What we consider to be a 'healthy' meal has changed considerably over the years. Photo / Getty Images
From low-fat mania to our obsession with protein, here’s how the food we consider healthy has evolved over the decades.
Growing up as one of seven children in the 1960s, Professor George Grimble remembers the family diet being similar to that of wartime rationing.
Typical meals included cottage pie, a roast on a Sunday, maybe fish fingers.
“My parents thought processed food wasn’t value for money,” recalls Grimble, who went on to become a pioneer in nutrition research at UCL.
By 1975, he was studying for a PhD in the Department of Nutrition at the London School of Hygiene, before embarking on his own clinical research.
Across the decades he has watched what is considered a healthy plate of food slowly change. “It was exciting, particularly in the 1980s when so much research was taking place to understand the importance of fish oils, dietary fibre and short-chain fatty acids. Things were really cooking back then,” he says.
The most marked change over the past 50 years has been a shift away from a simple healthy plate that unapologetically represented the three major macronutrients – carbohydrates, proteins and fats – towards more nuance about how we regard each of them.
There have been some missteps along the way, too; low-fat mania still persists in some corners.
As specialist dietitian Nichola Ludlam-Raine says: “If you look back across the decades, the ‘perfect healthy plate’ has steadily shifted from low-fat and calorie counting to high-fibre, minimally processed and plant-forward.”
The biggest change in the last 20 years, says the author of How Not to Eat Ultra-Processed, is that “we now care far more about food quality, fibre and overall pattern than single nutrients”.
So how and why has a healthy plate changed through the decades?
In the UK in the 1970s, a “healthy, balanced meal” was often thought of as meat, two veg and potatoes.
The emphasis was on an uncomplicated plate with plenty of protein, starchy carbs, and vegetables, with less focus on fats, sugars or portion control compared with today’s nutrition advice.
“Nutritional adequacy was important as a legacy of wartime rationing,” explains Grimble. “So one sufficient in iodine or calcium, with sufficient protein intake (55g a day for men and 45g a day for women).”
In the early 1970s, the Ministry of Agriculture, Food and Fisheries was still king of our plates.
“They had a very large say in what the British diet should be. It had to be good for British agriculture and also food security,” says Grimble.
As such, the meat tended to be beef, veal, mutton and lamb, which was readily available in the UK, without too much concern for saturated fat content. The average person ate a pound of red meat each week, compared to just over half of that today.
Accompanying it would be veg that was still familiar to those who had grown up in wartime: “Root veg like turnips, carrots, parsnips and potatoes,” says Grimble.
Carbs were carbs, with white bread much more popular than brown or wholemeal.
While as far back as 1958, American physiologist Ancel Keys’ Seven Countries Study suggested a strong correlation between diets high in saturated fat and the increased incidence of coronary heart disease, the change was slow to happen.
Lard – promoted by the Ministry – was still widely used in the UK, although in decline.
“My mum would have used it quite happily for frying,” says Grimble.
By the mid-70s, however, a major shift occurred when the medical establishment started to have a point of view on what we should all be eating to stay healthy.
In 1974, a report called Diet and Coronary Heart Disease recommended that people should lower their consumption of fat, especially saturated fat. And in 1976, the Royal College of Physicians published a report on diet and cardiovascular disease recommending that saturated fat intake be lowered. Cholesterol intake also became a concern.
John Yudkin, then professor of nutrition and dietetics at Queen Elizabeth University, presented an alternative view, believing that the role of dietary fat in causing heart disease was exaggerated, and the role of sugar had been minimised.
“It was a very lively time,” recalls Grimble. “The story goes that Yudkin was nobbled by Ancel Keys, but John Yudkin was more than capable of looking after himself thank you very much.”
While the issue would continue to be a topic of debate, the prevailing narrative became that saturated fat was bad. As such, leaner meats such as chicken, which had become more affordable because of the adoption of US-style factory farming, started to make more regular appearances at British meal times.
Meanwhile, Parveen Yaqoob, a professor of nutritional physiology at the University of Reading, says: “Concerns about sugar were not really there in the 1970s in the way they are now. The link between sugar and heart disease and diabetes wasn’t known.”
Diet culture was thriving, with low-fat everything. Butter was out, margarine was in and cottage cheese was king. Similarly, low-fat, low-cal Ryvita perfectly fitted with the decade’s health requirements. Weight Watchers frozen meals began to appear, with Lean Cuisine.
At university in the 1980s, Yaqoob recalls buying butter ghee to cook with. “When my mum came around to visit, she was surprised because she had shifted to vegetable ghee, which was considered healthier,” she recalls.
