Fluent Essays

PIO- Among adults, how does household income impact fruit and vegetable intake? A concise and effective synthesis will be the building steps to highlight the need for your study. During the synthesis, also look to take note of what is already known and what needs further investigation, what the current trends are and/or any gaps in the literature, as this can inform your study’s methodology to add to the body of literature and nicely leads into the last sections. This may be more like 4-5 paragraphs, with each paragraph highlighting different themes/concepts across the studies.   Remember that you will not summarize the studies included in the narrative, as these are succinctly outlined in table form. You will instead weave the components of each study into a picture so that the reader can see what is known, what is unknown and how your study will add to the knowledge to/provide further insight into that area. Table1. Summative Table of Studies Assessing Changes in Fruit and Vegetable Intake Among Different Income Levels. Author, Year, Design, Class, Study Purpose Population Interventions Results Conclusions Strengths/ Limitations Horino M, Liu SY, Lee EY, Kawachi I, Pabayo R 2020 Cross-Sectional Study Class D The focus of this research is to see if there's a link between adult fruit and vegetable consumption and income inequalities in the United States. N= respondents residing in the 50 states and the District of Columbia aged above 18 years. (n = 270,612) The six-item fruit and vegetable frequency questionnaire were used to assess fruit and vegetable consumption. women were more likely to consume fruits and vegetables 5 times daily, fruits 2 times daily, vegetables 3 times of daily. Sd: (OR = 1.07, 95% CI = 1.03, 1.11) among women, sd for vegetables (OR = 0.93; 0.87–0.99), fruits (OR = 0.95; 95% CI, 0.92–0.99) This is one of the first empirical studies to indicate a link between income inequality and fruit and vegetable consumption among adults in the United States. When women live in a state with significant wealth inequality, their health is more likely to suffer. Strengths: Large sample size and sample area Use of standard deviation analysis Limitations Possible source of errors from huge sample size Herran OF, Patiño GA, Gamboa EM 2019 Cross-Sectional Study Class D The goal of this study was to determine inequalities in fruit and vegetable consumption. adults aged 18 to 64 (n = 5,217) and geo-demographic units (n = 33) location: Columbia The consumption of fruits and vegetables was estimated with a food frequency questionnaire administered as part of the 2010 Colombian National Nutrition Survey (ENSIN). Inequality indices for the consumption of whole fruits and fruit juice and for raw and cooked vegetables were estimated using data on wealth, food security, geographical area and monetary poverty  consumption of cooked vegetables was 64.8% (95%CI: 59.2-70.4) among men and of fruit juice was 86.1% (95%CI: 82.4-89.8) among women. The Colombian populace does not consume the recommended amounts of fruit and vegetable. Fruit juice is preferred by both men and women over entire fruits. Men are clearly at a disadvantage when it comes to vegetable eating. Poor people consume fewer fruits and vegetables. Strengths: Large sample size, age distribution and geographical coverage. Limitations: Possible errors from the questionnaire method. Affret A, Severi G, Dow C, et al 2018 Prospective Cohort study Class B Factors linked to an increase in fruit and vegetable consumption on a socioeconomic level N= 98,995 (n= 58 193 women with information on diet) Location: France Analysis of F and V consumption in: 1) Women with Large family Women with partners Larger household vegetable consumption (OR=1·33; 95 % CI 1·24, 1·42). Living with a partner vegetable consumption (OR=1·07; 95 % CI 1·02, 1·13)  Individuals with higher socioeconomic status were more likely to increase their consumption of fruits and vegetables. As a result, effective health interventions for socioeconomically disadvantaged individuals are critical. Strengths: Large sample size, use of standard deviation Limitations: Gender bias study Dijkstra SC, Neter JE, Brouwer IA, et al 2018 Longitudinal Globe Study Class C As data was collected over a period. To study the socioeconomic factors that influenced changes in fruit and vegetable consumption between 2004 and 2011. N = 2978 Dutch adults aged 25-75 years Location: Netharlands A self-reported questionnaire in 2004 and 2011, including questions on fruit and vegetable intake (frequency per week), indicators of socio-economic position (education, income) and perceived financial barriers (fruits/vegetables are expensive, financial distress). Associations were analyzed using ordinal logistic regression lowest income in 2004 were more likely to report a decrease in intake of cooked vegetables (P-trend<0·001) and raw vegetables (P-trend<0·001) between 2004 and 2011 lowest education level in 2004 were more likely to report a decrease in intake of