RIP 5 A Day

The 5 A Day program was quietly retired last week. The press coverage focused on the finding that Fewer than a third of American adults eat the amount of fruits and vegetables the government recommends, a trend that's remained steady for more than a decade.

Actually, the figure from the CDC's BRFSS 2005 prevalence data is 23.2% - less than a third must have sounded better than less than a quarter. For a point of comparison I looked at the data from the NCI evaluation of the program: the prevalence of adults who reported eating at least 5 servings of fruits and vegetables a day was 19% at baseline in 1990; 22.1% in 1994 - 3 years after the launch of the campaign; and 22.7% in 1996.

The NCI evaluation report also noted that the addition of more intensive state level interventions beginning in 1994 had done very little to change fruit and vegetable consumption. In fact, the only deflection in the prevalence was when the campaign first launched with major national leadership and social marketing support from the NCI (that I did participate in). That support declined noticeably after the evaluation report, finally concluding with shifting the program to the CDC. Of course, if some people had known then what they know now, 3% increases (actually a 16% increase over baseline, but epidemiologists don't seem to calculate that way) would have been cause for celebration. The flat line since then supports the idea that the 16% change wasn't a secular trend either - the other favorite toss-off explanation at the time to move the money out of the program and back into research.

Now we have a broken program, 10 years of wasted time, a brand washed away (check with the stakeholders), a new information-based effort to replace 5 A Day that explains to people why more fruits and veggies matter, and bromides such as this (from the MMWR report on the new data):

The lack of success in meeting national goals for fruit and vegetable consumption indicates a need for additional measures to educate and motivate persons to make healthier dietary choices. Nutritional interventions should go beyond increasing individual awareness and target the family, local community, and overall society to eliminate barriers to healthy eating, provide support for persons who are making healthy changes, increase resources for populations with greater need, and emphasize nutritional policies that have an impact on society.

We could also go back to marketing - that's when it worked!

Watch for the one day media coverage: To get people to eat more of these nutrient-rich foods, the CDC, the Produce for Better Health Foundation and other leading health groups are launching a new initiative Monday called "Fruits & Veggies — More Matters." This will replace the "5 A Day" campaign.

I'll be wandering aimlessly.