GP and Clinical Lecturer, Dr James Gill, calls for personalized NHS approach to weight-loss in response to ZOE 'anti-diet' regime

Frankly from a physics perspective, the concept that all calories are not created equal, almost doesn't seem to make sense, but what we have to appreciate, is how an individual's body interact with those calories will differ from one person to the next. In exactly the same way that one person may naturally have a greater muscle mass, and thus benefit from the strength which comes from that, another person may lack the same level of absolute power, but may have higher levels of endurance, our bodies are different, and we need to recognise that also means different fuels may affect us in different ways.

Professor Tim Spector has been at the forefront of democratising this idea of personalised nutrition which frankly has been the sort of revolution that has been needed in the public, rather than academic/clinical, nutrition space for the last 30 years. The understands of our personal diets is becoming increasingly relevant due to the excess of processed foods which contribute to the make up of the modern diet, and the effect on how that affects our physiology and food relationships.

However it is one thing, to have a good hypothesis, albeit supported by a strong scientific rationale, but it is quite something else to have that hypothesis supported with a randomised control trial to validate that approach. This is something which has been confirmed today via nature medicine looking at personalised dietary advice.

The nature article, compared standard dietary advice against a personalised dietary program, the results clearly demonstrated a positive improvement in a group of fats called triglycerides, additional improvements were seen in bodyweight, a metric of measurement of diabetes - the HbA1c level, diet quality and gut microbiome. All of which are significant to improving our future health outcomes.

It's vital to highlight this is study did not suggest a personalised diet plan is a miracle intervention, several markers health; blood pressure glucose, insulin, and other proteins did not change. However, given there were no adverse events, and with no medications being prescribed these positive wins, from guided diet changes have to be considered a success for the patient and the teams doing the interventions.

Obviously, there are going to be many confounding factors in a study like this, the most important simply being that of the intervention bias, whereby having a personalised approach, means that there is more active participation and this alone is likely to promote change by the study group, as compared to the control group who were given standard advice. However, I think it is vital that we highlight the endpoint, that the patient in the personalised nutrition group, overall had an improved health surrogate measures, so I would argue the INTERVENTION is of value here.

Frankly, I view this this study outcome as a strong indicator that the NHS should look towards more personalised approach to dietary advice rather than the current generic one size fits all with regard to dealing with the health emergency which is obesity. We already have targeted interventions with regard to the DESMOND referrals for early diabetes which has a positive outcomes for patients. To quote an often deployed public health quote, this study suggests we really should look at allocating funds to help people “stop falling into the river in the first place, rather than spending money on pulling them out”