Beyond ‘5 a day’

By Amber Wheeler, PhD student at University of South Wales, @amberfood on Twitter

I agree with Pamela Mason that we need new sustainable dietary guidelines in Wales. But if we really want to improve the well-being of current and future generations in Wales, as per the Well-being of Future Generations (Wales) Act 2015, guidelines must be targeted at all parts of the food system – not just at the consumer, like previously. Take the case of fruit and vegetables, and one of the most well known dietary guidelines: ‘5 a day’.

5 a day logo

Although everybody knows they should be eating five portions of fruit and vegetables per day, the campaign has been hugely unsuccessful in terms of making a difference to consumption. In fact, consumption has gone down by 7% in Wales since the campaign was introduced by the UK Department of Health in 2003.

When the campaign was launched, 39% of people ate ‘5 a day’ compared to 32% now. Wales now has the lowest reported consumption of fruit and vegetables in the UK (Public Health Wales Observatory, 2013). The implications for the health of the nation are stark. The UK Faculty of Public Health (2005) estimates that a poor diet is linked to 30% of life years lost in early death or disability.

So why has this campaign been such a failure? I would argue it’s because it has focused on just one small part of the food system: namely, consumers. This is not enough to drive change in the whole system.

food system

 

While people are told to eat more fruit and vegetables, the rest of the food system is making available ever-more-processed foods at ever-decreasing prices, relegating fruit and vegetables to the expensive and inconvenient choice. Healthy food is now estimated to be 3 times more expensive than unhealthy food per calorie (Jones et al, 2014) meaning that lower-income households are more likely to be overweight/obese (Fabien Society, 2015).

In a hospital café I visited the other day I couldn’t find any portions of fruit or vegetables to buy. So my daughter, who was ill and hungry, had a glass of pop and a packet of crisps when I would have bought her a glass of fruit juice and an apple. We have to create contexts that enable, not inhibit, healthy behaviour.

If all parts of the food system were working towards increasing the availability of fruit and vegetables, perhaps the ‘5 a day’ campaign would have been more successful, and Wales would be healthier.

What we need to do is put sustainable dietary guidelines at the heart of our food system, along the lines of the ecological public health model proposed by Tim Lang and others (Lang and Rayner, 2012), so that the whole food system is working towards them. In terms of fruit and vegetables it might look something like this:

5 a day targeted at all food system

If we look at production and retail distribution: Wales currently has around 1.5 million hectares of agricultural land, but only 1449 hectares grows fruit and vegetables. That’s just 0.1% of agricultural land growing an essential part of the Welsh population’s diet, contributing to an estimated measly 3% of the nation’s fruit and vegetable requirement.

wales map just 0.1% fruit n veg

The fruit and vegetable requirement of the Welsh population per year is 620,000 tonnes*. If we were to be able to grow 100% of this in Wales, at a realistic yield of 14 tonnes per hectare**, this would require 44,286 hectares of land – 31 times more than the present but still only 2.8% of all agricultural land. Wales should be aiming to produce more of its fruit and vegetable requirement than it does now: 5%, 20%, 50%, 100%? What do you think?

Percentage of fruit and veg needs able to be met Tonnes needed for 3.1m Welsh pop (plus 35% waste) Area of land required at

14t/ha

Percentage of total agricultural land available 1,559,558 Percentage grade 1-3 land available 345,839 Times more land needed to produce fruit and veg than present
100% 620,000 44,286 2.8 12.8 31
90% 558,000 39,857 2.6 11.5 28
80% 496,000 35,429 2.3 10.2 24
70% 434,000 31,000 2.0 9.0 21
60% 372,000 26,571 1.7 7.7 18
50% 310,000 22,143 1.4 6.4 15
40% 248,000 17,714 1.1 5.1 12
30% 186,000 13,286 0.9 3.8 9
20% 124,000 8,857 0.6 2.6 6
10% 62,000 4,429 0.3 1.3 3
5% 31,000 2,214 0.1 0.6 2
3% 15,500 1,107 0.1 0.3 0
  Current  1449 1559558.0 345,839  

In terms of retail food distribution, minimum requirements should be set for fruit and vegetable availability. For example, for every meal-buying customer in a hospital café there should have to be at least one portion of fruit or vegetables available. Buffets should have to supply at least one portion of fruit or vegetables per person and so on. Catering staff should receive training on how to increase fruit and vegetable content during food hygiene courses. These actions would automatically lead to increases in demand that Welsh producers could tap in to.

