The aim of this paper is to describe a proposal for a critical review of literature for a dissertation project to be undertaken in the final year of a nurprogramramme. A critical literature review is a method of summarizing and judging the report in a methodical way (Petticrew & Roberts, 2006). Initially an introduction, including background and justification for the chosen topic i.e. to analyze the extent to which eating five a day will have impact on the prevention of heart disease and cancer in the general population will be described. Secondly the additional steps that will be undertaken to complete the project will be considered including the methodology to be used. Consequently a discussion and conclusion will finalize the dissertation help proposal. The topic selected in this literature review will provide a wisdom in the health sector and will provide assistance in evaluating the benefits of eating five a day in respect to prevention against diseases.
The nature of the research assessment will be by performing in the form of a literature review; which is this is a summary of different articles on a topic and is a metthe appropriate evidencealuating appropriate evidence (Dunn, 2012). Two different types of literature review exist, a narrative that pays attention on qualitative assessment to the specific term or concept as opposed to a literature review which assesses a particular health care intervention (Dunn, 2012). In health care a literature review should be done in a systematic way, applying a comprehensive searching strategy with inclusion and exclusion criteria to be presented in the literature review (Petticrew and Roberts, 2006). In the present health and social care environment an abundant amount of information is available and it is the expectation of a health care professional to keep abreast of recent research in order to provide evidence based care. However, it would be very difficult to expect a person to be able to read every piece of research that is available, so the ability to be able to assimilate and evaluate literature is the key (Petticrew and Roberts, 2006).
The research question is will seek to investigate whether there really is a key influence on the inclusion of ‘five a day’ in the diet and whether it prevents heart disease and cancer. I would outline at this stage what ‘5 a day’ is referring to and its several benefits in regard to prevention of cancer and cardiovascular diseases. This is worth investigating this as a contemporary issue where diet and health; especially the five a day campaign, is an issue that is strongly advertised in government campaigns and the media. However there has also been strong contention in the media when it comes to exactly what constitutes the five a day we should include in our diet, whether five a day is enough and even if the nutritional quality of fruit and vegetables available has a beneficial effect on our health (Rolfes, Whiteney and Whitney, 2010).
Some areas of health in the United Kingdom in particular are declining with increased mortality rates especially for heart disease and cancer. One report has found that 1 in 3 deaths are due to cancer alone (Murray, Newton, Fenton, Fleming, 2013). Five a day means 5 different portions of fruit or vegetables a day dependent on the type and size of fruit or vegetables, one banana for instance would count as one portion and two satsumas would count as one(Department of Health, 2003).The department of health the 5 a day message in order to lower the risk of serious health problems such as cancer and heart disease, thus far however the campaign has had limited success (BBC, 2013).
Initially six articles were found ( see example literature search in appendix A ) the general themes of which arose were around the benefit of fruit and vegetables and the risk of cancer and cardiovascular disease, these articles have been summarized in a table ( see table in appendix B). A more extensive search to find relevant articles will be performed in the dissertation. Due to the nutritional and health benefits it is recommended that fruits and eating habits five a day should be included in the diet, with a minimum intake of five portions each day. Fruit and vegetables should be integrated into every meal as well as should be a first choice for a snack. Several studies on the population have shown that people who have included fruits and vegetables in their diet have a lower risk of chronic diseases such as cancer and cardiovascular (Department of Health, 2003).
The relevance of this question to practice lies in the fact that health promotion is an important part of a nursing role. The Royal College of Nursing state that nurses have a strong contribution to the role of public health (Royal College of Nursing, 2007). It is advised that a diet rich in fruit and vegetables should be recommended for people with cardiovascular health problems; such as the Mediterranean diet as endorsed by the Department of Health (Department of Health, 2010). It could be said the prevention of Illness is important to lessen not only the likelihood of the onset of many diseases but also to reduce the impact on the NHS financially and otherwise (NHS, 2013). The current UK government presently takes this view seriously with their Change 4 Life programs whereby they seek to change health behavior throughout the UK (NHS, 2013).
Increased awareness of the benefits of a healthy diet and regular exercise may bring substantial financial savings to NHS by reducing chronic and long term illness associated with poor nutrition (NHS, 2013). It is recognized that much of the long term health care provided in the UK is in respect of illness that could have been prevented from leading a healthy lifestyle (not smoking, reducing alcohol intake, reducing intake of red meat and processed foods, reducing cholesterol etc.) and as such diverts precious resources away from the illness outside of the control of the individual (NHS, 2013). The argument prevention is better than cure can be directly applied in this instance.
