The definition of what constitutes a healthy diet is continually shifting to reflect the evolving understanding of the roles that different foods, essential nutrients, and other food components play in health and disease. A large and growing body of evidence supports that intake of certain types of nutrients, specific food groups, or overarching dietary patterns positively influences health and promotes the prevention of common non-communicable diseases (NCDs). Greater consumption of health-promoting foods and limited intake of unhealthier options are intrinsic to the eating habits of certain regional diets such as the Mediterranean diet or have been constructed as part of dietary patterns designed to reduce disease risk, such as the Dietary Approaches to Stop Hypertension (DASH) or Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. In comparison with a more traditional Western diet, these healthier alternatives are higher in plant-based foods, including fresh fruits and vegetables, whole grains, legumes, seeds, and nuts and lower in animal-based foods, particularly fatty and processed meats.

Non-communicable diseases (NCDs) such as cardiovascular disease, cancer, chronic respiratory diseases, diabetes, obesity, and cognitive impairment are among the leading causes of death and disability throughout the world, affecting populations in developed as well as developing countries . Although there are established genetic and environmental contributors to NCD risk, modifiable lifestyle-related factors play a large role at the individual level. Dietary choices, for example, contribute to the risk for developing hypertension, hypercholesterolemia, overweight/obesity, and inflammation, which in turn increase the risk for diseases that are associated with significant morbidity and mortality, including cardiovascular disease, diabetes, and cancer. Indeed, the marked rise in chronic NCDs has a causal link to global dietary patterns that are becoming increasingly Westernized, being characterized by high levels of fatty and processed meats, saturated fats, refined grains, salt, and sugars but lacking in fresh fruits and vegetables.

In recognition of the importance of the diet as a determinant of disease risk, the World Health Organization (WHO) Global Action Plan for the Prevention and Control of Noncommunicable Diseases includes strategies for addressing unhealthy diet patterns among its initiatives directed at reducing behavioral risk factors; the other components comprise physical inactivity, tobacco use, and harmful alcohol use. Dietary changes recommended by WHO include balancing energy intake, limiting saturated and trans fats and shifting toward consumption of unsaturated fats, increasing intake of fruits and vegetables, and limiting the intake of sugar and salt.

The main problems in eating healthy

The average person could probably recite the recipe for healthy eating: more fruits and vegetables, less red meat and processed foods. It sounds simple enough. Yet Americans still struggle to follow a healthy diet. Heart disease remains the leading cause of death, and obesity rates have grown from 30.5% in 2000 to 42.4% in 2018. Adopting a healthy diet can help combat both of these, but only an estimated 22% of Americans follow the American Heart Association’s dietary recommendations. So, if we know how to eat healthy, why doesn’t everyone do it? Part of the problem lies in people’s misguided assumptions. Many still view healthy eating as being too restrictive — low fat, low calorie, low sugar. Then there are the perceptions that healthy foods are expensive and recipes complex.

A healthy, balanced diet can help us keep a healthy weight, reducing our risk of 13 different types of cancer. And what you eat can also have an effect on your risk of cancer. Eating too much processed meat increases the risk of bowel cancer. Whereas a diet low in red meat and high in fibre from wholegrain foods may reduce the risk. But a healthy diet is not always easy to achieve, and people from lower income groups face substantial challenges when it comes to accessing healthy food.

Inequalities in diet and eating are extremely complex – the healthy option is not always the easy option, or an option at all. But there are still things that can be done to tackle the differences between groups in access to healthy balanced diets. Lack of resources take healthier options off the table for some. And the proliferation of fast-food outlets in more deprived areas provide a quick, easy, and often less nutritious alternative.

Food gives us energy (measured in calories) and the nutrients we need to keep our bodies fuelled up and ticking over. And when faced with these limited resources, high-calorie meals are often the easiest and cheapest option available. Products that are higher in fat, salt and sugar often have more calories, are cheaper, and are more likely to be advertised and part of price promotions such as 2-for-1 deals.

If someone is struggling to make ends meet, then they are more likely to be buying these products to get enough calories. And it’s not just the cost of products, but the cost of products relative to others that is really important. With costs of food and other household bills rising faster than income, more people are facing the prospect of food poverty or food insecurity .

