You've Done the Online NHS Health Check. Now What Goes in the Trolley?

The NHS Health Check is moving online. A digital version you complete at home, on your phone and in your own time, is being tested with GP practices and local authorities in England ahead of a national rollout, and government plans aim for around a million online checks in its first four years. The reason is uptake. Only around four in ten people invited to the in-person check have actually had one, and a version you can do from the sofa reaches people a Tuesday morning appointment never will.

That is good news. It also creates a very particular situation. You finish the check, a set of numbers appears on screen, and unless something is flagged, nobody rings you. There is no appointment, no leaflet handed across a desk, no one to ask. You are holding a cholesterol figure, a blood pressure reading, a BMI and a heart risk score, with the general instruction to eat better and move more.

That instruction is correct and almost useless. "Eat better" does not tell you what to put in the basket on Thursday.

So this is the missing page. We have taken the results the check reports back, in the order it reports them, and written what each one changes about a normal supermarket shop. No supplements to buy, no eleven-ingredient recipes, nothing you need a health food shop for.

One thing before we start, and we mean it: this is about food, and it does not replace your GP. If your check flagged something, or you have been asked to book an appointment, do that first.

What the online NHS Health Check gives you back

The NHS Health Check is for adults in England aged 40 to 74 who do not already have certain conditions such as heart disease, type 2 diabetes or kidney disease, and it is offered roughly every five years. Think of it as a heart and circulation stocktake rather than a full blood panel: cholesterol, blood pressure, height and weight, some lifestyle questions, and a calculated risk of a heart attack or stroke over the next ten years.

The online version reports the same things on screen, and each result comes with the reference figures the check itself uses, so we are not going to restate thresholds here. What follows assumes you have your own numbers in front of you and want to know which aisle they point at.

Cholesterol results: total, HDL and non-HDL

Your check will usually give you total cholesterol and non-HDL cholesterol, and often HDL alongside. Non-HDL is simply everything that is not HDL. It has become the figure UK services tend to lead on, because it captures more of the picture than total cholesterol on its own.

If these are the numbers you have been asked to keep an eye on, the eating pattern usually recommended is a familiar one: more soluble fibre, more oily fish, less saturated fat, and unsaturated fats in place of some of it. That is the advice. Here is the shop.

Cholesterol: what to put in the basket

• Breakfast aisle. Porridge oats, whole or jumbo rather than instant sachets with added sugar. Oatcakes for the cupboard. A big bag of oats costs less per portion than almost anything else in the shop.
• Tinned goods. Tinned sardines, mackerel and pink salmon. Tinned beans, chickpeas and lentils in water with no added salt. Four tins of pulses in the cupboard is four dinners you can bulk out without buying more meat.
• Fresh counter or freezer. Two portions of fish a week, one of them oily, is the standard UK recommendation. Frozen mackerel and salmon fillets count, and they keep.
• Dairy. This is where saturated fat quietly adds up. Lower-fat milk, lower-fat natural yoghurt, and a stronger-flavoured cheese so a smaller amount still tastes of something.
• Oils and spreads. Rapeseed or olive oil as the default cooking fat.
• Snacks. Unsalted nuts instead of the salted ones. Plain popcorn kernels if you want something to do with an evening.

If cholesterol is the number you are working on, our high cholesterol meal plans page sets out how we build a whole week around it.

Blood pressure: where the salt in your shop really comes from

The check records a blood pressure reading and tells you which band it sits in. If it is high enough to need attention, you will be told to see someone, and you should.

For everyone else, the main food lever here is salt, and most of your salt does not come from the salt pot. It comes from bread, sauces, stock cubes, cured meats, cheese and ready meals. NHS advice for adults is no more than 6g of salt a day, about a teaspoon in total, including everything already in the food you buy.

