With children’s vegetable intake in decline, decision makers are too focused on pointing the finger at parents, a new study suggests.
When it comes to children’s nutrition, key players in our food system are stuck on the idea of individual responsibility.
That’s a key finding of new research that surveys decision-makers about their views on New Zealand children’s declining vegetable intake.
The latest Health Survey data shows that for the last five years, children’s vegetable intake has been declining across all ages, ethnicities and socio-economic groups, while fruit intake has plateaued. Nearly half of children aged between two and 14 aren’t eating the recommended vegetable intake of two to three servings per day, and fruit and vegetable intake tends to be lower among older children, boys, and those living in more economically disadvantaged areas.
The University of Auckland’s School of Population Health asked major players within our food system about their views on the causes of the decline, and for possible solutions. Importantly, the research then stacked these suggestions up against the interventions that have been proven to work.
Despite the decline in fruit and vegetable intake being so widespread, and the mention of systemic barriers such as food environments and poverty, the interviewees found it hard to move away from solutions that addressed only individual behaviour.
“It was much easier to point the finger and blame at parents, when that’s not what’s driving it,” says researcher Dr Sarah Gerritsen, a co-author of the study. “Like poverty, we know this impacts a child’s nutrition – it’s really difficult for parents to section off portions of their food budget to spend on fruit and vegetables when they have so many other pressing things to spend money on. It was more difficult for them to come up with solutions to that.”
The interviewees included people working in government, policy and NGOs, as well as growers and retailers. The focus on these decision-makers aligns with UNICEF’s call for key players across local and global food systems “to be held accountable for providing healthy, affordable and sustainable diets to children”, as the current food environment increasingly encourages the opposite.
Gerritsen says everyone surveyed found the decline concerning, linking it to poor physical and mental health. “That in itself is important, because children’s nutrition often gets dumped to the bottom of the pile as not critical now, when actually this is something we need to be turning around,” she says.
The participants were able to identify a wide range of linked systemic barriers, including poverty, housing, accessibility, and the effects of urbanisation and climate change, but were often “unable or unwilling” to come up with solutions to solve these.
The results exemplify why it can be difficult to get effective policies, even those considered “basic” by those studying public health – such as increasing healthy food available in schools – over the line.
One of the interviewees said that while fruit and vegetables can be expensive, “you could still buy lettuce for 99 cents”. Another could understand why it was more complicated. “When I go to the supermarket and look at fruit, how much you pay and what you get, I can see why families would choose to get high-energy food, and easier foods to prepare.”
Overall, Gerritsen says that despite some solutions being backed up by evidence, it’s hard to get people on board with effective policies as these often “challenge their views of the world”.
“A lot of New Zealanders like to think that if everyone just knew what to do then they’d do it, and that it’s a parent’s responsibility to feed their children correctly, rather than a community taking responsibility for this.
“But we all have a vested interest in making sure all children are eating healthy food. We all need to see children growing up healthy and getting the nutrients they need, and developing, and having access to healthy food for life.”
Many of the suggestions centred on the general population, rather than those most in need, or on improving people’s knowledge, when the real barriers lie in accessibility. Only one participant mentioned raising welfare benefits or child tax credits so low-income families could afford more fruit and vegetables.
“A lot of the first off-the-bat responses are that ‘we need to improve people’s education about seasonal fruit and vegetables and where to make the best purchases’,” Gerritsen says. “But when it comes down to it, is that changing how much money they have to spend on fruit and veg?
“I think we need to be looking at that wider food environment of what’s available for people to eat that’s easy and cheap, but is also going to sustain them and help them grow strong.”
The completed research was sent to the participants, which Gerritsen believes has the potential to be “powerful” in that it will those surveyed how their suggested solutions stack up against the international evidence and whether the outcomes would reach children with the lowest intakes.
For example, Gerritsen said some retail strategies, like miniature or attractively presented vegetables, or telling growers’ stories, was a way of “preaching to the converted”, and wasn’t likely to improve intake across all social groups.
“[Retailers] aren’t seeing a decline in fruit and vegetable sales in New Zealand, so that’s interesting. They’re just selling more to a smaller market, which is sort of wrong. That’s why the promotion to younger children through early childhood education is so much more powerful, because you’re actually reaching children who need it.”
She says two high-impact solutions that were commonly suggested included subsidising fruit and vegetables, and improving access in early childhood education, where children are spending larger proportions of their time from younger ages. These have the potential to take pressure off parents, and ensure repeated exposure to vegetables, which is crucial for a child to begin accepting and enjoying them.
Gerritsen suggests Aotearoa’s successful fruit in schools programme be extended up to decile five schools, and include vegetables, which would help to normalise them as a snack.
She says it’s important to get this right, as early exposure makes all the difference for lifelong healthy eating habits: “It’s not something that a person’s going to come to at 18 years of age – you need to start earlier.”
While it’s a complex issue, Gerritsen says there’s plenty of potential for the decline in vegetable intake to be curbed, if we can get on board with the approaches that have evidence behind them.
“A lot of things have been shown to make a difference, so there’s no excuse not to be moving ahead with these.”
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