New research shows we struggle to adhere to advice on what to eat and drink - despite the impact on our lifespan. Photo / 123RF
Judging by our cultural obsessions, you'd be forgiven for assuming that Britain has become a nation of foodies. We watch the cookery shows, buy the accompanying books, visit farmers' markets, and invest in expensive kit (bread machines, blenders, slow cookers and so on).
We also apparently care about health and nutrition. By 2020, the UK's health and wellness industry was worth more than GBP£20 billion (NZ$40b). We measure our calories and count our steps using fancy wearable tech.
Yet our diets have barely improved in the past 30 years. A global study led by researchers at Tufts University in Boston, Massachusetts, has found that countries around the world are now only slightly healthier than in 1990, and the UK is no exception.
Using the Alternative Healthy Eating Index, which ranks diets on a scale of zero to 100, with zero denoting heavy consumption of sugar and processed meats and 100 representing the optimal balance of fruits, vegetables, legumes, nuts and whole grains, the study found Britain had improved by just 1.5 points, to 42, by 2018. This despite a series of healthy eating campaigns – most memorably the state-backed exhortation, since 2003, to eat our five-a-day.
Why, then, do unhealthy diets remain so deeply entrenched? Data from the National Diet and Nutrition Survey suggests only a third of adults aged 19 to 64 were meeting the five-a-day target for fruit and vegetable consumption by 2019. And while last month's study examining dietary changes since 1990, published in the Nature journal, found higher education was generally linked to greater consumption of healthy foods, it was not always linked to lower consumption of sugar-sweetened beverages and red or processed meat.
Separate studies published last month found more than 80 per cent of the UK population will be overweight or obese by 2060, at a cost to the economy of £142 billion ($284b) a year, and cancer cases among under-50s are rising rapidly, with ultra-processed or junk food believed to be the main culprit.
In Scotland, life expectancy at birth has now fallen to 76.6 for boys and 80.8 for girls, according to new data published in September, compared with 79.3 and 83.1 respectively in England.
"The conversation I have repeatedly [with patients] is that people are aware [of the need to eat well] but it just doesn't fit in with their lifestyles," says Dr Gero Baiarda, clinical director at GPDQ healthcare services and a member of MyGP.
"They find it inconvenient. Whether it's lunch or dinner time, people say, 'I'm busy and it's easy to stay at my desk and get a Deliveroo.' "
Patients at his practice in Windsor also report exhaustion as a demotivating factor when it comes to cooking healthy meals from scratch.
Even if some of those meals purport to be healthy, the true story is often different. "I think there's ignorance about what is actually in food and I've been blown away sometimes by the calorie counts on things I've considered healthy," says Baiarda. The vast majority of convenience foods are low in protein and fibre and high in salt, sugar and fat.
Even baby foods have been found to contain alarming amounts of sugar. In July, a British Dental Association survey of 109 food pouches aimed at children under 12 months found more than a quarter contained more sugar by volume than Coca-Cola.
Instead of a nation of foodies, we have become a nation of addicts, hooked on sugar and salt before we can even walk.
"We are becoming a sugared nation from the moment we're born," says Tam Fry, chairman of the National Obesity Forum. "First foods for children are stuffed full of sugar and that's what they've come to expect from a very early age. Shifting that is an absolutely impossible task."
Another problem, suggests consultant dietitian Helen Bond, is a continuing lack of knowledge of how to go about cooking meals from raw ingredients. "People don't have the know-how," she says: "People know they should be eating more fruit and vegetables and fibre, but what we're missing is [knowledge of] how to put that into practice."
In 2016, a study by Lurpak found Britons spent more than five hours a week consuming "food media", but only four hours actually cooking. Psychologists have come up with various theories to explain why we bother watching these shows if we're not actually home cooks ourselves, including the reality element that makes us feel connected to those on screen, and the programmes' ability to emotionally transport us. Home-made food has become aspirational, it seems.
Evidence suggests that cost – or at least the perception of it – is often a factor when making suboptimal food choices. "Cost is a barrier for about a third of people who don't eat enough fruit and vegetables," said the Association of UK Dietitians in 2019. "Some say they simply can't afford them whilst others say they can't buy as many fruit and vegetables as they would want to."
