Dietary advice: foods or nutrients.

There is considerable debate over the content of dietary advice to be given to individuals within the United Kingdom, and most other industrialized countries, and the most effective way of presenting this advice. In the present paper I would like to debate the merits of giving advice in terms of recommendations about nutrients or in terms of foods. In doing this I will not be concerned in detail with the content of the advice, nor with whether it should be directed at all the individual members of the population or targeted at the ‘at-risk’ members (Rose & Day, 1990). In this debate I start from the premise that dietary advice should provide the individual with the basis for action in choosing the appropriate diet for himself or herself. This is true even when the target relates to the diet of the population as a whole, because the diet of the population is de fact0 the sum of the diets eaten by the individuals who comprise that population and any dietary change that follows the advice is the sum of all the changes made by individuals. Individuals, not populations, choose the food they consume. In order for dietary advice to be effective, two essential criteria must be fulfilled. First, the individual must understand the advice sufficiently to be able to assess his or her current diet and to be able to make the appropriate changes to that diet so that it conforms with the advice given. Second. the individual must be motivated to comply with the advice. I do not propose to discuss this aspect further, but unless the motivational issues are addressed, dietary advice, however soundly based and excellently presented, will fail to achieve its objectives. Furthermore, it is, I think, important to recognize that advice by its very nature may be accepted or rejected and I suspect that as a general proposition most advice, dietary or otherwise, is rejected. Therefore, when we consider the form that dietary advice should take, we should consider how well the advice will be understood and form the basis for action.