Deep learning based food recognition has achieved remarkable progress in predicting food types given an eating occasion image. However, there are two major obstacles that hinder deployment in real world scenario. First, as new foods appear sequentially overtime, a trained model needs to learn the new classes continuously without causing catastrophic forgetting for already learned knowledge of existing food types. Second, the distribution of food images in real life is usually long-tailed as a small number of popular food types are consumed more frequently than others, which can vary in different populations. This requires the food recognition method to learn from class-imbalanced data by improving the generalization ability on instance-rare food classes. In this work, we focus on long-tailed continual learning and aim to address both aforementioned challenges. As existing long-tailed food image datasets only consider healthy people population, we introduce two new benchmark food image datasets, VFN-INSULIN and VFN-T2D, which exhibits on the real world food consumption for insulin takers and individuals with type 2 diabetes without taking insulin, respectively. We propose a novel end-to-end framework for long-tailed continual learning, which effectively addresses the catastrophic forgetting by applying an additional predictor for knowledge distillation to avoid misalignment of representation during continual learning. We also introduce a novel data augmentation technique by integrating class-activation-map (CAM) and CutMix, which significantly improves the generalization ability for instance-rare food classes to address the class-imbalance issue. The proposed method show promising performance with large margin improvements compared with existing methods.