Life
    Health

    Can you count to five?

    9 May 2015

    I remember when one was guaranteed two things from London cabbies — a good journey and a good natter. Once we’d done the weather, cyclists and the congestion charge, they would move on to ask what I did and, as soon as I mentioned ‘nutrition’, off they would go: ‘One minute they say, “Eat this” and the next it’s, “Don’t eat that”. And what about that five a day? You try being a cabbie and getting a salad. They want to live in the real world.’

    The journey may still be good but the banter has stopped, because now cabbies are on the phone just like everyone else. For me it’s blessing really, as I used to dread having to defend every single nutrition-related story they might have heard about. Worse still is that the friendly cabbies were right: the messages did and do keep changing, which is one reason why dietary edicts can fail to influence the people who need them the most.

    But what about five a day, probably the best-known nutrition message in history? Has that changed? The mantra itself was not the creation of some group of learned nutrition experts and public health officials who examined evidence and considered modern lifestyles before arriving at a simple saying. It actually began life in 1991 as a marketing slogan put together in a collaboration between the US National Cancer Institute and a commercially funded group of growers and farmers in California known as the Produce for Better Health Foundation. While the message does of course have huge merit, it wasn’t based on any definitive research.

    That hasn’t stopped it becoming lodged in our collective psyche. ‘Five a day’ may well be one of the most recognisable marketing slogans of all time, giving ‘Because you’re worth it’ and ‘Only the crumbliest, flakiest chocolate’ a run for their money.

    Somewhat confusingly, the advice on how much fruit and vegetables to aim for daily differs around the world, despite the advice now being based on research that is globally available. In Britain we are advised to eat at least 400g (about a pound) of fruits and vegetables daily, or 80g (that’s three ounces) per portion: hence the five a day. In Finland the overall figure is 500g, and in Canada it rises to seven to ten portions — but there’s no holding back in Australia, where the official recommendation is for six 75g portions of vegetables and another two 150g servings of fruit.

    And despite the familiarity of the ‘five a day’ slogan, we Brits aren’t taking heed. A National Diet and Nutrition Survey published in 2012 showed that only 31 per cent of British adults aged between 19 and 64 get their five a day — and only 10 per cent of children.

    But what are five portions of fruit and vegetables? The Livewell section of the NHS website advises that one small portion of fruit is two or more small plums or satsumas, seven strawberries or 14 cherries, while a medium-sized portion is an apple, banana or pear. A small portion counts as one of the five a day and a medium-sized one does too, possibly one and a bit. For vegetables, a raw tomato, three celery sticks or 5cm of cucumber will do it for salads —but for cooked food you’ll need two spears of broccoli or four heaped tablespoons of spinach or beans, but only three of carrots or peas. A smoothie counts as one portion, because they contain beneficial fibre, even though there are natural fruit sugars — but two smoothies still count as just one. (Fibre trumps fructose but only in the first glass it seems.) A 150ml glass of unsweetened juice counts as one, while the second one doesn’t count owing to the lack of fibre. Beans count as one portion even if you eat an entire branch of Whole Foods. Potatoes don’t count at all, unless they’re sweet potatoes. Well, that’s clear then.

    The five-a-day mantra looked as if it was about to be updated last year after researchers at UCL analysed data from 16 worldwide studies of the eating habits of more than 800,000 people. The outcome? Seven or more portions are required; aim for ten and not five; fruit juice shouldn’t count at all; frozen and canned food shouldn’t be included any more; vegetables have four times more value than fruit, as each portion of vegetables reduces risk of death by 16 per cent compared with 4 per cent for fruit. However, the incidence of cardiovascular disease and cancers didn’t decrease in any meaningful way beyond the five a day. The cabbies were right about the confusion then, and surely that’s back to five a day?

    Numbers aside, perhaps it’s time to update the slogan. The United States has moved away from numbers with a simple ‘Fruits & Veggies — More Matters’. Or we could go with a quote from In Defence of Food by Michael Pollan, a professor of journalism at the University of California in Berkeley: ‘Eat food. Not too much. Mostly plants.’