'Healthy' foods have most of us confused, survey finds

— "The low recognition of the importance of healthy fats is disappointing," Mozaffarian said.

Older respondents were also more likely to label saturated fats as unhealthy, which most experts agree is correct, according to the survey.

The spread of conflicting information and even misinformation might be playing a role in America's obesity epidemic, said Dr. Roxanne Sukol, preventive medicine specialist at the Wellness Institute at Cleveland Clinic, who was not involved in the new survey. She did not find the survey results to be surprising.

"Two-thirds of us are overweight or obese," Sukol said.

"Fifty percent of Americans have either diabetes or prediabetes by age 65 now," she said, referencing data from the US Centers for Disease Control and Prevention (PDF). "That means that whatever we're doing, it's really not working. So it's proof that yes, in fact, people are confused. They're not making choices that benefit their health, and it's not because they're not trying."

As with any survey, there are limitations, and all of the data in this survey came from self-reports, Sanders said.

"We're limited because we can't really examine how people are behaving; we just know how they say they're behaving. So that is one limitation with any self-reported survey," she said. However, Sanders added that since this survey is conducted annually, the data allow trends to emerge.

"Our biggest trend over time has to do with purchasing factors, and we know that taste and price have always been the top two factors that have driven purchasing, with healthfulness following behind in the third spot," Sanders said. "In terms of what is healthy, we know that it doesn't always beat out what tastes the best or what has the best price, in terms of impacting a food purchase."

Why 'healthy' can be confusing

" 'Healthy' is a term that's at the core of so many of our conversations around food, but there's still a lot of debate about what is healthy, and we see this around the FDA's recent efforts to update guidelines for the term 'healthy' and its use in food labeling," Sanders said.

Last year, the US Food and Drug Administration launched a public process to redefine what the word "healthy" means when it's used on food labels.

For a food product to be marketed as healthy, it should have low levels of total and saturated fat, sodium and cholesterol, and have at least 10% of the daily requirements for vitamins, fiber and other nutrients, according to the FDA's current criteria (PDF).

The Cleveland Clinic's Sukol thinks the word "healthy" is confusing and should be replaced with the term "nourishing," as some processed foods have been marketed as "healthy."

"The big problem is that we've been told that we can nourish ourselves with these ultraprocessed foods, and we cannot. They don't nourish us. That's why I believe that obesity is (at least in part) a malnourished state, as opposed to the standard message being propagated in our society, which is that obesity is an overindulged state," Sukol said. "But if that were true, then diets would work."