|3 examples of eating disorders - most common||Anorexia, Bulaemia, Binge eating|
|UK stats for eating disorders||1.6 million in UK affected - 11% men 89% female (9/10). 14-15 most affected. 1/100 people aged 15-30 suffer from anorexia. 50% disorder not otherwise specified. 10% anorexic, 40% bulaemic.|
|UK statistics paper BMJ||BMJ. The incidence of eating disorders in the UK in 2000–2009: findings from the General Practice Research Database. based on 5% of population (about 3 million)|
|Results of paper on the incidence of eating disorders||-A total of 9072 patients with a first-time diagnosis of an ED were identified. -The age-standardised annual incidence rate of all diagnosed ED for ages 10–49 increased from 32.3 (95% CI 31.7 to 32.9) to 37.2 (95% CI 36.6 to 37.9) per 100 000 between 2000 and 2009. -The incidence of anorexia and bulaemia was stable; however, the incidence of EDNOS increased. -The incidence of the diagnosed ED was highest for girls aged 15–19 and for boys aged 10–14.|
|Incidence of all eating disorders for age 15-19||164.5 for girls but 17.4 for boys.|
|EDNOS||eating disorder not otherwise specified|
|Summary of paper||-the incidence of diagnosed ED significantly increased between 2009 and 2000. -The incidence of AN and BN has remained stable however, the incidence of EDNOS increased. -At peak age of diagnosis (15–19 years), 2 girls/1000 are likely to be newly diagnosed with an ED in the UK. -this suggests that ED may be the most common new onset mental health disorder in adolescent girls after depression.|
|Anorexia - what is it||may see themselves as overweight, even when they are dangerously underweight. typically weigh themselves repeatedly, severely restrict the amount of food they eat, and eat very small quantities of only certain foods. Anorexia nervosa has the highest mortality rate of any mental disorder. Suicide more common in women with anorexia than other mental disorders.|
|Symptoms of anorexia||-Extremely restricted eating -Extreme thinness (emaciation) -A relentless pursuit of thinness andunwillingness to maintain a normal or healthy weight -Intense fear of gaining weight -Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight (other symptoms on page 34)|
|Bulimia nervosa- what is it||have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behaviour that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviours. Unlike anorexia nervosa, people with bulimia nervosa usually maintain what is considered a healthy or relatively normal weight.|
|Symptoms of bulimia||-Chronically inflamed and sore throat -Swollen salivary glands in the neck and jaw area -Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid -Acid reflux disorder and other gastrointestinal problems -Intestinal distress and irritation from laxative abuse -Severe dehydration from purging of fluids -Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and other minerals) which can lead to stroke or heart attack|
|What us binge-eating||lose control over his or her eating. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.|
|Symptoms of binge eating||-Eating unusually large amounts of food in a specific amount of time -Eating even when you're full or not hungry -Eating fast during binge episodes -Eating until you're uncomfortably full -Eating alone or in secret to avoid embarrassment -Feeling distressed, ashamed, or guilty about your eating -Frequently dieting, possibly without weight loss|
|The concept of balance in nutrition||The supply of nutrients is equal to the requirement of the body for those nutrients (pg 4)|
|Dietary Reference Value (DRV)||A general term which covers all the figures of EAR, RNI & LRNI.|
|Estimated average requirements (EAR)||The estimated average requirement (mean) of a group for a particular nutrient or for energy.|
|Reference Nutrient Intake (RNI)||The amount of a nutrient (mean + 2SD) which is sufficient for almost all individuals (97.5%). It exceeds the requirement of most people. Habitual intakes > RNI are almost certain to be adequate.|
|Lower Reference Nutrient Intake (LRNI)||The amount of a nutrient (mean – 2SD) which is sufficient for only a few individuals (2.5%). Habitual intakes < LRNI will almost certainly be inadequate.|
|key facts from WHO||OW/Ob= 4xunderweight|
45% deaths among children under 5 is linked to undernutrition- mainly in LMICs in which rates of childhood overweight ad obesity are rising.
Global burden of malnutrition are serious and lasting.
|What is malnutrition (undernutriton)||is the state where the level of nutrient supply has declined to the point of deficiency and normal physiological function can no longer be maintained|
|What does FTT mean||failure to thrive|
|UNICEF conceptual model of the causation of undernutrition||BASIC CAUSES (potential resources -> Economy -> Political and ideological system -> Resources and control)|
Leads to inadequate education
Leads to UNDERLYING CAUSES (inadequate access to food, inadequate care for mothers and children, inadequate health services and unhealthy environments) leads to IMMEDIATE CAUSES (inadequate dietary intake <-> disease) leads to manifestations UNDERNUTRITION which leads to consequences of undernutrition (disease, disability, and death).
|causes of undernutrition||•Babies and young children lose weight when ill and do not recover weight afterwards.|
•Babies are bottle-fed. Milk powder incorrectly mixed or mixed with unsafe water leading to low weight or diarrhoea.
•Families do not know what food to give babies and young children especially when the baby is moving from breast milk to food.
•Families do not have enough food to give the children.
•Not enough of the money available to the family is used for good food.
•Girls are not given enough to eat as people think they don’t need so much food.
•Young children have small stomachs but they are given too much bulky food so their diet is not balanced.
•There is enough food but not enough variety especially food that makes you grow.
•Families are not interested in giving good food.
•Family members (including children) may not know how to prepare balanced meals.
|Establishing nutritional status; direct methods||individual using objective criteria. methods; Anthropometric, biochemical (laboratory), clinical, dietary evaluation|
|Establishing nutritional status; indirect methods||community level measuring influences. methods; Ecological (crop production), economic (per capita income, expenditure on food), Health (IMR, U5MR)|
|in the field which measure are used||need instruments which are appropriate for the filed, appropriate technologies, (-Level of complexity and ease of use -Precision (numeracy) -Accuracy and Reliability) normally a lack of numeracy so colour scales could be used, precision isn't the main aim just needs to be 'good enough'|
|what are AWC's||started by the Indian government in 1975 as part of the Integrated Child Development Services program to combat child hunger and malnutrition. Anganwadi means "courtyard shelter" in Indian languages. A typical Anganwadi centre provides basic health care in Indian villages.|
|underweight||low weight-for-age (thinness)|
|stunting||low height-for-age. chronic undernutrition|
|Anthropometric cut offs (Z scores or SD) Normal =||>1|
|Mild||<-1 to -2|
|moderate||<-2 to -3|