Clean Labels vs Health

Originally Published: October 3, 2019
Last Updated: February 4, 2021
This feature image is a charicature of dairy products with a focus on nutrition facts.l

In evaluating clean labels vs health, dietary recommendations for clean eating are consumer-driven and not backed by science, according to Joanne Slavin, Ph.D., RD, Professor, Department of Food Science and Nutrition, University of Minnesota. Slavin’s presentation was titled: “Do Clean Labels Have Unintended Health Consequences?”

Clean labels are not based on decades of nutritional recommendations, which haven’t changed a great deal since first articulated in 1894 with a focus on protein and calories.

Enrichment of foods, such as vitamin A and D in reduced-fat milk or dairy-alternatives, is needed to help consumers meet recommended levels of intake of these nutrients. However, their listing on labels as “vitamin A palmitate” and “vitamin D3” may be viewed as chemicals and not acceptable when clean label “rules” are followed.

The Dietary Guidelines for Americans (DGA) have been published since 1980 and are developed by experts on the Dietary Guidelines Advisory Committees (DGAC). The U.S. Department of Health and Human Services, as well as the department of Agriculture, jointly publish the DGA every five years to provide evidence-based recommendations to promote health, prevent chronic disease and maintain healthy weight. The DGA are important, as they form the basis of federal nutrition policy and programs; help guide health promotion and disease prevention initiatives; and inform various organizations and industries. However, Slavin noted that some recommendations “are unrealistic, difficult to communicate to consumers and promote a ‘hit list’ of dietary components associated with disease.”

Slavin asked: “What is a clean label?” In his 2008 book In Defense of Food, journalist and activist Michael Pollan stated that consumers should “not eat anything with more than five ingredients or ingredients you can’t pronounce.” In 2014, one international ingredient vendor offered that “a clean label means the product can be positioned as natural, organic and/or free from additives/ preservatives.” These definitions stress use of ingredients accepted by consumers. The ingredient list should be short, simple and feature minimally processed ingredients where possible.

In the pursuit of clean label, the ultra-processing of foods has been demonized by some. Ultra-processed has been defined as “made from processed substances extracted or refined from whole foods… with little or no whole foods. Products include burgers, frozen pizza and pasta dishes, nuggets and sticks, crisps, biscuits, confectionery, cereal bars, carbonated and other sugared drinks, and various snack products.” Ultra-processed foods are associated with for profit, big food and drink companies.

NOVA food classification, proposed by World Public Health Nutrition Association, is a four-tiered classification system ordered according to the extent of processing rather than nutrient content. NOVA Category 4, ultra-processed foods, includes industrial formulations with many ingredients, usually. “Although public health advice of NOVA is that ultra-processed foods—with an emphasis on fat, sugar and salt—should be avoided to achieve improvements in nutrient intakes,” noted Slavin, “disease links between intakes of ultra-processed foods and health are lacking.”

There are nutritional and health challenges to clean eating, including Orthorexia Nervosa—a condition coined by Steven Bratman, M.D. in an essay published in the October 1997 issue of Yoga Journal. “Orthorexia Nervosa is defined as a fixation on the virtue of food or an unhealthy obsession with healthy eating,” in which people feel a sense of satisfaction and control with extremely restricted and ordered healthy eating.

“Required vitamins and minerals for enrichment cannot meet rules of clean label, as many view these as chemicals. Intakes of nutrients of concern—fiber, potassium, calcium and vitamin D—will only get worse by clean label ‘rules,’” explained Slavin. She provided the example of protein quality for plant-based ingredients, such as soy, which has improved digestibility and absorption due to processing. The same is true for the addition of healthy ingredients—whole grains, vegetables, fruits, pulses—as well as the removal of added sugar, sodium, and saturated and trans fats in some processed foods.

Slavin concluded that the movement to greater support for plant-based diets over nutrient intake will continue. Ultraprocessing is the new villain associated with a distrust of food technology as the solution for nutrition problems—even if that technology solves issues. She stressed, “It is critical to have those skilled in food technology and production on scientific panels that determine nutrition policy.”

“Do Clean Labels Have Unintended Health Consequences,” Joanne Slavin, Ph.D., RD, Professor, Department of Food Science and Nutrition, University of Minnesota

This presentation was given at the 2019 Clean Label Conference. To download presentations from this event, go to

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