5 Fruit and Vegetables a day

Introduction
This essay explores public health promotions regarding wellbeing issues. The topic focused in on is diet, obesity and exercise. This is one of the five key areas of public health promotion in the United Kingdom (UK). This topic was chosen after completing a lifestyle self-analysis which showed that eating fruit and vegetables was one of the weaker aspects of the author’s healthy lifestyle. This essay will specifically investigate healthy eating by consuming more fruit and vegetables. It will do this by researching 5 different types of articles and analysing whether health promotion interventions have a positive impact on helping people to change their diet.

Main essay
This essay focuses on the general population and the effect of health promotional interventions on the consumption of fruit and vegetables. This subject was determined by the author as an area of improvement for people that is easy to change and be very beneficial. Improved knowledge on the subject is needed because although it is positively presented, eating 5 fruit and vegetables a day as recommended by the UK government REF is sometimes challenging for various reasons. The reason that each of the five articles used for this essay was chosen is because they are all focused on eating more fruit and vegetables and are all linked to health interventions.

The strategy adopted while conducting the search for information on this subject was to input very specific information into the NELSON search engine. NELSON was used because it has a wide variety of academic journals all in one place that can be easily accessed to provide both a quantitative and qualitative piece of research. The information inputted had to be specific in order to find the correct articles needed. This was learnt when the search input criteria began as ‘fruit and vegetables’ producing 101,219 results. Subsequently, more exact wording for each subject article was chosen such as ‘eat more fruit and vegetables qualitative article’ which yielded 21 results. The resulting articles were systematically reviewed and the qualitative article chosen for this essay was found to be most relevant to the chosen subject and the best to be used for this assignment.

These reviews were rationalised by relevance, suitability and interest based on subject, audience, publisher and content. The method used in the retrieval of the You-Tube clip and poster was different because these are aimed at the general public. The search engine on Google images was used to view and identify a pertinent poster and the You-Tube search engine was used to identify the social media clip. Again the search had to be specific for both of these, so the wording ‘5 fruit and vegetables a day campaign’ was used to acquire the You-Tube clip. Even with this specific wording 1780 results did arise but the clip used for this essay was only eighth down the list. The opinion article was found using google web search and by examining website links that were suggested then reviewing those links.

After synthesising all the 5 articles chosen and critically analysing them collectively as one piece, the author has learnt that targeted health interventions can be successful. All the articles are based on the supposition that eating more fruit and vegetables makes your body healthier, but that most people do not eat enough. The World Health Organisation (2002, p.118) report that increased fruit and vegetable consumption does reduce the risk of many diseases, and certain cancers such as gastric, oesophageal and colorectal cancers. Eating five portions of fruit and vegetables or more every day can reduce cancer and heart disease and decrease the number of deaths from certain diseases by an estimate of 20% (Department of health, 2000, p.113). The main thread that connects all the articles is that of making fruit and vegetable consumption easier.

The articles are either health interventions themselves like the poster and You-Tube clip. Research into health initiatives like the qualitative and quantitative pieces, or information about the United Kingdom guidelines that form the health initiatives like the opinion based article. They all look at health interventions in a positive light and believe that they are successful. Thomson and Ravia also suggest that interventions do increase fruit and vegetable intake in most studies undertaken (2011). Improvements that could help increase fruit and vegetable consumption include giving information on products that are less expensive (NHS Choices, 2010), making people aware of different types of fruit and vegetables and the portion sizes (World Cancer Research Fund, 2013), helping people to have a flexible food plan (Jeyanthi and Ziebland, 2004), trying to eat a combination of both fruit and vegetables not just one type (Roberts, 2011) and helping people to change more than just one meal in the day to make a bigger impact (Hughes et al., 2012 ).

The role of a nurse in the promotion of eating more fruit and vegetables is to motivate people through education. Many hospital nurses view health promotions as informal media campaigns that give generalised health advice, whereas health education is seen as a more formal process with desired outcomes specific to each individual patient developing from empowered health interventions (Piper, 2008). Health education and promotion is a vital part of a nurses job role and most nurses help each patient individually rather than focusing on the health promotion of the hospital as a whole (Whitehead, 2005). Nurses can practice change themselves to become role models by eating more fruit and vegetables as they understand the health benefits of doing this. Nurses can help their patients to practice change by educating them and enabling them to make an informed self-intervention decision to change their diet. Information leaflets can be given to patients and referrals made to dieticians or support groups to help people in their choice of healthy eating.

