International news and exclusives GIDEON MENDEL/CORBIS This Thisweek– week– –Vegetables have an image problem– Can the Food Dudes get kids to choose broccoli over burgers? Obesity-hit nations are desperately hoping so ANDY COGHLAN CHARLIE, Tom, Raz and Rocco are superheroes on a mission to save the world from General Junk, whose evil plan is to destroy the world by stealing all its fruit and vegetables. Luckily, these “Food Dudes” have superpowers that spring into action whenever they eat their greens. In completing their mission, the Food Dudes also hope to save the lives of millions of real children who risk early death from cancer, heart disease and diabetes because they refuse to eat fruit and vegetables. Corny, yes. But governments and child nutritionists in Europe, the US and Canada are taking the 8 | NewScientist | 21 July 2007 Food Dudes very, very seriously. The programme has outperformed all others in its capacity to wean children onto foods they almost universally dislike on first tasting. With childhood obesity rates continuing to rise in western countries, new approaches to get kids to eat more healthily are desperately needed. Earlier this month, an Associated Press evaluation of 57 healthy-eating initiatives in US schools showed that just four had any impact on fruit and vegetable consumption, and even those impacts were minimal. Meanwhile, a study published last week revealed that a Dudes programme on fun will transfer to the US,” says Karen Jetter of the University of California, Davis. Key to the Food Dudes’ success is peer pressure, and the behavioural changes it brings about. Previous schemes simply reeled off messages about the need to eat fruit and veg and left kids to tuck in. “You can’t force kids to eat things – you have to bring them with you, and failure to do that is an error made by people who don’t understand behaviour,” says Fergus Lowe, who co-developed the Food Dudes FOOD DUDES 2006 Superheroes battle the forces of junk £120 million “free fruit” scheme introduced in UK schools in 2004 also failed to work. Janet Cade and her colleagues at the University of Leeds showed that although children initially ate an extra half-a-fruit portion at school, they lost interest after about seven months, and many ended up eating less fruit at home because parents thought they were getting their fill at school (Journal of Epidemiology and Community Health, DOI: 10.1136/ jech.2006.052696). So could the Food Dudes be the answer? The government of the Republic of Ireland is already sold on the idea. It was so impressed by results from an ongoing pilot trial of the programme in 150 Irish primary schools that in February it decided to end the trial prematurely after two years and launch it nationwide to all children aged 4 to 11. The full roll-out will begin in September. Trials are also under way in the UK and Italy, while California and Canada are preparing for pilot trials too. “I think the focus of the Food –What’s their secret?– www.newscientist.com In this section ● Dark enery particles go chameleonic, page 10 ● Meat is environmental murder, page 15 ● How to grow old while staying young, page 15 programme at the University of Wales, Bangor. “Our focus is on behaviour change and psychological principles.” In essence, the Food Dudes programme attempts to convince children to try fruit and vegetables again and again until they actually begin to like the taste. “If you eat a food repeatedly for 10 to 15 times, you learn to like it,” says Lowe. “It educates and habituates the taste buds, but you need to repeatedly eat the food for this to happen.” Spread over 16 school days, the six episodes of Food Dudes keep the children “on message” long enough for them to love what they once hated, he says. Children take home educational packs for their parents containing charts to monitor home consumption of fruit and vegetables, and are also rewarded for their efforts with pencils, pens, stickers and pencil cases. Lowe says that the children’s enthusiasm for the dudes and their message provides a powerful counterfoil to the massmarketing of junk foods on TV and elsewhere (see “Fighting flab on TV”, right). The results have been “overwhelming”, says Michael Maloney of the Irish government’s Food Board, who has played a key role in overseeing the pilot studies in Ireland. The pilot in six schools during 2002 and 2003 showed that on average, participants’ daily consumption of fruit rose from 49 to 93 grams over the course of a year. The most impressive results were in the 20 per cent of children who ate the least fruit and veg at the outset. Their consumption rose from 1 gram to 52 grams on average, suggesting that the most nutritionally deprived children would benefit most. Preliminary results for the much larger pilot study of 150 schools also look good, says Maloney, although the final analysis is not yet complete. They suggest that 90 per cent of participants are now eating one or more portions of fruit per day, www.newscientist.com instead of none at the outset. And vegetable consumption is up from zero to at least one portion a day in 80 per cent of kids. What’s more, earlier trials in British schools suggested the benefits lasted at least 18 months after the children watched the episodes of the Food Dudes (European