The Real Challenge in ‘Eat Real Food’: Access, Not Just Advice

The Science Behind ‘Eat Real Food’  

Earlier dietary guidance often encouraged consumers to choose foods labelled ‘low fat,’ ‘low sugar,’ or ‘cholesterol free,’ inadvertently fuelling the growth of highly processed products that met nutrient targets but were frequently high in starch, salt, sugars, and artificial additives. The 2025–2030 Dietary Guidelines for Americans represent a marked departure from previous nutrient-focused messaging, placing ‘Eat Real Food’ at the centre of federal nutrition guidance. The revised pyramid prioritises protein, vegetables, fruits, healthy fats, and whole grains, while explicitly recommending reduced consumption of highly processed foods, refined carbohydrates, and added sugars (Figure 1).

Figure 1: Eat Real Food Pyramid

Source: Real Food (realfood.gov)

The Global Burden of Disease Study 2019 identified diets low in whole grains, fruits, legumes, nuts, and seeds, together with excessive sodium intake, as major contributors to the global burden of disease. Similarly, the EAT–Lancet Commission estimated that shifting towards diets rich in plant-based foods and reducing the consumption of refined grains, added sugars, and excessive animal-source foods could prevent 10.9–11.6 million premature deaths annually, while simultaneously reducing pressure on land, water, and the climate. These findings have repositioned dietary guidance as a tool not only for improving health but also for promoting sustainable food systems.

A defining feature of the new dietary paradigm is its emphasis on food processing. Advances in nutrition research, particularly through the NOVA classification, distinguish minimally processed foods from ultra-processed foods (UPFs).^[1] A growing body of evidence links high intake of UPFs with a wide range of adverse health outcomes. A 2024 umbrella review synthesising evidence from nearly 10 million participants found consistent associations between high UPF intake and increased risks of all-cause mortality, cardiovascular disease, obesity, type 2 diabetes, depression, and anxiety disorders. Although research continues to evolve, these findings have strengthened calls for dietary guidelines that prioritise minimally processed foods over industrially formulated products.

Food systems account for approximately one-third of global greenhouse gas emissions, while agriculture consumes nearly 70 percent of global freshwater withdrawals. Diets centred on diverse plant-based foods generally have lower environmental footprints than those dominated by highly processed foods and excessive animal-source products.

The Limits of ‘Real Food’ as Policy

While the scientific rationale underpinning the ‘Eat Real Food’ approach is compelling, translating this philosophy into effective public health policy is considerably more complex. Its effectiveness will ultimately depend on how the concept of ‘real food’ is defined and implemented across diverse populations. One of the principal challenges is that the term lacks a universally accepted scientific definition. Although consumers generally associate ‘real food’ with fresh and minimally processed products, food processing exists along a continuum rather than as a simple dichotomy. Many foods routinely recommended as part of healthy diets — including pasteurised milk, frozen vegetables, canned beans, yoghurt, fortified cereals, and fermented foods — undergo processing that improves food safety, extends shelf life, reduces food waste, or enhances nutritional value. For policymakers, therefore, the challenge is not to eliminate processing but to distinguish clearly between beneficial processing and ultra-processing, ensuring that dietary guidance remains evidence-based rather than ideological.

For policymakers, therefore, the challenge is not to eliminate processing but to distinguish clearly between beneficial processing and ultra-processing, ensuring that dietary guidance remains evidence-based rather than ideological.

According to The State of Food Security and Nutrition in the World 2024, approximately 2.8 billion people worldwide cannot afford a healthy diet, with affordability remaining a major barrier in South Asia and sub-Saharan Africa. Fresh fruits, vegetables, nuts, and quality protein sources are often substantially more expensive than calorie-dense processed foods. Consequently, encouraging people to ‘eat real food’ without addressing food affordability, market access, and food environments risks placing responsibility on individuals while overlooking the structural determinants of dietary behaviour. Evidence consistently shows that food choices are shaped not only by knowledge but also by factors such as income, pricing, marketing, convenience, and availability. Dietary guidelines must therefore be complemented by supportive policies such as front-of-pack nutrition labelling, healthier public procurement, restrictions on marketing unhealthy foods to children, and fiscal measures that make nutritious foods more accessible.

India’s Nuanced Approach

For India, these debates are particularly relevant as the country faces the triple burden of malnutrition, with persistent undernutrition and micronutrient deficiencies coexisting alongside rapidly increasing obesity and diet-related non-communicable diseases (NCDs). According to the National Family Health Survey-6 (NFHS-6), 29.3 percent of children under five remain stunted, while anaemia affects 57 percent of women of reproductive age and 67 percent of young children, even as overweight and obesity continue to rise. Recognising these changing realities, the Dietary Guidelines for Indians (2024) have shifted from a nutrient-centric approach towards food-based dietary patterns, promoting dietary diversity, whole cereals and millets, pulses, fruits, vegetables, nuts, dairy, and home-cooked meals, while explicitly recommending reduced consumption of foods high in fat, sugar, and salt, and limiting ultra-processed foods.

Importantly, India’s approach is more nuanced than many global narratives. Rather than rejecting all processed foods, the guidelines recognise the continued importance of fortified staples, pasteurised milk, and fermented foods in addressing food safety and micronutrient deficiencies. They also draw upon India’s rich culinary traditions, where diets based on millets, pulses, seasonal produce, and locally available ingredients naturally align with the principles of healthy and sustainable eating. This balance between traditional food wisdom and contemporary nutrition science offers an important model for countries undergoing rapid dietary transitions.

For India, the challenge is not simply to encourage healthier food choices but to create policies that make such choices affordable, accessible, culturally acceptable, and environmentally sustainable.

Ultimately, the significance of the new ‘Eat Real Food’ pyramid lies not in its inverted design, but in the shift it represents from nutrient-centric advice to food-based dietary guidance. For India, the challenge is not simply to encourage healthier food choices but to create policies that make such choices affordable, accessible, culturally acceptable, and environmentally sustainable. Success will depend less on dietary guidelines themselves than on transforming food environments through nutrition-sensitive agriculture, healthier public food programmes, responsible food industry practices, improved consumer information, and stronger regulation of ultra-processed foods. In that sense, the future of nutrition policy lies not in redesigning the food pyramid, but in redesigning the food system itself so that the healthiest choice becomes the easiest choice for all.

Shoba Suri is a Senior Fellow with the Health Initiative at the Observer Research Foundation.

The author acknowledges the use of ChatGPT for language editing.

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