2.17 After smoking, what people eat is the next biggest contributor to cancer deaths, and may be responsible for up to a third of all cancer deaths. A healthy diet is one that is high in fruit and vegetables and cereals, and low in fat, salt and sugar.
2.18 Increasing fruit and vegetable consumption is considered the second most effective strategy to reduce the risk of cancer, after reducing smoking. In particular, people who do not eat fruit and vegetables regularly are at greater risk of several common cancers, including colorectal and stomach cancers. There is evidence that people who eat at least five portions of fruit or vegetables a day are much better protected against cancer and heart disease than those who don't. A change to a diet that is rich in fruit and vegetables can reduce the risk of death from cancer in those under 75 within the following ten years.
2.19 In the UK the average consumption is only about three portions a day. There are large differences between different social groups. Those in low income groups eat substantially less fruit and vegetables than those in the highest income groups, and this contributes, with smoking, to the cancer health gap in England.
2.20 People make their own choices about what to eat, but too many people feel a diet rich in fruit and vegetables is not a real option. Affordable fruit and vegetables are not always accessible, particularly for those in deprived communities, and families may be reluctant to buy food that may not be eaten. It is also partly due to attitudes and awareness. The specific health benefits of fruit and vegetables in preventing cancer and heart disease are not widely known, and many people think they are already eating enough.
2.21 A national five-a-day programme Working closely with the food industry, the Food Standards Agency, and key stakeholders, the government will develop a national five-a-day programme to increase access to fruit and vegetables and make a healthy diet a real choice for everyone. It will include a communications campaign to start in 2001. The government will also work with producers, retailers and others to increase provision and access to fruit and vegetables - particularly in deprived communities, schools and hospitals.
2.22 Local five-a-day initiatives are already underway. Five pilot sites, in Sandwell, Somerset, Airedale and Craven, County Durham and Hastings have been set up to increase consumption of fruit and vegetables across the whole population, through coordinated, evidence-based and practical interventions. These projects are being carefully evaluated.
Sandwell
Somerset
Airedale and Craven
County Durham
Hastings
2.23 Learning the lessons from the pilot schemes, and based on evidence of effective interventions to increase fruit and vegetable consumption, the national roll-out of local five-a-day initiatives will begin in 2002. It will link with Health Improvement Programmes (and to the Healthy Community Collaborative).
