It may be more expedient politically to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.
Is It Better to Advise More Plants or Less Junk?
4.8/5 - (101 votes)
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
The World Health Organization has estimated that more than a “million…deaths…worldwide are linked to low fruit and vegetable consumption.” What can be done about it? There’s always appealing to vanity. A daily smoothie can give you both a golden glow and a rosy glow, both of which “have been shown to enhance [one’s] healthy appearance” in Caucasian, Asian, and African skin tones. But, what about giving it away for free?
A “free school fruit scheme” was introduced in Norway for grades 1 through 10. Fruit consumption is so powerfully beneficial that if kids just ended up eating 2.5 grams more fruit a day, the program would pay for itself in terms of saving the country money. That’s the weight of half of a single grape. However, that’s assuming that miniscule increased fruit consumption would be retained throughout life. It certainly seemed to work while the program was going on, with “a large increase in pupils eating fruit.” But, what about a year after the free fruit ended? They were still eating more fruit—they were hooked! And then, three years later, same thing—eating about a third of a serving more, three years later; considerably more, if sustained, than necessary for the free fruit program to pay for itself.
And, there were some happy side effects. There was a positive spillover effect, where not only were the kids eating more fruit; their parents started eating more, too. And, although “[t]he intention of these programs was not to reduce unhealthy snack intakes,” that’s exactly what appeared to happen; the fruit replaced some of the junk. Increasing healthy choices to crowd out the unhealthy ones may be more effective than just telling kids not to eat junk—which could actually backfire. When you tell kids not to eat something, they may start to want it even more.
Which do you think worked better—telling families to increase plants, or decrease junk? “Families…were randomly assigned to one of two groups…:” encouragement to get at least two servings of fruits and veggies a day, with no mention of decreasing junk; and the other group, who were encouraged to bring their junk food intake to less than ten servings a week, but with no mention of fruits and veggies. What do you think happened? “The Increase Fruit and Vegetable intervention [just naturally] reduced their high-fat [and] -sugar intake, whereas” those told to just “Decrease Fat and Sugar” cut back on junk, but didn’t magically start eating more fruits and vegetables.
This crowding-out effect may not work on adults, though. In a cross-section of more than a thousand adults in LA and Louisiana, those that ate five or more servings of fruits and veggies a day did not consume significantly less alcohol, soda, candy, cookies, and chips.
“This finding suggests that unless the excessive consumption of [junk] is curtailed, other interventions…[may] have a limited impact. It may be politically more expedient to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.”
“In [most} public health campaigns…, the message…[is] direct and explicit: don’t smoke, don’t drink,…don’t take drugs. In contrast, [food] campaigns have focused” [more] on eat healthy foods than cut out the crap. “Explicit messages against junk are rare.”
In the U.S., “if [just] half of the population were to increase fruit and vegetable consumption by one serving each per day, an estimated 20,000 cancer cases might be avoided each year.” 20,000 people who would not have gotten cancer, had they eaten their fruits and veggies. “The… USDA…recommends…half [our] plate be filled with colourful fruits and vegetables,” but less than 10% of Americans hit the “recommended daily target.”
Given the sorry state of affairs, should we even bother telling people to strive for “5 a day”? Or, might just saying “get one more serving than you usually do” end up working better? The researchers thought “that the more realistic ‘just 1 more’ goal would be more effective than the very ambitious ‘‘5 a day’’ goal.” But, they were wrong.
Those told to eat one more for a week ate about one more, and those that were told to eat five ate five. But, here’s the critical piece. A week later—a week after the experiment was over—the group that was told to eat “5 a day” was still eating about a serving more, whereas the “eat 1 more” group went back to their miserable baseline. So, “more ambitious” eating goals may be “more motivating.”
Perhaps this is why, “[i]n the US, ‘5 a day’ was replaced [with a recommended] daily consumption of 7–13 servings’ of fruits and vegetables. But, if the recommendation is too challenging, people will just give up. So, instead of just sticking with the science, policy makers need to ask themselves questions like: “How many servings are regarded as threatening?”
Please consider volunteering to help out on the site.
- Bere E, Veierød MB, Skare Ø, Klepp KI. Free School Fruit--sustained effect three years later. Int J Behav Nutr Phys Act. 2007 Feb 19;4:5.
- Ungar N, Sieverding M, Stadnitski T. Increasing fruit and vegetable intake. "Five a day" versus "just one more". Appetite. 2013 Jun;65:200-4.
