Personalised vs Public Health Nutrition: Benefits & limitations

Evidence based, fact-checked – 8 min read

In recent years, the conversation around nutrition has shifted from generalised dietary guidelines to more targeted, individual-focused interventions. While public health nutrition has provided invaluable guidance to reduce widespread deficiencies and chronic disease risks at the population level, it often fails to address the unique and dynamic needs of individuals. This is where personalised nutrition, particularly through the lens of Functional Medicine and Nutritional Therapy, as practised by BANT-registered practitioners by myself, arguably holds the upper hand. Read on to find out why.

Public health nutrition model: Strengths & limitations
Public health nutrition is rooted in epidemiological research and focuses on broad dietary recommendations intended to benefit the majority. It’s responsible for promoting messages like “eat five portions of fruit and vegetables daily” or “reduce saturated fat intake.” based around the UK Eatwell guide (fig.1). These guidelines are important for setting a foundational baseline, especially in reducing nutrient deficiencies and guiding food policy (1). However, these one-size-fits-all recommendations can overlook substantial variations in genetic makeup, microbiome diversity, pre-existing health conditions, surgical history (e.g., cholecystectomy), medication use, and physical activity levels. What works well for a sedentary individual with metabolic syndrome may not suit an athlete focused on muscle synthesis and recovery, a person with type 2 diabetes or someone diagnosed with Alzheimer’s disease, jsut to give some examples. Public health nutrition is designed to provide evidence-based dietary advice that promotes general health, reduces chronic disease risk, and prevents nutrient deficiencies at the population level. It works, up to a point, but it doesn’t consider:

– Biochemical individuality (genetics, microbiome, metabolism)
– Health conditions (e.g., IBS, PCOS, type 2 diabetes)
– Past surgeries (e.g., cholecystectomy affecting fat digestion)
– Unique lifestyle demands (e.g., athletes, shift workers)
– Nutrient absorption issues
– Medication-nutrient interactions
– and many more considerations.

UK dietary recommendations and relevance to Gibraltar
The UK’s current national food model, the Eatwell Guide was published in its current form in 2016, based on updated recommendations from The Scientific Advisory Committee on Nutrition (SACN), an independent expert committee that provides scientific advice on nutrition and related health matters to the UK government (9). Established in 2001, SACN advises the four UK health departments and other governmental bodies on a range of nutrition-related issues, including nutrient intakes, dietary patterns, and the nutritional status of the population. Its remit encompasses evaluating scientific evidence to inform public health policy, with particular attention to vulnerable groups and health inequalities. ​One argument against these population-wide recommendations, is that nutrition evidence changes quickly, and it could take years for it to be updated and implemented nation-wide. However, Public Health Gibraltar dietary recommendation mirrors that of the UK, and iv long been a proponent that Gibraltar should have it’s own dietary guidelines, as I strongly believe we are demographically and socioculturally distinct to the average UK-born individual – ie, a more naturally Mediterranean-based diet historically than the UK, with much more sun exposure, it’s own dietary preferences, culture, traditions, and potentially distinct disease prevalence and genetic risk factors.

Functional medicine: A systems biology approach
Functional Medicine is a root-cause, systems-based model that looks at how and why illness occurs and restores health by addressing the individual’s specific biological imbalances, as opposed to convention medicine approaches which focus on disease and symptoms resolution (fig.2). When applied through Nutritional Therapy, as practiced by BANT professionals, it means evaluating the whole person, not just isolated symptoms (2). For example, a person without a gallbladder has compromised fat digestion, risking deficiencies in fat-soluble vitamins such as Vitamin A, D E or K. Public health guidelines may encourage the inclusion of healthy fats, but they don’t account for the need for personalised support or modified fat intake in such individuals. Similarly, a blanket recommendation to increase whole grains for fibre could exacerbate symptoms in someone with irritable bowel syndrome or small intestinal bacterial overgrowth. However, in my opinion and clinical experience, there are many ways in which both models can (and should) work together synergistically. Learn more about my Nutritional Therapy programme and how it could help you prevent or find resolution to your diabetes, hormonal imbalances, skin health, symptoms and medical diagnoses by clicking HERE.

Sport performance & recovery: Genes and personalisation may be key
Professional and recreational athletes have highly specific nutritional needs. Carbohydrate timing, protein quality, and micronutrient adequacy (especially electrolytes) are essential to performance, recovery, and adaptation (3). A low-fat, high-fibre public health diet may undermine performance and exacerbate symptoms in endurance athletes or those engaged in resistance training. Through personalised assessment, Nutritional Therapists can tailor macronutrient ratios, meal timing, and supplementation strategies to support training goals and reduce inflammation, fatigue, and injury risk, especially in athletes already carrying diagnosed health conditions. Genetic sports variants known as Single Nucleotide Polymorphisms (SNPs), tiny natural variations in our DNA that can influence how our bodies process nutrients, respond to foods, detoxify, manage inflammation, or even handle stress, factors that can also genetically vary ethnically and via individual environmental exposures (fig.3). Everyone’s genetic code is slightly different, and these small differences can explain why some people thrive on certain diets while others struggle. Integrative Sports Nutrition uses insights from your unique SNPs and health profile to tailor food and supplement choices that best support your energy, digestion, mood, reduce competitive symptoms and optimise long-term health, helping you get the most out of what you eat, based on you, not the average person in a given population. For more info on my Integrative Sports Nutrition Programme visit the site by clicking HERE.

