DIET RELATED DISORDERS Overnutrition Obesity Cardiovascular diseases Hypertension

DIET RELATED DISORDERS Over-nutrition � Obesity � Cardiovascular diseases � Hypertension � Diabetes mellitus (Type II Diabetes) Under-nutrition � Anaemia � Osteoporosis � Diverticular disease

COMMON DIET RELATED FACTORS High saturated fat intake High cholesterol Lack of dietary fibre High salt consumption Over indulgence of alcohol Insufficient water intake Incorrect energy balance Diet high in processed food Eating or not eating for reasons other than hunger Lack of key nutrients in diet Poor absorption of nutrients

COMMON LIFESTYLE RISK FACTORS Lack of exercise in relation to energy intake Smoking Stress Genetics Physiological status Age Socio-economic status

WHAT IS OBESITY? ‘Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health…’ (WHO 2012) ‘A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight. ’ (WHO 2012)

CAUSES Energy intake exceeds energy output Too much processed food Environmental Factors Obesity Genetics People eating for reasons other than hunger

SYMPTOMS Visibly overweight Inability to participate in prolonged exercise Tiredness Shortness of breath Obesity Sore joints

CONSEQUENCES Physical: � Decreased life expectancy due to increased risk of: Hypertension Diabetes Mellitus Some form of cancer (bowel and breast) Cardiovascular disease Arthritis Psychological and Social: Poor self image � Neglected/excluded from normal activities � � Cannot assume all obese problem are socially disadvantaged Economic: Clothing costs and styles � Job discrimination � Costly dietary foods, products and services �

TREATMENT Diets and Dieting � The more restrictive the diet the more chance of failure � Low carbohydrate, high protein and fat diets are expensive. �A Cause high water loss, high levels of ketones in the blood (ketosis), nausea and lethargy variety of food is key to a healthy weight Exercise � Increases BMR � Increased fitness = improved positive self-image = motivated to maintain � Increases energy expenditure

TREATMENT Behaviour Therapy � Analyses social and psychological behaviour factors � Avoid cues that trigger the desire to eat when not hungry � E. g. Eating at the movies. Popcorn makes you thirsty. Drink something sweet. Does it become a treat or a meal? Weight Control Groups � Offer mutual support � Distribute information Medical Methods � Hospital Fasting � Stomach Stapling (Laparoscopic banding) � Appetite suppressants � Jaw Wiring � Cosmetic surgery

WHAT IS DIABETES MELLITUS? ‘Diabetes is a chronic conditio n in which the levels of glucose … in the blood are too high. ’ (Victorian Government 2012) ‘Diabetes Mellitus means the body is unable to use glucose for energy, as the hormone insulin is not working properly. ‘ (Margee, K & Oliver M 2010)

SYMPTOMS Thirst and frequent urination Loss of blood circulation Blurred vision Diabetes Loss of feeling, tingling or numbness in hands and feet Poor circulation in feet – can lead to gangrene

Not enough insulin is produced by the pancreas The body does not respond to insulin properly Glucose is not used by cells in the body properly Excess glucose spills into urine Cells in the body are deprived of fuel needed to function (Jelil & Layugan 2012)

TREATMENT Type 2 Diabetes can be managed through lifestyle and diet: � Increase physical activity Lower blood glucose levels Control blood pressure Improve blood cholesterol Manage stress � Eat a variety of foods low in fat and high in fibre and low in GI � Lose weight � Limit alcohol

THE GLYCAEMIC INDEX (GI) ‘The speed at which a carbohydrate food breaks down into glucose has been studied and the foods have been ranked. ’ (Queensland Government 2011) The amount and type of sugar in the food impact the GI of food Q 1. How can the GI be used to support a diabetic?

