Intended for healthcare professionals

Rapid response to:

Analysis Food for Thought

Making nutrition guidelines fit for purpose

BMJ 2019; 365 doi: (Published 16 April 2019) Cite this as: BMJ 2019;365:l1579

Rapid Response:

Re: Making nutrition guidelines fit for purpose

Bero et al ask about making nutritional guidelines fit for purpose, but is this possible beyond a simplistic level? Humans evolved as hunter gatherers and adapted to their specific environments. Over the past few thousand years there has been mobility of increasing degrees, but adaptation to new diets happens slowly. For example, lactose tolerance is common in northern Europeans, with a different genetic mutation identified in those parts of east Africa where cattle rearing developed separately. Few people whose forebears migrated into these areas have this tolerance. Separately we are learning about the importance of the microbiome in digestion, which appears to be as unique as a fingerprint.
There is no "one size fits all" approach to nutrition, except that nobody has adapted to modern hyperprocessed foods. Some basic nutritional guidelines are essential, around balance, vitamins and minerals.
Maybe the only useful guideline is: "if neither of your grannies would recognise it, don't eat it ".

Competing interests: No competing interests

23 April 2019
Michael Peel
Graham Road Surgery, Weston super Mare