Evidence from the literature
Personalised nutrition tailors dietary recommendations to an individual’s unique biological makeup, health status, and goals. This approach can be more effective in managing chronic diseases, improving metabolic health, and achieving specific health outcomes. PRO: Research suggests that up to ~70% of the population may not respond optimally to Public Health nutrition advice. For example, a study supporting the benefits of personalised nutrition was a study published in Nature Medicine by Berry and colleagues (2020) in collaboration with King’s College London, who demonstrated that individual responses to foods are influenced by factors such as genetics, microbiome composition, and lifestyle (fig.5), reinforcing the need for personalised dietary approaches (5)​. Another landmark study by Zeevi and colleagues (2015) published in the journal Cell, and who analysed the postprandial glycemic responses in 800 individuals, found high interpersonal variability in blood glucose responses to identical meals (6). This variability suggests that uniform population-based dietary approaches may not be effective for everyone (6). Another study published in the Nature Medicine journal, found that personalised dietary programs led to significant improvements in cardiometabolic health compared to standard dietary advice (7). CONS: However there are also concerns about generalisability of the outcomes from these studies conducted in specific populations, to other populations, such as Gibraltar. Additionally, personalised and genetic-based personalised weight loss approaches may not always reach expected clinical outcomes, as evidenced in a Randomised clinical trial (8), although the said study did have considerable limitations, such as a relatively small sample size (n=145), single-centre design, and the short duration of the trial (12 weeks).

Personalisation in Action: Examples of situations which may benefit from personalised approaches

1. Post-Cholecystectomy: Require tailored fat intake and specialised support to optimise nutrient absorption (critical for fat-soluble vitamins A, D, E, and K).
2. Peri-menopausal women with weight gain and fatigue: May benefit from dietary hormonal-balancing strategies far beyond recommendations by Public Health Nutrition.
3. Men with cardiometabolic risk factors and family history of CVD: A personalised plan may involve genotyping for gene status, advanced lipid testing, and anti-inflammatory dietary patterns.
4. Cognitive impairment: Persons at risk of, exhibiting mild cognitive impairment, diagnosed with dementia, or with a family history of neurodegenerative diseases which could benefit from early preventative strategies, such as my personalised BRAINCOG programme. Click HERE to learn more.

Personalised Nutrition: Are there some limitations?
While personalised nutrition based on functional medicine offers tailored insights into individual health needs, it also comes with some notable limitations. One of the primary barriers is cost, which includes comprehensive functional testing (such as genetic, microbiome, or hormonal panels), one-on-one consultations, and despite professional-grade personalised supplements or interventions, this approach can often be expensive, and often not covered by public health systems or insurances. Additionally, the evidence base, while still growing, is still evolving; not all functional tests are universally validated or clinically actionable. There’s also the challenge of access and equity, as this approach may not be readily available to those in lower-income or rural communities. Lastly, implementation requires a high level of personal responsibility and compliance, which can be overwhelming for some individuals. These factors must be weighed carefully when recommending or adopting personalised nutritional strategies. Despite all this, the health benefits can be substantial, and I do tailor my programmes to suit the individuals goals and budget as much as possible in order to overcome these hurdles.

Why BANT and Functional medicine practitioners lead the way
BANT-registered Nutritional Therapists (like myself) study nutrition at a minimum degree level and additional clinical training requirements (similar training to a dietician), to legally and professionally support patients with chronic and complex health with or without prescribed medications conditions on a one-to-one setting. I have optionally extended those requirements by completing a Master of Science in Personalised nutrition. BANT-registered Nutritional Therapists follow a rigorous evidence-informed framework, underpinned by evidence-based pathophysiological reasoning based on a holistic, systems biology approach, biochemical individuality, and ongoing (compulsory) continued professional development (CPD). Their work integrates the latest research with clinical experience, offering bespoke plans that evolve as a person’s physiology and goals change. Therefore, working with an academically and clinically-trained nutrition professional who is regulated by accredited UK regulatory bodies (fig.4), is important to consider from a client / patient perspective, as these skills will provide the necessary assurances to guarantee that any recommendations are based on the most rigorous and latest evidence (which is ever changing). Registered Nutritional Therapists (as regulated by BANT in the UK and Gibraltar) use detailed case histories, functional testing, and ongoing assessments to fine-tune nutritional protocols and recommendations based on:

– Digestive health (e.g., SIBO, post-gallbladder removal fat malabsorption)
– Immune imbalances
– Hormonal fluctuations (e.g., perimenopause, thyroid conditions etc)
– Cognitive function and mood
– Sports performance, recovery and genetics
– Environmental and lifestyle factors
– and many more private functional lab tests which can book with me by clicking HERE.

Conclusion: The Future is personalised
In an era of genetic testing, microbiome mapping, and wearables, nutrition must move beyond population averages. Public health nutrition is a great starting point, but the kind of personalised, functional approaches that I offer, truly empowers people to reclaim health, optimise performance, prevent and even reverse many diseases in a more nuanced and meaningful manner, as evidenced by my client testimonials (READ HERE). Get in touch to work with me to drastically improve your health using the contact form below.

GET IN TOUCH