Poor diet and food insecurity in the UK

People in poverty get sicker and die younger than the rest of the population.  These are health inequalities and this is the focus of Bag of Taste’s work.  Many of the diseases that affect them are disproportionately diet-related, such as obesity, diabetes, heart disease, mental illness, and cancer.

To understand the causes of poor diets, click here, or read on for more details

Current diets in the UK

In 2015-2016, the UK population overall were not eating enough fruit, vegetables, oily fish, or fibre, and were eating too much sugar and saturated fat . Public health campaigns such as ‘5-A-Day’, introduced in the early 2000s, and Change4Life, launched in 2009 (DEFRA 2017) saw some positive changes, however these were reversed after the financial crisis of 2007 and haven’t yet recovered. We also know that disadvantaged people (e.g. people on low incomes and those living in deprived neighbourhoods) are more likely to consume unhealthy diets and are less likely to respond to these public health campaigns (The Marmot Review 2010, Magurie 2015a, Adams 2016). This may partly explain why disadvantaged groups also experience more chronic diseases, such as cardiovascular diseases, type 2 diabetes, cancers, and related conditions like obesity (Petrovic 2018).

Why does a healthy diet matter?

Eating a healthy diet high in fruit, vegetables, and low in salt, sugar, and fat is considered a major way to reduce the risk of developing chronic diseases and poor quality of life. The World Health Organisation estimated that poor diet is related to 30% of life-years lost globally, i.e. the years of life lost due to early death and disability (World Health Organization 2002). Meanwhile, research has found that poor diet is responsible for about 10% of chronic illness and death in the UK, similar to the amount due to smoking (Rayner 2005). Chronic diseases place an enormous economic strain on the NHS, let alone the devastating effects on the lives of people affected and their families.

Why do people have poor diets?

There are multiple and complex factors that influence dietary choices (Furst 1996, Mozaffarian 2018). However, there are three key factors: affordability, availability, and knowledge/skills (Aggarwal 2011). For the Bags of Taste analysis of the factors, click here

Affordability

The Department of Health defines food poverty or household food insecurity as the “inability to afford or to have access to food to make up a healthy diet”. Shockingly, this is a real issue in the UK, and has gotten worse since the financial crisis in 2007 (DEFRA 2017). The charity Sustain estimates that 8.4 million people in the UK struggle to get enough to eat (https://www.sustainweb.org/foodpoverty/whatisfoodpoverty/). Between 2017 and 2018 The Trussell Trust, the largest UK food bank network, provided over 1.3 million three-day emergency food supplies; a 13% increase on the previous year (https://www.trusselltrust.org/news-and-blog/latest-stats/end-year-stats/). Since 2007 the price of food has risen (DEFRA 2017), which has hit low-income households the most (Houses of Parliament 2016).

Availability

The availability of unhealthy food is another barrier to achieving a healthy diet. The number of fast food outlets in the UK has increased dramatically over the past ten years (Food Foundation 2016) with disproportionately more fast food outlets concentrated in deprived areas (Macdonald 2007; Magurie 2015) and conversely, deprived urban areas have much lower access to fresh vegetables and fruits. This can have detrimental effects on the choices and health status of people living in these areas. One large study found that the greater the amount of fast food outlets in an area, the more fast food people ate and the higher their risk for obesity (Burgoine 2014).

Knowledge and skills

Knowledge and skills around home cooking and healthy food are other important factors to achieving a healthy diet. In one study, men of retirement age reported that poor cooking skills and low motivation to change dietary habits were some of the main barriers to eating healthy (Hughes 2004). In another study in Scotland, women who reported low cooking skills and who think healthy foods take too long to prepare were less likely to meet the fruit and vegetable dietary recommendations (McMorrow 2017).

 

How are Bags of Taste helping?

Bags of Taste tackles issues of poor diet and household food insecurity by targetting people in poverty that have repeatedly and consistently failed to improve their diets, and providing them with the wrap-around support that they need.  Our participants have multiple barriers to cooking and need economic, practical and psychological support.  We particularly target deprived areas with high concentrations of fast food outlets where poor diet and household food insecurity are most likely. In turn, we minimise chronic disease and financial difficulty.


References

Adams J, Mytton O, White M, Monsivias P (2016) Why are some population interventions for diet and obesity more equitable and effective than others? The role of individual agency. PLOS Medicine

Aggarwal A, Monsivais P, Cook A, Drewnowski A (2011) Does diet cost mediate the relation between socioeconomic position and diet quality? European Journal of Clinical Nutrition

Bann D, Johnson W, Leah L, Kuh D, Hardy R (2018) Socioeconomic inequalities in childhood and adolescent body-mass index, weight, and height from 1953 to 2015: an analysis of four longitudinal, observational, British birth cohort studies. The Lancet Public Health

Burgoine T, Forouhi N, Griffin S, Wareham N, & Monsivais (2014) Associations between exposure to takeaway food outlets, takeaway food consumption, and body weight in Cambridgeshire, UK: population based, cross sectional study. British Medical Journal, 348: g1464

Department for Environment, Food and Rural Affairs (2017) Food Statistics Pocketbook. DEFRA

Department of Health (2002) National Service Framework for Diabetes. London: Department of Health

Fabian Commission on Food Poverty (2015) Hungry for Change. Fabian Society and Lambie-Munford H, Crossly D, Jensen E, Verbeke M & Dowler E

Food Foundation (2016) Force Fed: Does the Food System Constrict Choices for Typical British Families)

Furst T, Connors M, Bisogni C, Sobal J, Winter Falk L. Food Choice: A conceptual model of the process (1996) Appetite

Houses of Parliament (2016). Postnote: Barriers to Healthy Food (2016)

Hughes G, Bennett K, Hetherington M (2014) Old and alone: barriers to healthy eating in older men living on their own. Appetite; 43(3): 269-276

Macdonald L, Cummins S & Macintyre S (2007) Neighbourhood fast food environment and area deprivation – substitution or concentration? Appetite, 49 (1): 251-254.

McMorrow L, Ludbrook A, MacDiarmid J, Olajide D (2017) Perceived barriers towards healthy eating and their association with fruit and vegetable consumption. Journal of Public Health: 39(2):330-338

Magurie E & Monsivias P (2015a) Socio-economic dietary inequalities in UK adults: an updated picture of key food groups and nutrients from national surveillance data. British Journal of Nutrition 113, 181-189

Maguire E, Burgoine T & Monsivais P (2015b) Area deprivation and the food environment over time: A repeated cross-sectional study on takeaway outlet density and supermarket presence in Norfolk, UK, 1990–2008. Health & Place, 33: 142-147)

Mozaffarian, D., Angell, S. Y., Lang, T. Rivera, J. A. (2018). Role of government policy in nutrition-barriers to and opportunities for healthier eating. BMJ ; 361:k2426

Petrovic D, deMestral C, Bochud M, Martley M, Kivimaki M, Vineis P, Mackenback J, Stringhini S (2018) The contribution of health behaviors to socioeconomic inequalities in health: A systematic review. Preventative Medicine

Rayner M, Scarborough P (2005) The burden of food related ill health in the UK. BMJ 59(12)

The Marmot Review (2010). Fairy Society, Healthy Lives: Strategic Review of Health Inequalities in England Post-2010. London, UK: The Marmot Review

World Health Organisation (2013) Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva: World Health Organisation

World Health Organisation (2002) World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organisation