THE GLYCAEMIC INDEX (GI) Low = < 55% Intermediate = 55 -69% High > 70% Milk Yoghurt Nuts Beans Pasta Weet bix Brown Rice Soft drinks Brown rice Sucrose French fries White bread Jelly Beans Water melon Rice crackers

CARDIOVASCULAR DISEASE High Cholesterol Inactivity Hypertension Risk Factors Smoking Stress Excess Weight

TREATMENT Reduce dietary fat intake � � � Eat low fat foods such as grains and vegetables Reduce fatty foods such as butter and chocolate Eat fish in place of fatty meats Eat lean cuts of meat Cook by grill, steam or microwave Avoid fast foods Reduce weight Increase soluble fibre Reduce cholesterol Low salt diet – less strain on the heart avoid adding salt and buy no added salt products � avoid fast foods �

ATHEROSCLEROSIS Referred to as hardening of the arteries Affects large and medium arteries and occurs where arteries branch or at points of mechanical stress Aorta (main artery from the heart) is commonly affected. Also affects arteries supplying the heart itself, the head and neck, the kidneys and lower limbs

RISK FACTORS Increased saturated fat in the diet Low HDL and Omega 3 intake Personality Type A Atherosclerosis Increased aged Smoking

SYMPTOMS Fast heart rate Irregular heart beat Atherosclerosis Changes in sleep patterns Chest pain or discomfort during activity

CONSEQUENCES Any artery affected by atherosclerosis is liable to blockage, which can lead to death of the tissue or organ. � Heart Attack � Stroke � Gangrene

HYPERTENSION ‘High blood pressure (hypertension) means that your blood is pumping at a higher pressure than normal through your arteries. ’ Several causes of hypertension: � Salt Causes water retention; thus, the blood volume increases in the blood vessels � Obesity � Smoking � Age � Alcohol

DIVERTICULAR DISEASE Results from long term constipation When bowel content is firm, it becomes too hard for the muscles to propel it by normal contractions Prolonged constipation causes the intestine walls to thicken; thus, create increased pressure in the bowel Pressure causes the walls to rupture – forming a pouch or diverticular If these pouches become infected and inflammed it is referred to as diverticulitis

Diverticular Disease Diverticulitis

DIVERTICULAR DISEASE Abdominal cramps and bloating Painful bowel movement bleeding Symptoms Diarrhoea Nausea vomiting

TREATMENT Gradually add fibre to your diet Exercise regularly Drink plenty of water Avoid straining

ANAEMIA Anaemia is a deficiency in the number or quality of red blood cells. The red blood cells carry oxygen around the body, using a particular protein called haemoglobin. ’ (Better health 2013) Can be a result of iron deficiency, folate deficiency (megaloblastic anaemia) or B 12 deficiency (pernicious anaemia) Milk anaemia can occur in children between the ages 1 and 3 years if excessive milk replaces iron rich foods in the diet

CAUSES OF ANAEMIA Malabsorption – where the body is not able to use the nutrients in the diet, caused by conditions such as coeliac disease. Inherited disorders – such as thalassaemia or sickle cell disease. Bone marrow disorders – such as cancer or infection. Blood loss – due to trauma, surgery, cancer, peptic ulcer, heavy menstruation, bowel cancer or frequent blood donations. Infection – such as malaria and septicaemia, which reduce the life span of red blood cells. Periods of rapid growth or high energy requirements – such as puberty or pregnancy.

GROUPS AT RISK OF ANAEMIA: Infants & Young Children Pregnant Women Vegetarians At risk Elderly Athletes Adolescent girls

ANAEMIA Symptoms include: Tiredness � Reduced physical work capacity/ productivity Loss of appetite, motivation and enthusiasm Reduced energy Behavioural problems � Due to lack of attention / tiredness Paleness

OSTEOPOROSIS

OSTEOPOROSIS Bones become porous and fragile due to loss of minerals Calcium is the main micronutrient but vitamin D, C and A all contribute to absorption of calcium and normal growth of bones and teeth Peak bone mass is achieved by most people by the late 20 s and this protects against age related bone loss and fractures � Low calcium intake limits the bones’ ability to achieve optimal mass and density

OSTEOPOROSIS Risk Factors include: Age � Low BMI � Bone loss correlates with age Underweight people lose bone strength Gender Men have a greater bone density at maturity � Women have greater losses later in life due to hormonal changes � Smoking Alcohol Abuse � Physical Activity � Promotes calcium loss by enhancing fluid loss When muscles work they pull on the bones, which promotes bone strength Excess caffeine and sodium intake