In relation to preventing many of the scientists have found that the anti-carcinogenic properties of diet are best for creating strong immunity. In one of the longest research studies it has been found that eating an additional of 200gm fruit and vegetables every day is equivalent to two servings and reduces the occurrence of cancer by 4%. This finding confirms about the pessimistic approach of developing a body of scientists over the last decade that the protective impact of fruits and veggies against cancer is very much limited (Rolfes, Whiteney and Whitney, 2010). It reflects a dramatic reversal of researchers found 20 years ago and a potential loss in risk of cancer was found.
The importance of fruit and vegetables are that they are full of fiber, vitamins and minerals. They are also said to contain antioxidants which can help many health issues such as lowering blood pressure (Dauchet, 2009). The 5 a day slogan was invented by the American Cancer Institute in 1991 (American Cancer Institute, 1991). Previous to this little was heard regarding the importance of 5 a day, since then though the term has become increasingly popular. Many supermarket chains and food manufacturers place the 5 a day logo on their food products to indicate how many fruit and veg are in a particular item of food as standard. The 5 a day concept was then adopted by the Department of Health in 2003 (Department of Health, 2003).
One of the best diet for prevention or fight against cancer is particularly plant based diet that includes a range of fruits and vegetables. A plant based diet here means eating foods which come from fruits, vegetables and grains. As these foods are less processed and are cooked less and mixed with other ingredients, the other benefit of plant based food is that it also aids in increasing the fiber intake. Fiber, is also known as cellulose is major part of plants i.e. grains, vegetables and fruits and plays a vital role in keeping the digestive system healthy and clean which can prevent the risk of cancer (Kuchinski, Flaws & Casanas, 2002).
According to a survey of the World Health organization Organization, a diet high in fruit and vegetables as part of the 5 a day campaign lowers the risk of serious health issues such as heart disease, cancer, strokes and obesity (Dunn, 2012). Conversely however the British Journal of Cancer haveit has been found that in order to beat cancer giving up a lifestyle habit such as smoking or alcohol is far more important than 5 a day (Key, 2010).
The rationale for choosing the subject area is that the five a day concept is a fairly recent phenomenon, in the past there have been several health campaigns that have been put forward by the government such as anti-smoking and alcohol reduction, but the five a day slogan has been taken on with increasing intensity. It is enthralling to find out if this popular concept has made an impact and furthermore if it really does make a difference to our health in preventing disease and serious illness.
The aim of the present research reporcenteredature review is centred around the research question: To what extent does eating five a day have an impact on the prevention of heart disease and cancer in the general population? This proposal outlines a number of objectives that are sought by undertaking the review which are as follows:
In order to formulate an answerable question the PICO method was used, this stands for Population/Problem, Intervention, Comparator and Outcome (Sackett, Richardson, Rosenburg & Haynes, 1997). By using this method one is able to break down a question into its component parts, in this case the P element was- the general public, I - Five a day, there was no comparator and the Outcome was Prevention of heart disease and cancer.
The research question was designed in a manner that could help in attaining the research aims and objectives by providing key words that focus the literature searching and the objective of the study. Key words that will be used will be five a day, impact, cancer and heart disease. In the research the exclusion criteria of respondents in the survey would be given to chronically ill individuals, children under the age of 15 years. On the other hand the inclusion criteria will be given to both male and female, English language, people from every class and high risk inhabitants. In order to derive a detailed information various secondary sources will be analyzed and response from diverse sources will be represented.
From the discussion above it could be stated from the proposal that it carries huge significance in the area of health benefits of including fruits and vegetables in the diet to reduce the chances of disease occurrence.
Research in this area will provide the benefits of eating five a day and how does including fibers in the diet with fruits and vegetables creates strong immunity against cancer causing factors and safeguards from heart diseases. As has been mentioned many deaths are still attributable to cancer and heart disease Therefore prevention is an important point and as a nurse one can provide advice not only eating 5 a day but on which particular fruit and vegetables are more beneficial. In conclusion this proposal sets out to provide a framework of current information to provide an informed, challenging and cohesive dissertation.
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