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Key Dietary Recommendations

Committee on Medical Aspects of Food Policy,
1994 and 1998
Maintain a healthy body weight (BMI 20-25kg/m2)
fat intake to 35% energy
saturated fat to 10% energy
salt intake to 6g/day
added sugars to < 10% energy
fruit and vegetables to at least 5 portions per day
increase dietary fibre intakes from a variety of sources

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General Dietary Habits of Adults
by Income Group (NDNS 2002)
Foods less likely to be eaten by men and women in households in receipt of benefits, include:
whole grain and high fibre breakfast cereals
oily fish
fruit and vegetables
fruit juice
Foods more likely to be eaten by men and women in households in receipt of benefits, include:
table sugar
whole milk
burgers and kebabs
meat pies and pastries

Children’s Diets (NDNS 2000)
Fruit & vegetables
One in five eat no fruit
Three in five eat no leafy green vegetables
Half drink no fruit juice
Differences in consumption between social groups in fruit and vegetable consumption
Salt, fat and sugar
% energy from total fat has fallen, but saturated remains high
too much salt - up to twice recommended levels
two-thirds drink more fizzy drinks than milk

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NSFS Aim and Scope
To provide 2.5 million children aged 4 to 6 in 16,000 primary schools with a free piece of fruit each school day from 2004
200 school days - 500 million pieces of fruit a year (70,000 tonnes)
Equivalent to 40% of British apple market

NSFS Evaluation
NSFS thoroughly evaluated
Results so far show that it is popular:
80% of eligible children took the fruit - absence/refusal
School staff - way of improving children’s health (99%)
Schools - support to teaching and learning about healthy eating (97%)
Future evaluation will assess whether free fruit:
displaces other food
is eaten in addition to other food
has an impact on diet of whole family

NSFS Update
New Opportunities Fund investment of £42 million for next 2 years
Scheme is being extended on a region by region basis:
By end of 2002, 500,000 children in 4000 schools receiving free fruit
By Summer / Autumn 2003 over 1 million children in 8000 schools
….until complete coverage from 2004

School Fruit - The Future
Dietary assessment tools
Whole school package (e.g. promotional materials such as Food Dudes)
Possible introduction of vegetables
Management structure
Supply chain

Five-a-day Community Initiatives
Evidence based pilots to address the barriers to increased consumption: access & availability, attitudes & awareness
Five 1 year pilots, 2000-1
Targeted 1 million people
Interventions in multiple settings

Examples of Activities in Five-a-day Community Initiatives
engage primary care staff
free voucher scheme
provision in corner-shops
initiatives in workplace and schools canteens
food co-ops and community cafés
food blender loan scheme
food mapping work
local media campaigns

"Stemmed a fall in consumption"
Stemmed a fall in consumption, against the national trend.
Overall, had a positive effect in people with the lowest intakes. Those with lowest intakes at baseline increased intakes by about 1 portion.
Frequency of intake was an important determinant of fruit and vegetable consumption.
35% of people in intervention area reported improved access compared to 21% in control area.
17% of people in intervention area stated that 5 a day optimal compared to 8% in control area.
Full results:

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Communications Programme
increase awareness of the health benefits of fruit and vegetables, particularly targeting those groups with the lowest intakes
provide clear and consistent messages including:
to eat at least 5 portions of a variety of fruit and vegetables a day
what counts as a portion

Five-a-day: What Counts?
1 portion = 80g
Fresh, frozen, canned, dried and 100% juice count towards five a day
100% juice, beans and pulses, and dried fruit count once, even if more than 1 portion is eaten
Potatoes don’t count
Composite foods
sugar, fat and salt cannot be ignored
further consideration - technical group

Five-a-day Logo Development
Focus groups
think they already eat enough and are confused with the notion of portions
want a mark of value
food industry
health education
consumer organisations
other government departments
Technical guidance
What Counts group

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Press Response to Five-a-day
“Fruit and veg to get fat free logo” The Sun
“5-a-day fruit and veg plan revamped” The Guardian
“The five steps to a healthy diet” The Daily Telegraph
“Stamp of approval for fruit and veg” The Times

Five-a-day Resources
handbook for local community initiatives
handbook for primary care
evaluation questionnaires for children and adults
logo and brand available for use
materials and leaflets (portion counter, posters)
caterers’ handbook
regional seminars

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Work With the Food Industry
Across industry – farmers, manufacturers and producers, suppliers and distributors, retailers, caterers
EU Fresh Fruit and Vegetable regime - funding for producer organisations
Assistance with programme implementation - availability and access
Involved in the development of the logo and supporting materials – including the What Counts? guidelines

Monitoring Action
Assessment of initiatives
development of tool to assess Five a day community initiatives
development of tools to assess National School Fruit scheme
Understanding of Five a day messages
Health Survey for England
Trends in dietary intakes
National Diet and Nutrition Surveys,                   National Food Survey

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