Dietary health and sustainability are inextricably linked. Food systems that are not sustainable often fail to provide the amount or types of food needed to ensure population health. The ongoing pandemic threatens to exacerbate malnutrition, and noncommunicable diseases (NCDs). This paper discusses threats and opportunities for food environments and health status across the WHO European Region in the current context. These opportunities and threats are focused around four key areas: NCDs and health systems; dietary behaviour; food insecurity and vulnerable groups; and food supply mechanisms. Food systems were already under great stress. Now with the pandemic, the challenges to food systems in the WHO European Region have been exacerbated, demanding from all levels of government swift adaptations to manage healthiness, availability, accessibility and affordability of food. Cities and governments in the Region should capitalize on this unique opportunity to ‘build back better’ and make bold and lasting changes to the food system and consequently to the health and wellbeing of people and sustainability of the planet. © 2020, The Author(s).