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The Total Diet Approach

From the Global Stevia Institute: Spotlight on The Total Diet Approach, the latest position paper from the Academy of Nutrition and Dietetics

How prioritizing the overall diet may help focus healthy eating messages.

A person’s overall eating pattern is more important for a healthy diet approach than focusing on “good” or “bad” foods, according to a new position paper from the American Academy of Nutrition and Dietetics. The oversimplification of nutrition messages, classifying dietary choices as good or bad, may even discourage people from making healthier choices, concludes the Academy.The total diet approach suggests that a broad range of foods and beverages can meet nutrient needs over time. It also recognizes that individual choices are dynamic and may be based on a variety of factors, including taste preference, culture, and health status. The Global Stevia Institute has touched upon several of the paper’s key messages including, moderation and balance and how small steps can encourage people to follow a healthful diet. Stevia, a natural origin no calorie sweetener, can help people enjoy sweetness, without the calories and fits into an overall healthful diet and lifestyle approach.

The Total Diet Approach

The total diet or eating pattern is defined as the combination of foods and beverages that provide energy and nutrients, and constitute an individual’s complete dietary intake over time (1). This approach is built upon overall eating patterns, which provide health benefits and adequate nutrients within energy needs. In the “Total Diet Approach to Healthy Eating”, the Academy asserts that “all foods can fit within this pattern if consumed in moderation with appropriate portion size and when combined with physical activity.” The paper also highlights the roles of nutrient dense foods and energy dense foods in a balanced diet. Nutrient density is a comparison of key nutrients in a food or beverage compared to its calorie content (2). Energy density, also known as calorie density, refers to the amount of energy (in calories) a food contains per gram or serving.

The Consequences of “Good vs. Bad”

Studies show that Americans are aware of the importance of healthy diets and physical activity, yet most people do not meet recommendations that have been consistently communicated over the years. For example, 68% of people do not eat more than two servings of fruit daily and 74% of people do not eat more than two servings of vegetables daily—falling far short of the nine servings recommended per day (when maintaining a 2000 calorie diet) (4). In this environment, the Academy suggests that labeling foods as “good foods” and “bad foods” is inconsistent with the total diet approach and may lead to people giving up efforts to improve their diets. In a 2011 survey, 82% of American adults recognized that not wanting to give up foods they like as a reason for not eating more healthfully (5).

The oversimplification of nutrition messages, especially when foods are presented negatively or in exaggerated distinctions of good and bad, can hinder the adoption of healthy dietary patterns and may also lead to overall rejection of nutritional guidance and unhealthy eating behaviors. Furthermore, the oversimplification may promote dichotomous thinking about food choices as people judge foods with a good versus bad or all or none approach that is unsustainable over time. This type of thinking can often be seen in “magic bullet” dieting methods. The quick fix approach to weight control often fails over time due to its restrictive all or none approach. When on the diet, the person feels in control of their choices and accomplished, but when they encounter a tempting food, loss of control can occur. The person may indulge in a “forbidden” cookie, for example, and then may feel a sense of failure, and abandon their approach. In contrast, emphasizing the total diet can allow one to enjoy favorite foods in moderation, with some sensible limits, and accepts personal choice, which is more sustainable than the dichotomous approach over time.

Critique of the Total Diet

Controversy around the total diet approach may point to its acceptance of non-nutritious foods. The Academy refutes the critique, suggesting that its recommendations for making nutrient dense choices consistently emphasize the importance of limiting intakes of foods and beverages that are high in saturated and trans fats, added sugars, salt and alcohol so that one’s total diet meets nutrient needs without exceeding needed calorie levels. Foods that may be low in nutrients and high in calories should be enjoyed as occasional treats or in limited amounts as ingredients when they add to the flavor of foods with high nutrient density.

Stevia adds Sweetness to a Healthful Total Diet Approach

Stevia, the natural origin no calorie sweetener, can help people enjoy foods and beverages with lower calorie levels and make it easier for people to maintain a healthy, prudent eating style without feeling deprived. Stevia may be found foods and beverage products, where it helps to reduce calories or can be used to add sweetness to food and beverages at home. These calorie reductions add up throughout the total diet and help to promote a balanced overall dietary pattern.

Reviewed by Global Stevia Institute Advisory Board Member Keith Ayoob, EdD RD


1. US Department of Agriculture (USDA), US Department of Health and Human Services. Dietary Guidelines for Americans, 2010.

2. Academy of Nutrition and Dietetics, Nutrient Density - Meeting Nutrient Goals within Calorie Needs

3. Brown, Judith E., Nutrition through the Life Cycle, Wadsworth Publishing, 4 edition (June 9, 2010)

4. National Center for Chronic Disease Prevention and Health Promotion. Nutrition and Physical Activity: Helping People Choose Healthy Eating and Active Living

5. 2012 IFIC Foundation Food & Health Survey, Accessed on Feb 1 2013

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