Intended for healthcare professionals

Observations Food and Nutrition

Brutal pragmatism on food

BMJ 2013; 346 doi: (Published 25 June 2013) Cite this as: BMJ 2013;346:f3728
  1. J T Winkler, retired professor of nutrition policy, London Metropolitan University
  1. jtw{at}

We urgently need a new public health strategy on nutrition

Nutrition policy has failed. Everywhere, people grow fatter and fatter. It is time to do something different, something that works.

We must start by honestly acknowledging what has proved inadequate and what is politically improbable, then select among the options remaining, in a spirit of brutal pragmatism. The choice is not what is ideal but what might be effective.

We do not have much time. Closely following the obesity epidemic is a diabetes epidemic that would combine human tragedy, medical overload, and financial catastrophe. The need for a new strategy is urgent.

Special diets do not work. They are transformative for some people, but most resign or relapse. Dieting is not a public health solution for societies where more than half of adults are overweight.

Education does not work either. Surveys by the World Health Organization and the Organization for Economic Co-operation and Development show that developed countries overwhelmingly rely on information programmes directed at consumers, urging them to choose different foods. But such information motivates only a minority.

The most important reason for failure is the one that nutritionists …

View Full Text

Log in

Log in through your institution


* For online subscription