Nutrition is not always a lifestyle choice. It’s harder to be healthy if you live in the North
Professor Amelia Lake, dietitian and public health nutritionist at Teesside University, writes about the health inequalities facing people in the North of England
by: Professor Amelia Lake
22 Jul 2025
An aerial photograph of Liverpool. Image: Pexels
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Today, if you walk into any major supermarket, you can find a four-pack of apples that cost twice as much as a large sharing bag of crisps which contain almost half the recommended daily calorie intake. It’s almost inevitable that, in 2025, it costs more to lead a healthy lifestyle.
For our most vulnerable, this means those on low incomes or living in poverty enter a vicious cycle – limited access to nutritious foods leads to poorer nutrition, which leads to a detrimental impact on their health and finances, and so on.
A new report on nutrition and diet in the North of England paints a stark picture for northerners: poor diet is not just a personal issue – it’s a regional crisis with national consequences.
It has been authored by Nutrition North, part of the Northern Health Science Alliance, which includes scientists and researchers from top universities and NHS trusts across the North who work together to address the region’s nutritional and health challenges.
The report shows that the North suffers from the worst diet-related health outcomes in England. Obesity, high blood pressure, diabetes, heart disease and cancer, are all more prevalent here than anywhere else in the country.
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Food insecurity – where people don’t have reliable access to affordable nutritious foods – is considerably higher in the North. We have the highest rate of food insecurity in England and households in the North East spend 16% less on food than the national average. More northern children are eligible for free school meals and fast-food outlets are 26% more concentrated in northern communities, particularly in the most deprived areas.
Recent research from the Food Foundation found that, on average, healthier foods are more than twice as expensive as less healthy foods. People in the most deprived communities would need to spend almost 50% of their disposable income on food to afford the government-recommended healthy diet.
These aren’t just statistics – they’re stories of lives cut short, families burdened, and communities held back. A healthy diet is not about individual choice in areas where there is such structural inequality and when families have to choose between heating and eating.
Hairy Biker Si King, the TV chef from County Durham, is one of many people who have backed the report. He has pointed out that food should nourish us, bring us together, and help us thrive – but too many in the North are missing out on the basics: fibre, calcium, fresh veg, and healthy fats. These aren’t hard-to-reach luxuries – they’re basic essentials.
The North also has the highest density of fast-food outlets in England. This is not a coincidence – it’s a consequence of planning, poverty, and policy.
Put simply, good nutrition prevents disease and keeps people healthy and productive. Poor nutrition can lead to obesity, diabetes and cancer. It can slow recovery from illness and prevent people working, all of which becomes a massive financial burden both to the NHS and to local economies.
These poor outcomes are avoidable, and the North is rich in expertise, collaboration, and innovation. From work in Liverpool to reform fast food advertising and train midwives to deliver nutrition advice to Teesside University’s work on reversing Type 2 diabetes and fast-food outlet planning restrictions, the North is already leading the way in tackling nutritional inequality.
But we need more. We need bold, place-based strategies, auto-enrolment for free school meals, expansion of voucher schemes, and holiday food programmes are interventions that can be scaled up. Planning policies can restrict the proliferation of fast-food outlets, and advertising restrictions should be enforced in deprived areas where unhealthy food marketing is most aggressive.
Crucially, we need to embed community support through a skilled nutrition workforce. Nutrition advice should be culturally relevant, locally informed, and accessible at every stage of life. Ensuring patients have access to dietitians within the healthcare setting will also provide trained support for changing food habits for those who are already ill.
These are all recommendations that would apply across the whole of England but are particularly needed in the North of England where the barriers, deprivation, and health outcomes are already worse.
The North deserves better. We deserve policies that reflect our realities and investments that match our needs. It’s time for government, industry, and civil society to come together and feed the North with the attention and resources it deserves. Because when we nourish the North, the whole country benefits.
Professor Amelia Lake is a dietitian and public health nutritionist at Teesside University.