Reducing fat became the mantra of the 1980s. In 1985, the frozen food brand Findus introduced a new “Lean Cuisine” range to its UK offerings. How did they make them low calorie? By cutting out excess fat. Following the same principle, breakfast cereals – often made from refined carbs – began to replace the fat-based breakfast.
At the same time as the war on saturated fat was taking place, academics were proving the benefits of polyunsaturated fats; a type of healthy fat that includes omega-3 and omega-6 fatty acids.
By the 1980s, when Grimble moved into clinical research and gastroenterology, the use of fish oils as an anti-inflammatory was coming into popular consciousness.
A clinical trial published in the Lancet in 1989 studied men who had already had a heart attack and put them on diets that increased their fatty fish intake, fibre intake and decreased their saturated fat intake. “Nearly half the men under 70 years of age who had survived myocardial infarction and who entered the trial found that the diet reduced heart attacks by 29 per cent.”
Colleagues in the field were also exploring the importance of dietary fibre.
“Nutritional epidemiologist Sheila Bingham set up a clinical nutrition centre in Cambridge where they started to look at the metabolism of fibre in the colon and short-chain fatty acids,” says Grimble.
“It was discovered that butyric acid is brilliant because it causes cells to differentiate. Anything that causes cells to differentiate is an anti-cancer agent. Fibre became really groovy.”
Meanwhile, the protein content of beans was also being reappraised and found to be good in terms of quality.
The low-fat mantra continued to grip nutritional guidance and the decade experienced peak fatphobia. So it’s perhaps no surprise that the humble spud suddenly acquired a shining health halo, thanks to its energy-giving high carb status. Fibre became trendy as scientists discovered its cholesterol-lowering properties. Baked beans – cheap, tinned and loaded with soluble fibre – were suddenly granted a prime position on the “healthy plate”.
The 1990s also saw the rise of functional foods like the probiotic drink Yakult, along with fortified cereals. Slimfast shakes became popular with dieters.
Public health messaging largely centred on reducing fat (especially saturated fat) and eating plenty of starches. “We worried about cholesterol in foods like eggs and prawns, and often chose low-fat everything, even if it meant more sugar!” says Ludlam-Raine.
With the nation in search of healthy polyunsaturated fats, olive oil use increased significantly, helped by the rise of celebrity chefs and cookery shows.
In 1994, The Balance of Good Health plate, the UK’s first national food guide, was introduced – a visual representation of a healthy, balanced diet, divided into five food groups with recommended proportions.
A combined project between the Department of Health, the Ministry of Agriculture, Fisheries and Food and the Health Education Authority, the largest two segments were fruit and vegetables; and bread, other cereals and potatoes. The smaller three were milk and dairy foods; meat, fish and alternatives; and foods containing fat and sugar.
The guide was intended to represent an overall diet and not individual meals.
In the early 2000s low-carb diets like Atkins were all the rage. Red meat was still widely seen as a protein-rich healthy choice and steak was practically considered a diet food.
In the UK sales of bacon, eggs and steak rose while bread and pasta began to decline.
It was the decade when wholegrains finally moved out of the health shop and into the supermarket basket, and we understood that not all carbohydrates are made equal.
“We started talking about wholegrains and the glycaemic index (GI),” says Ludlam-Raine.
As well as being encouraged to eat at least five-a-day for fruit and veg, she adds: “Healthy fats from nuts, olive oil and oily fish gained traction too.”
The popularity of the Atkins diet, with its emphasis on reducing carbohydrates and increasing healthy fats, was fuelled by concerns that low-fat products often contained high amounts of added sugar to compensate for the removed fat.
“We realised a low-fat diet is probably higher in carbohydrates, and not all carbohydrates are the same. Complex and wholegrain are better. There became nuances to the whole low-fat story that weren’t there before,” says Yaqoob.
Another major change was the shift away from worrying about dietary cholesterol from eggs, with major health organisations updating their guidelines to remove specific limits on egg consumption. There is now no recommended limit on how many eggs people should eat, as long as you eat a varied diet.
“People used to worry about cholesterol intake, but actually now we don’t worry about that at all because the cholesterol intake in a diet is very small and it doesn’t really have an impact on your blood cholesterol,” says Yaqoob.
In 2007, the Eatwell Plate replaced the original 1994 graphic. The sizes of the segments on the plate stayed the same, but some of the wording changed.
Instead of “bread, other cereals and potatoes”, the carbohydrate section of the Eatwell Plate was labelled as “bread, rice, potatoes, pasta and other starchy foods”.
The change reflected the influence of international cuisines on the UK diet.
Similarly, the protein segment expanded to include eggs, beans and other non-dairy sources of protein; acknowledging the wider range of protein sources available beyond meat and fish and a greater understanding of plant-based proteins.
