I have spent the last year chairing an official governmental review of Scotland's diet and health, published last week. It takes a sober look at what everyone is and is not doing to address Scotland's poor diet-related ill-health.

Jokes about the deep-fried Mars bar (not an urban myth but true ) are out of order. Scotland is actually a food policy 'canary', an early warning for the rest of the UK. Like everywhere it has rocketing obesity, a huge healthcare bill and wide inequalities in eating.

Its food sector is also dominated by a few big players whose eyes have been focused on competition, not hard-to-reach issues such as health or the environment.

Scotland also has good news. It realised earlier than the rest of the UK that neither hand-wringing nor blaming others will do. In the early 1990s academics, people in government, food watchers and progressives in all food sectors accepted that they needed a new shared framework. After gathering evidence, the Scottish Diet Action Plan was launched - please note - by an anti-nanny-state Conservative government. Targets were set, recommendations made. Ten years on, this is what we reviewed.

Our findings are sober. Despite good intentions, the diet targets have not been met. Fat consumption is stubbornly high. Fruit and vegetable consumption is low. Fish is being exported, not eaten. Industry is still focused on exporting whisky, soft drinks and meat. And yet, Scotland has also taken world leads on banning tobacco, shifting school meals and rapidly raising breastfeeding rates. Its top politicians have also had the guts to see health as an issue on which they need to lead.

Rather than offer another vast list of recommendations, the panel offered four core 'directions of travel' which need to be taken by all, wherever they are in the food chain or health worlds.

The first is that unless everyone faces the gap between rich and poor, food culture will not be moved; stop blaming the poor and chasing rich pockets.

The second is that health policy must reconnect human with environmental health. Solutions to 'green' challenges are linked to human health.

Thirdly, the food industry must see health as core not niche business. Fourthly, there must be leadership. Everyone and everything has to change.

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