The latest findings from the National Diet and Nutrition Survey (NDNS) offer a comprehensive picture of the UK population’s eating habits, nutrient intakes, and nutritional status between 2019 and 2023. Against a backdrop of the COVID-19 pandemic and rising cost-of-living pressures, this period marks a pivotal moment in understanding public health trends and the challenges of achieving dietary recommendations.
Understanding the Survey
The NDNS is the UK’s gold standard for dietary surveillance, assessing the diets and nutritional status of individuals aged 18 months and over across all four nations. The survey employs a robust methodology, including:
- Background interviews
- Four non-consecutive days of dietary recall using the Intake24 online tool
- Physical measurements (height, weight)
- Biological samples (urine and blood)
- A physical activity questionnaire
The 2019–2023 fieldwork includes over 7,000 participants, with data now disaggregated by age, sex, income, and deprivation indices to reveal the influence of social and economic factors on diet.
Key Findings
Fruit and Vegetable Intake Remains Suboptimal
Despite long-standing public health messaging, most UK residents are still falling short of the ‘5 A Day’recommendation:
- Only 17% of adults and 9% of teenagers met the daily target.
- Average consumption was 3.3–3.7 portions per day for adults and 2.8 portions for adolescents.
A likely combination of methodological changes, COVID-related food access issues, and economic constraints may have contributed to lower intakes compared to previous survey rounds.
Meat Consumption Shows Mixed Results
While average red and processed meat intake was below the recommended 70g/day, a significant proportion of adult men (27%) still exceeded the 90g/day limit, suggesting scope for further improvement.
High Consumption of Sugar-Sweetened Beverages
Consumption of sugar-sweetened soft drinks remains high, particularly among:
- Teenagers (11–18 years): 124ml/day average, with high consumers reaching 606ml/day
- Adult men (19–64 years): 108ml/day average, peaking at 768ml/day
These figures underscore the persistent role of sugary drinks in excess sugar intake, despite taxation and reformulation efforts.
Nutrient Intakes: Where Do We Stand?
Energy Intake and Underreporting
Except for toddlers, average energy intake was below the Estimated Average Requirement (EAR) across all age groups, likely reflecting a 30% underreporting rate, a known issue in dietary surveys.
Saturated Fat and Free Sugars Above Recommended Levels
- Saturated fats contributed 12.5% of total energy for children and 12.6% for adults, exceeding the <10% recommendation.
- 85% of children and 82% of adults did not meet this target.
- Free sugars accounted for 10.5% of energy in children and 10% in adults.
- Only 9% of children and 19% of adults adhered to the <5% recommendation.
- Teenage girls had the highest intake, at 12% of energy.
Fibre Deficiency Is Widespread
Fibre intake remains one of the most critical shortfalls:
- 96% of adolescents and adults did not meet their daily target.
- 78–86% of younger children also fell below recommendations.
This has implications not only for digestive health but also for chronic disease risk.
Micronutrient Status: Persistent Deficiencies
Vitamin D
Low vitamin D status, associated with bone and muscle health risks, was found in:
- 23% of teenagers
- 18% of working-age adults
- 12% of older adults
Winter months worsened deficiency levels, especially in adolescents.
Folate
Folate is crucial for fetal development during pregnancy. Concerningly:
- 83% of women of childbearing age had RBC folate levels below the threshold associated with increased risk of neural tube defects.
- 12% of teens and 4% of adults were classed as folate deficient.
Iodine
While general iodine levels were adequate, girls aged 11–18 and women aged 16–49 had insufficient urinary iodine concentrations, reflecting potential future risk for thyroid health and pregnancy outcomes.
Moreover, a year-on-year decline in iodine status since 2013 was observed, with levels dropping by 29% in teenage girls and 25% in adults.
Income, Inequality and Dietary Disparities
Income and Diet Quality
Participants from higher-income households:
- Consumed more fruit, vegetables, and fibre
- Had better vitamin D and folate status (in some groups)
However, poor dietary practices (e.g., excess sugar and saturated fat intake) were prevalent across all income groups, highlighting systemic issues beyond individual behaviour.
Deprivation and Nutritional Status (England Only)
Using the Index of Multiple Deprivation (IMD), more marked differences were observed than by income alone:
- Those in the most deprived areas generally had poorer diet quality.
- The gap was most visible in teenage and working-age groups.
Out-of-Home Consumption: A Major Nutrient Source
- 72% of participants reported buying food from the out-of-home sector (cafés, takeaways, restaurants) at least once in the last 7 days.
- For those who did, 23% of their total energy intake came from these occasions—along with high proportions of free sugars, saturated fat, and sodium.
This suggests the need for continued reformulation, clearer labelling, and policy engagement with the out-of-home sector.
Looking Ahead: Implications for Public Health Policy
The 2019–2023 NDNS data paint a sobering picture: despite decades of public health campaigns, the majority of the UK population continues to miss key dietary recommendations. Nutrient deficiencies remain a concern, especially for teenagers, women of childbearing age, and low-income households.
Policy priorities should now include:
- Folic acid fortification (already scheduled for non-wholemeal wheat flour by 2026)
- Expanded efforts to improve vitamin D intake and supplementation awareness
- Incentives and reformulation strategies in the out-of-home and processed food sectors
- Tackling income- and deprivation-related dietary inequalities through targeted support and access to affordable, nutritious food
Conclusion
This NDNS report serves as both a progress check and a policy alarm bell. To reverse the growing burden of diet-related diseases, urgent and sustained action is needed—not just in education and awareness, but across the entire food system.
More information:
https://www.mrc-epid.cam.ac.uk/blog/2025/06/12/ndns-2019-2023-dietary-deficiencies
