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Published 10 January 2023
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This publication is available at https://www.gov.uk/government/publications/healthy-eating-applying-all-our-health/healthy-eating-applying-all-our-health
This guide is part of All Our Health, a resource which helps health and care professionals and the wider public health workforce prevent ill health and promote wellbeing as part of their everyday work.
The information in this module is aimed at the general population and will help frontline staff promote the benefits of a healthy, balanced diet.
Individuals requiring weight management advice or those with special dietary requirements or medical needs should receive tailored advice from their doctor and/or a registered dietitian.
We also recommend important actions that managers and staff holding strategic roles can take. View the full range of All Our Health topics.
Eating a healthy, balanced diet is an important part of maintaining good health and reducing the risk of chronic diseases such as cardiovascular disease, type 2 diabetes and some cancers, such as bowel, breast and pancreatic cancer. The World Health Organization (WHO) states that consuming a healthy diet throughout the life-course helps to prevent malnutrition in all its forms as well as a range of non-communicable diseases (NCDs) and conditions.
Research shows that most people in the United Kingdom do not meet government dietary recommendations. The most recent UK National Diet and Nutrition Survey (NDNS) data shows that population intakes of saturated fat, sugar, and salt are above the government recommendations whereas intakes of fibre, fruit and vegetables, and oily fish are below government recommendations. It is estimated that on average, adults’ diets contain 200 to 300 more calories than recommended a day, and children who are already overweight or living with obesity up to 500 more calories than are required for a healthy body weight.
In the financial year 2020 to 2021, the NHS in the UK is estimated to have spent £6.5 billion on overweight and obesity related ill-health. This is around 4.7% of the NHS budget. Reducing obesity and improving diets is essential to increasing healthy life expectancy.
Government dietary recommendations are underpinned by the latest scientific evidence, based on advice from the Scientific Advisory Committee on Nutrition (SACN). SACN’s remit is to assess the risks and benefits of nutrients, dietary patterns, food or food components to health by evaluating the evidence base in its entirety and making dietary recommendations for the UK population (including vulnerable and diverse groups) based on its assessment. See more information on SACN and their most recent reports.
Health and care professionals are widely relied upon to provide accurate, and evidence-based advice. The food and drink we consume is a topic of interest to us all and that is why it is so important that healthcare professionals who may speak to patients about this are well informed.
Government advice on a healthy, balanced diet is encapsulated in the UK’s national food model, the Eatwell Guide. The Eatwell Guide reflects the latest dietary recommendations and key public health messages. It applies to most people over the age of 5 and is suitable for vegans and vegetarians too.
The food group segment sizes of the Eatwell Guide were developed objectively using a mathematical modelling approach, underpinned by the scientific evidence base. This resulted in a model that meets UK dietary recommendations. The proportions shown are representative of food consumption over the period of a day or even a week, not necessarily each mealtime.
The Eatwell Guide provides a visual representation of the types and proportions of foods needed for a healthy balanced diet to promote long-term health at a population level and includes key messages such as:
The Eatwell Guide principles apply to most people regardless of weight, dietary restrictions, dietary preferences or ethnic origin. The foods included in the image are recognised as representative of the wider food group, including foods specific to particular ethnic minority groups.
Everyone should aim to drink 6 to 8 glasses of fluid every day. Water, lower fat milk and sugar-free drinks including tea and coffee all count. Although drinks containing caffeine, such as tea and coffee, are mild diuretics, the fluid component of these (for example, water and milk) negates any dehydrating effect at normal levels of consumption.
Fruit juices and smoothies also count towards fluid consumption, although they should be limited to no more than a combined total of 150ml a day.
Sugary drinks are one of the main contributors to excess sugar consumption amongst children and adults in the UK. Swap sugary soft drinks for diet, sugar-free or no added sugar varieties to reduce sugar intake in a simple step.
Alcohol can also contain lots of calories (kcal) and should be limited to no more than 14 units a week for men and women.
The calorific content of an alcoholic beverage depends on the type of alcohol, the volume served and the addition of mixers. As an example, 1 pint of standard strength lager contains approximately 136kcal, a 175ml medium glass of wine contains approximately 135kcal and a 25ml shot of spirit (40% vol) contains approximately 56kcal.
For more information on alcohol, see Alcohol: applying All Our Health. There is an interactive e-learning version of this topic now available.
Evidence from the WHO shows that consumption of more than 400g of fruit and vegetables a day is associated with a lower risk of heart disease, stroke and some cancers. Therefore, government advice is to consume at least 5 80g portions of a variety of fruit and vegetables a day. Despite the programme being known as ‘5 a day’, the recommendation emphasises consuming at least 5 portions a day, implying that this is a minimum consumption recommendation.
For dried fruit, a portion is 30g, which is roughly equivalent to 80g of the produce in fresh weight. Dried fruit should be eaten at mealtimes, not as a between-meal snack, to reduce the risk of tooth decay.
Pure fruit or vegetable juices and smoothies should be limited to a combined total of 150ml a day. This is because crushing fruit and vegetables releases the sugars they contain to produce free sugars. Free sugars also include the sugars added to food or drinks, and sugars found naturally in honey and syrups. These free sugars are linked to excess weight and tooth decay.
