A Slice of Bread and Butter
The voice of The Bread and Butter Thing - with stories from the frontline of the cost of living crisis from one of the UK's leading food charities.
A Slice of Bread and Butter
The Broken Plate Report And The Real Price Of Eating Well
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A healthy diet should not be a luxury item, yet the numbers in the Food Foundation’s Broken Plate report make it feel exactly like that. We’re joined by Hannah from the Food Foundation to talk through what the report is really saying about the UK food system, and why so many families are being pushed towards cheap calories even when they want to eat well.
We get into the headline that stops you in your tracks: for the lowest-income households with children, up to 85% of disposable income would need to be spent to afford the government’s recommended healthy diet. We also unpack the deeper structural problem behind it, including the finding that healthier calories are roughly twice the cost of less healthy calories, and what that means when wages and benefits do not keep pace with inflation and food inflation. From there, we look at targeted support that can actually shift diets, including the Healthy Start scheme, where it works, where it falls short, and who gets left out.
Then we connect affordability to consequences. We talk about dietary inequality showing up as childhood obesity, dental decay that is too often ignored, and a declining healthy life expectancy with a near 20-year gap between the least and most deprived. Hannah also shares how lived experience stories in the report echo the data, from yellow-sticker shopping to the risks of poor-quality surplus. We finish with practical ideas we’ve been debating, including an “Eat Well Card” approach to fruit and veg discounts and small changes like adding beans, lentils, and pulses to stretch meals with fibre and protein.
Bread And Butter Thing Welcome
SPEAKER_01Hello and welcome back to a slice of bread and butter with me, Mark, and Vic. We're from the Bread and Butter Thing.
SPEAKER_02We run a network of mobile food clubs that take surplus food from supermarkets, farms and factories. We take it straight into communities where families are struggling to get by.
SPEAKER_01For less than a tenant, our members get bags packed with fruit, veg, fridge food, and covered staples. It's a weekly shop that helps stretch the budget and take some of the pressure off.
SPEAKER_02Our members are at the heart of everything we do. They turn food into friendship and neighbours into community, and that's what makes us tick.
SPEAKER_01Yeah, and today we're not actually talking to a member, we're talking to Hannah from the Food Foundation who was telling us all about their broken plate report.
SPEAKER_04We have a particular interest in addressing dietary inequalities.
SPEAKER_01Like-minded then.
SPEAKER_04Yes, very much.
SPEAKER_01So we thought it'd be really good if you came on the pod and talked to us about the broken plate report.
SPEAKER_04Yeah,
What Broken Plate Measures
SPEAKER_04so the broken plate is a um a report that we publish roughly annually, um, give or take, and it's basically a stock take of what's happening in our food system. So we look at a number of indicators of what's happening sort of within our food environment. So looking at things like the affordability of healthy food, we look at things like marketing and advertising of different types of food. And then importantly, what we also do is we look at the impact that this is having both on diets and on health outcomes. And what we see every year is huge inequalities. And really, what the point of the report is to sort of highlight the problems that we face and really try to create that sense of urgency for what we all need to do, but particularly what government needs to do.
SPEAKER_01When
Healthy Diet Price Shock
SPEAKER_01we talk about affordability here, what we really are talking about is the affordability of better calories, shall we say, healthier calories.
SPEAKER_04Yeah, so what we're most worried about is the fact that for the lowest income households with children, up to 85% of their disposable income would need to be spent to afford the government's recommended healthy diet, which is just totally unreasonable to expect. And it really highlights a couple of things. One is that we really need to be looking at sort of wages and benefits and actually making sure that healthy food is really affordable. But we also need to be looking at what we can do around food prices to not necessarily make food cheaper, but make it more affordable and make sure that the difference between sort of less healthy and more healthy food allows people to get what they need. And that leads me on to the other metric that we look at, which is the relative cost of healthy food. So we're looking at this at a population level. So what we do is compare healthier versus less healthy calories. And what we see is that healthier calories are on average about twice as expensive as less healthy calories. Now, that hasn't massively changed over the last few years, but we have definitely seen a divergence and we've seen that the healthy food in particular has increased relatively in price per calorie, while the less healthy food has sort of stagnated, if not slightly decreased.
SPEAKER_01You were talking before about not trying to make healthy food cheap but affordable. How do you address that without trying to find some way of subsidizing healthy food?
