Sustainable food systems require the integration of and alignment between recommendations for food and land use practices, as well as an understanding of the political economy context and identification of entry points for change. We propose a food systems transformation framework that takes these elements into account and links long-term goals with short-term measures and policies, ultimately guiding the decomposition of transformation pathways into concrete steps. Taking the transition to healthier and more sustainable diets as an example, we underscore the centrality of social inclusion to the food systems transformation debate. Addressing trade-offs between the environment, health and inclusion in the quest for sustainable food systems requires integrated and coherent policies. This Perspective proposes a food systems transformation framework that brings these elements together and enables the design of concrete development pathways for food sustainability.