Spring 2005    Vol. 13, Issue 1


Chronic Disease and Obesity Prevention Step Up Worldwide Interest in Fruit and Vegetable Promotion

The Sesame Street children's program promotes "5 A Day The Color Way."

Despite more than a decade of initiatives and efforts by countless government, nongovernmental and commercial organizations worldwide, individuals still aren’t consuming enough fruits and vegetables. For example, more than half of all Americans know they need to eat at least five daily servings of these healthy consumables, but only 20 percent actually achieve that minimum. This is lamentable, expensive and potentially fatal, since diets low in fruits and vegetables not only increase the risk of chronic disease and obesity, they also increase health care costs, lower the quality of life and heighten mortality rates for billions across the globe.

After a decade of disappointing trends for fruit and vegetable intake, a 2004 study by NPD Foodworld for Produce for Better Health Foundation (PBH) showed a 1 percent increase in per capita consumption in the United States. This rate suggests a slow march to close the consumption gap and, coupled with the recently increased federal fruit and vegetable recommendations, is decidedly unacceptable. This situation, along with growing global awareness that the economic burden associated with poor health is daunting for developed nations and potentially disastrous for developing ones, may explain why efforts to increase fruit and vegetable consumption are beginning to take hold around the world. In an important step toward a coordinated global effort for better health, planning is already underway for an international federation, an alliance of national fruit and vegetable program leaders aimed at increasing the intake of fruits and vegetables.

Consumption Gap Necessitates U.S. Action
The average American eats only 3.6 daily servings of fruits and vegetables (2.2 servings of vegetables and 1.4 servings of fruits), according to a 2005 NPD Foodworld report, and on any given day, the National Center for Health Statistics has found that 45 percent of children eat no fruit, and 20 percent eat less than one serving of vegetables. Meanwhile, 25 percent of all heart attacks, strokes, cancers and diabetes cases are attributed to diet.

Changing eating habits are at least partly to blame, with the routine omission of the side dish at dinner and the fact that more meals are eaten outside the home limiting opportunities for fruit and vegetable consumption. Federal food and nutrition assistance programs reach millions of vulnerable adults and children with healthy foods and eating messages, yet, the first significant changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food package in almost 30 years have only recently been recommended. Consistent with federal dietary guidelines, the inclusion of a broad variety of fruits and vegetables is proposed.

If consumers are to increase their intake, they need knowledge; they also require motivation, opportunity and ability, according to a 1999 Journal of Marketing article by M.L. Rothschild. Communication efforts can help motivate people, but marketing and policy are necessary to create an environment where the healthy choice is the easy choice.

To this end, PBH unveiled a National Action Plan to Promote Health Through Increased Consumption of Fruits and Vegetables earlier this year. Developed with input from food, nutrition, marketing, communications and policy leaders as well as a thorough assessment of scientific literature, the plan identifies more than 75 short- and long-term strategies in nine different settings, including supermarkets, restaurants, schools, worksites and communities, to help Americans of all ages boost their fruit and vegetable consumption. Overall plan objectives include:

  • Increasing the accessibility and desirability of fruits and vegetables, by making them tasty, attractive, convenient, affordable, plentiful and easily available
  • Offering practical strategies to help increase individuals’ ability to obtain and prepare meals and snacks rich in fruits and vegetables.
  • Changing Americans’ attitudes and habits so that they include fruits and vegetables at every eating occasion.

Alongside the national plan (which is already supported by dozens of national health, nutrition and policy experts and organizations), PBH recently launched several innovative consumer programs under the umbrella of its 5 A Day The Color Way campaign, which teaches consumers to eat a colorful variety of fruits and vegetables every day. The foundation is also partnering with retail giant Wal-Mart to conduct family-oriented educational events in the chain’s 1,700 U.S. stores and with the world-renowned Sesame Street Workshop to reach toddlers and their families. ACNielsen research has shown that awareness of the foundation’s Color Way campaign leads to increased fruit and vegetable purchases and reported consumption.

PBH has also stepped up efforts to help prioritize fruits and vegetables in federal policies and programs. Most notably, with PBH input, the new Dietary Guidelines for Americans 2005 recommend consumers eat more fruits and vegetables than any other food group. Since the guidelines form the basis of U.S., and sometimes other nations’, food and nutrition policy, at a minimum, the new recommendations of five to 13 (as opposed to nine) daily servings of fruits and vegetables should mean more of these healthy consumables in federal nutrition programs, such as WIC and the national school lunch and breakfast programs.

In the year ahead, PBH will build support for its national action plan. It will also encourage school districts to put fruits and vegetables first in their wellness policies and will work with national and local partners to expand a new school fruit and vegetable snack giveaway program, which is currently limited to eight of the 50 states.

Worldwide Attention Also Grows
As U.S. efforts to promote fruit and vegetable consumption multiply, so do international initiatives. Recognizing that overweight, obesity and related diseases account for some 60 percent of deaths and 47 percent of disease globally, last May, the World Health Organization (WHO) and the Food and Agriculture Organization endorsed WHO’s Global Strategy for Diet, Physical Activity and Health. This global roadmap to public health highlights increased fruit and vegetable consumption, noting the proven effectiveness of 5 A Day-type programs and encouraging U.N. member nations to adapt similar programs in their countries.

In August 2004, representatives of 31 countries took part in the 4th International 5 A Day Symposium presented by PBH and WHO. Out of this conference came the call for an international federation of fruit and vegetable promotion programs. As the pioneer of 5 A Day-type programs, PBH is now helping to create this international federation to provide networking, educational forums, and model materials and techniques.

PBH is also supporting WHO’s regional program launch efforts. In April 2005, the foundation shared its expertise with other 5 A Day-type program leaders of The Americas at a first-ever Pan-American Congress on Promotion of the Consumption of Vegetables and Fruits in Guadalajara, Mexico. It will participate in a similar gathering in South Africa in September.

The goal is to make healthy living easy, in America and abroad. To do so requires resolve and cooperation. Now that the ball is rolling, maybe we can finally expect results.

For more information on:
--International Federation…Ron Lemaire, rlemaire@cpma.ca
--PBH’s National Action Plan…www.pbhfoundation.org/actionplan
--U.S School Wellness Policies…www.schoolwellnesspolicies.org
--WHO-related programs and initiatives…http://www.who.int/dietphysicalactivity/en, http://www.who.int/dietphysicalactivity/publications/en/fruit_vegetables_report.pdf, http://www.congresoverdurasfrutas.org/

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