Smooth peanut butter

Smooth peanut butter is the item where the leaflet this book follows and almost everybody else part company, and where the disagreement is likely to matter to you in practice.

The disagreement

Smooth peanut butter is one of the most consistently permitted foods in the other leaflets compared for this book. St George's, Oxford, Milton Keynes and Leeds all allow it, and crunchy versions are classed as medium or avoid wherever they appear. The reasoning is that grinding has already done what teeth cannot, and that the result behaves like a fat rather than like a nut.

The leaflet this book follows takes a simpler line and puts nuts on the avoid list without carving out an exception for smooth nut butter.

Why it matters more than most of these arguments

Because peanut butter is one of the most energy-dense things you can put on a slice of white toast without any cooking at all. When appetite is poor and standing at a hob is hard, a food that needs a knife and nothing else is worth a great deal. Milton Keynes lists it among the foods that help thicken a high-output stoma, so it is doing two useful jobs at once.

What this book does

Follows the leaflet and keeps it out of every recipe, and says so rather than quietly omitting it. There is no peanut butter anywhere in the book. Where a recipe wants the same creamy sweetness on toast, it uses lemon curd, seedless jam or a smooth chocolate spread with no nut pieces in it, which is not the same thing and does not pretend to be.

What you should do

Ask. This is the first item to raise at a dietitian appointment, ahead of spices and oats, because the answer is more likely to be yes than for anything else in the amber middle and because it is genuinely useful if it is. If your team says smooth peanut butter is fine, then it is fine, and this book being stricter is not a reason to go without it. If they say no, that settles it, and everything here already works without it.