Poor diet is the leading risk factor in the UK for morbidity and premature death, accounting for 12.5% of the total burden of disease, primarily due to cancer, cardiovascular disease and diabetes. In addition, two thirds of adults are overweight or obese - the consequence of sustained overconsumption - contributing a further 8.5% of all ill-health. If we are to create a sustainable healthcare system we need a stronger focus on the prevention of these avoidable diseases.
Fortunately the fundamental components of a healthy diet are well established - we need to consume less saturated fat, sugar and salt while instead eating more fibre, fruit and vegetables. Around 33,000 premature deaths could be avoided each year in the UK if we achieved the dietary recommendations for good health. But the simple concept of eating well belies the complexity of the change required and we need to rise to the challenge with a far more sophisticated portfolio of interventions than hitherto.
At best actions to date have been well-intentioned, but at worst they have been patchy and inconsistent. We have relied heavily on increasing knowledge, educating individuals to make better choices, while elsewhere condoning a food system that provides and promotes less healthy options. New research shows that most of what we eat is not the result of a reasoned choice, but rather that the purchase and consumption of food often occurs below the level of conscious decision-making. This implies that nudges in the environment to change the default choice to a healthier alternative will be an important component to improving eating habits. But some question whether this will be enough. Is stronger policy action required – a nanny to protect the nation from eating itself to an early grave?