Why have nutritional and dietary guidelines failed to incorporate this evidence despite its internal consistency?

Because guideline ecosystems can become anchored to legacy frameworks and measurement traditions, particularly cholesterol-centred risk paradigms, while neglecting carbohydrate–insulin biology, nutrient sufficiency, and individual vulnerability. The report highlights that public-good nutrition research has been neglected and underfunded, leaving too few independent scientists able to challenge entrenched assumptions.

The report argues that a lack of policy scope, in addition to official resistance to taking a broader lens to assessing the science discussed in this report is predominantly a reflection of institutional lock-in. The report emphasises that officials will claim that such a review is 'outside the work programme'.

A long-standing governance culture has kept carbohydrate science, the carbohydrate–insulin model, and nutritional sufficiency outside formal policy scope for decades. Conventional macronutrient and micronutrient guidelines are based on preventing deficiency, rather than assuring optimum health. Guidelines do not address insufficiency, where people aren't deficient, but may have symptoms and conditions that are reflective of insufficient nutrition across and between nutrient groups. The report also notes that guideline constraints may deter clinicians from recommending lower-carbohydrate interventions, even when clinically indicated.

The scientific evidence that underpins this report is broader than current guideline specifications used to e.g. for macronutrient or micronutrient guidelines. This report integrates cellular and mechanistic studies, biomarker research, case reports, cohort studies, population-level epidemiology, and early-adopter clinic outcomes, and then assesses coherence across levels of evidence. It argues that over-reliance on epidemiology alone can anchor policy in incomplete or outdated evidence.

The report integrates mechanistic, clinical, and population evidence, even though guidelines often exclude such synthesis because real-world metabolic illness is a complex, multi-system phenomenon, and policy must reflect causal pathways rather than downstream correlations alone. Integration allows policy to incorporate individual vulnerability, emerging mechanistic insights, and practical clinical reversibility without waiting decades for institutional consensus to catch up.

Why have nutritional and dietary guidelines failed to incorporate this evidence despite its internal consistency?

BACK TO:

Information

Providing scientific & medical information & analysis in the service of the public's right to be independently informed on issues relating to human & environmental health.