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One could argue that, in 2026, people have access to information. Not only that, but they are fed it constantly, from all different directions. Why, then, are there often such large gaps between the knowledge available to – and freely shared with – the public, and the decisions they take, specifically when it comes to decisions regarding their health?
For example, for years the NHS has been sharing guides to healthy eating, reminding us all of the importance of eating ‘5-a-day’, while nutritionists have begun using platforms like social media to promote balanced meals and the value of including a variety of food sources in one’s diet.
There is an abundance of information on healthy eating for various stages of life available with a simple search online, amongst other sources. In spite of this, the latest report conducted by The Health and Food Supplements Information Service (HSIS) shows that the UK population are lacking in many of key vitamin and mineral levels.
By taking a closer look at the Dietary Deficits and Future Health and Wellness Fall Outs report, we explore why this may be, where the UK’s nutrient levels are falling short, and how pharmacy teams can try nudge the dial.
What’s the damage?
The report looked at consumer attitudes and highlighted gaps in the UK’s dietary knowledge as well as their day-to-day diets. Dr Nisa Aslam, co-author of the HSIS paper, found the results to be particularly worrying.
“We are continuing to see a demise in public health nutrition," says Dr Aslam, "with poor consumption levels of vitamin D and calcium, especially for those 11 to 18 years, iron, folate, and iodine dietary levels – particularly amongst girls and women – alongside selenium, potassium and low oily fish consumption,” she explains.
The HSIS data found that 93 per cent of adults admitted their food choices could be healthier. The research shows a disconnect between what people think they are eating and what the data states.
According to the research, 60 per cent of people said they tried to ear the recommended 5-a-day but surveys found that fewer than 20 per cent of adults and 10 per cent of teenagers hit the fruit and vegetable target. Other statistics showed that:
- Only 30 per cent try to eat fish twice a week. Most also stick to white fish, as opposed to the recommended weekly serving of omega-3 rich oily fish
- “Just 26 per cent of respondents opt for wholegrain versions of bread, rice and pasta where possible,” says the report
- 24 per cent of respondents said they make an effort to limit ultra-processed foods (UPFs) and saturated fats – surprising statistics especially given the mainly negative airtime granted to UPFs over the last few years.
“We’ve had decades of public health advice about reducing fat, sugar and salt, and eating more fruit and vegetables. Yet our diets continue to deteriorate according to the Government’s own data,” says Carrie Ruxton, dietician and advisor to HSIS. Before looking at why we may be here, let’s briefly explore where we are.
“Poor nutrition is already strongly linked to the UK’s biggest killers”
The findings
The HSIS report highlights widespread shortfalls in nutrients such as vitamin D, iron, calcium, folate, selenium, potassium, omega-3 fats and iodine. Consumer data from HSIS showed that two-thirds of adults (67 per cent) don’t know which foods contain vitamin D.
In a part of the world where, for much of the year, people will not be getting enough vitamin D from exposure to sunlight, they need to actively be including foods high in vitamin D in their diet – or taking a vitamin D supplement.
“Vitamin D helps regulate the uptake of calcium and phosphate, which are essential for healthy bones, teeth and muscles,” says Carrie.
Calcium, another important vitamin for healthy bones and teeth, as well as blood clotting and regulating muscle contractions (including our heartbeat) which is best found in milk, cheese and dairy foods also showed worryingly low levels.
HSIS research found that one in 10 (nine per cent) adults and one in six (17 per cent) children aged 11 to 18 have intakes below the Lower Reference Nutrient Intake (LRNI).
The LRNI represents the amount of a nutrient that is enough for only a small number of people in a group, who have low requirements. In other words, the majority will need more.
What is important to note, is that these deficiencies are not isolated. A deficiency in one vitamin or mineral can impact how another is absorbed by the body.
Vitamin D, which supports calcium absorption, is activated by magnesium, while vitamin C enhances iron uptake. In a nutshell, if one nutrient level begins to fall, it can have a ripple effect on others, triggering a series of shortfalls.
To summarise some of the report’s findings on nutrient levels:
- Three out of four women of child-bearing age have blood levels of folate (vitamin B9) below the levels needed to protect against neural tube defects
- Riboflavin (vitamin B2) intakes are below the LRNI in 23 per cent of 11 to 18-year-olds and 15 per cent of 19 to 64-year-olds
- 34 per cent of 11- to 18-year-olds and 28 per cent of 19 to 64-year-olds have potassium intakes below the LRNI
- 34 per cent of 19- to 64-year-old women have iron intakes below the LRNI
- 36 per cent of children (11- to 18-year-olds) and 45 per cent of adults (19- to 74-year-olds) have dietary selenium intakes below the LRNI – women and girls are most at risk.
