Planting Seeds for Change: Fruits, Vegetables, and Youth Participation | World Obesity Federation

Planting Seeds for Change: Fruits, Vegetables, and Youth Participation

25.10.23 |Article

The CO-CREATE Dialogue Forum tool can be used to generate ideas to improve the EU School Fruit and Vegetable Scheme. The University of Oslo’s Sondre Haugsbø Herstad explains.

According to a old proverb from the late 19th century, 'an apple a day keeps the doctor away'.

Though the saying should not be interpreted literally - as there is no single food that can prevent all health problems - it serves as a reminder that fruit and vegetables, such as apples, are an important part of a balanced and healthy diet. Fruit and vegetables are a key source of essential nutrients, such as minerals and vitamins, which play a vital role for proper growth and optimal biological function in youth.1

The importance of fruit and vegetables is recognized by health authorities worldwide, and most countries in the EU region recommend a daily intake between 5-7 servings.2 However, few children consume the recommended amounts, and less than half of European children and youth eat fruit and vegetables daily3. This becomes evidently more concerning as food preferences and eating habits established in childhood tend to follow into adulthood,4 underlining the critical importance of fostering healthier eating habits from an early age.

To combat this problem, the EU School fruit, vegetables, and milk scheme supports the distribution of fruit, vegetables, and milk products to school-aged children, with the aim to increase the consumption of healthy and sustainable diets5,6. In 2022, they reached more than 17 million children across the EU region7. Although children and youth are often the target group for preventive initiatives to improve healthy behaviours, their active participation in shaping, implementing, and assessing such initiatives have remained minimal.8,9

CO-CREATE Dialogue Forum Tool

Recognizing the need to involve youth voices in their ongoing evaluation, the EU scheme coordinators approached the CO-CREATE project with a task to collect the views of younger children on the scheme, using the CO-CREATE Dialogue Forum tool.

At the heart of CO-CREATE, an EU Horizon 2020 funded project, lies a core principle of youth involvement and active participation10,11.

The Dialogue Forum tool encompasses a five-step process where participants discuss an idea or policy and collaborate on actions. More specifically, the Dialogue Forum encourages the participants to share their own perspective and reflect on 'what they care about', identify 'obstacles, 'opportunities', 'aspects to consider', and 'actions needed to be taken' with regards to an idea.12

With the idea to 'make the EU school fruit, vegetables, and milk scheme a social event', two Dialogue Forums with pupils aged between 10-12 years old were conducted in three countries – Ireland, Norway*, and Romania. Inspiringly, our young discussants were able to recognize factors that could influence the effect of the scheme both at the individual and societal level. At the individual level, they recognized that fruit and vegetables could be beneficial for their health and school performance.

At the societal level, they highlighted the importance of sustainability, the concern for food waste, as well as the need for local produce to reduce the impact on the environment. Although the CO-CREATE Dialogue Forum tool was initially developed to facilitate policy discussion between older adolescents (16-18 years old), stakeholders, and business representatives12, our experience with the young adolescents was that they enjoyed and were able to follow the structured dialogue, and in the end they felt they had a broader understanding, and some expressed that they were ready to take action.

*Norway is not part of the EU School Fruit, Vegetable, and Milk Scheme, but have a national school milk and school fruit scheme.

In closing, the Dialogue Forum tool was able to plant seeds, which could contribute to better implementation, higher uptake and better effect of the EU School Fruit and Vegetable Scheme. However, this would require tending to the continued growth of the local and national engagement of youth in the implementation of this and similar policy initiatives.

This blog was written by Sondre Haugsbø Herstad.

  1. FAO. Fruit and vegetables – your dietary essentials. The International Year of Fruits and Vegetables, 2021, background paper. FAO: Rome. 2020.
  2. EU Commission. Food-Based Dietary Guidelines in Europe - table 3. EU Commusion. Accessed 21.08, 2023.
  3. Zolfaghari M, Meshkovska B, Banik A, et al. Applying a systems perspective to understand the mechanisms of the European School Fruit and Vegetable Scheme. Eur J Public Health. 2022;32(Supplement_4):iv107-iv113. doi:10.1093/eurpub/ckac054
  4. Bere E, te Velde SJ, Småstuen MC, Twisk J, Klepp K-I. One year of free school fruit in Norway–7 years of follow-up. Int J Behav Nutr Phys Act. 2015;12(1):1-7.
  5. EU Commision. School scheme explained. EU Commission. Accessed 21.08, 2023.
  6. EuroHealthNet. EuroHealthNet responds to the EU school fruit, vegetables and milk scheme. 2022. Accessed 21.08, 2023.
  7. EU Commission. School scheme data portal. EU Commission. Accessed 21.08, 2023.
  8. Larsson I, Staland-Nyman C, Svedberg P, Nygren JM, Carlsson I-M. Children and young people’s participation in developing interventions in health and well-being: a scoping review. BMC health services research. 2018;18(1):1-20.
  9. Frerichs L, Ataga O, Corbie-Smith G, Tessler Lindau S. Child and youth participatory interventions for addressing lifestyle-related childhood obesity: a systematic review. Obes Rev. Dec 2016;17(12):1276-1286. doi:10.1111/obr.12468
  10. Klepp K-I, Helleve A, Brinsden H, et al. Overweight and obesity prevention for and with adolescents: The “Confronting obesity: Co-creating policy with youth” (CO-CREATE) project. Obes Rev. 2023;24(S1):e13540. doi:
  11. Bröer C, Ayuandini S, Baillergeau E, et al. Recruiting and engaging adolescents in creating overweight and obesity prevention policies: the CO-CREATE project. Obes Rev. 2023; 24(S1):e13546. doi:10.1111/obr.13546
  12. World Obesity Federation. CO-CREATE Dialogue Forum Tool. World Obesity Federation. 2022. Accessed 21.08, 2022.


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