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N° 12 • May 2007 • “SOCIAL MARKETING”
Overcoming the socioeconomic and
gender gap in fruit and vegetable intake

European action to increase
fruit and vegetable consumption
Why is it so difficult for most people to reach the dailyrecommendation for fruit and vegetables? In Sweden, less than To address the growing challenge of chronic diseases - cancer, coronaryheart disease and obesity - on health, the economy and development, 20 percent of the adult population reaches the intake goal of 500 EGEA 2007 adopted the following statement, following valuable input grams per day, and less than 10 percent of children reach their goal of 400 grams. A universal pattern can be observed across northern Europe: Intake is lower in men compared to women, in people on low incomes and in those with lower education compared to higher socioeconomic groups. Is it a matter of low and the WHO Regional Office for Europe.
availability? Is the perceived high cost of fruits and vegetables Increasing fruit and vegetable consumption is an important part of preventing desired change? Are other, less healthy foods and comprehensive prevention of chronic diseases. Currently only aminority of European citizens eat the daily recommended amount of beverages too readily available and too cheap? Or is it a matter of lack of knowledge, skills or widespread taste preferences for The WHO European Charter on counteracting obesity sets goals for curbing the epidemic and reversing the trend in children and The answer to these questions should guide us in the search of adolescents by 2015. It recommends increasing consumption of fruitand vegetables.
effective measures to increase consumption in all groups in the The German government has given, during its Presidency, commitment to increase fruit and vegetable intake by 2010, so that 20% more Among higher socioeconomic groups, targeted promotional people are consuming at least 5 portions of fruit and vegetable eachday; and that by 2010, an extra 30% of catering (such as activities and health counselling is probably an adequate strategy kindergartens, schools, cafeterias and old people’s homes) serve to reduce the gender gap in consumption. However, in order to healthy meals, which include fruit and vegetables.
overcome the socioeconomic gap, additional instruments are The 2007 EGEA conference "The Role of Fruit and Vegetables in the needed. Social marketing employing traditional marketing Fight Against Obesity" has identified a number of effective and elements - product, price, place and promotion - could be a way innovative solutions to increase consumption of fruit and vegetables.
forward. One proven approach to increasing consumption is Among these effective solutions, three main areas of action should begiven priority: establishment of free or subsidised fruit and vegetable schemes • Increase access to and availability of fruit and vegetables in
in schools and work places. However, this might not be enough to prevent obesity and chronic diseases. Governments, • Improve information on the health benefits of fruit and
municipalities and employers need to consider whether free or vegetables and increase advertising for fruit and vegetables.
subsidised fruit and vegetable schemes should be made • Reduce social inequalities in fruit and vegetable consumption.
conditional upon removal of unhealthy snacks from schoolcanteens, vending machines and cafeterias, i.e. heighteningbarriers for unhealthy foods and beverages competing with fruitand vegetables. In this way, environments truly supportive to fourth edition
Stockholm Centre for Public Health, Sweden IFAVA Board of Directors
IFAVA Committees
J. Badham • South Africa • 5-a-Day for better health TRUST
L. Damiens • France • “La moitié” • Aprifel
C. Doyle •
USA • American Cancer Society
P. Dudley • New Zealand • 5+ a day
T.Yoshimura •
Japan • Japan Vegetable & Fruit Meister Association
J. Badham • South Africa
S. Barnat • France
J. Badham • South Africa
R. Lemaire • Canada • 5 to 10 a day
L. Damiens • France
L. Damiens • France
P. Dudley • New Zealand
E. Pivonka • USA • 5 A Day
P. Dudley • New Zealand
K. Hoy • USA
R. Lemaire • Canada
C. Rowley • Australia • Go for 2&5® • Horticulture Australia
R. Lemaire • Canada
E. Pivonka • USA
C. Rowley • Australia
S. Tøttenborg • Denmark • 6 a day
R. Pederson • Denmark
T. Yoshimura • Japan
IFAVA Contact info
International Fruit And Vegetable Alliance
c/o Canadian Produce Marketing Association
9 Corvus Court
E-mail: [email protected] E-mail: [email protected] Ottawa, ON K2E 7Z4 Canada
International Fruit and Vegetable Alliance The public policy of generic food marketing
for fruits and vegetables
— Parke Wilde —
