Even prior to COVID-19, there was a considerable push for food system transformation to achieve better nutritional and health – as well as environmental and climate change – outcomes. In 2019, several major publications focusing on transforming agricultural and food systems to achieve nutritional and climate change objectives argued for major changes in agricultural land use, production systems and dietary choices. They placed an emphasis on increasing resource use efficiency, reducing agricultural extensification and reducing consumption of meat-based products while increasing nutritionally dense foods. However, these reports fail to fully consider the impact of these measures on the livelihoods of the approximately 2.7 billion rural people who depend on small-scale food production and to propose specific measures to ensure the rural poor participate in – and benefit equitably from – food system transformation. Although the importance of inclusion in food system transformation is gaining traction, including in a recent Cornell Atkinson Center for Sustainability – Nature Sustainability Expert Panel Report on food system transformation, in this paper we argue that recent research, modelling and discourse on food system transformation is insufficient and that specific actions are needed to ensure that food system transformation does not take place on the backs of the rural poor.