policy coherence to promote fruit and vegetable intake
TRANSCRIPT
Policy coherence to promote fruit and vegetable intakeEGEA – 3 June 2015
World Cancer Research Fund International
Policy & Public Affairs Manager
Bryony Sinclair
Overview
1. What is policy coherence and why is it important?
2. A coherent approach: effective policy actions for fruits and vegetables throughout the NOURISHING Framework
What is “policy coherence”?
OECD definition: “…the systematic promotion of mutually reinforcing policy actions across government departments and agencies creating synergies towards achieving the agreed objectives.”
Put simply, policies that do not undermine each other to achieve objectives already agreed by government.
Why do we need policy coherence?
Multiple, mutually-reinforcing, coherent actions needed across govt depts to support individuals to adopt healthy behaviours:
• Direct behaviour change interventions (eg from doctors)
• The food environments which influence these behaviours
• The food systems which underpin these environments
1. For people
Many sectors & govt depts need to take action to achieve policy coherence
Policies that meet objectives for other sectors will engage those sectors in our efforts to improve fruit and vegetable consumption
e.g. economic objective for agriculture sector
Greater sales/consumption of fruit & vegetables provides livelihood for fruit & vegetable growers
2. Policy coherence to leverage support from other sectors
www.wcrf.org/NOURISHING
WCRF recommendations for cancer prevention.
A coherent approach: examples of effective policy actions for fruits and vegetables throughout the NOURISHING framework
Source: Amaro S, Viggiano A, Di Costanzo A, Madeo I, Viggiano A, BaccariME, et al. Kalèdo, a new educational board-game, gives nutritional rudiments and encourages healthy eating in children: a pilot cluster randomized trial. European Journal of Pediatrics 2006;165(9):630–5.
Board game designed to transfer knowledge about a
healthy diet (randomised controlled trial)
Students playing game weekly for 24 weeks showed:
– significant increase in nutrition knowledge
– significant increase in weekly intake of vegetables (0.7 servings more per week)
Kalèdo educational board game
• Aim: increase fruit & vegetable consumption through individual nutrition counselling sessions with tailored nutrition education package
• After 6 weeks, patients with dentures who received two 121 nutrition counselling, sessions showed:
– a significant increase in fruit consumed – a significant increase in readiness to change their
diet ( fruits and vegetables)
Source: Bradbury, J, Thomason JM, Jepson NJ, Walls AW, Allen PF, Moynihan PJ. Nutrition counselling increases fruit and vegetable intake in the edentulous. Journal of Dental Research 2006;85(5):463-8.
Dietary counselling sessions in a dental setting
Knowledge• Significant increase of
recommended servings of fruit and vegetables (77.7%-89.2% for fruit; 20.4%-43.9% for vegetables)
Source: Pollard CM et al. 2007
Consumption• Significant in vegetable intake during
campaign (esp for men)• Self-reported fruit and vegetable
consumption by 0.8 servings/day after campaign (0.2 servings of fruit; 0.6 servings of vegetables)
Fruit and vegetable public awareness campaign in Western Australia
• Mass media (TV, radio, press)• Publications (e.g. cookbooks)• Public relations events• Point-of-sale promotions• School-based activities• Community activities• Website: www.gofor2and5.com
Green Carts in New York City
• NYC made 1,000 licenses available through Local Law 9 to street vendors who sell fresh fruit & vegetables in neighbourhoods with limited access to healthy foods and where consumption is low
• 92% of customers said location & prices are 2 main reasons for shopping at Green Carts
• 71% of customers reported increased consumption of fresh fruit & vegetables since shopping at the Green Cart
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Source: Siegel KR, Ali MK, Srinivasiah A, Nugent RA, Narayan KM. Do we produce enough fruits and vegetables to meet global health need? PLoS One. 2014 Aug 6;9(8):e104059.
Need for fruit & vegetables vs supply, by country income level
Investment needed in low-and middle-income countries in producing fruit & vegetables & getting into domestic market - roads, transport, refrigeration
Source: Dalmeny et al, 2003
Australian example:• Nutritional status improved among
aboriginal children whose families received weekly boxes of subsidised fruit and vegetables
• Significant increases in the levels of biomarkers of fruit and vegetable intake (e.g. vitamin C)
Sources: Black AP, Vally H, Morris P, et al. Nutritional impacts of a fruit and vegetable subsidy programme for disadvantaged Australia Aboriginal children. British Journal of Nutrition 2013; 110:2309-2317. Black AP, Brimblecombe J, Eyles H, et al. Food subsidy programs and the health and nutritional status of disadvantaged families in high income countries: a systematic review. BMC Public Health 2012;12:1099
Fruit and vegetable subsidy programmes for disadvantaged families
Subsidy schemes that work:
• 12.5% supermarket price discount on healthier options
• Subsidised monthly food vouchers
• Subsidised weekly family food packages
• Free home-delivered fruit juice weekly
• Fruit and vegetable vouchers for local supermarket or farmers market
• Eg offering fruit and vegetable in schools
• In USA over 1 school year, low income children
• Fresh fruit and vegetable intakes were higher among students at schools participating in Fresh Fruit and Vegetable Program (0.32 servings/day)
• 1st step to effect gradual change
Action is needed across sectors to promote fruit and vegetable intake
Health e.g. Government/ministry, health NGOs, healthcare providers, health insurance companies
Agriculture e.g. Government/ministry, fruit & vegetable producers, traders/importers, wholesalers, retailers, processors, agriculture NGOs
Education e.g. Government/ministryschools, school authorities, NGOs, professional associations, higher education institutions
Food service e.g. restaurants, catering/cafeteria/canteen services
…and communications, environment, commerce & trade, consumer protection, etc
In summary
Policy coherence…
– Ensure coherence/consistency in environments and systems that underpin choices people make
– Leverage support from other sectors
Benefits of increased markets for fruit and vegetables
– Health and economic eg increased market for fruit and vegetables for producers, increased health & reduced health care costs
For further information
@wcrfint
facebook.com/wcrfint
www.wcrf.org
Bryony SinclairPolicy & Public Affairs Manager
Thank you!