Using health claims on foods in the European Union and the United States for more than two decades did not have a noticeable positive impact on public health and neither on the innovation or sales of such food products. The objective was to assess the reasons for this limited impact using a narrative review approach. Consumers assess the value of health claims on foods case-by-case in a way that can be explored with the opportunity, ability, and motivation framework. Perceived relevance of a health claim seems to be an important motivational factor in consumer responses. Thus, targeted marketing of foods with health claims should be applied specifically to those consumers for which the claimed benefit is relevant. Language for the health claim should be used that is reflective for the scientific substantiation as well as credible and clearly understood by the target consumer. The food should be a credible carrier for the claimed benefit, and not be compromised on taste and other sensory properties. Finally, consumers should be made more aware of what health claims are, and what they are not, in relation to healthy eating. With these adaptations the use and impact of health claims may become more effective.