Plenty of cooks will counter that it's entirely possible to eat well on a budget, as long as you're willing to try. Indeed, the World Cancer Research Fund has reported previously that you can in fact eat your five-a-day for about 42p (0.84c). (Granted, this price has no doubt risen amid recent inflation.)
It's arguably easier to make the right choices in some parts of the country than others. A Social Market Foundation report on the barriers to eating healthily found access to food may be a barrier for those living in so-called "food deserts" – areas poorly served by food stores. Some households, said the authors, "may find it difficult to easily access a wide range of healthy, affordable food products". Its analysis suggested eight per cent of deprived areas in England and Wales were food deserts, with an estimated total of 10.2 million people in Britain living in places where healthy food was harder to come by. Rural communities were overrepresented in this category.
For the rest of us, even with our easy access to supermarkets, it still undeniably takes longer to cook from scratch. While we might be willing to spend our time (and money) on food in restaurants, the number of which has grown dramatically since 1990, we're perhaps less keen to spend it at home, where meals have become quicker and less communal.
"Historically, we ate more around the table," says Bond. "Now, more people eat on the go or in front of the television."
Unpicking the lifestyle changes that got us here might be a tall order. But, argues Fry, ministers can and should act to curb the freedom of the food industry to keep us locked in unhealthy habits. "Successive governments have failed to get the food industry to get its act together," he says.
There are so far few signs Liz Truss will be the prime minister to change this. She already hopes to scrap the sugar tax on soft drinks and is reviewing other anti-obesity measures, which could potentially lead to the ditching of the ban on high-sugar products being displayed at supermarket checkouts and the requirement for calorie counts on menus.
It has been pointed out many times that failure to step up intervention costs the taxpayer dear when the NHS is left to pick up the bill, down the line.
In the meantime? "We need to provide practical advice that appeals to different socioeconomic groups, depending on people's budgets," says Bond. "And we need to make sure we're choosing the right foods when we go shopping – buying in season – and cooking from scratch. It doesn't have to be expensive, but we've got to help people make those choices. It's about giving people confidence."
At face value, it seems as though peanut butter is an unhealthy choice as it's high in calories. But spread on whole grain toast or sliced apple, it makes for a snack that will keep you fuller for longer. That is thanks to its high protein and healthy fat content; it also provides a source of fibre, vitamins and minerals (such as Vitamin E and potassium). Almond butter is another good choice, as it's a source of essential omega-3 fatty acids.
Make your own version with a bit less salt and sugar for a high-fibre snack that's surprisingly healthy. When popped at home, rather than in a vat of oil, popcorn is relatively low in calories (around 120 calories per 30g serving). Most people don't consume enough fibre – only one in 10 Britons reaches the recommended 30g per day – so homemade popcorn could be a good way to boost your wholegrain intake.
You may think of cheese as an end-of-dinner-party indulgence but, when consumed in moderation, it can be a valuable source of protein and calcium for maintaining bone health. While most cheeses are relatively calorie-dense, research has actually shown that dairy intake is associated with a reduced risk of childhood obesity and, in adults, improved body composition.
A steak a day would be overdoing it, but red meat has multiple health benefits provided you choose the right source. It's rich in iron, zinc and B vitamins, as well as being one of the main dietary sources of vitamin B12, which helps with the production of red blood cells and the maintenance of the nervous system. A healthy, balanced diet can include up to 70g of red meat per day, according to NHS guidelines. Opt for unprocessed, lean sources of red meat, like a pork tenderloin or skinless duck breast, to reap the nutritional benefits with less saturated fat.
Cocoa-rich dark chocolate contains antioxidant compounds called flavanols, which have been proven to protect against the buildup of cholesterol as well as slightly lowering blood pressure. Another study found that dark chocolate can even improve cognitive function by increasing blood flow. Of course, you should savour a few squares rather than eat the whole bar – which is easier said than done.
Washington Post: The mindset should be - less fuss, more fun with company.