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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 December 15; 335(7632): 1266.
PMCID: PMC2137083
The Bigger Picture

Food glorious food

Mary E Black, public health physician, Belgrade, Serbia

I am a fully paid up member of the dietary police. Walter Willet’s excellent book Eat, Drink and be Healthy: The Harvard Medical School Guide to Healthy Eating is my bible. Five (or more) portions of fruit and vegetables a day can maintain and improve your health; it is shocking how many people never eat an apple, let alone broccoli. Stirring stuff, and a call for results-based action; language we hear each day in the NHS. But as with all goals and targets we can sometimes lose sight of the big picture.

Two years ago I introduced financial incentives to get my children eat more fruit and vegetables—10 euro cents for each portion consumed. I knew I was winning when my (then) 8 year old asked if he could have a whole euro if he managed 10 portions a day. After two months the payments stopped but the behavioural pattern had indelibly changed. Breakfast at our house is now wholemeal bread, porridge, and fruit, dinner is a stir fry packed with vegetables. As a doctor and as a mother I have met my goals and targets.

This autumn I shepherded my children and others from Serbia on a sailing camp to Slovenia. We stayed on an orchard farm, producing bumpy orange fruit known locally by the uninspiring name of kaka fruit. Piles in various stages of ripeness lay around: I tasted one and found it interesting. The next one was a bit rotten. I went back to dietary police duties, holding back the tide of chocolate spread, soft drinks and sugary cereals provided by other parents, and militantly serving up “meatballs” containing 70% grated carrots. Kaka fruit dropped off my radar screen; we missed the village kaka festival featuring cakes, jams, and dancing. We merely glanced at the strange, stubby trees on our motorised way to the harbour.

Today, I passed an expensive designer fruit stall in Manhattan’s Grand Central station. There sat a pyramid of kaka fruit, perfectly shaped, blemish free, larger, yet a slightly less glowing orange than the ones in Slovenia. Each one was a whole dollar. The label said “Persimmon.” As a child I had fantasised about the fabled persimmon but had never actually seen one; Northern Ireland got its first avocado only when I was a teenager.

I realised what I had missed by focusing on my portion-based dietary goals and targets that week in Slovenia. I had overlooked wandering with my children in warm autumn orchards, discovering a new food, and exploring the sticky flesh of a freshly picked exotic fruit; and we had all missed the chance to glory at the revelation that is a persimmon. There is more to life, and to health services, than goals and targets.

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