Mirroring trends across the Caribbean and the West Indies, the Turks and Caicos Islands are seeing an increase in the consumption of foods associated with diet-related disease and ill-health such as diabetes, obesity, hypertension and heart disease. These shifts are often attributed to the changing food preferences of consumers, as islanders are thought to be aspiring to a modern and ‘Americanised’ diet. Drawing on accounts derived from group and individual interviews with Turks and Caicos islanders – chiefly the women who are responsible for feeding work - this paper unpacks the notion that changing diets are a symptom of shifting tastes and preferences. Rather, narratives point to interlocking ecological, economic and social shifts that over time compound the effects of losing access to a culturally valued local source of healthy protein: fish and seafood. Taking an ecofeminist sociological perspective, this paper argues that challenges of food insecurity and diet-related ill-health share both mutual problems and pathways to common solutions.