The possible benefits extend well beyond the health of consumers to more businesses, more jobs, more training opportunities, more prosperity, more diversity, and more resilience. In fact, this approach has the potential to contribute to all seven goals of the Well-being of Future Generations (Wales) Act 2015: a more prosperous Wales, a more resilient Wales, a healthier Wales, a more equal Wales, a Wales of cohesive communities, a Wales of vibrant culture with thriving Welsh language and a globally responsive Wales. It would also fit into the new vision proposed for Welsh Agriculture: ‘A prosperous, resilient agriculture industry promoting Wales’ present and future well-being.’ (WG, 2015, p.5).

more than 5 a day
By targeting the sustainable dietary guidelines, like the ‘5 a day’ message, at every part of the food system, it should be possible to create an environment where eating more fruit and vegetables is the affordable and convenient choice. This should lead to increases in consumption, improvements to health and well-being, and wider sustainability. All of which the ‘5 a day’ campaign, targeted solely at consumers, failed to achieve alone.

  1. Grow fruit and vegetables on 3% of agricultural land in Wales
  2. Set minimum requirements for fruit and vegetable availability.

Amber Wheeler is currently undertaking a PhD at the University of South Wales exploring a ‘needs and capacity’ approach to the potential development of a more secure and sustainable food system using the fruit and vegetable sector in Wales. If you have any ideas you would like to contribute please tweet @amberfood or contact: amber.wheeler@southwales.ac.uk

*620,000 t/pa based on 5 a day/400g per person per day, per annum plus 35% food waste =0.2 t per person times 3.1 million. ** 14 t/ha based on aggregated realistic yields from ADAS (2015), Nix (2014), Lampkin et al (2014) and Horticulture Wales (2015).

References

ADAS (2015) Personal Communication Chris Creed Horticulture Consultant.

Department of Health. (2005). Choosing a better diet: a food and health action plan. Available at: http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4105709.pdf (Accessed: 1 September 2015)

Fabian Society. (2015) A recipe for inequality. Why our food system is leaving low-income households behind. Retrieved from http://foodandpoverty.org.uk/wp-content/uploads/2015/03/ARecipeforInequality_WEB.pdf

Faculty of Public Health (2005) Food Poverty and Health. Briefing Statement. Available at: http://www.fph.org.uk/uploads/bs_food_poverty.pdf (Accessed: 1 September 2015)

Horticulture Wales (2015) Horticulture Wales Crop Calculator. Available at: http://www.horticulturewales.co.uk/Library/Crop-Calculator.aspx (Accessed: 4 September 2015)

Jones, N. R. V., Conklin, A. I., Suhrcke, M., & Monsivais, P. (2014). The growing price gap between more and less healthy foods: Analysis of a novel longitudinal UK dataset. PLoS ONE, 9(10).

Lampkin, N., et al. (2014). 2014 Organic Farm Management Handbook. Newbury, Organic Research Centre Elm Farm.

Lang, T. and G. Rayner (2012). “Ecological public health: the 21st century’s big idea? An essay by Tim Lang and Geof Rayner” BMJ Open 345, 1-5.

Nix, J. (2014). John Nix Farm Management Pocketbook. Melton Mowbray, Agrobusiness Consultants Ltd.

Public Health Wales (2015) Child Measurement Programme for Wales 2013/2014, Public Health Wales NHS Trust Date: May 2015, ISBN: 978-1-910768-02-0

Public Health Wales Observatory (2013) Health of Children and Young People in Wales. Carmarthen: Public Health Wales NHS Trust.

Welsh Assembly Government (2005) The Welsh Health Survey 2003/2004 Cardiff:Welsh Assembly Government.

Government, W. (2014). Welsh Agricultural Statistics 2012 and 2013. Statistical Publications Unit. Cardiff, Welsh Government.

Welsh Government (2015) The Welsh Health Survey 2014. Cardiff: Welsh Government.

Welsh Government (2015). Well-being of Future Generations (Wales) Act 2015. Welsh Government. Cardiff.

LINK to my TWITTER account – https://twitter.com/amberfood

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One thought on “Beyond ‘5 a day’

  1. steeeveg says:

    This is a great summary of the situation, Amber. Local Authorities in particular can and should ensure that fresh fruit and healthy snacks are available at the facilities that they run, especially those like leisure centres and swimming pools which are intended to promote health and fitness. And of course the example of junk food in hospitals is a classic example of non joined-up thinking, or less politely ‘stupidity’. Through Food Cardiff we must put pressure on Cardiff Council to take a lead on this as the capital that others will hopefully follow.

    Like

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