A granola bar enthusiast walks into a grocery store, scouting for a healthy treat. The first shelf is lined with KIND Bars, with wrappers flaunting things like "five super grains" and zero genetically engineered ingredients. Below sit boxes of Quaker Chewy bars, 100-calorie oat snacks spotted with marshmallows and chocolate chips. Finally, there's Annie's Homegrown granola bars, gluten-free and "made with goodness."

So which product should a health-conscious snack fanatic chose? According to a new survey by the American Heart Association and the International Food Information Council Foundation, they're probably a little stuck.

The report found 95 percent of shoppers at least sometimes seek healthy options when grocery shopping. And yet, only a little over a quarter said they find it easy to determine which products are good for them and which should stay on the shelves.

"There is a lot of competing information out in the food landscape," says Alexandra Lewin-Zwerdling, vice president of research and partnerships at the International Food Information Council, who worked on the report. Shoppers are heading into the supermarket with advice from fitness professionals, nutrition bloggers, scientific studies and social media ringing in their ears.

"This kind of sea of information causes conflict and doubt," says Lewin-Zwerdling. A survey last year by the IFIC found 59 percent of respondents were somewhat or strongly confused by conflicting health advice.

Marketing claims can add to the confusion, says Jo Ann Carson, a professor of clinical nutrition at the University of Texas Southwestern Medical Center and past chair of the American Heart Association's nutrition committee. She points to a banana she saw marketed as having "no cholesterol."

"Well, no bananas have cholesterol," Carson says.

The new survey found that once inside the grocery store, shoppers rely on labeling to determine whether a product is healthy. Most gravitate toward the Nutrition Facts panel and the ingredients list. Some turn to environmentally minded and socially conscious icons, such as those that denote whether the item in their cart is grass-fed, fair trade or even bird friendly. Other symbols act as stamps of approval from organizations like the Non-GMO Project and the American Heart Association. Walmart has its own bright green "Great For You" label, which the company attaches to some of its healthier offerings.

"You name it, there's a symbol for it," says Lewin-Zwerdling. But, she says, customers risk being bombarded with too many niche icons on their packaging. "Consumers are looking for a simple way to know if a product is healthy."

The Food and Drug Administration is considering throwing one more symbol into the mix to try to clear things up. The agency announced last June that it is contemplating designing an icon to place on healthy foods, similar to the symbol the U.S. Department of Agriculture uses for organic products.

Lewin-Zwerdling says the study by the IFIC and AHA found a clear appetite among shoppers for this kind of simplified icon. Over half of the 1,017 U.S. grocery shoppers who participated in the study said they wanted a symbol that clearly indicates whether a food product is healthy.

However, she notes that there's no clear time frame for when a "healthy icon" might be unveiled by the FDA or what it might look like. The agency is in the process of redefining what food products can claim to be healthy. The FDA's current criteria, last updated in the 1990s, uses a strictly low-fat definition of the word "healthy" — which means foods like avocados and almonds, rich in healthful fats, don't fit the bill.

Some food labeling experts have cautioned against creating too simple a binary distinction between healthy foods and unhealthy ones.

Charlotte Vallaeys monitors food labels as a senior policy analyst for Consumer Reports. She has seen health-conscious customers stumble over confusing or misleading branding and conflicting research. She notes that some products are certified organic by the U.S. Department of Agriculture, while others are marketed with the word "natural" splashed across the label.

"How are [consumers] supposed to know that 'organic' is backed by almost 100 pages of federal regulations and 'natural' doesn't have any?" Vallaeys says.

Still, Vallaeys warns, slapping a "healthy" symbol on food products goes against the direction nutritionists are heading.

"Nutrition experts now are shifting away from focusing on individual foods and individual nutrients, and they're really focusing more on healthy eating patterns," she says. "That's something you really can't distill into a single food."

Plus, she says, the public may be confused about what foods are healthy, but the basics aren't changing.

"Eat lots of fruits and vegetables and whole grains," she says. "We've heard it all before. It's not new."

Copyright 2019 NPR. To see more, visit https://www.npr.org.

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