January, 2006

Fruits of Thought

ReThinking 5 A Day

The organization that spearheads the 5-A-Day effort, the Produce for Better Health Foundation (PBH), recently announced that “overall fruit and vegetable consumption is on the rise for the first time in nearly 15 years, with a combined increase of one percent in annual eatings per capita between 2002 and 2004...”

One percent? Over two years? Surely the study can’t be so rigorous as to identify that small a shift in a statistically significant manner. And what does “annual eatings per capita” even mean? It turns out it signifies the number of times the average person consumes a fruit or vegetable annually. In other words, it does not measure consumption in weight or volume. Even if accurate, the study could just as well be establishing an increase in “grazing,” in which people have smaller meals more frequently and thus consume produce more often but in smaller servings, thus not consuming any more produce by weight or volume.

PBH goes on to claim “the study also defines a clear link between awareness and consumption, with a jump in consumption of five or more daily servings reported by those claiming awareness of the foundation’s Color Way message.” In reality, the “clear link” is opaque, because no attempt is made to hold steady for intelligence, education or exposure to other public health messages. It is just as reasonable to believe people who are intelligent, educated and receptive to public health messages both eat in a more healthful manner and are aware of the “5-A-Day The Color Way” message.

It is natural for executives to claim a success and try to establish their program’s responsibility for it. But in this case, such crowing is counterproductive because reassuring an important constituency of the success of the program is likely to breed a complacency that prevents the kind of radical reassessment that may be required.

Despite the great efforts made by the sterling staff of PBH and the retailers and suppliers who support it, this great team has been given an impossible task. The total budget for PBH in 2004, for example, was $6.4 million. McDonald’s U.S. advertising expenditures in 2004 were approximately $1.4 billion. That is $6.4 million versus $1.4 billion, and that is one restaurant chain.

Such a small effort is unlikely to pierce through the marketing buzz that consumers live in. It is just not enough money to move the needle on consumption, and that is true even when adding in the value of logos printed on bags and whatnot.

What to do about this is less certain. Some argue we have to use the resources we have to do the best we can; others argue if we don’t have enough money, there is no point in spending money to no end.

There is another option though: to rethink the very nature of PBH and 5-A-Day. Not just a new slogan or positioning statement, but a real rethinking of how we can boost consumption.

The 5-A-Day program has always been an education initiative. In promoting 5-A-Day The Color Way, the Foundation chose to go beyond a general admonition to eat fruits and vegetables or that a diet with a high percentage of fruits and vegetables is good for you to a claim that individual produce items have unique and beneficial characteristics that ought to compel consumption.

If these characteristics were actually well established, it is possible the small budget wouldn’t matter much. If there was persuasive evidence that eating a particular fruit or vegetable would prevent cancer or heart disease or stroke, perhaps, like the man who invented the proverbial mousetrap, the world would beat a path to the door of the produce industry.

But such evidence doesn’t really exist. Look at the 5-A-Day Website and read why you should eat “white” produce: “White, tan, and brown fruits and vegetables contain varying amounts of phytochemicals of interest to scientists. These include allicin, found in the onion family.”

Not exactly compelling, is it? Most people would wait and see what these scientists discover before changing their diet. All through the Website, every claim is qualified by words like “may reduce the risk of cancer.” Of course, that is the same as saying “may not reduce the risk of cancer.”

There are legal restraints that prevent PBH or other parties from making unsupported claims. But there is a procedure to get the FDA to approve qualified health claims and the real question is, why doesn’t PBH file to get health claims approved?

The fact that the Foundation hasn’t made such filings may tell us that the whole 5-A-Day effort may be putting the cart before the horse. The science isn’t yet conclusive enough for PBH to feel comfortable asking the FDA to approve specific health claims for different produce items.

Which points to the way for PBH to make a major contribution to increasing produce consumption: Set up an R&D fund to raise money, not for marketing but for the top-level scientific research needed to convince the FDA to approve qualified health claims for various produce items.

Produce is a commodity, and neither the individual grower nor the community of growers typically has the funds or expertise needed to produce highly regarded scientific research persuasive to the FDA. But PBH could raise money specifically for this purpose and build the infrastructure to produce compelling research, item by item, on the benefits of consuming different items.

Then, when PBH gets FDA to approve Qualified Health Claims, we will have a compelling scientific story to tell. But job one is not just to tell people what to do but to be able to tell them why they should do it. The science isn’t quite there yet, and that may be the root of the problem.  pb