Conclusion
To summarise this assignment, five different types of articles were obtained to use in this research essay to further the authors learning. They were found through both an online library search and the popular web search engine google, using precise search criteria. This research was then analysed and has been perceived to demonstrate that health interventions can be used to increase the fruit and vegetable consumption of the general public, therefor having a positive impact on changing their diet. The author has learnt a variety of ways to help people increase their fruit and vegetable consumption and realised that education is vital part of a nurse’s job role.

References

Department of health (2000) The NHS plan-A plan for investment, A plan for reform. Norwich:HMSO Hughes, R., Edwards, K., Clarke, G., Evans, C., Cade, J., Ransley, J. (2012) Childhood consumption of fruit and vegetables across England: a study of 2306 6-7 year olds in 2007, British Journal of Nutrition, 108, p733-742. Jeyanthi, J., Ziebland, S. (2004) Reported barriers to eating more fruit and vegetables before and after participation in a randomized controlled trial: a qualitative study, Health Education Research, 19(2), p.165-174. NHS Choices (2010) 5 A DAY: natural history in the supermarket. YouTube [online]. Available from: http://www.youtube.com/watch?v=Sl_oN-0hI4s [Accessed 9th February 2015] Piper, S. (2008) A qualitative study exploring the relationship between nursing and health promotion language, theory and practice, Nurse Education Today, 28, p.186-193 Roberts, S. (2011) Does it really matter if your 5-a-day is all fruit or all vegetables?, Mostly Eating [online]. Available from: http://www.mostlyeating.com/does-it-really-matter-if-your-5-a-day-is-all-fruit-or-all-vegetables [Accessed 9th February 2015] Thomson, C., Ravia, J. (2011) A systematic review of behavioral interventions to promote intake of fruit and vegetables, Journal of the American Diettetic Association, 111(10), p.1523-1535. Whitehead, D. (2005) Health Promoting Hospitals: the roel and function of nursing, Journal of Clincal Nursing, 14(1), P.20-27. World Cancer Research Fund (2013) What counts as a 5 a day portion?. WCRF [online]. Available from: http://docs.wcrf.org/pdfs/5-a-day-portion-poster-Jun2013.pdf [Accessed 19th February 2015] World Health Organisation (2002) The world health report 2002-reducing risks, promoting healthy life. Geneva:WHO

Appendices

Social media

NHS Choices (2010) 5 A DAY: natural history in the supermarket. YouTube
[online]. Available from: http://www.youtube.com/watch?v=Sl_oN-0hI4s [Accessed 9th February 2015]

This social media item has been chosen because it is located on YouTube with intended easy access for the general public. It was uploaded by NHS Choices 4.5 years ago in 2010. The NHS Choices website is directed at the general public and aims to put people in charge of their own health care, promoting healthy living.

The social media item is a short video about eating 5 fruit and vegetables a day. The YouTube clip is aimed at parents. It is titled ‘5 a day: natural history in the supermarket’. It recognises that children will have favourite types of fruit and offers the public information on how to buy less expensive options. It mentions how parents can disguise vegetables within food, in order to make healthy dinners, without their children necessarily knowing. It also reinforces that fathers can help to find healthy foods as well, rather than it just being the role of the mother.

In summary, the social media item is promoting the consumption of more fruit and vegetables. At the end of the clip a website link is provided where tips can be found for eating more fruit and vegetables.

Poster
World Cancer Research Fund (2013) What counts as a 5 a day portion?. WCRF [online]. Available from: http://docs.wcrf.org/pdfs/5-a-day-portion-poster-Jun2013.pdf [Accessed 19th February 2015]

This poster has been chosen because it is informative and easy to read. It was published by the World Cancer Research Fund as a visual aid to the guidelines for a good diet. The World Cancer Research Fund website is aimed at organisations and the general public and provides cancer prevention advice.

