Personalised nutrition aims to deliver targeted advice to promote dietary behaviours that are beneficial to health based on individual characteristics. Given the financial implications (for providers and participants) of characterising, developing, implementing, communicating and supporting individual behaviour change there remains potential for personalised nutrition to widen health inequalities within populations. Some commentators promote a universal approach to achieve wider population-level benefit. Universal approaches attempt to provide a whole systems perspective with individual outcomes, potentially smaller in scale, impacting at the population level. In the UK the national food-based guidance, the Eatwell Guide, is used to communicate advice on diet consistent with UK government dietary recommendations based on robust, independent assessment of the best available evidence by the Scientific Advisory Committee on Nutrition. Effort was taken in ensuring all UK government recommendations in 2016 (when the UK’s national food-based guidance was last reviewed following changes in dietary recommendations on carbohydrates and sugars) could be achieved at a population level based on available and recognised foods. There is evidence that moving towards a diet consistent with national food-based guidelines has positive benefits for health and the environment. There is debate about the cost of a healthy diet and the impact of including elements of sustainability elements. This commentary considers how developments in healthy eating indices may be beneficial as a universal approach could provide opportunities to support individuals move towards healthier diets. It also raises questions about the evidence requirements and timing of any future amendments to the UK’s Eatwell Guide.