Policy efforts to increase fruit and vegetable consumption across the developed world have resulted in modest gains and increased awareness (most notably among children), yet largely they’ve fallen short in impacting long-term consumption behavior, according to a review by University of Sydney researchers.
Current average consumption of fruits and vegetables globally is much lower than the World Health Organization recommended intake of 400 g per person per day. In the US, only 6 to 8% of consumers hit their recommended daily target for vegetables and fruit, with the average American consuming only 1.8 cups per day. In Europe, consumption stands at only 220 g per person per day for adults. And just 5.6% of Australian adults overall had an adequate daily consumption of fruit and vegetables.
In an effort to increase consumption, countries including the US, Australia, Canada, New Zealand and several countries in the EU have conducted multi-million-dollar informational and educational campaigns over the past decade. Indeed, the US has spent roughly $3 to $5 million per year on the “Fruits & Veggies – More Matters” campaign since its launch in 2007. It’s estimated that the Danish “6 a day” campaign is costing approximately DKK 4 million (US $0.73 million) per year, while Australia’s national “Go for 2&5” campaign conducted between 2005 and 2007 cost AUD 4.76 million (US $4.17 million).
Despite targeting behavior, most of the interventions have led to only small increases in fruit and vegetable intake when compared with the increases required to meet the recommended daily levels of consumption. In the US, survey results between 2004 and 2009 showed that while consumers’ fruit and vegetable intake remained unchanged at 1.81 cups per person per day, it did increase for children less than 6 years old and between 6 and 12 years old, by 7% and 5%, respectively. More promising still was that brand awareness of the “Fruits & Veggies – More Matters” slogan and logo increased from 11% in 2007 to 26% in 2012, according to the researchers.
The Australian “Go for 2&5” campaign lacked support from the fruit and vegetable industry, ultimately falling short of its goal, given that only 5.6% of Australian adults met the daily recommended intake for fruit and vegetable consumption in 2011–2012, according to the researchers.
The Danish fared better, with vegetable and fruit consumption for the 4- to 10-year-old group increasing by 29% and 58% respectively between 1995 and 2004, and 41% and 75%, respectively, for 11- to 75 year olds. All told, for the period 2003–2008, the average intake of vegetables and fruits for adults (18–75 years old) averaged 445 g per person per day, higher than the minimum WHO recommended level.
“Success is higher for those campaigns where there is a high degree of collaboration between industry (producers), retail, government and quasi-government organizations, such as the Heart and Cancer Foundations/Societies, in rolling out and administering the interventions,” the researchers wrote.
One of the more successful campaigns, the Food Dudes program, resulted in a 60 to 200% increase in fruit and vegetable consumption and where monitored, an associated decline in consumption of unhealthy foods by 20 to 100%, according to a trial among primary school children (four to 11 years old) and two- to four-year olds in the US, UK and Italy. The impact is highest among children who are the poorest eaters. The program, structured around a series of DVD adventures starring young heroes called Food Dudes, promoted the following: behavioral change; goal-setting; simple and unambiguous messages; were run intensively for longer time-frames; encouraged the proactive involvement of all family members; and were interactive rather than just promotional.
Given that merely advising consumers to eat more fruit and vegetables doesn’t appear to widely effect long-term behavioral change, the researchers suggested that “more subtle and proactive strategies need to be introduced to facilitate a change that is sustainable. One targeted approach includes food service outlets, such as cafes and fast food chains, choosing to automatically include fruits and vegetables as a side dish in their meals, with the consumers having to request a substitute, if they so desire.”
In addition, high visibility at the retail level in multiple locations of stores and convenient, economical single-serve packs may also help increase consumption.
“Promoting consumption of fruit and vegetables for better health. Have campaigns delivered on the goals?”
Authors: Reetica Rekhy and Robyn McConchie