Director, Food Policy and Applied Nutrition, Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA The economics of food marketing are very different for branded majority of the commodity’s producers, managed jointly by a products (such as Coca-Cola) and generic products (such as most producer board and the U.S. Department of Agriculture spinach sold in bulk). The producer of a branded product has a (USDA), and funded through mandatory assessments on the strong incentive to advertise. By contrast, the producer of a producers. The federal government enforces the collection of generic product knows that any voluntary advertising expenditure the mandatory assessments, approves the advertising and will benefit competitors. In economic jargon, the competitors will marketing programs, and defends checkoff communication in court as the federal government’s own message -- in legal Of course, there are some branded fruit and vegetable products jargon, as its own “government speech”(1). (such as Dole packaged spinach, to continue the spinach Using the federal government’s powers of taxation, these example). However, at least in the United States, it is clear that checkoff programs collected more than $600 million from product branding -- and hence voluntary advertising -- is much producers in 2004. The checkoff promotions sometimes put the less prevalent in the fruit and vegetable industries than in other federal government in the awkward position of undermining the segments of the food market. This disparity leads to a concern more scientifically deliberate nutrition messages of the Dietary that private-sector incentives favor the advertising of Guidelines for Americans, which are intended as the comparatively unhealthy foods and penalize the advertising of government’s authoritative statement on nutrition communication. For example, the Guidelines related to obesity Producers of unbranded food products have sought government prevention do not focus on particular nutrients, as in the “low- assistance in solving the “free rider” problem in marketing carb” fad diets favored by the meat industry or the “high- generic food products. In the case of fruits and vegetables, calcium” fad diets favored by the dairy industry. Instead, the producer organizations, nutrition foundations, and the federal Guidelines focus on overall calorie balance within the context of a government all perceive the merit in generic marketing and healthy diet that is high in fruits, vegetables, and low fat dairy: promotion. One result has been the “5-a-day” and later “5-to-9-a-day” program, which is a public/private partnership that • To maintain body weight in a healthy range, balance encourages consumers to increase their daily servings of all fruits calories from foods and beverages with calories expended.
and vegetables, regardless of the brand. In addition to this • To prevent gradual weight gain over time, make small national partnership, some regional fruit and vegetable marketing decreases in food and beverage calories and increase physical orders include mandatory producer contributions to a marketing However, these fruit and vegetable promotion programs are only By contrast, the federal government’s pork checkoff program a very small part of the U.S. federal government’s interventions to relies on a low-carb dietary message, “Counting carbs? Pork’s help food producers solve their “free rider” problem and promote perfect.” The federal government’s dairy checkoff program used their generic products. For example, the contribution to the “5- weight loss as a central theme in the last couple years: “3-a-Day.
to-9-a-day” program from the federal government’s National Milk-cheese-yogurt. Burn more fat, lose weight”(1). Far from Institutes of Health was merely $3.6 million in 2001. More adhering to the Dietary Guidelines’ emphasis on lowfat dairy recently, the federal participation in the program has been products, the dairy checkoff advertisements commonly promote administered by the Centers for Disease Control (CDC), but it is milk and cheese without reference to fat content, and they not clear how much money CDC commits to this effort (multiple sometimes promote products that are high in fat and saturated email requests to the CDC’s program and public information fat, as in the checkoff program’s recent collaboration with Pizza offices over several weeks could not turn up a specific dollar Hut to promote a three-cheese stuffed crust pizza or its collaboration with Wendy’s to promote the Wild Mountain BaconCheeseburger.
By contrast, the federal government offers much greater help tothe powerful meat and dairy industries through the federal Observers of nutrition policy in the United States have some hope generic commodity promotion programs, known as “checkoff” that the upcoming 2007 Farm Bill, which reauthorizes a wide programs. As recently summarized in a longer perspective array of agricultural and food programs, will be more favorable to fruit and vegetable production and promotion than such bills The advertising campaigns from the checkoff programs have been in the past. At the same time, the political calculation include: “Beef. It’s What’s for Dinner,” “Ahh, the Power of that favored meat and dairy promotion at the expense of the Cheese,” “Pork. The Other White Meat,” “Got Milk?,” and the Dietary Guidelines in past years has not fundamentally changed.
“Milk Mustache” campaign. These campaigns are so familiar It remains to be seen whether U.S. public policy can support that many readers will recognize the slogans immediately nutrition objectives through fruit and vegetable promotion on a and be surprised only to hear that they are federally scale that would noticeably compete with other subsidy programs in the agriculture budget or with other food products in the The programs are established by Congress, approved by a REFERENCES1. Wilde P. Federal Communication about Obesity in the Dietary 2. U.S. Department of Health and Human Services and U.S. Department Guidelines and Checkoff Programs. Obesity. 2006;14: 967-973.
of Agriculture. Dietary Guidelines for Americans, 2005 (6th Edition). Washington, DC: U.S. Department of Health and Human Services and U.S. Department of Agriculture; 2005.
