21st November 2025
Why poor diets are a systems issue not just a food issue.
Part 1
Recently The Eat-Lancet Commission updated its Planetary Health Diet. This is a scientifically developed diet that can be followed anywhere in the globe using local, traditional ingredients. As the name ambiguously suggests, it is a diet that both promotes our physical health and planetary health. It is a diet rich in plant based foods with small amounts of fish, meat and dairy items.
The 2025 overview begins with the arresting sentence: “The food we eat is more than a personal choice.” Can what we choose to eat make that much of a difference to the lives of other people?
The report continues: “It is a public issue with global consequences. What we eat affects agricultural land use, greenhouse gas emissions, water availability and quality, labor systems, and public health. Today’s food systems are, in many ways, failing. Millions face hunger, while others suffer from completely preventable chronic diseases. Food production contributes to environmental degradation and deepens inequality, when it could be the primary source of environmental regeneration, and justice. The EAT-LancetCommission’s approach to food addresses these challenges by linking health, sustainability, and justice. It promotes a shift in both consumption and production patterns, making healthy and sustainable food more accessible and reducing pressure on planetary boundaries. Transforming food will require cooperation across sectors, cultures, and regions. But the science is clear: changing what we eat is essential to building a future in which both people and planet can thrive.” (1)
What we choose to eat can shape how much land has to be used to produce our food and if that is less than at present, then more land can be used to restore biodiversity and the natural resilience of the world’s ecosystems.
What we choose to eat can reduce greenhouse emissions and so contribute to ensure a more amenable (or perhaps just less disastrous) environment for everyone.
What we choose to eat can reduce the amount of water needed for agriculture and so can make water available for more essential needs such as drinking and sanitation.
What we choose to eat can have an impact on the welfare given to livestock, the welfare given to the soil, the welfare given to agricultural workers and food producers. (For example a cheap cup of coffee may come at the expense of deforestation where the beans are grown, at the expense of an inadequate price paid to the person growing and processing the beans, at the expense of a poorly paid barista, and at the expense of society if the coffee chain doesn’t pay its taxes. (2))
So yes, the EAT-Lancet Commission is clear that diet is not just about the food we eat but also about the systems that being the food from the farm to the plate. And not only that, these systems also impact our health not just through the food produced but through the impact that food production has on our environment – and thus on our health – and that it has an impact on incomes earned by those in the food industry which again (as we will see in more detail below, impacts health.
Part 2
In many way the Planetary Health Diet as a guide, is not hugely dissimilar from the UK government’s Eat Well diet guide (3) – although the later increases the proportions of plant based foods at the expense of cereals/ starch and animal based foods. This Eat Well guide dates back to 2016 which itself is not very dissimilar to the 2014 guide known as the Eat Well Plate.
The UK government produces a regular National Diet and Nutrition Survey. This is “designed to assess the diet, nutrient intake and nutritional status of the general UK population … is used by UK governments to monitor progress towards achieving diet and nutrition objectives and to develop food and nutrition policies”. (4)
Has the Eat Well guide improved healthy eating in the UK? Sadly not.
According to analysis of the data by Field Doctor, the most recent survey shows :-
- only 17% of adults eat at least five portions of fruit and vegetable a day
- We eat 100% more sugar, and 25% more saturated fat than is recommended
- 96% of adults eat an insufficient amount of fibre
- 18% have sub optimal levels of vitamin D (5)
Whilst the Roadmap for Resilience: A UK Food Plan for 2050 (produced by The Agri-Food for Net Zero Network), notes that under 1% of people in the UK fully meet dietary guidelines and comments: “Poor diets cost the UK dearly – through pressures on the NHS, lost productivity and poor quality of life. Shifting towards healthy diets is a win-win that cuts emissions, saves public money, and helps improve the quality of life and work for productivity.” (6)
And The Broken Plate Report 2025 (produced by the Food Foundation) highlighted the following findings from its research:-:
- Over a third of supermarket promotions on food and nonalcoholic drinks are for unhealthy food.
- Over a third of food and soft drink advertising spend is on confectionery, snacks, deserts and soft drinks, compared to just 2% on fruit and veg.
- Three quarters of the baby and toddler snacks that have front-of-pack promotional claims contain high or medium levels of sugar.
And
- On average, healthier foods are more than twice as expensive per calorie as less healthy foods, with healthier food increasing in price at twice the rate in the past two years.
- To afford the government-recommended diet, the most deprived fifth of the population would need to spend 45% of their disposable income on food, rising to 70% for those households with children.
And
- children in the most deprived fifth of the population are nearly twice as likely to be living with obesity as those in the least deprived fifth by their first year of school
- Ditto twice as likely to have tooth decay in their permanent teeth. (7)
Clearly both poverty and the high cost of healthy foods, plays a big part in the unhealthy diets of many people in the UK. Other factors are also relevant, some linked to poverty and inequality such as
- lack of access to cooking facilities (especially true of people living in hostels, bed and breakfast or other shared accommodation). Research carried out in 2020 revealed that 1.9 million people in the UK didn’t have a cooker and 900,000 didn’t have a fridge. (8)
- Lack of access to local shops selling fresh produce – so called food deserts – affecting 1.2 million people. (9)
- Lack of time to prepare and cook meals especially for households juggling multiple jobs and/or long hours (apparently this hasn’t been widely researched (10) but in one recent survey of 2000 adults, 21% sited lack of time as a reason for not eating healthily (11)).
And other factors that have an impact across the board
- Power of advertising in promoting ready meals and ultra processed foods. This report from Obesity Action Scotland is very clear as to the advertising has on diets. (12)
- Lack of experience of cooking from scratch – again this is area which has received little research so the conclusion is conjecture.
What I think these various surveys show is, that whilst lack of financial resources a major factor in poor diets, unjust social systems may be a more embracing reason. It is unjust social systems that means that households do not have adequate cooking facilities, do not have access to fresh food shops, so not receive adequate incomes and especially so for those households with children. At the same time big businesses have a disproportionate amount of power in influencing what is advertised and to whom, and in controlling (or at least influencing) where and how food is sold, and a major role in continuing to underpay their workforce.
Systems change is essential nationally and globally if we are to ensure everyone has a healthy diet (ideally the Planetary Health Diet) and a healthy environment in which to live.
Postscript
The Food Foundation produced a manifesto report to educate new MPs as to what changes were possible to improve healthy diets for all. https://foodfoundation.org.uk/sites/default/files/2023-09/Election%2024_Manifesto.pdf
- https://eatforum.org/eat-lancet/the-planetary-health-diet/
- https://www.ethicalconsumer.org/company-profile/starbucks-corporation
(5) https://www.fielddoctor.co.uk/health-hub/uk-eating-habits-2025
(6) Page 17 https://www.agrifood4netzero.net/wp-content/uploads/2025/10/AFN-ROADMAP-SUMMARY.pdf
(7) https://foodfoundation.org.uk/sites/default/files/2025-01/TFF_BP_At a Glance_FINAL.pdf
(9) https://sheffield.ac.uk/social-sciences/news/12-million-living-uk-food-deserts-studys-shows
(10) https://www.sciencedirect.com/science/article/abs/pii/S0195666306003813
(11) https://www.psychreg.org/busy-lifestyles-hinder-healthy-eating-many-britons/
(12) https://www.obesityactionscotland.org/media/as3leiwg/food-and-drink-advertising-briefing-2023.pdf