SPEAKER_04Yeah, so I mean there's I think there's a lot of different ways that we can do that. So, I mean, one is fundamentally making sure that our wage and benefit levels um um are high enough to afford a healthy diet, and importantly that those are increased with um inflation and particularly food inflation, um, which we often but not always see as is sometimes a bit higher than overall inflation. So it's really important that those two things are moving at the same place and that we kind of recalibrate to make sure that everyone can access that healthier food. I think there's a lot that can be done at a local level, looking at sort of novel ways to connect producers with whether it's community dining, whether it's social retailer, all the kind of different interventions that we can do there. It also supports the sort of resilience of our food system more generally, which then in turn can potentially help mitigate some of the sort of price fluctuations that we see. So there's a whole kind of systems answer to your question as well.
Targeted Support And Healthy Start
SPEAKER_04The other thing that we're particularly interested in at the Food Foundation is how you support those lower-income households very specifically with targeted support. So we do a lot of work around the Healthy Start scheme. So that's a scheme where you basically give weekly payments to low-income households with young children to spend on fruit, veg, milk, and formula. So really essential parts of a healthy diet for those young children. And what we see in our food insecurity survey is that food insecure households are cutting back on fruit and vegetables. So we see that direct impact that if you are struggling to afford food, it is the fruit and vegetable consumption that gets hit hardest.
SPEAKER_01As you say, Healthy Star is up to four years old, I think it is. Yeah. You've got to be on universal credit. It's gone up recently, but it's not kept up with inflation, etc. It's a good start, isn't it? But there's more targeted thinking required in this space.
SPEAKER_04We see a lot of sort of benefits from the Healthy Star scheme, but it's currently a very small scheme because, as you say, it's only for families with children under four. The criteria for accessing it is very low. So we're advocating it for it to be aligned with universal credit in the same way that we've recently seen free school meals expanded to all children on universal credit. And also the value is not keeping pace with inflation. So there was a 10% uplift this year, which boosted it to £4.65 per week. Had it stayed pace with inflation since the last cost of living crisis, so back in 2021, it would be £5.88, so over a pound more than it currently is. And that's not taking into consideration that we're expecting food inflation to be quite high towards the end of this year. So, how do you target the groups that we know are most vulnerable to food insecurity and really make sure that we are supporting them? Because we know from our food insecurity survey that people who are affected a lot by disability have higher rates of food insecurity. We know that people who are affected by sort of mental health as well, single-parent families are another one because they'll just continue to be left behind.
SPEAKER_01Sad fact right now, really, isn't it?
When Diet Harms Health
SPEAKER_01And let's talk a bit about the outcomes of an unhealthy diet.
SPEAKER_04So we've looked at a few different indicators. So one is childhood obesity, where we see that children from lower income households are almost twice as likely to be affected by childhood obesity. And we see that it increases from reception through to three to year six. So the kind of stat headline that we used in the in the report was that in an average English reception class of 30 children, three will be living with obesity, and then this increases to seven children, so more than doubles by the time they reach year six.
SPEAKER_01Isn't that fascinating in the years that they no longer qualify for a healthy start? They become more obese.
SPEAKER_04Yeah, and I think it's actually quite concerning that there are so many children starting school already with obesity, and there's a whole concern about those early stages of nutrition, the commercial baby food market being very high in sugar. You reach school and suddenly you're much more, I guess, aware of things like the marketing and the promotion that goes on and it just increases. And we're not really doing a very good job at managing to bring those rates down yet. I think one of the other statistics that in some ways I think is I don't know if it's more shocking, but we often talk about childhood obesity. That's often the tokenistic health metric, and it's a really, really important one, don't get me wrong, but I think dental decay gets forgotten. So more than one in five five-year-olds have had tooth decay, and it increases to one in three in deprived areas. And we see a similar pattern in year six. But if we're damaging adult teeth and children or even our baby teeth, it's sort of really problematic for a range of reasons. We know it's a key cause of hospitalizations as well. You know, if you damage those teeth early on, you kind of don't get you don't get your teeth back. You get one go at it. Um, and this is from, in particular, those sugar and and soft drinks and those kind of pureed foods.
SPEAKER_01I couldn't agree more. So we find it with bread and butter members, for example. We did a survey on dental, and the typical pattern would be, Hannah, that they would not go to the dentist for a filling because even on the NHS it's like 70 quid, right? And then they just pull on themselves because dental care is expensive even with the NHS subsidy.
