Amid reports of worsening levels of obesity among children, the School Fruit and Vegetable Scheme (SFVS) and 5 A DAY are once again facing criticism as nurses dismiss the value of multi-million pound campaigns to promote health.
In the last few years, the department of health has injected increasing funds into various advertising and PR campaigns to encourage people to eat more fresh produce, stop smoking and practise safe sex. But representatives of the Royal College of Nursing have hit out against this decision, saying the money would be better spent on treating the most critical patients and high-risk groups of society instead.
And, if the figures are to be believed, despite plans to spend some £36 million on providing free fruit in schools this year, reports suggest the government’s campaigning has failed to increase consumption of fruit and vegetables. At the last count, in the UK’s most deprived areas, only one in five people admitted to eating the recommended five portions of produce a day.
Fresh Produce Consortium chief executive Nigel Jenney agrees the static trends in consumption are disappointing but openly commends the government initiatives, especially 5 A DAY and SFVS, maintaining they have shown, and continue to show, demonstrable long-term benefits, both in making people aware of the nation’s ailing health and securing future sales of produce.
NHS PASA purchasing manager Mike Tiddy readily concurs, and avidly defends the DoH’s financial and physical commitment to the scheme, on the grounds of improvements he has seen already which demonstrate the importance of consistency in hoping to effect such dramatic change. “An evaluation was undertaken in early 2004 which did show an increase in the consumption of fruit and vegetables but this stopped as soon as they stopped having the scheme,” he says.
While a follow-up evaluation has yet to be taken, after 99 per cent of the nation’s schools have joined the SFVS, Tiddy says the Department is expected to carry this out later in the year. Meanwhile, all anecdotal responses indicate consumption levels and attitudes are improving, and Tiddy predicts the formal evaluation will confirm such findings. At the same time, while the same amount of government funding will be spent on procuring the produce going forward for the academic year of 2006/2007, Tiddy says the total sum allocated for the SFVS is marginally lower this year, owing to improvements in the efficiency of the scheme.
The ethos of the SFVS is getting them young enough to make a lasting impression, Tiddy says, although he recognises there is still room for improvement in some areas, to curb the teenage tendency to rebel against all things worthy, which largely boils down to further education, he says: “The Department would like to see the SFVS integrated more with other nutritional and obesity-fighting initiatives.”
According to statistics newly released from the annual Health Survey for England 2004, obesity among children has almost doubled in the last 10 years, with around one in four 11 to 15-year-olds now considered obese. The survey found obesity levels among younger children had also risen. Among two to 10-year-olds, 16 per cent of boys and 11 per cent of girls were registered obese - up by six per cent and one per cent, respectively, from 1995. Meanwhile, the figures for adults are similarly alarming. For both men and women, the incidence of obesity has risen to 24 per cent since 1993 - up from 13 per cent for men, and 16 per cent for women.
Laurence Swan, chairman of the Freshfel working group on promotion, agrees the bulk of funds should be directed at primary school children and points to the success of the Bangor Project, highlighting the need to add “the magical element of psychology” in bringing about long-term changes in behaviour. The methods involved in the project have been considered inappropriate by some parties, but Swan believes the results speak for themselves. “Some parents have objected to teachers ‘bribing’ their children with rewards but we are facing a real obesity epidemic and the project has shown that it is the psychological element that brings about real change,” he says.
As well as targeting the very young, Freshfel has been surveying attitudes prevailing within secondary schools. Having access to fresh produce is essential but the rise in obesity across Europe can also be attributed to a combined lack of provision for exercise and cookery instruction in schools, Swan suggests. To this end, Freshfel has called for a return to more traditional timetables, reinforcing the importance of a multi-faceted approach.
“A lot of people might eat more fresh products if they knew what to do with them but, because of the pressures of the curricula, parents and to a lesser extent academic staff have accepted that other subjects should take priority,” Swan claims. “But if we want people to pick up a turnip and think ‘this is delicious, I know what to do with it’, we must get Home Economics back on the policies of the various ministries of education across Europe.”
Jenney says the government is in a difficult position, with some schools of thought attacking it for not doing enough to turn the tide on the ailing state of the nation and others accusing it of over-interfering and exacerbating people’s frustrations over the suggestion that we have entered the era of the “nanny-state”. At the end of the day, it is the government’s role to make people aware of the issue, which is what they have been doing very efficiently, he says.
Yet, given the anti-establishment attitude perpetuated by certain groups of the public, Jenney proposes a change of tack might prove effective. So, while government schemes have traditionally used fear as a means of persuasion in their advertisements, the FPC-led Eat in Colour campaign will have a more positive framework. He suggests fruit and veg has long been burdened with a reputation for being “dull and worthy” or “too unfamiliar and scary”, so the impending campaign will seek to reverse such stigmas.
“We want to create a real desire among people to eat fruit because they know it gives certain benefits and generate a sense of ‘joyfulness’ around fruit,” he says.
In response to the accusations of wasted money, he says people should take a more balanced view of government expenditures: “The cost of a PR strategy is far less a burden than paying for someone to have a heart by-pass,” he claims. Furthermore, in a recent submission to the health division of the EC, Freshfel calculated e5.6bn a year was needed for health problems directly linked to not eating enough fruit and veg in the EU25 countries - an outlay which is unsustainable long-term, Swan says.
“People have expectations that when they reach old age, the NHS will see them through but even though the government is putting more and more money into health, it simply can never achieve all that is necessary,” he concludes. “So, we have to use every tool possible to encourage people to be healthier and ease the financial burden.”
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