Cancer prevention: Policies and actions to increase vegetable and fruit consumption

The way people live their lives, and in particular their patterns of diet and physical activity, are significantly affected by external factors. Implementing polices and actions that affect these external factors could help prevent cancer by, among other things, increasing consumption of vegetables and fruits. Policy and Action for Cancer Prevention provides evidence-based recommendations for policies and actions, involving all actors, that would help achieve the public health goals of the 2007 WCRF/AICR Second Expert Report.

Integrated and coordinated action across actor groups is vital, although some groups will have more relevance for a particular area than others. Some of the recommendations aimed at multinational bodies, civil society organisations (CSOs), government and industry that could increase vegetable and fruit consumption are highlighted below.

Actions taken by multinational bodies (for example the World Trade Organization and United Nations bodies) often do not have public health in mind. But these actions can profoundly affect patterns of diet and other factors that affect cancer risk. Recommendations aimed at multinational bodies are that they should build the protection and maintenance of public health into all relevant agriculture, food, health, economic, trade and environmental agreements. Also, UN bodies should ensure their cancer prevention policies are integrated with strategies designed to prevent and control other diseases. Implementing these recommendations could take the form of using global food trade rules to improve health, and removal of agricultural and other subsidies that damage public health. They could also involve monitoring the impacts of climate change and economic globalisation on all stages of food production.

CSOs (for example charitable foundations, scientific and professional associations) are a vital part of society that can advocate and also develop and sustain public policies, often in association with other actors. They frequently take the initial lead in such work. The recommendations to CSOs include the need for them to press governments to implement effective policies and programmes for nutrition, and to hold other actors accountable. It is also important for CSOs to mobilise the media and public opinion in support of healthy nutrition (eg a mainly plant based diet), and to advocate traditional ways of life when these generate healthy, sustainable dietary patterns. Additionally, CSOs should form alliances to strengthen their impact.

Governments and their agencies have the central responsibility for protecting and improving public health, including the prevention of diseases such as cancer. Government in this context includes national, state, provincial, municipal, and local levels. Legislation, pricing and other policies can be used to Promote healthy diets. Many of the Policy Report recommendations for government could increase vegetable and fruit consumption. For example, in addition to establishing and maintaining public health education programmes, governments should also encourage safe, nutrient-dense, relatively unprocessed foods by other means. This could range from support of horticulture to restricting advertising of ‘fast food’ and other processed foods to children. Additionally, governments should provide catering that is of high nutritional quality in schools and all government and publicly funded facilities.

Industry (for this article only food and drink industries are considered) is a potential leader and can also be a partner in initiatives designed to improve and protect public health. The Policy Report recommends that industry should make public health a priority during development, reformulation, and promotion of food products. Industry should also ensure that healthy meals, snacks and foods are competitively priced and that accurate information is used in all advertising and on food labels.

This article focuses on a subset of the recommendations that could impact on vegetable and fruit consumption and other patterns of diet and physical activity. There are other recommendations for the actors mentioned above, and also for people (as individuals and members of communities), media, schools, workplaces and institutions, and health and other professionals (see http://www.dietandcancerreport.org/pr/ for full details). To achieve the greatest results, all actors need to work together to implement policies and actions to prevent cancer and improve public health.