Overcoming the socioeconomic and gender gap in fruit and vegetable intake

The interplay of 5 A Day Campaigns with food-based dietary guideline promotion

The Plan of Action endorsed at the International Conference on Nutrition in 1992 called on governments to provide to the public “qualitative and/or quantitative dietary guidelines”1. Subsequently, many countries developed food-based dietary guidelines (FBDG). Fruit and vegetables are an important component of a healthy diet, and their sufficient daily consumption could help prevent certain chronic diseases. To increase the consumption of fruit and vegetables in the population, several countries have programmes that promote fruit and vegetables, often under the slogan “5 A Day”. This article looks at the implementation of FBDG in Chile, Germany, New Zealand and South Africa and its interplay with the 5 A Day programme in each country. Most of the information comes from key informant interviews. Each of these countries has a specific FBDG regarding fruit and vegetables:

The role of 5 A Day programme in dietary guidelines implementation

In Chile, the 5 A Day programme contributes to FBDG dissemination. The activities of the public sector and the 5 A Day programme are coordinated and the same messages and materials are given to the public. The German 5 Am Tag association communicates mainly its own message, however without leaving out other important factors of a healthy diet. Governmental representatives agree that 5 Am Tag is part of the FBDG promotion, since they co-sponsor 5 Am Tag and the FBDG specifically include the “Take 5” message. In New Zealand, from the governmental point of view the 5+ADay programme has no specific role in the implementation of the FBDG. All interviewees agreed that 5+ADay is complementary to FBDG promotion. In South Africa, a better coordination and collaboration with the public side has recently started and it is felt that 5 A Day can be the “voice” for the fruit and vegetable guideline.

The interplay of governmental FBDG implementation and 5 A Day programmes in the four case study countries

In Chile, INTA, an academic institution, promotes the FBDG and 5 Al Día, which gives credibility to the programme in the population and for government collaboration. As a “neutral party”, INTA achieved a multi-sectoral dialogue and buy-in. As the 5 Al Día message is included in the new FBDG, the programme gives an opportunity to use its channels to communicate all FBDG to the public, therefore diversifying the “traditional” communication channels.

In Germany, the FBDG are chiefly promoted by the BMVEL and its agencies, which are a member of or sponsor of the 5 A Day association. As in Chile, the 5 Am Tag message is part of the FBDG; hence, message and logo are included in government sponsored nutrition information, which gives a consistent picture.

In New Zealand there is no real interplay with the national government (exception: fruits in schools project), which is conscious that 5+ADay is industry lead. However, the message and number “5” is included in the government sponsored FBDG; hence there is no conflict in the messages, even though they are not promoted in a joint campaign.

In South Africa, there is reluctance from the side of the national government to interact directly with the 5 A Day Trust, even though the fruit and vegetable message is part of the FBDG. However, 5 A Day is not seen as hindering the implementation of FBDG or that it could “threaten” an overall healthy diet approach – FBDG and 5 A Day are complementary; and promoting all FBDG through the entry-points 5 A Day uses may be beneficial.

FBDG give positive and negative messages regarding a total diet. “5 A Day” only gives a positive message. Some informants pointed out that it is “easier” to give those positive messages to the population than the negative “eat less” ones. However, for a balanced diet, the 5 A Day message needs to be combined with the “instead of” message. Hence, the “bad news” needs to be part of the nutrition information given to the population as well as at the policy level. Policy makers should support fruit and vegetable promotion, but they should also focus on the “eat less” / “instead of” messages.

While not all governments endorse the 5 A Day programme, the informants concurred that these programmes are complementary to FBDG implementation and not counterproductive.

Additionally, nutrition education, as a rather “top-down” approach, is often not complemented by community involvement and/or environmental changes and FBDG are not taken into account by other public policies. 5 A Day programmes, if set-up as public-private partnerships, can have policy impact and are well situated to complement education with environmental changes. Such set-up may be conducive for overall FBDG implementation as well.

  1. WHO/FAO, Technical Report Series 880, 1998.
  2. Instituto Nacional de Tecnologia de Alimentos y Nutricion / Ministerio de Salud Chile, 2005.
  3. Deutsche Gesellschaft für Ernährung, 2004.
  4. Ministry of Health New Zealand, 2003.
  5. Vorster et al., S African J Clin Nutr. 2001;14 (3) (Suppl.):S3-6.
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