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It has long been known that consuming a diet that is rich in fruit and vegetables is beneficial for our physical and mental health. However, it is important that healthy diets are also sustainable for the natural environment in terms of greenhouse gas emissions, water consumption, and land use. According to the Eatwell Guide, the recommendations given for a ‘healthy diet’ also have a 32% lower environmental footprint than the current national diet. Therefore, supporting a diet that is similar to the Eatwell Guide is important for sustainability as well as health.
However, and rather crucially, the price of purchasing a healthy, sustainable diet is often higher than the cost of a less healthy diet. The Food Foundation estimates that healthy foods are over twice as expensive per calorie as less healthy foods. So, whilst the benefits of consuming fruit and vegetables are undeniable, what is questionable is whether such a diet is accessible and affordable for all.
The current cost of living crisis is highlighting the difficulties faced by some households to purchase food, with the decision to either “heat or eat” becoming increasingly common. Food insecurity refers to the inability to reliably access a sufficient quantity of affordable and nutritious food, and the cost of living crisis has meant that even more households are struggling in this respect. Individuals experiencing food insecurity often cope with this by purchasing cheaper, but less healthy foods as a means of survival. However, prolonged consumption of high calorie, nutrient-poor food is linked to weight gain and the development of obesity, which may further widen existing socio-economic inequalities in health.
The Collaboration for Healthier Lives in the UK report families experiencing food insecurity spend up to 76% of their monthly food budget in supermarkets. Hence, supermarket promotions, advertising, and online product placement are instrumental in healthy food affordability and accessibility to healthy food. Evidence is needed on how to best support people living with both food insecurity and obesity to make healthier, more sustainable food choices that will not only benefit their own health but also the planet’s.
Given this, myself (Dr Rebecca Stone), Professor Charlotte Hardman and Dr Mark Green from University of Liverpool are part of a large, 3-year, UKRI funded project, led by University of Aberdeen: FIO Food: Food Insecurity in people living with Obesity. The overall aim of this project is to provide actionable evidence for policy on retail strategies to address dietary inequalities in people living with obesity and food insecurity, to support sustainable and healthier food choices in the UK food system (Figure 1). Work Package 1 is led by Professor Hardman and supported by myself, and Dr Green supports Work Package 2.
Figure 1: An overview of the FIO Food project.
In Work Package 1, we are concerned with the lived experience of people living with obesity, and so we have looked at how the cost of living crisis is associated with food insecurity and what coping strategies in regards to cooking and preparing food are used in response to this crisis. To investigate this, we conducted an online survey of 583 people living with obesity. Our findings suggested that greater perceived impact from the cost of living crisis was associated with greater experiences of food insecurity, and greater experiences of food insecurity were associated with greater use of budgeting practices, use of supermarket offers, use of energy saving appliances, and use of resourceful cooking, but not with the use of meal planning (see figure 1). A pre-print is available to read of this paper.
Figure 2: Findings from Work Package 1 exploring the relationship between the cost of living crisis, food insecurity, and food purchasing behaviours and food preparation practices.
Work Package 1 is also concerned with understanding what people living with obesity and food insecurity might find helpful to support them with purchasing healthier, more sustainable food in the supermarket. We found that to support healthy food purchasing, the most helpful solutions were related to price and incentivisation strategies (e.g., price discounts on healthy food), and the least helpful solutions were related to education and awareness (e.g., calorie labelling) (Figure 3).
Figure 3: A summary of what was ranked as the most helpful to people living with obesity to purchase healthier food in the supermarket.
We also found that to support sustainable food purchasing, the most helpful solutions were also related to price and incentivisation strategies (e.g., offers/promotions on sustainable food), and the least helpful solutions were also related to education and awareness (e.g., carbon footprint round up of basket) (Figure 4).
Figure 4: A summary of what was ranked as the most helpful to people living with obesity to purchase healthier food in the supermarket.
To find out more about our work on the FIO Food project and to keep up with our findings, follow us on X: @CharlotteHardm3 and @DrRAStone
This research is funded through the Transforming the UK Food System for Healthy People and a Healthy Environment SPF Programme, delivered by UKRI, in partnership with the Global Food Security Programme, BBSRC, ESRC, MRC, NERC, Defra, DHSC, OHID, Innovate UK and FSA.