The importance of nutrition on health. Dr Mabel Blades Blog

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The importance of nutrition on health Dr Mabel Blades mabel@qmnds.demon.co.uk Blog http://mabelonamission.blogspot.co.uk/

Aims My Background Nutrition and health Malnutrition

The eatwell plate

Regular meals Good nutrition Eating regular low fat meals reduces total and LDL (bad) cholesterol and reduces resistance to insulin Regular meal eaters tend to have a lower energy (calorie) intake compared to those who eat irregularly By eating regularly (meals and snacks) you will help keep your blood sugar levels stable.

Breakfast Breakfast provides the body and brain with fuel after an overnight fast - that's where its name originates, breaking the fast! Without breakfast you are effectively running on empty, like trying to start the car with no petrol!

Good nutrition Starchy carbohydrate at each meal preferably wholegrain Good source of energy As well as starch, they contain fibre, calcium, iron and B vitamins. Gram for gram they contain fewer than half the calories of fat.

Good nutrition A DAY campaign based on advice from the World Health Organization, minimum of 400g of fruit and vegetables a day lower the risk of heart disease, stroke, type 2 diabetes and obesity.

Good Nutrition The bitter truth about sugar It's addictive, potentially harmful and absolutely everywhere. But is sugar really a poison that should be kept out of vulnerable hands?

Sources of sucrose/sugar

How much sugar Added sugars shouldn t make up more than 10% of the energy (calorie intake) you get from food and drink each day. This is about 70g for men and 50g for women The government recommends that free or added sugars shouldn't make up more than 5% of the energy (calories) you get from food and drink each day. That's a maximum of 30g of added sugar a day for adults, which is roughly seven sugar cubes.

Good nutrition Look for the "Carbohydrates (of which sugars)" figure in the nutrition label. high over 22.5g of total sugars per 100g low 5g of total sugars or less per 100g

Good nutrition Red meat is a good source of protein, plus iron and zinc. Department of Health advises people who eat more than 90 grams (cooked weight) of red and processed meat a day to cut down to 70 grams.

Good nutrition Poultry and fish also a good source of protein, plus contain iron and zinc. A healthy diet should include at least two portions of fish a week, including one of oily fish. Pulses provide protein, low fat also iron, zinc and fibre--cheap

Good nutrition Vitamin D sources oily fish, such as salmon, sardines and mackerel, eggs, butter and fortified fat spreads, fortified breakfast cereals, some powdered milk supplement containing 10 micrograms (400 IU) of vitamin for people 65 years and people not exposed to much sun vitamin D deficiency can lead to bone pain and weakening bones.

Hydration Lack of fluid can contribute to Urinary tract infections Constipation Oral and dental problems Joint pains Confusion which can result in falls and visits to hospital Tiredness and irritability Kidney damage

Hydration One and a half to two litres of fluid per day with more in hot weather All fluids except alcohol and strong caffeine containing drinks contribute to this Rich people drink tap water

Malnutrition bad nutrition/diet Usually under nutrition called malnutrition

CQC Regulation 14: Meeting nutritional and hydration needs

Malnutrition what is it BMI less than 18.5kg/m2 Unintentional weight loss more than 10% in last 3-6 months BMI less than 20 plus weight loss more than 5% In last 3-6months

Malnutrition General population 1 5% Chronic disease 1 12% District nurse patients 2 19% Care homes 1 41% Hospital admissions 1 32% BAPEN 2007-2011 0 10 20 30 40 50 Percentage of individuals underweight (BMI<20kg/m 2 )

Malnutrition 2008-2009 Doubling of cases in hospitals and care homes

Consequences of malnutrition Weight loss Muscle weakness and fatigue Apathy, depression and self neglect Impaired immune response Tissue breakdown and impaired wound healing Increase risk of fracture Osteoporosis Constipation Anaemia Impaired temperature control feeling cold Increased risk of hospital admission & length of stay FOR OWNERS RISK OF LEGAL ACTION

Dehydration UK Care homes 20-30% dehydrated Associated with major causes of mortality and morbidity in older people Confusion & delirium Falls & fractures Heat stress, infections Stroke, myocardial infarction Poor wound healing, pressure ulcers Drug toxicity (and more)

What do you think malnutrition costs? Britain spends 6 billion a year on the medical costs of conditions related to obesity

Cost of malnutrition Treating malnutrition in the UK costs > 5 billion per year due to 1 : Increased malnutrition-related complications Increased cost of treatment Increased GP visits Increased length of stay in hospital ADDITIONAL 13 B FOR CARE

Individuals 'Britain's worst care home': Damning report into 'harrowing neglect' at 3,000-a-month home aims to stop 'institutionalised abuse' of the elderly Lack of respect and dignity, poor nutrition and hydration. The 3,000-a-month Southern Cross-run home was shut down in 2011 following an investigation by the Care Quality Commission

5 th February 2016 Care home owner jailed after elderly woman 'left emaciated and soaked in her own urine due to neglect' Ivy Atkin weighed just 3st 12lbs when she died from pneumonia brought about by 'wanton and reckless neglect'

Care home malnutrition Grandmother died from malnutrition and left looking like 'a skeleton' while under nursing home care Irene Willits, 88, died from malnutrition just a day after being taken from the home in Rochdale to hospital. 4st 12lbs

No Win No Fee The no win no fee system ensures that claiming the compensation you deserve is riskfree Encourages people to take legal action It s taken seven years for Marilyn Payne to win justice for her father against the care home nurses who neglected him, but helped by a Clinical Negligence Solicitor she got 450,000

Food first SUPPLEMENTS EXPENSIVE NOT ALWAYS TAKEN CAN BE USEFUL CAN USE IN RECIPES

Fortification 25 g cheese approx 100 kcal 5 g protein 10 g butter approx 70 kcal 25g double cream 120 kcal 25g dried skimmed milk powder 90 kcal 9g protein 100 ml Double Cream 460kcal

TASTE Flavour Texture of foods Appropriate Apperance

Taste buds salty sour bitter sweet umami

JAPANESE RESEARCH Taste tests revealed that elderly patients who had lost their taste; umami helpful It is found in foods that contain high levels of glutamate, such as cured meats, shellfish, soy sauce, cheese and green tea, and other foods rich in protein

Bliss Point Level of sugar Fat Salt CARAMEL SAUCE 363kcal

Individuals More calories and better nutrition people feel better Get up and enjoy company Eat better End of Life care

Thank you Dr Mabel Blades mabel@qmnds.demon.co.uk Blog mabelonamission.blogspot.co.uk