One-Size-Fits-All or Personalized Nutrition: What is the Perfect Diet?

Is there really a one-size-fits-all diet? It’s easy to see the appeal – a simple, strategic, straightforward way of eating that ensures optimal health. Though we all share a considerable amount of DNA, it’s no secret that we all [as humans] are uniquely different. But with varying degrees of epigenetics, different environmental exposures, a variety of lifestyles and habits, and the like, it’s no surprise that one way of eating isn’t such a productive and efficient hallmark of nutrition. With the discovery of these differences and the recognized significance of them came the birth of personalized [or precision] nutrition – tailoring needs to each individual. But even the most personalized nutrition and health strategy has its limitations, most of which are related to the sustainability and adherence of such practices.

As a nutrition practitioner, most of my job actually isn’t developing nutrition strategies – it’s focused on behavior change. The science is rather [mostly] black and white when it comes to nutrition – a clear, identifiable collection of foods that are functional and healing, serving a purpose to optimize an individual’s health. But success for my clients is measured by how well they can implement sustainable choices into their lives, not by how well they can recite the recommendations I have provided. The science may be black and white (i.e., do and do not, eat and avoid, etc.) but how well does this translate into real action for real people in the real world?

In the 1970’s, Swedish nutritionist Anna-Britt Agnsäter developed the Food Pyramid, a dietary model that illustrated food choices by dividing them into categories. This Swedish model served as an early inspiration for similar initiatives in other countries, including the United States. In 1992, the United States Department of Agriculture (USDA) adopted the concept, and the Food Pyramid was officially introduced to the American public as a visual guide to healthy eating. The Food Pyramid was intended to address the growing concern about the rising rates of diet-related health issues such as obesity, heart disease, and diabetes (all of which can be prevented and addressed with nutrition). By offering a simple and intuitive representation of food categories, it aimed to help individuals make informed choices about their daily diet. The pyramid’s design depicted a wide base of grains and cereals, followed by layers of fruits, vegetables, dairy, and proteins, with fats and sweets at the top (indicating minimal consumption). Though the Food Pyramid’s simple design made it accessible, it received criticism for its lack of specificity and for potentially encouraging excessive carbohydrate consumption. In 2005, the USDA replaced the original Food Pyramid with MyPyramid, incorporating feedback and nutritional research findings. The MyPyramid aimed to provide more personalized and practical dietary guidance, with specific serving sizes and personalized recommendations, guiding individuals based on age, gender, and activity level. While MyPlate had a more tailored approach, it face criticism for its complexity and was often deemed difficult to interpret and apply effectively. And finally, in 2011 (nearly 20 years ago), the MyPlate was introduced, representing a shift towards a simpler and more user-friendly approach to dietary guidance. MyPlate divides a plate into four sections: fruits, vegetables, protein, and grains, accompanied by a smaller circle for diary (the federal government won’t let you ignore the large dairy companies). The visual emphasizes portion control, balance, and the relative proportions of different food groups in each meal. MyPlate’s launch was a significant milestone in nutrition education, promoting visual simplicity and the idea that a healthy diet can be as straightforward as dividing your plate into these key components.

The progression from the Food Pyramid to the MyPyramid to the MyPlate reflects ongoing efforts to provide more effective and practical nutritional guidance to the public. These symbols have not only illustrated changes in dietary recommendations but also how they’re communicated.

But there are problems, one’s that must be addressed properly before arriving at success:

MyPlate does a poor job of outlining what an optimal diet actually looks like.

There’s no arguing that there have been considerable efforts directed at educating the public on what good nutrition looks like. But the overwhelming desire for simplifying the complexities of nutrition has done just that – made it too simple. A plate with four components with a general recommendation of servings or portion sizes is hardly a robust and effective prescription of ideal nourishment. The construct of MyPlate lacks the paramount recommendations for promoting gut health, ensuring electrolyte balance, immunity promotion, and guidelines for preventing insulin resistance (to name a few). There is a vast difference in health qualities between a small, organic blueberry and an herbicide laden strawberry; between a genetically modified salmon and a grass-fed, pasture-raised beef steak; between a cup of white rice and a cup of quinoa. The point being, we have reduced the beautiful, complex, and powerful characteristics of produce and foods to over-simplified categories that are too vague, and ultimately, misleading.

Personalized nutrition is key to our health but it’s a muscle we’re not flexing.

