In addition, the total lack of cheap but healthy prepared foods. In the USA, "healthy" = "salad" = "$15 at Sweetgreen" or something. But living here in Japan, despite the cost of groceries being consistently higher than it is in the USA, there's an huge variety of healthy $5-10 meals, as well as healthy, low-calorie/high-protein snacks easily available at any convenience store (that are actually delicious - dried seafood and pickled veggies are a favorite), that simply doesn't exist in most of the USA.

For instance, I just had a grilled fish lunch set meal (teishoku) similar to this one [1] with miso soup (full of veggies), pickles, eggplant and small bowl of rice for $6 today, which based on similar meals at chain stores that publish calorie counts, probably amounts to maybe 600-750 calories with around 30-40 grams of protein. If you're hungry maybe choose a pork cutlet instead for the same price, or add a side dish for $1, or switch to a larger serving of rice for free.

That said, even if those options were available, convincing Americans that "tasty" is not equivalent to "supersaturated with butter and corn syrup" is a difficult proposition...

[1] https://upload.wikimedia.org/wikipedia/commons/c/ca/%E3%82%B...

>The biggest issue from what I can see is the lack of time / skill / willingness for most people / families to do their own food preparation from base ingredients.

You forget one important piece of that puzzle, I think: access to (affordable) base ingredients. From my outsider perspective, having read some articles and seen some activists talk about this, there seems to be a thing in the US they call "food deserts"[0] where in many, mostly not very affluent neighborhoods there simply are no stores left that do sell fresh base ingredients, only "dollar stores" that sell highly processed cheap "food".

[0] https://en.wikipedia.org/wiki/Food_desert

Part of this is true, part of this is not.

Stores carry what is demanded of their customers, and they don’t carry what they can’t sell before it goes bad. The food isn’t there because it’s not consumed, and because you can’t buy it, it’s not consumed. Fresh food is expensive and goes bad, it’s too much risk as a small business to carry if you don’t think you can sell it. That’s the issue you often see.

My second point would be the huge number of ethnic markets in low income areas with a tone of fresh fruits and veggies. When consumed, they are carried.

There is a culture of convenience that pushes people to shelf stable meals. Those are quick, and generally unhealthy.

Even in affluent locales, quality base ingredients are noticeably expensive.

Portion size / spoilage / price per unit are also a huge issue for those who are single. I'd have to eat almost the same thing every day to properly use up most highly perishable (good for me) foods before they spoil.

I am single, and I generally do not have much of an issue with that here in Germany. "Loose" fruit and vegetables[0] and "single-sized" packaged stuff[1] is widely available without much of a price difference. I rarely have to throw anything out because it spoiled, and I don't have to eat the same stuff for days on end, either.

Is that really such an issue where you live? Interesting.

[0] "Loose" stuff is usually sold by weight, there are scales in the supermarket where you weigh whatever you intent to buy, so buying small quantities has no surcharge at all.

[1] Smaller packages usually are a little bit more expensive than "family size" ones. But I hardly buy anything perishable in such packages anyway. It's mostly things like noodles or cereal, which if stored correctly, can last for months if need be, so buying a cheaper family-size pack as a single is not an issue for me.