Journal of Clinical Nutrition, DOI: 10.1038/sj. ejcn.1601838 and DOI: 10.1038/ sj.ejcn.1602024), suggesting that the children retain their taste for fruit and vegetables. Maloney urges all countries to give it a try. It costs about £35 per child, which would be a wise investment if it weans them for life onto a diet that helps prevent obesity, diabetes, cancer and heart disease. “It’s a one-off investment “The most impressive results were in the 20 per cent of children who ate the least fruit and veg at the outset” in every child, so the cost-benefit is a no-brainer,” says Maloney. No wonder then that other countries are interested in the Food Dudes. “Convincing children in particular to consume the recommended daily amounts of fruit and veg is a major challenge,” says Ron Lemaire, director of the Canadian Produce Marketing Association in Ottawa – a country where obesity rates for children have tripled in 25 years, and the level of people either overweight or obese has grown 70 per cent. “We’re in the process of looking at the potential of running a pilot for the Food Dudes programme in Canada,” he says. Likewise, Jetter is hoping to kick-start a programme in California. In the US, adult obesity rates doubled between 1980 and 2000, and the incidence of overweight has doubled among children and tripled among adolescents since 1980. Likewise, in the US only 25 per cent of adults eat the recommended five daily servings of fruit, and even fewer adolescents do so. ● FIGHTING FLAB ON TV However successful the Food Dudes programme is, children will still face a torrent of tempting TV ads for unhealthy food. The good news is that research from Australia suggests that “counter adverts” promoting healthy foods do register with children and can change their eating habits. “Changing the food advertising environment to one where nutritious foods are promoted and junk foods are relatively unrepresented would help to normalise and reinforce healthy eating,” says Helen Dixon of the Centre for Behavioural Research in Cancer at the Cancer Council Victoria in Carlton, Victoria. “From our experiment, children who viewed healthy food ads showed significantly more positive attitudes towards [healthy] foods compared with beforehand,” she says. More than 900 children from schools in Melbourne participated in the study, which tested their attitudes to healthy eating and probed their TV viewing habits. It showed that junk food advertisements, which account for 81 per cent of food ads on commercial TV in Australia, do exert an influence on children’s eating habits. Children who watched 28 hours of TV per week were 18 per cent more likely than those who watched 7 hours to have positive attitudes to junk foods, and were 14 per cent more likely to like junk food. When the children viewed adverts for healthy as well as junk food, the researchers found that the healthyeating message did register, despite the ads for junk food. “Our results support the proposition that increasing the number of ads for nutritious food at times when children watch TV may serve to promote the appeal of these foods,” says Dixon, whose team’s results appear online in Social Science & Medicine (DOI: 10.1016/j. socscimed.2007.05.011). HEAVY LEVY Taxing unhealthy food could save as many as 3200 Britons from strokes and heart attacks each year, a study by epidemiologists has found. However, critics say a “fat tax” would hit the poor hardest because they spend 30 per cent of their income on food, twice the proportion spent by richer households. A team led by Mike Rayner of the University of Oxford estimated the impact of a “fat tax” on health. They applied three tax scenarios to genuine data on food purchasing and consumption in the UK in 2000. In the first scenario, only dairy foods rich in unhealthy saturated fats were taxed. Paradoxically, they found that deaths from strokes and heart attacks would increase by between 1900 and 4000 per year. That’s because consumers would switch to cheaper, untaxed products such as carbohydrates loaded with extra salt, which raises the risk of heart attacks by increasing blood pressure. In the second scenario, Rayner and his colleagues taxed foods according to a standard nutrition rating that assigns a “healthiness” score to foods based on eight nutritional parameters including iron content and total calories. When Rayners team applied tax to all food items scoring as “unhealthy”, it led to 2300 fewer deaths each year. The third, most successful scenario was when the team taxed all items containing salt, sugar and fat. This saved 3200 lives (Journal of Epidemiology and Community Health, DOI: 10.1136/jech.2006.047746). Critics complain that this last regime would disproportionately hit the poorest households, raising their food expenses by 4.6 per cent. “The likely outcome of this is that fresh foods like fruit, vegetables and meats are left out of the shopping to compensate,” says Ann Hobbiss of the Food Policy Unit at the University of Bradford, UK. Rayner says the regime could be made fairer for the poor if the resulting revenue was used to subsidise fruit and vegetables. He says the government would also need to impose measures such as restrictions on advertising junk food for the policy to have maximum impact. 21 July 2007 | NewScientist | 9