National Cancer Institute Reviews 5 A Day Program & Calls for Expanded Efforts

FOR IMMEDIATE RELEASE: November 20, 2000

CONTACT: Robb Enright, Director of Public Relations & Production

302-235-ADAY; ext. 18

Bethesda, Md. - The National Cancer Institute (NCI) announced findings from a comprehensive review of the national 5 A Day program and called for expanded efforts by NCI, other government agencies and other organizations to further spread the message of eating 5 or more daily servings of fruits and vegetables. An NCI-appointed 5 A Day Program Evaluation Group presented the final report to NCI's Board of Scientific Advisors at a meeting Nov. 17 at NCI's Bethesda, Md. headquarters. Although the report does not prescribe funding recommendations, it reinforces NCI's commitment to 5 A Day while encouraging greater involvement from other groups. Based on these recommendations, NCI must submit a plan to the Board of Scientific Advisors to request funds for program implementation. Industry involvement is and will be a significant part of this plan. As NCI turns to implementing the report's recommendations and continues as co-sponsor of the national 5 A Day program along with the Produce for Better Health Foundation, the 5 A Day program will expand its role as the nation's largest public/private nutrition education initiative.

The 11-member 5 A Day Program Evaluation Group, chaired by John Potter, M.D., Ph.D., of the Fred Hutchinson Cancer Center in Seattle, Wash., was composed of leading health professionals from a variety of disciplines, including: cancer centers, hospitals, medical schools, universities and other organizations. The final report also outlined strengths, weaknesses and recommendations for future 5 A Day program efforts. NCI Director Dr. Richard Klausner, M.D., as a member of the NCI Board of Scientific Advisors, attended the meeting. Produce industry members in attendance included representatives from the Produce for Better Health Foundation; Produce Marketing Association, of Newark, Del.; United Fresh Fruit & Vegetable Association, of Alexandria, Va.; Dole Food Company, of Westlake Village, Calif.; and the Northwest Horticulture Council, of Yakima, Wash.

"The 5 A Day program evaluation presented to the Board of Scientific Advisors was as strong as we could have hoped it would be," said Elizabeth Pivonka, Ph.D., R.D., president of the Foundation. "The Produce for Better Health Foundation is grateful to NCI for playing a vital role as a leading federal voice for better health. We support the 5 A Day Program Evaluation Group's recommendation that NCI work more closely with the Centers for Disease Control & Prevention (CDC) and other federal agencies to bolster 5 A Day efforts. Much more could be accomplished by many if NCI and others allocated additional funds and resources to 5 A Day programs and efforts to increase fruit and vegetable consumption."

"As with all programs of the National Institutes of Health, the National Cancer Institute's 5 A Day program benefits from a thorough, independent review," said Gloria Stables, director of NCI's 5 A Day program. "To change eating behavior, the 5 A Day program depends on its many public and private partners. We thank the 5 A Day Evaluation Group for their outstanding scientific expertise and hard work in a thorough review of the Program and in making recommendations for the future. We also thank the countless other leading health organizations and produce industry members who participated in this review process. We are poised to accomplish more in the future as we work together to communicate the 5 A Day message."

Over the past year-and-a-half, Klausner received separate requests from members of Congress and from more than 250 produce industry members and state and local health agency officials calling for significant increases in funding NCI's communications budget. Among federal agencies, NCI is unique because Congress oversees the budget, but gives NCI's director wide discretion over research areas and funding allocated to those projects. As a result, the NCI 5 A Day program's budget has been set by NCI's director. Funding for 5 A Day communications efforts has been approximately $1 million each year since 1993. During this same period, the Foundation's budget increased from $840,000 in 1993 to $2 million this year. Although the NCI 5 A Day program budget remained stable, NCI's overall budget grew by approximately $1.2 billion from $1.8 billion, when the NCI 5 A Day program began in 1992, to a total of more than $3 billion by 1999. Until Congress passes an NIH budget, NCI is functioning under a continuing resolution which provides for the same amount of funding as last year, with no new programs. NCI leaders do not believe a new 2001 budget will be available before May, 2001. Some expanded activities may not occur until after the budget is finalized, though planning will begin earlier.