Building off of our last problem statement, MyPlate [and the federal governments general guideline(s) for nutrition] lacks a personal touch. Perhaps its written in the fine print on their website, but a simple suggestion of four food groups and associated portion sizes does not an effective nutrition strategy make. If you have polycystic ovarian syndrome, your dietary approach should look different than a teenager with hypothalamic amenorrhea. If you have celiac disease, SIBO, or Crohn’s disease, your dietary approach should look different than an adult with atherosclerosis. The comparisons are nearly endless. Yes, protein, vegetables, fruits, and grains are key components of any health-promoting diet. But the subcategories of each can vary greatly, and you (like the rest of American’s) should be aware of which foods serve unique, personal, and optimal functions for your body. It’s worth noting that this is [largely] done with the help of a dietitian, but to facilitate a healthier society, these are concepts that should be greatly promoted (even if it puts me out of a job).

In many ways, we live in an all-or-nothing society, fueled by perfection that ultimately defeats us.

Does this sound familiar? You start a diet and you’re doing well for a week or two. Then the holiday’s roll around or you have a little too much fun at the tailgate and next thing you know, you’re back to eating copious amounts of junk food. You realize that you’ve undone the progress you worked so hard for, recognize the difficulty of starting again, and ultimately return to the status quo while offering your internal health companion a deceiving head nod with a simple whisper “we’ll do better next time”. And then weeks, months, or years go by until “next time” arrives. I realize that this may sound a little harsh and perhaps it’s lacking some additional context, but the concept remains the same – most of us are either all in or all out. Few of us recognize the power of settling somewhere in the middle; being okay with making some small, simple, sustainable changes albeit imperfect ones. There’s significant power in that area of the precipice. Meeting nutritional needs that are at or above the threshold of good enough can have significant impact on health, even if they are not deemed “ideal”, “optimal”, or “perfect”.

My role as a registered dietitian nutritionist focuses on understanding a client’s current state of health, their habitual dietary intake and preferences, and desired outcomes to best design a nutrition approach that can help them functionally achieve their health goals. That’s the easy part. Helping clients’ implement my recommendations in an effective and sustainable way is where it gets tricky.

The endless pursuit of good health, vitality, and longevity is largely related to foods we nourish our body with. It’s time we clearly identify what true optimal nutrition looks like. At OPTIMOM, we offer a novel framework for good nutrition. It paradoxically offers a cohesive illustration of optimal personalized nutrition that is [largely] applicable to the masses. Furthermore, we recognize the significance of optimal nutrition whilst focusing on a sliding scale between good enough and gold standard (i.e., satisficing vs. maximizing, more on this in a future post).

Our framework for peak health (OptiBalance) includes 14 constructs, categorized into one of three domains: Essential, Foundational, and Personal. I prefer picturing our framework like a garden (my wonderful wife loves to garden).

The Essential components are the soil, water, sunlight, good air quality, and thriving ecosystem. Without these components, growth (i.e., health pursuits) is unlikely. The five Essential components are:

• Quality Sleep
• Proper Hydration with Electrolytes
• Avoidance of Environmental Toxins
• Adequate Fiber and Gut-Health Promoting Food Intake
• High-Quality Protein Intake

The Foundational components are the seeds and fertilizer that enhance plant growth. These are key practices that have serve the greatest health promotion.

• Strength and Resistance Training
• Cardiorespiratory Endurance Training
• Micronutrient Density Focused Eating
• Stress Management
• Incorporation of Beneficial Fats

The Personal components are the various gardening tools and techniques that may further benefit growth, harmony, and crop yield.

• Focus on Functional Foods
• Supplementation
• Intermittent Fasting
• Time-Restricted Eating

This framework offers an unmatched, comprehensive level of nutrition and health success. It offers a sliding scale of simplicity that at baseline, ensures basic needs are met for all individuals. The vertical arrangement of this framework also lends itself to effective health change, considering significant health optimization will be observed after implementing the very first Essential component.

I have found that this framework is not only useful as a practitioner, but also as a fellow food-eating human as well. Incorporating one component of this framework will impart health benefits. The framework starts with satisfying the most basic needs of each component while providing the gold standard or best practices for each. And the framework lends itself to both the one-size-fits-all need for public guidance and to the innate requirement of personalized nutrition. Though this is a novel addition to nutrition science and the future of dietary guidelines, it has never been more valuable and needed than right now.

To learn more about the OptiBalance framework and how to implement it in your health pursuits, we encourage you to join OPTIMOM and start optimizing your health today.

By Alek Dinesen, MS, RDN, CSCS, PN1
Fertility, Prenatal, & Postpartum Dietitian

Disclaimer: The information provided in this blog is for informational purposes only and should not be considered as medical advice. Always consult with qualified healthcare professionals before making any significant dietary changes or starting any supplements, especially during pregnancy and postpartum.