Simply telling the public to stop smoking, eat more fruit, or exercise more is not historically a very successful strategy. Perhaps one of the most recognisable campaigns of the last 20-years is the five-a-day message that has encouraged the UK population to eat fruit and vegetables. In spite of millions being spent on marketing this message (estimated to be £4-million for the last five years), recent figures suggest the number of adults in the UK actually meeting the five-a-day target is only 22% (approx 9.2 million people), and in those with low socio-economic status only 17% (1). More worryingly still there appears to be a downward trend. In 2009 the figure was 26% (or 10.9-million people), which incredibly represented a fall from 30% (21.1 million people) in 2006 (2).
Yet if you go out into the street and ask people how much fruit and veg they should eat as part of a healthy diet I suspect, although I have no actual data, that the vast majority of people would know the five-a-day mantra. The millions of pounds that have been spent on the five-a-day marketing campaign have, in my view, been hugely successful in raising awareness about the existence of a campaign. However, looking at the trend from 2006 to 2012, it is hard to view ‘five-a-day’ as anything but a failure.
The problem is that eating habits are just that – habits. And habits by their very nature are difficult to change. As a nutrition consultant working with a variety of clients in sport, business and every other walk of life, I face this exact same problem on a daily basis. People sit in front of me and nod enthusiastically when I explain what changes they need to make, and why, but getting someone to actually change what they are doing can take several sessions and many months of coaching, nudging and nagging. I see it at conferences and lectures too. I look out on people nodding, taking notes and fundamentally understanding what I’m saying. How many actually go away and change what they are doing I cannot say, but I suspect it is very few.
So the problem for the government and other organisations tasked with getting us to live healthier lifestyles is not one of getting philosophical agreement because by and large we have consensus. Smoking is bad, sedentary behaviour is bad, five portions of fruit and veg is good etc.. The challenge is to get the population at large to actually do something with the information, to actually change something, however small. In recent times there has been a greater emphasis on nudging rather than nannying. For example rather than simply telling people to cycle to work because it is healthy some towns and cities have invested in cycle lanes and cycle to work incentives. In Bristol a scheme set up in 1998 has reduced the number of people commuting by car from 50 to 32%, whilst walking and cycling have both increased from a combined 26% to 42% (3). Moreover, those commuters getting to work under their own steam achieve 80% of the recommended weekly physical activity simply by going to work. That’s good nudging.
Convincing my clients to make dietary changes, when they have sought me out, paid me a fee and generally committed to a process of change is one thing. Convincing the wider population to make healthy dietary choices is quite another. I certainly do not have the answers, but perhaps the time has come to think beyond ‘five-a-day’ and its newer relative the ‘change4life’ campaign. Education is a crucial part of the process, but it is easy for people to nod, agree, then carry on doing what they were doing. The solution requires us to turn those nods into action, giving people realistic and practical ways to make small but important changes – something as simple as having fruit available in the workplace, for example. So rather than relying on the government for all the answers, perhaps we all need to think about what we can do to influence change in ourselves, our families our workplace, schools and local community. Philosophically we are all agreed, now let’s take some action.
1. World Cancer Research Fund. Press Release: Only a fifth of Britons getting their recommended 5 A DAY. Accessed14/5/12.
2. Daniel Martin. Great five-a-day flop: Despite £4m campaign, number eating correct amount of fruit and veg FALLS. Mail Online. Accessed 14/5/12.
3. Brockman, R., & Fox, K. R. (2011). Physical activity by stealth? The potential health benefits of a workplace transport plan. Public Health, 125(4), 210-216.