How Americans Define Health for Food and Beverages

OBJECTIVES: To assess how American adults consider and define healthfulness of food and beverages. METHODS: In Fall 2021, a national sample of 1,878 adults balanced by age (18–34 years, 35–49, 50–64, 65+), sex, race/ethnicity (Non-Hispanic White, Hispanic/Latinx, Non-Hispanic Black, Asian/other), and annual income, completed an online survey asking about demographics and priorities for food businesses and product purchases, including select-all and agreement rated items on definitions of healthfulness for food and beverages. Pearson's r and Jaccard Index were used to assess correlation (PCC) and choice similarity, respectively. RESULTS: Among 12 definitions of healthfulness, respondents most commonly chose nutritionally balanced (67%); all natural (56%); supports health outcomes (55%); and full of vitamins and minerals (52%); followed by organic (41%); safe to eat (41%); specific nutrient profile (38%); locally grown/culturally relevant (27%); supports weight loss (25%); non-GMO (23%); aids athletic/physical performance (16%); popular diet (13%). These perceptions varied by race/ethnicity and age. Nutritionally balanced was selected by 78% of Asian/other adults and 82% of 65 + y adults, vs. White (69%), Black (64%), or Hispanic/Latinx (61%) adults; or 50–65 y (75%), 35–49 y (59%), 18–34 y (57%). Findings were more similar by income. PCC was highest for nutritionally balanced and: full of vitamins (0.81); supports health outcomes (0.80); and all natural (0.76). Jaccard similarity was < 0.55 for all definition pairs except organic and safe to eat (0.99). CONCLUSIONS: In a large, diverse national sample of US adults, consumers most defined healthfulness of food and beverages as nutritionally balanced, all natural, or supports health outcomes. Organic, supports weight loss, and non-GMO were much less reported as definitions of product healthfulness. No single definition was selected by >2/3of US adults; and combined with low Jaccard values, suggests a lack of consensus on simple definitions of healthfulness. Concepts were prioritized differently by age and race/ethnicity, but much less by income. These novel findings have implications for health communications, education, and guidance aimed at reducing consumer confusion about healthier food and beverage choices. FUNDING SOURCES: Vail Innovative Global Research; NIFA National Needs Fellowship.