The interplay of 5 A Day Campaigns
with food-based dietary guideline promotion
— Ingrid Keller —
Food Policy Centre, City University, London, UK The Plan of Action endorsed at the International Conference on In Germany, the FBDG are chiefly promoted by the BMVEL and its Nutrition in 1992 called on governments to provide to the public agencies, which are a member of or sponsor of the 5 A Day “qualitative and/or quantitative dietary guidelines”1.
association. As in Chile, the 5 Am Tag message is part of the FBDG; Subsequently, many countries developed food-based dietary hence, message and logo are included in government sponsored guidelines (FBDG). Fruit and vegetables are an important nutrition information, which gives a consistent picture.
component of a healthy diet, and their sufficient daily In New Zealand there is no real interplay with the national consumption could help prevent certain chronic diseases. To government (exception: fruits in schools project), which is increase the consumption of fruit and vegetables in the conscious that 5+ADay is industry lead. However, the message population, several countries have programmes that promote fruit and number "5" is included in the government sponsored FBDG; and vegetables, often under the slogan "5 A Day". This article hence there is no conflict in the messages, even though they are looks at the implementation of FBDG in Chile, Germany, New Zealand and South Africa and its interplay with the 5 A Day In South Africa, there is reluctance from the side of the national programme in each country. Most of the information comes from government to interact directly with the 5 A Day Trust, even though the fruit and vegetable message is part of the FBDG.
Each of these countries has a specific FBDG regarding fruit and 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 Chile Eat 2 plates of vegetables and 3 fruits every day2
through the entry-points 5 A Day uses may be beneficial. Germany Fruits and vegetables: take 5 a day3
FBDG give positive and negative messages regarding a total diet.
New Zealand Eat plenty of vegetables and fruits4
“5 A Day” only gives a positive message. Some informantspointed out that it is "easier" to give those positive messages to South Africa Eat plenty of fruits and vegetables every day5
the population than the negative "eat less" ones. However, for abalanced diet, the 5 A Day message needs to be combined with The role of 5 A Day programme in dietary the "instead of" message. Hence, the "bad news" needs to be part of the nutrition information given to the population as well as atthe policy level. Policy makers should support fruit and vegetable In Chile, the 5 A Day programme contributes to FBDG promotion, but they should also focus on the "eat less" / "instead dissemination. The activities of the public sector and the 5 A Day programme are coordinated and the same messages and While not all governments endorse the 5 A Day programme, the materials are given to the public. The German 5 Am Tag informants concurred that these programmes are complementary association communicates mainly its own message, however to FBDG implementation and not counterproductive.
without leaving out other important factors of a healthy diet.
Governmental representatives agree that 5 Am Tag is part of the Additionally, nutrition education, as a rather "top-down" FBDG promotion, since they co-sponsor 5 Am Tag and the FBDG approach, is often not complemented by community involvement specifically include the “Take 5” message.
and/or environmental changes and FBDG are not taken into In New Zealand, from the governmental point of view the 5+ADay account by other public policies. 5 A Day programmes, if set-up as programme has no specific role in the implementation of the public-private partnerships, can have policy impact and are well FBDG. All interviewees agreed that 5+ADay is complementary to situated to complement education with environmental changes.
FBDG promotion. In South Africa, a better coordination and Such set-up may be conducive for overall FBDG implementation collaboration with the public side has recently started and it is felt that 5 A Day can be the “voice” for the fruit and vegetableguideline. The interplay of governmental FBDG implementation and 5 A Day programmes In Chile, INTA, an academic institution, promotes the FBDG and 5Al Día, which gives credibility to the programme in the populationand for government collaboration. As a "neutral party", INTAachieved a multi-sectoral dialogue and buy-in. As the 5 Al Díamessage is included in the new FBDG, the programme gives anopportunity to use its channels to communicate all FBDG to thepublic, therefore diversifying the "traditional" communicationchannels.
REFERENCES1. WHO/FAO, Technical Report Series 880, 1998.
4. Ministry of Health New Zealand, 2003.
2. Instituto Nacional de Tecnologia de Alimentos y Nutricion / Ministerio 5. Vorster et al., S African J Clin Nutr. 2001;14 (3) (Suppl.):S3-6.