SPEAKER_04Yeah, and this is where you get those kind of interlocking concerns within what's going on at the moment. We know there are strains on the NHS, we know that there is a shortage of NHS dentists, it all fuels this growing inequalities and diet, we know is a really key determinant, particularly of the dental decay. And I think the other interesting health outcome relates to healthy life expectancy. So, firstly, it's the lowest that it's been. So we're seeing a decline in healthy life expectancy. We're seeing more and more, not just but sort of diet-related disease, which obviously puts pressure on the NHS, on productivity, so on the economy. But we also see a nearly 20-year gap between them the least and the most deprived.
SPEAKER_01And how's that moved, Hannah? Do you know how that's moved?
SPEAKER_04It I mean, it's it's not it's not good. And what we see is the healthy life expectancy. You can look at it by um households, but you can also look at it regionally as well. We see a lot of regional inequalities. So often the sort of Northeast fares much worse than, for instance, the Southeast. It's just really concerning, really. But I think when you come back to it, you can see that pathway from insufficient incomes, therefore can't afford a healthy diet, therefore aren't eating the sort of nutrients. It all just plays out. And then you also see sort of a life cycle going on. We know that inequalities in pregnancy can lead to poorer health outcomes. So it all interlinks and it does, you know, the food system is a huge part of that. Um, we really need to get to grips with how we make sure that everyone can access and afford a healthy diet because it's currently not working, at least not for citizens on the ground who are really struggling.
SPEAKER_01Yeah, it does frustrate me when I hear people talk about choice, because it's not about choice, because it this is almost a budgetary choice, right? So when you don't have money and you're you're looking for cheap calories, you're sacrificing your health, right? But at the same time, you're making choices in the moment that you have to make.
SPEAKER_04Yeah, exactly. You don't have what what could you do if you don't if you can't afford anything else, then you want to make sure that you get the most bang for your buck, as it were, but that doesn't necessarily mean it's filling you up with like the nutrition that you needed.
Stories From The Sharp End
SPEAKER_04And I think it's important just to signpost that in the broken plate report, while a large part of it is focused on these kind of like the data on the analysis and things like that, we also include stories from our ambassadors who talk through some of the challenges. So one um of our ambassadors talked about the experience of shopping yellow stickers, so those discounted foods and having to navigate what was available sort of at the end of the day that's close to its use by date in order to feed herself and her family. Someone else talked about the challenges of like surplus food, which is essentially out of date, it's rancid, it's not really fit for consumption anymore. But that's kind of what's being presented in some food banks and things like that. So there's there's a challenge with that.
SPEAKER_01It's not an answer.
SPEAKER_04It's heartbreaking because you hear these stories, and it was really interesting because the ambassadors that we worked with were given an overview of broken plate, but weren't given the data in advance or anything like that. And the stories they came back with really echoed what the data shows. You know, we can analyze this from a sort of very methodological academic way, but we can also speak to people on the ground, and it all tells us the same story that things are not working particularly for those lowest income households.
SPEAKER_02So
Why Choice Is A Myth
SPEAKER_02what's in this report then, Mark?
SPEAKER_01What I like about what they've done is really we we talk a lot about how healthy, nutritious calories are so difficult to afford, they're out of reach, they're twice as much, etc. Then we kind of circle around that, and Hannah put it really well, but what I like about it is what they link is the affordability issue with the health output. You know, we talked a lot about choice, and it's not a choice, because when you don't have the money, you don't have the luxury of choice. I think that's a really interesting one, but it was difficult to actually try and circle back round and come up with a coherent plan, I'd say, to try and find a way of getting healthy and affordable food to people that are struggling to get by, right? Which is why things like bread and butter and food clubs generally are something that's needed.
SPEAKER_02Yeah, for sure. Right now, it's really stark to think that if you want to eat a healthy diet, so what the NHS would say is a healthy diet, the right amount of fruit and veg, protein and carbs, and you've got kids and you're in a low-income family, you would be spending 85% of your income on food. And it just feels like just such an unreal expectation. So it's no wonder that people can't do that and then eat, you know, less quality food than what the NHS would like.
SPEAKER_01We've seen it a lot in our surveys, right? Time and again we talk about the residual income and what they've got left on a monthly basis, and we know that it's a really low figure, right? And it and it goes 25 to 50 quid up to 100 quid, maybe for the vast majority. What we're actually saying here is that they've done it as well and statistically proven that the lowest 20% demographic have got 85% of the residual income being spent on food, right? And they know that a healthy diet's still out of reach.
SPEAKER_02Yeah.
SPEAKER_01I'm trying to find data because I asked Hannah as well, and nobody's priced up the eat well plate for a while. So it doesn't feel like anybody's actually done it, and I think it's over a tenner now on a daily basis.