Beans and pulses (such as lentils and chickpeas) also count towards the recommended 5 a day, however they only count as one portion a day (80g), no matter how many are consumed. This is because although they are a good source of fibre, they contain a different mixture of nutrients than fruits and vegetables. Beans and pulses are a good source of protein and are generally cheap to buy so are a healthy way to bulk out meals, such as ragus, soups and casseroles, to make them spread further.
The latest NDNS data shows that the UK population still needs to consume more fruit and vegetables, with only 33% of adults and just 12% of children aged 11 to 18 meeting the 5 a day recommendation.
Eating a wide variety of fresh, frozen, tinned and dried fruit and vegetables every day will help provide a range of different nutrients. Frozen and tinned fruit and vegetables can often be cheaper than fresh varieties but try to choose tinned fruit and vegetables in natural juice or water, with no added sugar or salt. Value brands or ‘wonky’ fruit and vegetables are also usually cheaper options when shopping.
See NHS information on the types of fruits and vegetables that count towards your 5 a day.
The majority of the population can get all the vitamins and minerals they require from a healthy, balanced diet. However, some vitamin supplements are recommended in certain circumstances at a population level, such as vitamin D during the autumn and winter and folic acid for pregnancy.
In spring and summer, most people will get all the vitamin D they need through sunlight on the skin and from a healthy, balanced diet. However, during the autumn and winter we cannot make enough vitamin D from sunlight. Since it is difficult to get enough vitamin D from food alone, it is recommended that everyone should consider taking a daily supplement containing 10 micrograms of vitamin D during autumn and winter.
Some people may need to take a vitamin D supplement all year round, including:
Despite some reports linking vitamin D to a reduction in the risk of coronavirus (COVID-19), there is currently not enough evidence to support taking vitamin D solely to prevent or treat COVID-19. Read the COVID-19 rapid guideline: vitamin D report from the National Institute of Clinical Excellence (NICE) for more information.
For women who are pregnant, trying for a baby or could get pregnant, it is recommended that they take a 400 microgram folic acid supplement daily before and during pregnancy until they are 12 weeks pregnant. This is to help prevent neural tube defects, such as spina bifida, in the baby.
The government recommends all children aged 6 months to 5 years are given vitamin supplements containing vitamins A, C and D every day.
Babies who are having more than 500ml (about a pint) of infant formula a day should not be given vitamin supplements. This is because formula is fortified with vitamins A, C and D and other nutrients.
Vitamin drops for babies and young children are available through Healthy Start for those who are eligible.
Some individuals may choose to limit their consumption of animal products, for example meat and dairy. With careful planning and an understanding, it is possible to get the nutrients they need from eating a varied and balanced plant-based diet, including fortified foods and some supplements (such as a vitamin B12 supplement for those who do not consume animal products). For example, choosing fortified plant-based drinks and including nuts and seeds rich in omega-3 fatty acids (such as walnuts) each day.
Read NHS information on plant-based diets.
See Climate change: applying All Our Health more information on the role of a heathy diet for sustainability and the environment.
Healthy eating can often be portrayed in the media as complicated, confusing and contradictory. This can result in the incorrect assumption that official advice is always changing, leading to further confusion about what constitutes a healthy, balanced diet, when in fact UK government nutrition guidance has remained largely unchanged for many years. For example, a common misconception is that diets lower in carbohydrates promote weight loss. However, starchy carbohydrates form an integral part of a healthy, balanced diet and should make up around a third of the food we eat.
Government advice on carbohydrates is based on recommendations made by SACN in its 2015 Carbohydrates and Health report. The report concluded that the hypothesis that diets higher in total carbohydrate cause weight gain was not supported by the evidence from the long-term randomised controlled trails considered, and that significantly reducing consumption of whole food groups in the long term is likely to increase the risk of insufficient intakes of certain nutrients.
In addition, SACN, co-chaired with Diabetes UK, reviewed the evidence on lower carbohydrate diets for adults with type 2 diabetes (T2D) and concluded that lower carbohydrate diets may be an effective short-term option for adults with T2D and excess weight. However, there is insufficient evidence to recommend it long-term, and it is unknown if it is effective for all adults with T2D. This advice is not recommended for the general population.
For some examples of contradictory media headlines, see the former government Chief Nutritionist, Dr Alison Tedstone’s blog: Clearing up confusion caused by flip-flopping diet news.
This ‘All Our Health’ healthy eating information has been created to help all health and care professionals:
If you’re a front-line health and care professional, you should:
If you’re a team leader or manager, you should:
If you’re a senior or strategic leader you should:
The Public Health Outcomes Framework reports quarterly on key health outcomes, including the percentage of the population in a given region who meet the 5 a day recommendation or are overweight.
The Health Survey for England looks at overall trends for several health outcomes including overweight and obesity and breaks them down into regions of the country.
In 2019, Leeds City Council carried out a healthier vending trial in 18 machines across its council-owned leisure centres. An increase in the availability of healthier products (savoury snacks, confectionery and other snack options) was achieved by introducing nutrition criteria based on the Government Buying Standards for food and catering services and government sugar reduction guidelines.
The project resulted in over 11,000 fewer calories purchased on average per vending machine per week and a significant decrease in overall fat, saturated fat, sugar and salt vended compared to baseline. The research also found there was no overall reduction in sales.
See the Food active blog for further information about the trial.
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