3. Deutsche Gesellschaft für Ernährung, 2004.
Social Marketing Strategies to Enhance
Fruit and Vegetable Consumption
— Jennifer Scott, PhD - Tom Beall, M.H.S.A. —
Social Marketing campaigns are similar to product marketing is called “Fruits and Veggies: More Matters” and is designed to campaigns in that they are trying to change the attitudes and drive up adult consumption towards the goal of 9 to 11 servings behaviors of target audiences. However, they differ in that they (4.5-5.5 cups) of fruits and vegetables per day. In many ways, are generally not offering a product/service for purchase. This the new PBH campaign exemplifies the best practices detailed means that the “payoff” or reward for consumer compliance is much less tangible, it offers much less immediate gratification, 1. Specifically targeted Gen X moms (women aged between
and may even involve personal sacrifices and changes to deeply- 25 and 42 who have children under 18 years living at ingrained habitual behaviors. For this reason, Social Marketing home), and campaign messages and mediums are campaigns are required to epitomize the best practices designed to impact this group. This targeting is based on associated with conventional marketing campaigns, and are also the understanding that these Moms are: highly engaged in required to effectively tap into unmet needs, existing social their families’ health; active information-seekers; drivers and core values to be persuasive.
accessible through a variety of mediums; helping establish Studies of the effectiveness of public health campaigns over the habits of a lifetime in their children; and, have a significant past 50 years in the United States(1; 2; 3) indicate that success is influence over their partners and their parents.
2. Developed messaging that reaches all Moms with an
1. Conduct formative research to understand the needs
encouraging, motivational way. “Fruits and Veggies - More and interests of the target and refine the impact of Matters™” is a relevant rallying call to those moms who think their families (and they) consume enough fruits and vegetables. For Moms who feel like their families eat too 2. Segment the audience into meaningful sub-groups and
little, “Fruits and Veggies - More Matters™” helps them develop messages highly relevant to that group. Lack of begin to address this shortfall without setting an segmentation and message targeting are thought to be major factors that have contributed to failed social marketing campaigns(4; 5).
3. Because research showed that most Gen X Moms already
had a good attitude about fruits and vegetables in their 3. Ensure high message exposure in reach (how many
families’ diets, the campaign focuses on providing them people) and frequency (how many times they receive the with spurs to action, including: new ways to prepare fruits message). It is important to realize that there is a and vegetables; help negotiating different fruit and veggie minimum level of exposure to a message, below which it preferences within their family; and assistance in is unlikely to make an impact on the target audience.
recognizing and managing unhealthy food messages in 4. Use multiple mediums, and generate word-of-mouth
popular culture. Importantly, the campaign uses its discussion about the campaign among the target group. It interactive component to get Moms together with other has been demonstrated that information obtained through Moms to exchange tips, recipes and to offer each other word-of-mouth is considered twice as valuable as information from advertising (Keller Fay Group, 2006). 4. Cultivated various mediums for getting the word out,
5. Mobilize credible and popular third-party groups and including not only the on-line environment, but earned individuals in support of the campaign.
media and partnerships that initially include 21,000 retail The Produce for Better Health Foundation – which, together with stores, more than 170 products and the U.S. public health the U.S. Centers for Disease Control and Prevention, is responsible for the extremely successful “Five-A-Day” campaign in the United The “Fruits & Veggies -- More Matters™” campaign is also being States - has just launched a new campaign to increase the closely measured to ensure that it is having the desired impact consumption of fruits and vegetables in America. The campaign and to allow for its message to be strengthened over time.
Snyder, L.B. & Hamilton, M.A2002. A meta-analysis of US health Flay, B.R. and Sobel, J. L. (1983) The role of mass media in preventing campaign effects on behavior. In R.C. Hornik (ed) Public Health adolescent substance abuse. In T.J. Glynn, C.G. Leukefeld, & J. P. Communication: Evidence for Behavior Change pp352-384 Lundford (Eds.) Preventing Adolescent Drug Abuse NIDA Research Derzon, J.H. & Lipsey M.W. (2002) A meta-analysis of the effectiveness of mass communication for changing substance abuse knowledge, attitudes Myhre S. L. and Flora J.A. (2000) HIV/AIDS communications campaigns: and behavior. In W. D. Crano and M. Bergoon (Eds) Mass Media and Drug progress and prospects Journal of Health Communications 5, pp. 29-45.
Noar, S.M. A 10-year retrospective of research in health mass media campaigns: where do we go from here? Journal of Health Communications. 2006; 11(1):21-42.

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