The poster educates people as to the size of a 5 a day portion of fruit or vegetables. The poster itself is aimed at the general public. It is titled ‘Eat well – What counts as a 5 a day portion?’. It encourages people to make sure they eat 5 fruit and vegetables a day and shows how big the approximate portion size needs to be for an adult. The poster states that fruit and vegetables are the building blocks of a healthy diet, and displays pictures of many different varieties of fruit and vegetables that can be consumed. The poster is used as an aid to enhance understanding of cancer prevention guidelines.

In summary the poster is promoting the consumption of more fruit and vegetables, and is educating the general public on fruit and vegetable portion sizes.

Opinion based
Roberts, S. (2011) Does it really matter if your 5-a-day is all fruit or all vegetables?, Mostly Eating [online]. Available from: http://www.mostlyeating.com/does-it-really-matter-if-your-5-a-day-is-all-fruit-or-all-vegetables [Accessed 9th February 2015]

This article has been chosen because it illustrates one ladies opinion of the 5 a day guidelines recommended in the United Kingdom. She describes how the guidelines are not as structured or descriptive in the UK, as they are in some other countries. It was published on a healthy eating website in 2011 and is aimed at the general public to help people stay healthy.

This article describes how the guidelines do not include a ratio of how many portions of fruit should be eaten compared to portions of vegetables. Her opinion is that the ratio does not matter as long as you eat 5 portions because most people do not. Although she does encourage people to try and eat both fruit and vegetables. She states that limiting your choice to only one group of these can have an effect on your eating habits, by distorting meal proportions and stopping healthy snacking. She provides tips on how to refine your eating and enjoy both fruit and vegetables.

In summary the opinion based article reassures people that eating 5 portions from one group is better than not eating 5 of either, but that it is best to enjoy a combination of both to achieve your 5 a day.

Qualitative
Jeyanthi, J., Ziebland, S. (2004) Reported barriers to eating more fruit and vegetables before and after participation in a randomized controlled trial: a qualitative study, Health Education Research, 19(2), p.165-174.

This article was chosen because it provides information on a qualitative study into the barriers affecting the consumption of fruit and vegetables. It was published by the Oxford University Press in 2004 and is aimed at researchers, scholars and educators.

The study describes and compares barriers that are experienced by people both before and after a trial into a nurse led health intervention to increase fruit and vegetable consumption. It states that one of the most unchangeable barriers is the high cost and the lack of access to fruit and vegetables. Women participating in the study also disclosed that their male partners and children can hinder their attempts at introducing fruit and vegetables. The report declares that the intervention increased fruit and vegetable consumption, although additional barriers were discovered as the participants effectuated the changes in their diet. The study finds that flexible action plans can help people to adapt and maintain their new routines when unanticipated barriers arise.

In summary, the qualitative study reveals the barriers that are encountered when increasing fruit and vegetable consumption but also concludes that health interventions are successful.

Quantitative
Hughes, R., Edwards, K., Clarke, G., Evans, C., Cade, J., Ransley, J. (2012) Childhood consumption of fruit and vegetables across England: a study of 2306 6-7 year olds in 2007, British Journal of Nutrition, 108, p733-742.

This article has been chosen because it provides a quantitative study into the Government’s School Fruit and Vegetable Scheme. It was published in the British Journal of Nutrition in 2012. The British Journal of Nutrition distributes knowledge about nutrition.

The study that this article represents, reports that children are being enabled and encouraged to consume more fruit and vegetables due to the Schools Fruit and Vegetables Scheme (SVFS). The article is aimed at academics and professionals. It is titled ‘Childhood consumption of fruit and vegetables across England: a study of 2306 6-7-year-olds in 2007’. It states that the SFVS does increase the consumption of fruit and vegetables in children but does not eliminate the socio-economic differences between areas. Also a greater impact could be made if more meals were targeted. The report finds that children in deprived areas eat less fruit and vegetables. The article asserts that there is a lot of evidence stating that a good diet has benefits but that many people do not eat enough fruit and vegetables.

In summary, the quantitative study reveals that many children do not eat 5 fruit and vegetables per day and the SFVS helps raise consumption but that more meals could be targeted.