- Rekhy R, McConchie R. Promoting consumption of fruit and vegetables for better health. Have campaigns delivered on the goals? Appetite. 2014 Aug;79:113-23.
- Fisher JO, Birch LL. Restricting access to palatable foods affects children’s behavioral response, food selection, and intake. Am J Clin Nutr. 1999 Jun;69(6):1264-72.
- Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res. 2001 Mar;9(3):171-8.
- Bere E, Veierød MB, Bjelland M, Klepp KI. Free school fruit--sustained effect 1 year later. Health Educ Res. 2006 Apr;21(2):268-75.
- Øverby NC, Klepp KI, Bere E. Introduction of a school fruit program is associated with reduced frequency of consumption of unhealthy snacks. Am J Clin Nutr. 2012 Nov;96(5):1100-3.
- Cohen DA, Sturm R, Scott M, Farley TA, Bluthenthal R. Not enough fruit and vegetables or too many cookies, candies, salty snacks, and soft drinks? Public Health Rep. 2010 Jan-Feb;125(1):88-95.
- Bere E, Hilsen M, Klepp KI. Effect of the nationwide free school fruit scheme in Norway. Br J Nutr. 2010 Aug;104(4):589-94,
- Øvrum A, Bere E. Evaluating free school fruit: results from a natural experiment in Norway with representative data. Public Health Nutr. 2014 Jun;17(6):1224-31.
- Tan KW, Graf BA, Mitra SR, Stephen ID. Daily Consumption of a Fruit and Vegetable Smoothie Alters Facial Skin Color. PLoS One. 2015 Jul 17;10(7):e0133445.
Image credit: Kristina DeMuth. Image has been modified.
Video credit: Tyler McReynolds, Teetotalin LLC.
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
The World Health Organization has estimated that more than a “million…deaths…worldwide are linked to low fruit and vegetable consumption.” What can be done about it? There’s always appealing to vanity. A daily smoothie can give you both a golden glow and a rosy glow, both of which “have been shown to enhance [one’s] healthy appearance” in Caucasian, Asian, and African skin tones. But, what about giving it away for free?
A “free school fruit scheme” was introduced in Norway for grades 1 through 10. Fruit consumption is so powerfully beneficial that if kids just ended up eating 2.5 grams more fruit a day, the program would pay for itself in terms of saving the country money. That’s the weight of half of a single grape. However, that’s assuming that miniscule increased fruit consumption would be retained throughout life. It certainly seemed to work while the program was going on, with “a large increase in pupils eating fruit.” But, what about a year after the free fruit ended? They were still eating more fruit—they were hooked! And then, three years later, same thing—eating about a third of a serving more, three years later; considerably more, if sustained, than necessary for the free fruit program to pay for itself.
And, there were some happy side effects. There was a positive spillover effect, where not only were the kids eating more fruit; their parents started eating more, too. And, although “[t]he intention of these programs was not to reduce unhealthy snack intakes,” that’s exactly what appeared to happen; the fruit replaced some of the junk. Increasing healthy choices to crowd out the unhealthy ones may be more effective than just telling kids not to eat junk—which could actually backfire. When you tell kids not to eat something, they may start to want it even more.
Which do you think worked better—telling families to increase plants, or decrease junk? “Families…were randomly assigned to one of two groups…:” encouragement to get at least two servings of fruits and veggies a day, with no mention of decreasing junk; and the other group, who were encouraged to bring their junk food intake to less than ten servings a week, but with no mention of fruits and veggies. What do you think happened? “The Increase Fruit and Vegetable intervention [just naturally] reduced their high-fat [and] -sugar intake, whereas” those told to just “Decrease Fat and Sugar” cut back on junk, but didn’t magically start eating more fruits and vegetables.
This crowding-out effect may not work on adults, though. In a cross-section of more than a thousand adults in LA and Louisiana, those that ate five or more servings of fruits and veggies a day did not consume significantly less alcohol, soda, candy, cookies, and chips.
“This finding suggests that unless the excessive consumption of [junk] is curtailed, other interventions…[may] have a limited impact. It may be politically more expedient to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.”
“In [most} public health campaigns…, the message…[is] direct and explicit: don’t smoke, don’t drink,…don’t take drugs. In contrast, [food] campaigns have focused” [more] on eat healthy foods than cut out the crap. “Explicit messages against junk are rare.”
