Is It Better to Advise More Plants or Less Junk?

Is It Better to Advise More Plants or Less Junk?
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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.

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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.

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.

Image credit: Kristina DeMuth. Image has been modified.

Video credit: Tyler McReynolds, Teetotalin LLC.

Doctor's Note

More on appealing to vanity to improve fruit and vegetable consumption in my video Eating Better to Look Better.

But, aren’t there some folks who are down on smoothies? Here’s what the science says:

The flip side of free fruit programs is to tax instead of subsidize. See my video Would Taxing Unhealthy Foods Improve Public Health?

More on that kind of paternalistic attitude that you don’t care enough about your health to be told the truth in Everything in Moderation? Even Heart Disease? and Optimal Diet: Just Give it To Me Straight, Doc.

I’ll explore this same patronizing attitude when it comes to physical activity in my next video, How Much Should You Exercise?

If you haven’t yet, you can subscribe to my videos for free by clicking here.

39 responses to “Is It Better to Advise More Plants or Less Junk?

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  1. The bottom line is that those in the food industry are technically talking out of both sides of their necks. On the one hand they’re telling us we should eat healthy while on the other hand they have the media constantly bombarding us with ads showing unhealthy choices.

    Major hospitals are only allowing diet soft drinks laced with aspartame or other artificial sweeteners in their facilities knowing their link to cancer.

    We are the only species on the planet that wants to continue to feed ourselves food meant for babies before the eruption of teeth, milk. Milk does a body good, however cow’s milk is meant for cow’s babies, not humans. Nevermind the number of lactose intolerant people out there. The only calcium sources they want to promote are “fortified” with calcium and vitamin D. That means the good “stuff” was taken out and replaced with an imitation created in the laboratory, as if the body doesn’t know the difference. Well it does and we should listen to it!

    1. In breaking news, Dr. Michael Greger has been added to the FBI’s list of International Food Terrorists for threatening the public with nutritional advice, including his allegation that Twinkies are not a food group.

  2. Reminds me of my public school days in wartime East Prussia in the early 1940s when students got a small slice of whole grain rye bread and a piece of raw white turnip as a free school lunch. Actually a tasty combination!

  3. Where can I find the following article referenced in the video? I checked the sources page for this video, but I couldn’t find a link. … Recent research conducted by Reiss, Johnston, Tucker, Desesso, and Keen (2012) has concluded that “if one-half of the U.S. 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.” …

    1. Here is the cite, Heather.
      R Reiss, J Johnston, K Tucker, J M DeSesso, C L Keen. Estimation of cancer risks and benefits associated with a potential increased consumption of fruits and vegetables. Food Chem Toxicol. 2012 Dec;50(12):4421-7. Don’t know if it can be accessed free.

  4. Eating more fruit is a habit that is easy to adopt. We now start each day with a large bowl of fresh fruit salad to which we really look forward! Our pet dwarf angora rabbit also goes crazy for his serving as well. Even our pet cockatiel enjoys much on a piece of ripe banana.

    1. Almost anyone with a yard can grow some kind of fruit in their climate essentially for free. The biggest problem is that people keep moving every 6 years. You can take it with you. I know. I did .

  5. If you go and look at the research study, The students were given fruit for one year, and followed for the following 7 years. However, parts of the sustained effect may have been due to the fact that intervention pupils had an increased participation in the Norwegian school fruit subscription program [9, 10], a program that since 2003 has been available for all Norwegian elementary and secondary schools. It is therefore important to assess the sustained effect also when the participants have finished school and are not provided with fruit anymore.

    1. Ah, and you are the author. Thanks for sharing your creativity!

      You may already know this, but you can make tostada shells in the microwave with no oil; I have tostadas several times a week! :) Let them dry out first; that can happen in the refrigerator or not. I make eight at a time, and have a special rack for drying them without taking up much space. When you microwave them, do so in stages, because they go from done to burnt in a few seconds. They will curl up during drying but you can just put a plate on them and flatten them out after the first microwaving. The first couple of batches will show you the ropes.

      I have found that Mission’s “super soft” yellow corn tortillas work best (of the many I’ve tried), and of course yellow corn has more beta carotene than white corn.

  6. Most people I know don’t want to hear about changing their diet in any way. Truly SAD, but I get it because I was there once too. Wish there was some kind of magic to make changes happen BEFORE they get sick and desperate!

  7. Hello Michael!

    My name is Stefan. I live in Gothenburg, Sweden. A friend of mine recommended to me your book “How not to die”. Im really into the healthy lifestyle and taking care of my body the best way I can so I bought your book the following day and started reading immediately.