“Each vitamin and mineral shortfall is problematic in itself, but it’s the pattern of multiple gaps that is particularly worrying,” says Emma Derbyshire, public health nutritionist from HSIS and lead author.
“These will, inevitably, mean that many people are at risk of sub-optimal functioning and performance on a day-to-day basis, and may well be showing signs of insufficiency – even if they don’t recognise the link between their nutrient status and common niggles such as fatigue, brain fog, low mood, brittle nails or dry skin and hair.”
Dr Aslam agreed: "Many patients don't realise that common symptoms like low mood or brain fog can be linked to nutritional shotfalls. Often, it's not just one nutrient – it's a comnination." Anxiety, low energy and poor sleep are other common symptoms many accept as normal.
Further down the line, increasingly and consistently low nutrient levels can lead to type 2 diabetes and cardiovascular disease (CVD).
“Poor nutrition is already strongly linked to the UK’s biggest killers. 4.6 million people are diagnosed with diabetes, with 1.3 million more undiagnosed. Over 8 million people are living with cardiovascular disease, and there are 168,000 deaths annually from cardiovascular conditions,” notes the report.
While they are not a long-term solution, Carrie suggests using supplements can help combat nutrient shortfalls for the time being:
“The simple addition of a multivitamin and multimineral supplement, plus a source of omega-3s from fish oil or algae, would be a useful first step to putting the nation’s nutrition back on track and future-proofing people’s health and wellness as they age.”
Poor health and nutrition is linked to increased risk of type 2 diabetes and cardiovascular disease.
Barriers to better nutrition
One reason consumers may not be implementing dietary advice is that they are suffering from information overload, leading to an eroded trust and confidence in nutrition guidance, suggests Emma.
Unparalleled access to information also means that misinterpretation of nutritional guidance is on the increase. Similarly, oversimplistic statements, like telling people to ‘avoid ultra-processed foods’ are unhelpful, says Dr Aslam.
“Many consumers may be put off inexpensive and healthier processed options, such as baked beans, soy milk, cooking sauces or fortified breakfast cereals,” she says, where they needn't be.
Time constraints are still viewed by consumers as a significant barrier to healthy eating. “In the last five years, 59 per cent of consumers reported that busy lifestyles, time needed to spend cooking and the inconvenience of preparing foods were obstacles to healthy eating,” says Dr Aslam.
Other barriers gathered by HSIS included cost (see boxout below), a lack of knowledge or time, cooking skills, routine and traditions, motivation, single-parent households, dental health and fatigue.
A sign of the times
The Dietary Deficits and Future Health and Wellness Fall Outs report not only revealed that millions in the UK are failing to meet their basic nutritional needs daily, it also suggested potential reasons why this may be.
Guidance on healthy eating is readily available, and there is food on the shelves, so why is there still a discrepancy? The report suggested that this gap may be the result of the cost-of-living crisis.
“More than six in 10 adults surveyed by the Health and Food Supplements Information Service (HSIS) say that the cost-of-living crisis has impacted their food choices,” says the report.
Alongside citing other barriers to eating a balanced diet, the report commented: “Cost is also a factor, with a third of consumers (34 per cent) reporting that healthy foods are too expensive.”
Those who feel unable to afford food which will help them reach their nutrient goals are more likely to suffer from tiredness, low energy, sleeplessness, low mood, fatigue and stress or anxiety.
When people cannot afford healthy food, it can create a cycle in which poor nutrition leads to poorer health, lower productivity levels, reduced educational and employment opportunities and feelings of wellbeing in general.
Looking forward
“Far too many consumers have only a minimal understanding of the importance of nutrients for good health,” says HSIS pharmacist Noel Wicks.
"The Government, health regulators and the health and food sector need to do more to raise awareness of the wide range of health issues and problems that can be caused by inadequate intakes – particularly as it is so easy to plug these gaps with an inexpensive multivitamin and multimineral supplement.”
A combination of confusion, misinformation, an influx of information, cost and accessibility is driving the UK’s nutritional decline, which seems unlikely to change without improved education and better access to affordable food.
“We need to rethink our approach to health messaging, diet and nutrition education, because what we are doing is simply not working,” says Carrie. “Far too many people are already jeopardising their everyday wellbeing and long-term health.”
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