SPEAKER_02For three meals for one person.
SPEAKER_01Yeah.
SPEAKER_02Yeah. But our members have what, a quid, two quid to spend on food?
SPEAKER_01Yeah, exactly. We've talked
Ideas That Could Shift Diets
SPEAKER_01about your ideas around voucher schemes and how we could actually expand on those. Are you willing to share your ideas?
SPEAKER_02You put me on the spot once and I came up with this idea and now you've made it stick.
SPEAKER_01Yeah. You know, when you've got a good idea, Vic, you just got to keep repeating it and repeating it.
SPEAKER_02So I was on about the eat well card, wasn't I? To like riff off of the healthy start. But maybe to say it needs to be open for like a lot more people, so it's not just the pregnant to age four kids. And you know, you and Hannah were talking about how the healthy start card hasn't got the right levels set now in terms of the money that it should be giving people, it's like a quid out of out of sync with inflation and the cost of food. But I was thinking about with the eat well card, what happens if it gave people a percentage off? So rather than saying it's this amount of money, because then people are more incentivized to eat more fruit and veg. So if I had an eat well card, I'd be going into the supermarket and absolutely hammering the fruit and veg section and probably be nearly vegetarian because I'd be able to get my 20% off all of my fruit and veg, and that would make my shop. So you're incentivizing the behaviour as well as giving people a lift with the cost of it. So that was my idea. Nice. But I'm like not that friendly with Defree yet to uh get them to kind of take it from me.
SPEAKER_01So okay. Well, you're definitely better than I am at befriending civil servants and alike, because I was obviously too shouty. So I'm gonna give you that as homework to work on.
SPEAKER_02Yeah, I'm I mean, I am actively working on this. I was chatting to them yesterday actually, uh, about some of the incentives that and different programs that they're thinking about bringing out, like linked to the food strategy, which isn't now called the food strategy, is it? It's called the good food cycle or something.
SPEAKER_01Do you know? I love a pun, and you know where I'm gonna go with this.
SPEAKER_02Open goal.
SPEAKER_01Open goal. So um I did enjoy it when they actually called it Good Food Cycle. Because for those of you that don't know, I am now the chief exec of food cycle. Not good food cycle for the record. Defra, we can talk. But when they launched Good Food Cycle, I thought, oh, this is gonna be fantastic when I actually get into Food Cycle and can have a play with this.
SPEAKER_02Yeah, and I've never heard it in that way in my head until you and the minute I said it and I saw your eyes light up, I was like, oh wow, we've just done it. It's a gimme.
SPEAKER_00Yeah, yeah. It was just like, oh, she's opened that door again.
SPEAKER_02Yeah, yeah. And I think the other thing about childhood obesity that you didn't talk about that much is that we've now got children that are malnourished and obese.
SPEAKER_03Yeah.
SPEAKER_02Like that's mind-blowing if you think about it. Yeah. I mean, that when you layer in the dental decay, is just shocking. Like, what are we doing to ourselves?
SPEAKER_01Well, um, so I went to the launch event of the broken plate, and there was a doctor there from Olverhay Hospital.
SPEAKER_02Okay.
SPEAKER_01And he is seeing a new strand of asthma caused by obesity.
SPEAKER_02Wow.
SPEAKER_01So he is now seeing people that have new illnesses that are being discovered that are developing through obesity. So there are so many health implications to a poor diet. Because I I was reflecting on what I said to Hannah as well. It's just like it's really conflicting because I know people could make the right choice if they wanted to, right? But I don't think when you've got a quid or two quid a day to live on, you can't make the right choice. You physically can't make the right choice. And what drives me nuts is nobody's actually pricing it up to say, you know what, the cost to the NHS, etc., yeah, as a result of this poor diet is X. I mean, they did it for smoking, right? So why on earth are they not doing it for a rubbish diet?
SPEAKER_02I'll look at that. One of the things that we're looking to pilot with some academics, actually, is how we build in more lentils and beans and pulses into people's diets. When I was listening to you and Hannah, I was thinking about that because it's not the full answer at all. You know, this is a really complex systemic thing, but they are quite cheap. And if we can get people to make a bolnese half and half to pad out the meat and things like that, then it's got to be a really small step in the right direction. So if we, you know, as well as giving out 50% fruit and veg in our bags, yeah, yeah, and we give out a bag of lentils or a bag of beans every week or a tin or something that's really good quality ambient for them to mix in with the food that they're cooking. That's some fibre and some, you know, protein and stuff like that. So we're looking at doing a small pilot to see if we can influence some bigger work uh in a few of our hubs. Nice, yeah. I think there's a real like elephant in the room, and we see it all the time. And it's like I'm with you. People think that people don't want to eat healthily, they think that the sausage roll is like the meal of choice, and we know that our members will cook amazing food and love it because we create in the right conditions for them to be able to do that. And if we're not able to do that as a country, then that's gotta be a huge issue. And we pay for it elsewhere, don't we? That's the point. We're paying for it in the NHS, yeah.