In this decade all-out fatphobia was overtaken by a focus on healthy fats. The avocado went from being an exotic guacamole ingredient to a full-blown global lifestyle accessory. Plant-based diets got a turn in the spotlight, largely thanks to the rise of clean-eating influencers like Deliciously Ella.
Quinoa, kale, avocados and plant-based milk alternatives took centre stage in the 2010s, and we also saw the rise of very low-carb diets like keto. This was the decade when the depth of knowledge about nutrition sometimes threatened to take all the fun out of eating, and our shopping baskets often prioritised the exotic over the sustainable.
When the Eatwell Plate was updated in 2016, the main difference was the amount of nutritional information it sought to convey. As such, the changes became known as the Eatwell Guide.
Fibre was promoted to the top seat, with a greater emphasis on higher-fibre starchy carbs, a larger veg and fruit segment, beans, pulses and plant proteins.
The focus remained on lower-fat dairy or alternatives, and small amounts of unsaturated oils.
A major change was to start thinking about limits, not just allowances, particularly when it came to sugar. Treats, such as chocolate, biscuits, crisps, ice cream and various condiments such as tomato ketchup, it made explicit, should be eaten less often and only in small amounts.
“It brought in free sugars limits (30g a day for added sugars and those found in honey and fruit juice) and hydration guidance, i.e. more plants, more fibre, less free sugar and salt,” says Ludlam-Raine.
Food quality, fibre and the overall pattern of our diet is now considered more important than single nutrients. Wholegrains and healthy fats, like omega-3 rich salmon steaks are in, while ultra-processed foods, including diet ready meals are the enemy; less healthy plate, more naughty step. To some extent we’ve come full circle, as good old-fashioned home cooking is rightfully celebrated.
Kefir, sauerkraut and kimchi are also popular; fermented foods hardly figured in healthy diets until recently. While discussed in dietetic circles since the 1980s, it’s taken nearly 40 years for the gut microbiome to go mainstream.
“We called it the colonic microflora, but it’s now called the microbiome and it has become quite a mysterious entity,” says Grimble.
Now we know that fermented foods offer a range of health benefits.
“We’ve come a long way from when Ski yoghurt was introduced in 1963,” says Grimble.
Otherwise, the same healthy plate principles still hold as in 2016, with the major difference being a focus on a variety of micronutrients. The 30-a-week principle has seen us sprinkling nuts and seeds on our plates and experimenting with lentils and tofu.
“We’ve moved away from obsessing over single nutrients and towards patterns that protect heart, gut and metabolic health. The modern ‘perfect plate’ is fibre-rich, plant-focussed and still flexible enough to fit real life, including the likes of frozen veg, tinned pulses and quick wholegrain options. Healthy eating in 2025 is about patterns, not perfection: more plants, fewer free-sugars, moderate healthy fats and food that fits your culture, budget and schedule,” says Ludlam-Raine.
Concern about sugar now extends to worry about ultra-processed foods, in particular their effect on satiety.
Tins and frozen, however, have had a comeback: “We now recognise that frozen and tinned (in their own water/ juice, and with no added sugar or salt) are budget and time-friendly wins,” she adds.
After decades of the low-fat mantra dominating our diets there’s also been a decided back-track.
Full-fat milk is no longer the “no no” it once was. While it has a higher saturated-fat content, there are positives in terms of satiety.
“Cows’ milk in general is quite beneficial,” says Grimble. “Number one, it’s a carrier of a lot of iodine, of which we’re marginally deficient in the UK.”
He also states that research, meta-analyses and systematic reviews indicate that saturated fats are problematic, but not very problematic. “Certainly not as problematic as trans fats, which have been consigned to the dustbin. You should reduce them but they’re not hugely risky.”
Indeed, recent studies have shown that certain dairy products, including cheese, may have a neutral or even protective effect on cardiovascular health, despite their saturated fat content.
He is unconvinced by a fully plant-based approach. “Our guts are designed so that we are omnivores,” he explains. “So there’s quite a lot of room for the diet to adapt to more or less meat. However vegans are too strict. It really is an exclusionary diet and most of those have problems. Plant-based protein such as soya is not bad, but it’s not as good as beef or milk.”
Yaqoob doesn’t entirely agree regarding saturated fats, and says: “Recently some people have been arguing saturated fats are not bad, but there is quite a lot of evidence stacked against them over time.”
Grimble would welcome a return of some of our 1970s staples.
“Butter isn’t as bad as it’s been made out,” he says. “And potatoes are wonderful. The problem with potatoes is that you have to cook them, and I think it’s factors like that that have had an impact on the way people eat.”