This programme approaches Americans with a simple, short, positive, and actionable message: Eat 5 to 9 servings of vegetables and fruit daily for better health. Providing the public with a number ("5") is part of a strategy to give people a measurable, easily calculable goal. In addition, the focus on fruits and vegetables - rather than the complete set of dietary guidelines - is designed to simplify the information people needed to understand how to make dietary changes. Finally, this campaign promotes a positive message about diet, telling people they can eat more foods, like healthful fruits and vegetables, in contrast to the low-fat message, which encourages people to eat less of what they like. In constructing this programme, care was taken to not disparage other food groups.
PBH seeks to address mothers with children under the age of 11, as well at the children themselves. Delivering information to this segment of consumers is done through retailers, educators, health professionals, and the media.
Central programme components (summarised below) include mass media, point of purchase, community coalitions, and research. Other activities include the National Excellence Awards (which honor companies for their outstanding efforts to incorporate 5 A Day into their business, workplace, and community) and the National 5 A Day Month (September).
First, the 5 A Day site is a central means of reaching consumers. It details how they can eat "5 A Day The Color Way" - that is, by getting at least 1 serving from each of 5 colour groups every day: Blue/Purple (e.g., blueberries), Green (e.g., spinach), White (e.g., bananas), Red (e.g., tomatoes), and Yellow/Orange (e.g., lemons). Recipes, charts to track dietary progress, related links, and information about how to select and store fruits and vegetables are also included on this site. Colourful printed posters have been produced to support these messages; public service announcements (PSAs) have been broadcast on the radio.
The campaign is directed in very specific ways toward young eaters. By visiting the "kids" section of the 5 A Day site, children can access recipe tips, activity sheets, and a downloadable "There's a Rainbow on My Plate" colouring book. The latter is part of a free nutrition education curriculum that encourages kindergarten through sixth grade students to develop healthy eating habits. Introduced into 12,000 elementary schools and 3,000 participating supermarkets in March 2003, this programme involves various activities and lessons (tailored to specific age groups) and a teacher's guide.
Second, the point-of-sale component involves interventions in supermarkets and food-service operations. The idea here is to try to reach consumers in all demographic strata. State health coalitions work with supermarket retailers to conduct supermarket tours and taste tests to attract the attention of consumers and actively engage them in the programme.
Third, under the leadership of a coordinator in each State health department, the 5 A Day Program is implemented by using existing public health nutrition funding and voluntary industry in-kind support at the community level, where health authorities and industry licensees conduct 5 A Day events. Most States have developed coalitions involving representatives from the public and private sectors. The purposes for collaborating are to reach consumers more effectively, maximise the use of scarce resources, coordinate State and national media efforts, encourage innovation, and create working relationships between the public and private sectors. The focus of these community efforts is on behavioural change - theory-based and interactive activities designed to build skills on the part of people of all ages for healthy dietary change.
Finally, NCI funds behaviour change and communications research to determine effective strategies for increasing fruit and vegetable consumption. This research, as well as studies conducted by the National 5 A Day Partnership and other organisations, is detailed on the 5 A Day site.
According to organisers, cancer is the second leading cause of death in the United States, killing more than half a million people a year. Research indicates that approximately 35% of cancers in general, and as much as 90% of certain cancers, may be prevented with diet. Given current trends, they say, cancer will replace cardiovascular disease as the leading cause of death early in the 21st century.
Click here to access a summary of a full programme evaluation, published in 2000.
NCI, PBH. The Partnership is composed of representatives from Produce for Better Health Foundation, National Cancer Institute, United States Department of Agriculture, Centers for Disease Control and Prevention, American Cancer Society, Produce Marketing Association, United Fresh Fruit and Vegetable Association, National Alliance for Nutrition and Activity, and Association of State and Territorial Directors of Health Promotion and Public Health Education.