Five-a-Day advice can be ‘unrealistic’

Realistic messages, including those on Five-a-Day, are important for patients to be healthier, the new chair of the Royal College of General Practitioners (RCGP) has said.

Dr Helen Stokes-Lampard has said that while Five-a-Day is an excellent initiative to encourage patients to be healthier, as GPs it is sometimes equally important to ‘tailor advice to the patient based on their individual circumstances’.

Arguing that many children are being brought up with a culture of not having any fresh fruit and vegetables at all, she suggests that a target of five-a-day is difficult to implement, and recommends starting with one or two portions a day and building up to the five portions a day.

Clarifying her comments, Stokes-Lampard said: “It's not easy - or affordable - for many patients to eat five items of fruit or veg a day, and when they are faced with the temptation of cheaper unhealthy snacks, it's understandable that they choose them. However, there are lots of great ways to buy and cook fresh food more cheaply which we all need to share widely.

"We are absolutely not advocating unhealthy diets or for our patients to lead unhealthy lifestyles, but the message needs to be realistic for the patient in front of us. We need to make eating healthier easier and more affordable - and as a society we need to do more to encourage our patients to lead more active lifestyles.”

Dr Alison Tedstone, of Public Health England, maintained that ‘five fruit and veg a day is an affordable and achievable target and the cornerstone of a healthy balanced diet’.

Additionally, Stokes-Lampard also called into question whether smokers should always be told to give up, claiming that ‘patients are individuals’ and that ‘you can't treat everyone the same’. Suggesting to a patient who smokes 40 cigarettes a day to stop is more likely to persuade them to ‘disregard any advice’ from which nobody gains.