In the U.S., “if [just] half of the population were to increase fruit and vegetable consumption by one serving each per day, an estimated 20,000 cancer cases might be avoided each year.” 20,000 people who would not have gotten cancer, had they eaten their fruits and veggies. “The… USDA…recommends…half [our] plate be filled with colourful fruits and vegetables,” but less than 10% of Americans hit the “recommended daily target.”
Given the sorry state of affairs, should we even bother telling people to strive for “5 a day”? Or, might just saying “get one more serving than you usually do” end up working better? The researchers thought “that the more realistic ‘just 1 more’ goal would be more effective than the very ambitious ‘‘5 a day’’ goal.” But, they were wrong.
Those told to eat one more for a week ate about one more, and those that were told to eat five ate five. But, here’s the critical piece. A week later—a week after the experiment was over—the group that was told to eat “5 a day” was still eating about a serving more, whereas the “eat 1 more” group went back to their miserable baseline. So, “more ambitious” eating goals may be “more motivating.”
Perhaps this is why, “[i]n the US, ‘5 a day’ was replaced [with a recommended] daily consumption of 7–13 servings’ of fruits and vegetables. But, if the recommendation is too challenging, people will just give up. So, instead of just sticking with the science, policy makers need to ask themselves questions like: “How many servings are regarded as threatening?”
Please consider volunteering to help out on the site.
- Bere E, Veierød MB, Skare Ø, Klepp KI. Free School Fruit--sustained effect three years later. Int J Behav Nutr Phys Act. 2007 Feb 19;4:5.
- Ungar N, Sieverding M, Stadnitski T. Increasing fruit and vegetable intake. "Five a day" versus "just one more". Appetite. 2013 Jun;65:200-4.
- Rekhy R, McConchie R. Promoting consumption of fruit and vegetables for better health. Have campaigns delivered on the goals? Appetite. 2014 Aug;79:113-23.
- Fisher JO, Birch LL. Restricting access to palatable foods affects children’s behavioral response, food selection, and intake. Am J Clin Nutr. 1999 Jun;69(6):1264-72.
- Epstein LH, Gordy CC, Raynor HA, Beddome M, Kilanowski CK, Paluch R. Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. Obes Res. 2001 Mar;9(3):171-8.
- Bere E, Veierød MB, Bjelland M, Klepp KI. Free school fruit--sustained effect 1 year later. Health Educ Res. 2006 Apr;21(2):268-75.
- Øverby NC, Klepp KI, Bere E. Introduction of a school fruit program is associated with reduced frequency of consumption of unhealthy snacks. Am J Clin Nutr. 2012 Nov;96(5):1100-3.
- Cohen DA, Sturm R, Scott M, Farley TA, Bluthenthal R. Not enough fruit and vegetables or too many cookies, candies, salty snacks, and soft drinks? Public Health Rep. 2010 Jan-Feb;125(1):88-95.
- Bere E, Hilsen M, Klepp KI. Effect of the nationwide free school fruit scheme in Norway. Br J Nutr. 2010 Aug;104(4):589-94,
- Øvrum A, Bere E. Evaluating free school fruit: results from a natural experiment in Norway with representative data. Public Health Nutr. 2014 Jun;17(6):1224-31.
- Tan KW, Graf BA, Mitra SR, Stephen ID. Daily Consumption of a Fruit and Vegetable Smoothie Alters Facial Skin Color. PLoS One. 2015 Jul 17;10(7):e0133445.
Image credit: Kristina DeMuth. Image has been modified.
Video credit: Tyler McReynolds, Teetotalin LLC.
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Title
Is It Better to Advise More Plants or Less Junk?
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
For more on appealing to vanity to improve fruit and vegetable consumption, see my videos Eating Better to Look Better and Beauty Is More Than Skin Deep.
What does the science say about smoothies? See:
- Are Green Smoothies Good for You?
- Are Green Smoothies Bad for You?
- Green Smoothies: What Does the Science Say?
- The Downside of Green Smoothies
The flip side of free fruit programs is to tax instead of subsidize. Learn more by checking out my video Would Taxing Unhealthy Foods Improve Public Health?.
For more on the paternalistic attitude that you don’t care enough about your health to be told the truth, see my videos Everything in Moderation? Even Heart Disease? and Optimal Diet: Just Give It To Me Straight, Doc.
I explore this same patronizing attitude when it comes to physical activity in How Much Should You Exercise?.
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