Blood pressure: what to put in the basket

• Bread aisle. Salt content varies a lot between loaves that look identical. Compare the per-100g figure on two or three, pick the lower one once, then keep buying it.
• Cooking cupboard. Reduced-salt stock cubes, or a few jars of dried herbs, smoked paprika, cumin and black pepper, plus lemons and a bottle of vinegar. Flavour you are not paying for in sodium.
• Jars and sauces. A jar of pasta sauce can carry a surprising amount of salt. Tinned chopped tomatoes, garlic and herbs cost less and let you control it.
• Fruit and veg. Potatoes, bananas, leafy greens and beans all bring potassium into the week, which is part of the pattern usually recommended alongside cutting salt.
• Deli and chilled. Bacon, ham and sliced cured meats are among the saltiest things in a typical trolley. This is a question of how often, not a ban.

Our high blood pressure meal plans page explains how we keep a week's salt in check without the food tasting of nothing.

BMI: shopping for meals that keep you full

The check works out your BMI from the height and weight you enter. It is a blunt instrument, and the check will tell you so, but it feeds into your risk score, so it appears.

If you have decided weight is the thing you want to work on, the more useful shopping question is what makes a meal filling enough that you are not hunting through the cupboards at nine o'clock.

BMI: what to put in the basket

• Protein at breakfast. Eggs, plain Greek-style yoghurt, or oats made with milk. Breakfast is where most UK baskets are lightest on protein.
• Frozen veg. Peas, spinach, broccoli, mixed peppers. They add volume to a meal without adding much else, they do not rot in the drawer, and they are cheaper than fresh.
• Pulses again. Half a tin of lentils stirred into a bolognese means less mince for the same size portion.
• Fruit bowl. Whatever is in season and on offer. The point is that it is visible and already in the house.

No food in that list does anything on its own. It is a basket that makes a week easier to stick to, which is the part that actually counts.

Your heart age and 10-year risk score

The headline result is a percentage: your estimated risk of a heart attack or stroke in the next ten years, sometimes also shown as a heart age. It is built from your numbers plus your age, sex, family history and lifestyle answers, so some of what goes into it is not something you can shop for.

There is no single food that moves a combined score, and anyone telling you otherwise is selling something. What dietitians point to for heart risk is the overall pattern: broadly Mediterranean in shape, built on vegetables, pulses, wholegrains, fish, nuts and olive oil, with red and processed meat as an occasional thing rather than the default.

Heart risk: what to put in the basket

This is where the three lists above stop being three lists. Oats, tins of fish, tins of pulses, frozen veg, unsalted nuts, olive oil, a lower-salt loaf and a bag of fruit is one shop. That is the whole reason we built Nutridly around a basket rather than a dashboard.

If the check flagged your blood sugar

Some people come out of the check with a diabetes risk high enough that they are offered a blood sugar test, usually HbA1c. That is a different number with a different food conversation attached, and it deserves a proper look rather than a footnote here. Our blood sugar balance meal plans page covers how we handle it.

Is the online NHS Health Check available where I live?

Not everywhere yet. The online version is still being tested in a limited number of areas before it is offered nationally. Your GP practice, the NHS App or your local council's website will tell you whether it is open to you.

If it is not, you have not missed out. The in-person NHS Health Check still runs through GP practices and some local services, and many pharmacies offer a free blood pressure check for adults aged 40 and over.

And if you would like a wider picture than the heart markers the check covers, the Nutridly Core home kit is a finger-prick test posted to your door and processed in a UKAS-accredited UK laboratory. It covers 20+ markers including iron and ferritin, vitamin D, B12, folate, thyroid function and cholesterol, and the results land straight in your plan.

From the number on screen to Thursday's shop

What the check cannot do is the next six months. It gives you a snapshot and a sentence of advice, and then the weekly question of what to cook and what to buy is yours again.

That is what Nutridly is for. You enter the numbers you already have, from the online check, a pharmacy check, a GP print-out or a private blood test, along with what you will and will not eat, how much time you have and who else you are feeding. You get a week of meals built around those numbers, with every calorie and nutrient figure calculated from McCance and Widdowson's Composition of Foods Integrated Dataset rather than estimated, and a shopping list organised by supermarket aisle so the shop takes less time, not more.

It rebuilds every week without you re-explaining yourself, and it changes when your numbers change. Start your plan from your check results and get this week's meals and shopping list built around them. Keep your GP informed of any changes you make to your diet, and keep taking anything you have been prescribed.