fruits (P-trend=0·021), cooked vegetables (P-trend=0·033), raw vegetables (P-trend<0·001) and fruit juice (P-trend=0·027) Between 2004 and 2011, there was a widening of relative wealth and educational inequalities in fruit and vegetable consumption. Strengths: Large sample size, use of z-tests and t-tests Limitations: Use of self-reported questionnaire that cannot be fully relied upon. Menezes MC, Diez Roux AV, Souza Lopes AC 2018 Cross-Sectional study Class D Evaluate the impact of the food environment and self-efficacy views on the consumption of fruits and vegetables (FV). N= 3414 aged above 21 years Location: brazil A survey was used to assess participants' perceptions of the food environment, and they were questioned how confident they were that FV will be available in their area. self-efficacy in addition to FV consumption were higher in older participants and those with higher incomes and educational levels (p = 0.062) and (p < 0.001) Individuals' self-efficacy for improving FV intake was more relevant to increased consumption than perceptions of food surroundings among participants from poor socioeconomic backgrounds. Strengths: Large sample size Cross-sectional study analysis Limitations: Use of survey method could skip out potential participants * Results reported are those related to the research question; Class D studies are the lowest in the Academy of Nutrition and Dietetics’ Evidence Analysis Manual’s classification if hierarchy based on study design.18 Abbreviations- FV- fruit vegetable, sd-standard deviation , OR-odd ratio References 1. Horino M, Liu SY, Lee EY, Kawachi I, Pabayo R. State-level income inequality and the odds for meeting fruit and vegetable recommendations among US adults. PLoS One. 2020;15(9):e0238577. Published 2020 Sep 9. doi:10.1371/journal.pone.0238577 2. Herran OF, Patiño GA, Gamboa EM. Socioeconomic inequalities in the consumption of fruits and vegetables: Colombian National Nutrition Survey, 2010. Cad Saude Publica. 2019;35(2):e00031418. Published 2019 Mar 14. doi:10.1590/0102-311X0003141 3. Affret A, Severi G, Dow C, et al. Socio-economic factors associated with an increase in fruit and vegetable consumption: a 12-year study in women from the E3N-EPIC study. Public Health Nutr. 2018;21(4):740-755. doi:10.1017/S1368980017003196 4. Dijkstra SC, Neter JE, Brouwer IA, et al. Socio-economic differences in the change of fruit and vegetable intakes among Dutch adults between 2004 and 2011: the GLOBE study. Public Health Nutr. 2018;21(9):1704-1716. doi:10.1017/S1368980017004219  5. Menezes MC, Diez Roux AV, Souza Lopes AC. Fruit and vegetable intake: Influence of perceived food environment and self-efficacy. Appetite. 2018;127:249-256. doi:10.1016/j.appet.2018.05.011 Example of a Ven Diagram using animals Whales FishShrimp 7 6 5 1. Shrimp a. Have legs 2. Whales a. Breathe air b. Live birth 3. Fish a. Have scales 4. Shrimp & Wales a. Nothing unique to just the two 5. Fish & Whales a. Have fins b. Have a backbone 6. Fish & Shrimp a. Breathe underwater b. Lay eggs 7. Fish, Shrimp & Wales a. Live in the water b. Can swim 1 2 , S hr i m p Fi sh , S hr i m p 3 , S hr i m p Fi sh , S hr 4 , S hr i m p Fi sh , S hr i m p Example of a Ven Diagram using animals Summary of the above diagram: Whales are animals that live in the water, breathe air, have a live birth, can swim, have fins and a backbone. Fish are animals that live in the water, breathe underwater, lay eggs, can swim, have fins, scales and a backbone. Shrimp are animals that live in water, breathe underwater, lay eggs, can swim and have legs. Synthesis of the above diagram: When evaluating these 3 animals, all live in the water and can swim, yet there are differences among the animals. Whales and fish both have fins and a backbone, whereas shrimp do not. Two of the 3 animals are able to lay eggs (shrimp and fish) whereas whales have a live birth. Whales also have the unique ability to breath air, whereas both fish and shrimp can breathe underwater. There are no similarities between shrimp and whales. Lastly, 2 of the 3 animals have characteristics unique to themselves: fish have scales while shrimp have legs. Hopefully you can see the summary is simply a list of characteristics of each animal, whereas the synthesis is making direct comparisons of the animals to one another. This helps to highlight the similarities and differences among the animals, which helps to develop a better sense of how these animals cam compare to one another. The goal here is to then see how each of these animals can be substituted for different studies. The goal would then be to synthesize the studies reviewed, in this case 3, highlighting the similarities and differences across studies. For example, using the PIO or PICO question, start by seeing how each of the PICO/PIO components are similar and different [ie mean age of the population, any differences in intervention (dose or duration), and the outcome (hopefully that is consistently measured, but it’s important to identify if it’s not].