The 5 A Day Evaluation Group recommended to the Board of Scientific Advisors the following:

* That NCI continue the 5 A Day Program as a multi-faceted program to support research and programs to promote increased fruit and vegetable consumption.

* That NCI continue to lead the Program, and ensure that it has a director with high scientific credibility and appropriate expertise.

* That NCI's collaboration with the Produce for Better Health Foundation be continued and expanded.

* That NCI use its relationships with industry to ensure that fruits and vegetables become more available to high-risk and underserved communities.

* That direct expenditures and leveraged resources furthering delivery of the 5 A Day message be increased.

* That NCI partner with other NIH institutes to promote research on the role of specific fruit/vegetable components in lowering disease risk, promote methodological and applied behavioral research, expand awareness of other benefits of fruits and vegetables, and develop a surveillance plan to monitor fruit and vegetable consumption (including CDC and the Food and Drug Administration).

* That NCI partner more closely with the U.S. Department of Agriculture to better focus dietary guidelines and to promote research that will encourage fruit and vegetable consumption.

* That NCI partner with CDC to develop and manage state-level 5 A Day programs.

* That NCI increase resources, staffing and expertise to the states for dissemination, monitoring and evaluation of the Program.

* That 5 A Day remain a credible information source allowing better navigation through the fragmented and unreliable message environment surrounding food, nutrition and health.

* That the Program devote additional resources to a variety of media strategies, including a media-relations effort.

* That NCI "reinvent" the 5 A Day message on a regular basis, with attention to reaching minorities and low-income groups.

* That the Program re-think its channel-use strategy with a particular focus on new media, tailored communications, and how media channels may be used to reach lower socioeconomic status groups and the disadvantaged.

* That NCI and its partners develop a package of media evaluation approaches that are consistent, simple, complete and affordable.

* That NCI, in partnership with relevant organizations, develop operational strategies that are aimed at understanding and reducing disparities among ethnic groups and across education and socioeconomic differences.

* That NCI continue to take the lead in evaluating the effectiveness of the Program; this evaluation must include extensive involvement of the states.

* That NCI undertake a comprehensive evaluation of each of the 5 A Day components: media, research and all partnerships.

* That NCI, in partnership with other relevant federal agencies, coordinate, facilitate and strengthen surveillance and monitoring of fruit and vegetable consumption, psychosocial mediators of dietary behavior change, and possible environmental mediators of dietary behavior and behavior change.

* That NCI maintain and support intramural and extramural research in the following areas: research into dissemination methods, research into behavior change (research into the development of more effective dietary intervention programs, studies of children and adolescents when food preferences develop, studies on ways to develop supportive environments and increase fruit and vegetable availability, randomized controlled trials of interventions for middle and high-school students, policy research on ways to establish an optimal environment of making informed food choices in a free-market economy, research into environmental influences on dietary behavior and behavior change, research into mechanisms by which fruits and vegetables reduce cancer risk, research into influences on food choice, and research on methods of measurement of dietary behavior.)

There is no specific timeline regarding NCI's enhanced participation. Before May, NCI intends to begin preliminary meetings with other NIH institutes and other agencies to lay the groundwork for more collaborations involving 5 A Day. In the coming weeks, the Foundation will host an inter-agency meeting between NCI, CDC, the American Cancer Society and others to discuss how to create and reinforce partnerships to strengthen 5 A Day efforts and best leverage each other's strengths.

For more information on 5 A Day, contact the Produce for Better Health Foundation at 302-235-2329; fax: 302-235-5555; or check out and



The Produce for Better Health Foundation is the catalyst for creating a healthier America through increased consumption of fruits and vegetables. The Foundation is a nonprofit organization which, in cooperation with the National Cancer Institute, sponsors the national 5 A Day -- for Better Health program.