You’d think a nutritionist would know the correct usage of healthy vs healthful. Not so. At a recent nutrition educational meeting at the AMA, the nutritionist used the words interchangeably: healthful eating or healthy behavior. That’s a head-scratcher for me. I was hoping for clarification after a stinging rebuke—(I have been accused of being dramatic)—when my editing of healthy behavior to healthful behavior in a commentary had been reversed.

Shaken, I turned to the dictionary to confirm my position and found, as I thought, that healthful promotes health and healthy represents the state of good health. Yet, my editor’s complaint was that healthful seemed unnecessary. My attempts at persuasion fell short, so I had hoped the nutritionist’s discussion would help me gain my equilibrium.

Realizing her discussion placed her in my boat, I decided to see what the authorities who address it had to say.

Fowler’s Modern English Usage¹ notes that the distaste for the use of healthful is particular to the United States, a “problem that hardly arises in Britain.” Comparing 3 dictionaries for non-English speakers, Editor R. W. Burchfield observes that one calls its use “old fashioned or literary”; a second, “formal.” The third omits it.

Webster’s Dictionary of English Usage² says the confusion has existed since the 16th century and claims that the distinction between the terms was created as recently as 1881 by Alfred Ayers. Webster’s concludes that those who “observe the distinction between healthful and healthy … are absolutely correct, and in the minority.” Those who “ignore the distinction … are absolutely correct, and in the majority.”

The Chicago Manual³ hedges by making the distinction between the 2 words, but admits “But gradually healthy is taking over.”

As usual, it doesn’t really matter. But what should one do when making it an adverb? Healthfully or healthily? Hmmm.—Beverly Stewart, MSJ

1. Burchfield RW. Fowler’s Modern English Usage. 3rd rev ed. New York, NY: Oxford University Press; 2004.

2. Webster’s Dictionary of English Usage. Springfield, MA: Merriam-Webster Inc.

3. The Chicago Manual of Style. 16th ed. Chicago, IL: University of Chicago Press; 2010.