SPEAKER_01And that that's the bit that I don't get because it it's gonna be in billions, right? Things like heart disease and obesity are gonna be massive within the NHS as a cost.
SPEAKER_02Yeah, but you know what? I just heard myself then and thought, oh my god, you just sound like a government official. We're paying for it in the through the NHS. It's horrible. Like, actually, this is people's lives, like it's an economic problem. But it was kind of the right thing to say, but also not okay when I check myself because it's people's children, they're watching their children grow up in a way that is not healthy, but they've not got like as a parent, you want to be able to do something about that, don't you? You want to be able to fix things for your kids. So we've got all these parents out there that just can't do that, that haven't got the money to be able to do the right thing for the children. And how does that make people feel? That's that's a bigger cost than what the NHS is paying. Quite often, especially around child poverty, people think that the the answer is, well, we've now done breakfast clubs and we've got some universal free school meals, and we've got the holiday activity food program that's going through the through the holidays, so we're kind of doing it, but what everybody forgets is that those kids go home and look in a bare fridge, they just look in the empty fridge or the empty cupboard, and there's nothing, and that doesn't fix it, it doesn't fix it for any parent or for those kids to have like lovely meal times at home or anything. So we also need to think about the support that we give as the staff master to make it more fit for purposes.
SPEAKER_01It's the environment, right? We're talking about choice a lot, and in fact, I used to talk a lot a lot about this when we first kind of started with the social supermarket and stuff, because everybody used to say, you know, what's important first is just fill the bellies, and then we'll worry about the nutrition. And actually, it's not the best strategy, is it, really, just to fill the bellies? Because if you fill the bellies full of rubbish calories consistently, you end up with tooth decay, obesity, and heart issues. I think we're in a more informed place 20 years on, but we're still in this position where people simply can't make that choice.
SPEAKER_02But I think when people were saying fill the ben bellies, it was more of an acute issue. Everybody expected it to be an acute issue, like small bit of crisis or small bit of something, hiccup in the road, like you can get back on it.
SPEAKER_01Whereas it's consistent now and it's just now it's chronic, it's a chronic issue.
SPEAKER_02It's and so that's where the problem comes from. So I think the mindset has to change around that. You're right, about it being nutritious, food, and back to the it's not a choice. I don't think it is a choice. I think it's just people doing the best to survive, they're surviving, not thriving, and choice comes with thriving, doesn't it?
SPEAKER_01Yeah, making the best of a bad hand.
SPEAKER_02And our members do brilliantly at it. You know, every week we have 20 minutes of joy chatting to a member and hearing about how they're doing a brilliant job. And I think the broken plate report is super important, but what it doesn't do is kind of showcase, and it's this isn't its job, but this is where we come in to showcase how those people that are living in the world of the broken plate still do bloody brilliantly.
SPEAKER_01Yeah,
How To Follow And Get Help
SPEAKER_01uh, and for me, many congrats to Food Foundation and the team, and Hannah is the one that actually does all the legwork, so especially to Hannah, because I think this is the seventh iteration of it. So it's a long-standing report now, and and it's recognised and it's credible, and people use it and it yeah, and you see it cited in government and corporates and all the rest of it now. So if you haven't looked at it, I strongly would recommend. If you'd like to know more about the bread and butter thing and what we get up to, you can find us at Teen TBBT, on TikTok, on Instagram, Twitter, on LinkedIn, or online at breadandbutterthing.org.
SPEAKER_02And if you've got any feedback or thoughts on the podcast or you'd like to come and be our guest, drop us an email at podcast at breadandbutterthing.org.
SPEAKER_01And we are always open to new members at all of our hubs, so if you or someone you know would benefit from our affordable food scheme, you can find your nearest hub on the become a member pages of the website.
SPEAKER_02Yeah, and please do all the things that podcasts asks you to do. Like us, subscribe, leave a review, share us with your friends, chat about us on social. See you next time.
SPEAKER_01See you next time.
