Quality of life and self-rated health in relation to changes in fruit and vegetable intake and in plasma vitamins C and

E in a randomised trial of behavioural and nutritional education counselling

Andrew Steptoe, Linda Perkins-Porras, Sean Hilton, Elizabeth Rink and Francesco P. Cappuccio

Satriani P1803209511

Page 1

ABSTRACT

Page 2

Background : We have carried out a randomised trial comparing brief behavioural counselling with nutritional education counselling to increase fruit and vegetable consumption and associated biomarkers in adults from a low-income neighbourhood Objective : to assess the impact of interventions on quality of life and health status, and associations between changes in fruit and vegetable consumption, plasma vitamins C and E, and quality of life Design : Behavioural counselling and nutritional education counselling were carried out in 271 adults in two 15 min sessions in a primary-care setting. Physical and mental health status (medical outcome study short form 36) and selfrated health were assessed at baseline, 8 weeks and 12 months, and analysed on an intention-to-treat basis
Page 3

Results : Both groups reported increased fruit and vegetable consumption; plasma vitamin E and bcarotene also increased, with significantly greater changes in consumption and plasma b-carotene in the behavioural counselling condition. Physical and mental health status, and the proportion of participants in good self-rated health, increased in both groups to a similar extent. Individual differences in improvements in physical health status and selfrated health were correlated with increases in fruit and vegetable intake and in plasma vitamins C and E, independently of age, gender, ethnicity, financial status, smoking, BMI and use of vitamin supplements
Page 4

Conclusions : That participation in the present study was associated with improved health-related quality of life. Increases in fruit and vegetable intake and plasma vitamin levels may stimulate beneficial changes in physical health status in socio-economically deprived adults

Page 5

INTRODUCTION

Page 6

Background

Page 7

Rational
There were fears 10 years ago that cholesterol-lowering through fat reduction might induce depressive mood although subsequent trials allayed these concerns Changes in digestive symptoms that could adversely affect quality of life have been reported with increased fruit and vegetable intake

Objective
To evaluate the effects of participation in behavioural or nutritional education counselling for increasing fruit and vegetable intake on health-related quality of life and self-rated health To test whether changes in reported fruit and vegetable intake and in biomarkers over 8 weeks and 12 months were associated with health status assessed using the medical outcome study short form 36 (SF-36) and measures of self-rated health.
Page 8

METHODS

Page 9

Participants
Men and women (n 271) aged 1870 years

Total of 459 patients expressed interest in the study

188 were excluded

Page 10

Study design Research nurses

Recruitment
group randomised trial

Asessments
fruit and vegetable intake, plasma measures of b-carotene, Vitamin E (atocopherol) and vitamin C (ascorbic acid)

Interventions
in two 15 min individual counselling sessions carried out at a 2-week interval

Page 11

Counselling methods

The behavioural counselling included abbreviated nutritional

Readiness to change, dietary knowledge and perceived barriers were assesed

Emphasised attitude change

To change focused on specific behavioural goals and the practical implementation of change

Page 12

Measures

Fruit and vegetable consumption with a two item frequency questionnaire Self-rated health With a single item : Health is excellent/very good/good/fair/poor

Quality of life Using the SF-36 health status

Non-fasting venous samples Plasma vitamin C, vitamin E, -carotene

Page 13

Procedure

At the assesment session fruit and vegetable intake Information was was recorded, obstained by blood samples questionnaire were drawn and antropometric measures and a The patients medical history who agreed were obtained to take part in the study

Measures of fruit and vegetable intake, biomarkers and quality of live were repeated 8 weeks after the baseline and then after 12 months

Page 14

Statistical analysis

The behaviuoral and educational counselling group at baseline Assosiation between predictors and physical and mental health status summary

ANOVA and test

Multiple regressions

Changes in self-rated health logistic regression,and odds ratios with 95% CI are presented

Page 15

RESULT

Page 16

Page 17

Page 18

Page 19

DISCUSSION

Page 20

The present study was carried out in a primary-care centre in a lowincome neighbourhood Physical health status, mental health status and self-rated health all improved over the course of the study One explanation for the greater effects in the present study is that participants began with relatively poor Both counselling conditions stimulated increases in reported fruit and vegetable consumption over the 12-month follow-up period, accompanied by increases in plasma vitamin E and b-carotene
Page 21

Limitation

The present study was limited to residents in an ethnically mixed, low-income urban area, and may not be applicable to rural populations in other parts of the world

Page 22

CONCLUSION

Page 23

Our present results suggest that longterm changes in fruit and vegetable intake and plasma vitamin E concentration may have beneficial effects on physical health status and self-rated health.

Page 24

KRITIK JURNAL

Page 25

Abstraksi
Judul penelitian maksimal 15 kata : tidak (23 kata) Nama para peneliti dicantumkan pada jurnal : ya Jumlah kata pada abstrak antara 250-300 kata : ya (266 kata) Latar belakang pada abstarksi terdiri dari 1 kalimat : ya Tujuan pada abstraksi terdiri dari 1 kalimat : ya Desain penelitian pada abstraksi dari 3 kalimat : ya Hasil penelitian pada abstarksi terdiri dari 1 paragraf atau 5-7 kalimat : tidak (hanya 3 kalimat) Kesimpulan pada abstraksi terdiri dari 1-2 kalimat : ya (2 kalimat)
Page 26

Pendahuluan
Pendahuluan terdiri dari 3-4 paragraf : ya (3 paragraf) Pendahuluan jelas alurnya (permasalahan umum,masalah kecil yang diteliti,mengapa perlu diteliti, penelitian-penelitian sebelumnya yang terkait) : ya

Page 27

Bahan dan Metode

Disebutkan lokasi penelitian : ya Disebutkan populasi dan sampel :ya Disebutkan jumlah sampel : ya Dijelaskan ukuran-ukuran penelitian yang dilakukan : ya Dijelaskan analisis statistik yang dilakukan : ya Disebutkan uji statistik yang di gunakan : ya Disebutkan program statistik yang digunakan : ya Dijelaskan kriteria inkulsi dan eksklusi : ya
Page 28

Hasil
Penyajian hasil penelitian dalam bentuk : Narasi : ya Tabel : ya Gambar : ya Penjelasan tabel atau gambar dalam narasi tidak terlalu detail atau panjang : ya Jumlah tabel dan gambar tidak melebihi 5 tabel : ya Penulisan tabel harus dibuat secara komprehensif : ya
Page 29

Diskusi dan Kesimpulan

Di jelaskan keterbatasan penelitian : ya Membandingkan hasil penelitian sebelumnya dengan hasil penelitian yang dilakukan : ya Ada kesimpulannya : ya

Page 30

THANK YOU

Page 31