    What an amazing piece of art! I enjoyed every second of it and it confirmed very much of what I already knew about the importance of eating the right food. But it also gave me lot’s of new knowledge and perspectives. Im not saying I’m going all vegetarian or vegan but it inspired me so nowadays I at least try staying away from all animalfood like twice a week :)

    Why I contact you in the first place is bacause since about 4 years ago I’ve been making my very own special 1000ml smoothie basically every morning. In the beginning it only contained about 5-7 different ingredients. But as timed moved on and I started learning and studying even more about nutrition, I started adding up new things constantly. The last 3 years my smoothie has consisted of about 15-20 different ingredients. Nowadays it’s more of a 20-25.

    I list them for you here beneath:
    Water
    Frozen Mango
    Frozen Broccoli
    Frozen Spinach
    Frozen Blueberries
    Frozen Blackberries
    Frozen Beetroot
    Frozen Pinapple
    Banana
    Fresh pressed lemonjuice
    Applecider vinegar
    Fiber housing
    Peanut butter
    Honey
    Chlorella powder
    Wheet grass powder
    Cranberry powder
    Spirulina powder
    Cacao powder
    Maca powder
    Ginger powder
    Cinnamon
    Turmeric
    Coriander
    Cardamom
    Flavored Whey protein powder

    If it tastes good? Hell yeah it does! Therefor, what I would like to suggest and do is having a full body scan and also test all my bloodvalues etcetera and share with you my results. Im quite curious about how my body responds to this cocktail of supernutritions that i keep on adding every day, every week, every year.

    A couple of weeks ago I visited a Fitnessexpo and did some kind of “bodyscan” to detect overall fat mass in my body. From a gradescale of 1-15 where 1 is the best and 15 is the worst I scored a 2. I got credit for that. The interesting thing about this is I’ve been basically physically inactive the past 4 months due to an servere accident where I broke my collarbone right of into serveral pieces and had to have surgery and then staying in bed for 1 month without even walking. I’ve just been able to carefully start working out in the gym again. I still can’t run.

    With that in mind I know that my values probably where, and also can get – even better beyond. I’m currently 1,88cm tall, turning 30 years old this autumn and weights about 77kg. I saw that you are visiting Stockholm in Sweden the 2nd of October this year. It would be such an honor to meet you Michael! I for sure would like to offer you a full glass of “StefansSuperSmoothie”!

    Please write me back what you think about my proposal. I want to contribute to your research about health and food and hope to hear from you soon! :)
    My mailadress is: stefan.abrahamsson87@gmail.com

    Wishing you a great weekend
    Stefan Abrahamsson

  8. I don’t understand why to do such a long video
    for a point that can be explained in less than 5 seconds
    “Avoiding junk is far more effective than eating more fruits”
    That’s it
    Why to waste more than 6 minutes of our precious time?
    This video was boring exhausting and flat.

  9. Hi Ronen,

    Thanks for your question and feedback regarding this video.

    Dr. Greger’s goal is to provide explanation and application of the evidence in the field of nutrition. Sometimes this takes time to explain a mechanism, the progress of research over time, or challenges that accompany the topic. Of course, Dr. Greger could just give his recommendation for all of his videos in 5-10 seconds, but that’s not the only purpose of his work. Anybody can make a recommendation, but he wants to display the evidence behind his recommendations. We do appreciate your feedback at NutritionFacts.org, and I hope you find the other videos to be more to your liking.

  10. Many people say ”Everything in moderation” these days in my country. Even doctors misleadingly tell us that there is no worries given the amount of animal products average Japanese consume, and never tell how much is too much. Yes. As it’s said on anoter video, we don’t know exactly how much is killing us. I know that too, but still so many people here believe that even slite intake of fruits and vegetable can reduce the impact of the killers even if they don’t stop eating them. Is that true? They are at the same risk anyway right? Any convincing and supporting evidence to stop them please?

  11. Here in my country, even doctors promote eating in moderation not cutting out all animal products intake. They quote
    eating vegetables reduce the impact of animal products so you don’t have to eliminate all of them. Is that true? As long
    as we eat them, we are at the same risk right?

  12. Ryo,

    yes, doctors recommend eating meat. During my studies, as we learned how to plan menu, we had to include at least one serving of meat every day. Milk/eggs wasn’t enough. Otherwise you would worse grade for “lack of protein.” But this just doesn’t make sense. We don’t need to eat meat or any other animal products. What are the risks? See for your self:

    https://nutritionfacts.org/2016/10/11/what-about-eating-just-a-little-meat/

    Hope this helps,

    Moderator Adam P.

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