The food trends are making it worse

Most people imagine a scientific study to be a controlled, cause-and-effect experiment that takes place in a lab. But studying people and their habits is much more complicated. The majority of food studies aren’t providing conclusive evidence, They are simply giving theories based on observing a group of people. It’s not a controlled experiment.

The majority of food research is based on observational studies, which means a group of people is followed to see what happens over time. Studies search for answers to questions such as: Who lives longer? Who is more likely to develop a certain illness? Who is happier? Scientists attempt to determine what factors in people’s lives could be responsible for certain outcomes.

But the problem is that one group of people who make a particular lifestyle choice such as drinking coffee can be different in a variety of ways from people who don’t. Maybe they sleep more or less, eat more fruit, exercise more, make more money, have a better job or are different races or ethnicities. It’s just impossible to tease out the effect of an individual food out of someone’s busy, complicated life.

Instead of focusing on a few healthy foods to eat, it’s much better to have a healthy eating philosophy that guides your decisions when you’re planning meals, grocery shopping or going out to eat. Otherwise, it can be difficult to navigate the more than 200 food decisions you make each day, most of which are done on autopilot.

For example, if you follow a Mediterranean-style diet — which has been shown to reduce the risk of heart disease — you’re more likely to make decisions consistent with that philosophy of eating whole and nutritious foods. You’ll select more vegetables and fish at the grocery store, use olive oil in your cooking, and choose salmon and couscous over macaroni and cheese at a restaurant.

It’s better to ignore the hype about individual foods and instead try for an overall healthy eating pattern, like the Mediterranean diet. There’s good evidence that it leads to better heart health, although we still can’t say whether it’s the nuts or the oils or point to any specific food within the diet as being the one that makes the difference.

Young people turn to social media to gather meal inspiration and are influenced by the food trends they see on the various platforms. Since it is an environment where visual and social cues overlap, users are more impressionable and more likely to copy the food they see online. Furthermore, research indicates that social media may be altering our relationship with food. A study predicts that young people are exposed to food marketing around 30-189 times per week on social media, with high sugar and fast food being most commonly shown. According to the same study, young people who were exposed to vloggers promoting sugary and fatty snacks went on to eat 26% more calories than those who didn’t.

Many influencers who promote food content do not have an established food or nutrition background. Whilst enthusiastic, they may not fully understand the impact of what they are promoting to impressionable minds and the repercussions that may have over the long term.

It is not easy to change

We’re surrounded by information on taking care of ourselves, and we all know healthy eating is an important part of the equation. So why is it so hard to stick to a balanced diet and avoid junk food? Food is more than just fuel for our body—it’s part of our social and emotional lives. Lifestyle, stress and convenience play a big part in making unhealthy choices, even when we know better.

The psychology of junk food

There’s more to healthy eating than knowing what’s good for us. Junk food and unhealthy choices are available everywhere we go. In the supermarket, at the checkout (even if we avoid the lolly aisle). It’s promoted everywhere we go. Unhealthy choices are always there, and if you’re feeling vulnerable—particularly if you’re busy, stressed or tired—they’re ready to exploit you. We eat for a lot of different reasons: when you’re hungry, on social or family occasions when you’re expected to indulge, or sometimes you may comfort eat to make yourself feel better.

Comfort eating

Comfort eating (also called emotional eating), can be triggered by stress or anxiety, or can become a habit formed as a child. If comfort eating is part of your struggle with unhealthy foods, you can try:

• Focusing on getting enough sleep—there’s a link between fatigue and comfort eating
• Starting a food diary to identify what triggers your emotional eating—when do you do it and why
• Trying to eat healthier foods if you do comfort eat
• Look for new ways to manage stress and relax
• Don’t be afraid to talk to your doctor or other health professional for help. It’s a common issue and they’ll support you.
• Avoiding guilt—changing your eating habits is a long-term goal and feeling bad can lead you right back to unhealthy foods.

Food myths

Just as you can feel surrounded by junk food designed to destroy your willpower, myths about healthy food choices are everywhere too.

