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Policy coherence to promote fruit and vegetable intake

A coherent approach: effective policy actions for fruits and vegetables throughout the NOURISHING framework.

Bryony Sinclair
Policy and Public Affairs Manager
World Cancer Research Fund International

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Policy coherence to promote fruit and vegetable intake

  1. 1. Policy coherence to promote fruit and vegetable intake EGEA – 3 June 2015 World Cancer Research Fund International Policy & Public Affairs Manager Bryony Sinclair
  2. 2. 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
  3. 3. 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.
  4. 4. 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
  5. 5. 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
  6. 6. WCRF recommendations for cancer prevention.
  7. 7. A coherent approach: examples of effective policy actions for fruits and vegetables throughout the NOURISHING framework
  8. 8. 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
  9. 9. • 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
  10. 10.  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:
  11. 11. 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
  12. 12. 0 0.5 1 1.5 2 2.5 Low income countries Low middle income countries Upper middle income countries High income countries Billionkgfruit&veg Need Supply 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
  13. 13. Source: Dalmeny et al, 2003
  14. 14. 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
  15. 15. • 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
  16. 16. 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/ministry schools, 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
  17. 17. 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
  18. 18. For further information @wcrfint Bryony Sinclair Policy & Public Affairs Manager Thank you!