if a return to wholesome snacks might indeed help with appetite control, and our studies (2011 ; 2015) addressed that issue.
KIND was thus armed with strong arguments against the FDA decision from the start, but as noted, decided not to argue. We worked together on what's called a Citizen's Petition, making the case to the FDA that the products in question were indeed "healthy," and that the word pertained to the food, not to a nutrient value. That petition was circulated to leading and diverse experts in nutrition for input and comments, and subsequently, their support. KIND thus played the role of messenger, but the message came from some very prominent nutrition authorities.
FDA, for its part, was no less committed to dialogue. One might think a large federal agency would simply say, "the rules are the rules," but they did nothing of the sort. They listened, they reacted, they met with us, and they clearly reflected. The entire process was a great credit to both parties, and to their shared commitment to get it right for the sake of the shopping public, and public health.
In my view, they did just that. Of course, the reversal with regard to KIND is just the first step. The ultimate remedy for this predicament is a comprehensive update of those obviously antiquated FDA regulations. I am confident the agency is committed to just that, but it's a process that will inevitably take time, maybe even years. We will have to content ourselves for the moment in knowing that the game is afoot.
As a side note, it will not be enough for those updates to allow for "healthy" in the case of almonds, and walnuts, and flaxseeds. They must also close loopholes that allow for the application of "healthy" to low-fat junk foods. Believe it or not, those FDA regulations about what constitutes "healthy" do not address added sugar, and they certainly should.
While waiting on the world to change, you can take matters into your own hands by cultivating your own food label literacy. In the free, proven program my lab developed, we emphasize a short list of ingredients, and entries that belong. KIND talks about ingredients you can "see and pronounce," and I would add, in a bow to Michael Pollan, recognize as actual food. Those criteria line up well, and are a good place to start.
There is more to be done, but the FDA response to KIND, and their commitment to reevaluate the regulatory definition of "healthy" in light of current evidence and understanding, is meaningful progress, and full of promise for more. The discourse was kind all around, and the result of that dialogue -- genuinely healthy.
-fin
Director, Yale University Prevention Research Center; Griffin Hospital
President, American College of Lifestyle Medicine
Senior Medical Advisor, Verywell.com
Founder, The True Health Initiative
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