• Skipping meals: Don’t let feeling guilty tempt you to skip a meal to ‘save up’ for a splurge or make up for some junk you’ve eaten—you’ll be doing more harm than good. Research shows skipping meals can lead to eating more when you do eat and increase your stomach capacity. If your stomach size increases, you need more food to feel full.
• Weight loss superfoods: There are no magical foods that guarantee weight loss or burn body fat. The best choice is a balanced diet and small, sustainable changes to your lifestyle.
• Crash diets: If you lose weight quickly, you’re likely to put it back on within five years.

The takeaway trap

Even if you’re determined to eat healthily, being busy means you may end up eating out and looking for something convenient. Even with the best intentions, it can be tough to stay on the straight and narrow with takeaway options.

It’s tough to choose a healthy takeaway, because:

• It can be hard to regulate portion sizes—the food isn’t on a normal plate or bowl, so it’s tough to judge how much you’re eating.
• It’s a slippery slope—you may fall into the ‘upsize’ or ‘combo’ temptation and end up with sides and unhealthy extras you didn’t plan on.
• There are a lot more healthier options around these days, but you still don’t know what ingredients are going into most takeaways.
• Most ‘fast food’ choices don’t offer balanced meals containing vegetables, protein and carbs.

Why eating healthy matters?

There are many benefits of eating healthily. Healthy eating can:

• Lower your risk of chronic health conditions, such as heart disease, type 2 diabetes, and some cancers
• Support immune function
• Help the digestive system function
• Help to maintain a healthy weight
• Keep your bones and teeth strong and healthy
• Repair and strengthen muscles
• Improve energy levels
• Support brain function and brain health
• Boost mood
• Help with sleeping patterns
• Support healthy growth and development in children
• Supports healthy pregnancies

Poor nutrition is when we don’t get enough of the nutrients we need from our diet. This may happen for a number of reasons, such as following a diet that doesn’t contain a wide variety of healthy, nutritional foods. It can also occur when we follow a diet that is high in saturated fats, salt and sugar. Poor nutrition can also be caused by not eating enough or eating too much.

Some of the effects of poor nutrition include:

• Obesity – a poor nutritional diet full of fat and sugar can cause obesity, which is a major risk factor for many health conditions
• High cholesterol – high cholesterol levels can cause clogged blood vessels and lead to serious health problems
• High blood pressure – also known as hypertension, high blood pressure can be caused by poor diet and can lead to strokes, heart failure and kidney disease if left untreated
• Diabetes – being overweight and inactive, as well as a diet that is high in fat, carbohydrates, sugar and cholesterol, are all type 2 diabetes risk factors
• Cancer – research suggests a poor nutritional diet may be linked to an increased risk of developing certain cancers, such as bowel cancer
• Osteoporosis – a poor diet without enough vitamin D and calcium can increase your risk of osteoporosis — a health condition that causes bones to become weaker and more fragile
• Heart disease and stroke – other health conditions caused by poor diet, such as hypertension and high cholesterol, can increase your risk of stroke and heart disease

If you want to start eating more healthily, there are a number of easy changes you can make to your diet.

Here are some healthy eating tips:

• Eat your 5 a day: fruit and vegetables are full of many of the nutrients we need to maintain good health and support immunity, such as vitamins and minerals
• Base meals around high-fibre foods: a diet rich in fibre can reduce your risk of high cholesterol, hypertension, type 2 diabetes and heart disease. Choose wholegrain or wholemeal versions of pasta, rice and bread, which contain more fibre, vitamins and minerals than the white versions
• Eat a portion of oily fish a week: oily fish such as salmon and trout is full of omega-3 fatty acids, which are great for heart health (lowering your risk of heart disease)
• Include dairy or dairy alternatives in your diet: dairy products such as milk, yoghurt and cheese are rich in calcium, which helps keep your bones and teeth strong (and can protect you from osteoporosis as you get older). Fortified dairy alternatives like oat milk or soy products can also provide this, along with various other vitamins and minerals
• Eat plenty of legumes: beans, lentils and peas are all high in protein and fibre while also being low in fat — so they’re a great way to bulk out meals
• Eat less red meat: while red meat is a good source of protein, too much red meat (such as beef, pork or lamb) in your diet can increase your risk of high cholesterol and heart disease. Try to limit or avoid processed meats such as sausages and burgers, which are high in saturated fat
• Limit sugary foods and drinks: these can increase obesity and cause tooth decay. Avoid sugary snacks such as cakes, chocolate and biscuits and opt for fruit instead