Food and Behaviour Research

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Position of the academy of nutrition and dietetics: total diet approach to healthy eating

Freeland-Graves JH, Nitzke S. (2013) J Acad Nutr Diet. 113(2) 307-17. doi: 10.1016/j.jand.2012.12.013. 

Web URL: View this and related abstracts via PubMed here


It is the position of the Academy of Nutrition and Dietetics that the total diet or overall pattern of food eaten is the most important focus of healthy eating.

All foods can fit within this pattern if consumed in moderation with appropriate portion size and combined with physical activity.

The Academy strives to communicate healthy eating messages that emphasize a balance of food and beverages within energy needs, rather than any one food or meal.

Public policies and dietary patterns that support the total diet approach include the 2010 Dietary Guidelines for Americans, DASH (Dietary Approaches to Stop Hypertension) Diet, MyPlate, Let's Move, Nutrition Facts labels, Healthy People 2020, and the Dietary Reference Intakes.

In contrast to the total diet approach, classification of specific foods as good or bad is overly simplistic and can foster unhealthy eating behaviors. Alternative approaches are necessary in some situations. Eating practices are dynamic and influenced by many factors, including taste and food preferences, weight concerns, physiology, time and convenience, environment, abundance of foods, economics, media/marketing, perceived product safety, culture, and attitudes/beliefs.

To increase the effectiveness of nutrition education in promoting sensible food choices, skilled food and nutrition practitioners utilize appropriate behavioral theory and evidence-based strategies.

Focusing on variety, moderation, and proportionality in the context of a healthy lifestyle, rather than targeting specific nutrients or foods, can help reduce consumer confusion and prevent unnecessary reliance on supplements. Proactive, empowering, and practical messages that emphasize the total diet approach promote positive lifestyle changes.


See the accompanying news article: Is the “there is no such thing as bad foods, only bad diets” argument helpful?  in which Professor Marion Nestle of New York University points out very clearly

1) that the main beneficiaries of such statements are the 'junk food' companies

2) that the US Academy of Nutrition and Dietetics receives generous sponsorship from the food industry.

Conflicts of interest - and food industry influence on supposed 'public health advice' on healthy eating - are hardly new (see the article on who really built the 'Food Pyramids' by the Harvard Scool of Public Health).

But while these continue, it seems unlikely that much progress will be made in reducing the huge and increasing burden of diet-related illnesses (physical and mental) that have already brought the US, UK and many other countries to crisis point.