Health for life

The overall pattern of food that a person eats is more important to a healthy diet than focusing on single foods or individual nutrients, according to the Academy of Nutrition and Dietetics in its newly updated position paper "Total Diet Approach to Healthy Eating."

According to the position paper: "In contrast to the total diet approach, classification of specific foods as good or bad is overly simplistic and may foster unhealthy eating behaviors." The Academys position paper stresses that moderation, portion size and exercise are the key concepts for balancing food and beverage intakes.

The position paper has been published in the February Journal of the Academy of Nutrition and Dietetics and can be found on the Academys website. It states:

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.

The Academys position paper has been updated to lect the most current nutrition guidance, such as the 2010 Dietary Guidelines for Americans and the USDAs MyPlate food guidance system; the White Houses Lets Move! campaign to reduce childhood obesity and Healthy People 2020. Each of these public policies and dietary patterns supports the total diet approach.

According to the position paper, while studies including the Academys "Nutrition and You" national consumer survey show Americans are "conscious of the importance of healthy diets and physical activity," most people do not meet the recommendations of the Dietary Guidelines. For example, large majorities do not eat fruit (68 percent) or vegetables (74 percent) more than twice a day, and a substantial number (36 percent) engage in no leisure-time physical activity.

In that environment, according to the Academy: "Labeling specific foods in an overly simplistic manner as good foods and bad foods is not only inconsistent with the total diet approach, but it may cause many people to abandon efforts to make dietary improvements."

The position paper adds: "In 2011, 82 percent of U.S. adults cited not wanting to give up foods they like as a reason for not eating healthier. For these reasons, the concepts of moderation and proportionality are necessary components of a practical, action-oriented understanding of the total diet approach."

The Academys position paper notes that the most recent Dietary Reference Intakes use a total diet approach because it allows for a broad range of foods to meet a persons nutrition needs over time. Theore, a person can make diet choices based on individual perences, genetic background, personal health status and food availability.

The position paper was written by registered dietitians Jeanne Freeland-Graves, Bess Heflin Centennial Professor in the department of nutritional sciences at the University of Texas -- Austin; and Susan Nitzke, professor emerita and extension specialist in nutritional sciences at the University of Wisconsin -- Madison.

The Academys position paper contains advice and recommendations for health professionals as well as consumers. It explains how food and nutrition practitioners can use behavioral theories and models to develop effective nutrition communications; and how food and beverage choices are affected by multiple factors that influence peoples ability to make use of expert advice on healthy eating.

Updated sections of the position paper look at new indicators of nutrient quality, such as the Nutrient Rich Food Index, the European Union Nutrient Profiling System and the Overall Nutrient Quality Index. In addition, the Social Ecological model, used in the Dietary Guidelines, is incorporated into the Academys position as "a guide for understanding why we eat what we do."

According to the Academys position paper: "Food and nutrition practitioners have a responsibility to communicate unbiased food and nutrition information that is culturally sensitive, scientifically accurate, medically appropriate and tailored to the needs and perences of the target audience. Some health and nutrition professionals and many pseudo-experts promote specific types of foods to choose or avoid. A more responsible and effective approach is to help consumers understand and apply the principles of healthy diet and lifestyle choices. Unless there are extenuating circumstances (severe cognitive or physical limitations), the total diet approach is perred because it is more consistent with research on effective communication and inclusive of cultural/personal differences."

A new study by Queen’s University researchers has determined that adults who accumulated 150 minutes of exercise on a few days of the week were not any less healthy than adults who exercised more frequently throughout the week.

Ian Janssen and his graduate student Janine Clarke studied 2,324 adults from across Canada to determine whether the frequency of physical activity throughout the week is associated with risk factors for diabetes, heart disease and stroke.

“The findings indicate that it does not matter how adults choose to accumulate their 150 weekly minutes of physical activity,” says Dr. Janssen. “For instance, someone who did not perform any physical activity on Monday to Friday but was active for 150 minutes over the weekend would obtain the same health benefits from their activity as someone who accumulated 150 minutes of activity over the week by doing 20-25 minutes of activity on a daily basis.”

Physical activity was measured continuously throughout the week by having research participants wear accelerometers on their waists. Accelerometers are tiny electrical devices (about the size of a small package of matches) that record how much a person moves every minute.

Dr. Janssen divided the adults who met the physical activity guidelines (more than 150 minutes per week of aerobic activity) into those who were frequently active (active five to seven days of the week) and infrequently active (active one to four days of the week).

“The important message is that adults should aim to accumulate at least 150 minutes of weekly physical activity in whatever pattern that works for their schedule.”

The paper was published today in Applied Physiology, Nutrition and Metabolism