Week 6: nutrition and public health

Question 1

What is meant by the double bruden of malnutrition?

Answer 1

The co-existance of under and over nutrition and their associated health complications
This can exist within individuals (simultaneously or over a life time) households and populations

Question 2

What are the main disease burdens associated with obesity?

Answer 2

Type 2 diabetes mellitus
Cancer
Cardiovascular disease

Question 3

Who can be effected by the double burden of malnutrition?

Answer 3

Individuals - simultaneously (iron deficieny but obese) or over the course of a life span

Households - obese children and iron deficient/malnourished parents

Populations - same community, region or nation.

Question 4

Quantify the effects of malnutrition worldwide.

Answer 4

50 million children as underweight
156 million children are stunted
42 million children are overweight or obese
1.9 billion adults are obese or overweight (600 million of which are obese)
462 million adults are underweight
264 women are iron deficient

Question 5

What are the different factors that determin weight status?

Answer 5

Behavioural - lifestyle, habits and psychological
Social and demographic - socioeconomic, food insecurity/surplus
Biological - early life exposures, inheritbaility, epigenetic
Environmental - food supply, portion and cost, social and cultural aspects of food, trade policy.

Question 6

What do the different scores of BMI indicate about a persons weight?

Answer 6

below 18.5 - underweight
Between 18.5 and 24.9 is normal weight
between 25 and 29.9 is overweight
Above 30 - obese class 1
Above 35 - obese class 2
Above 40 - obese class 3

Question 7

How do we calculate BMI?

Answer 7

Weight in Kg divided by height in M sqaured

Question 8

What are the limitations to BMI?

Answer 8

Based on a model or weight males
Does not consider the difference between muscle mass and fat mass
Not adaptable to all races, ages and genders equally

Question 9

What values of male weight circumference indicate?

Answer 9

Male <94 cm is desirable
Between 94 and 102 is a high circumference
Above 102 cm is very high

Question 10

What values of female weight circumference indicate?

Answer 10

Below 80 cm is desirable
Between 80-88 cm is high
Above 88 cm is very high

Question 11

How does adult obesity prevalence vary by age and sex?

Answer 11

Males more likley to ba aboses then women in all age groups excpet under 24
Age increases rate of obesity in both sexes, but has a greater effect in males

Question 12

How does waist circumference vary by age and sex?

Answer 12

Women tend to have a higher waist circumference than men at all age groups.
Waist circumference increases with age in both genders, but more with men

Question 13

How does the presence of obesity vary by income and sex?

Answer 13

In both sexes obesity is higher in lower income groups
Obesity increases as deprivation increases, deprivation has a greater effect on female obesity.

Question 14

What is the overal prevelence of obesity and overweight like in men and women?

Answer 14

Slight increase over last 20 years but is relatively stable
65% are obese or overweight
30% are obese
Male and female obestiy rates are relatively similar but male overweight rate is higher than females.

Question 15

What are the trends in childhood obesity?

Answer 15

Younger generations are becoming obese earlier which then persits into adulthood
30% of children aged 2 to 15 yrs old are overweight or obese
Only 64% of 10-11yrs old are a health weight, obesity rates double between age 5 and age 10.

Question 16

How has childhood obesity changed over time and by gender?

Answer 16

At reception age - similar for boys and girls
In year 6 - significantly higher in boys than girls
Relativly stable since 2006 with a rapid peak in 2020/2021 thought to be related to covid-19

Question 17

What are activity statistics like for adults in England?

Answer 17

1 in 4 women and 1 in 5 men are considered physically inactive
Men are more likely to be stationary for 6 hours or more a day
34% of men and 24% of women engage in muscle strengthening activities twice a week

Question 18

How does BMI correlate to mortality?

Answer 18

Mortality is minimal at a healthy BMI
BMI below 18.5 has a significant increase in mortality
As BMI increases from overweight to obese mortality increases, increases at a faster rate at greater BMIs.

Question 19

What are the main mortalities associated with an unhleahty BMI?

Answer 19

Coronary heart disease
stroke
Cancer
Respiratory disease - equal for under and over

Overweight has more significant effect on the above

Question 20

What conditions are associated with obesity?

Answer 20

Type 2 diabetes
Hypertension
Cardiovascular disease
Asthma
Metabolic syndrome
Cancer
GERD
Gall stones
Osteoarthiritis
Sleep apnoea
Liver disease
Kidney disease
Reduced fertility
Pregnany complications
Depression

Question 21

What factors can cause an individual to become obese?

Answer 21

Social influences
Individual Psychology
Food production
Food consumption
individual activity
Activity environment
Biology

Question 22

How does the distribution of eateries correlate to obesity rates>

Answer 22

1 in 4 eateries are fast food outlets
Higher concentration of fast food outlets in more deprived areas.

Question 23

What is meant by portion distortion in terms of malnutrition?

Answer 23

Become more socially acceptable to eat/order larger portions of food

Question 24

What is recommended sugar intake in children?
How does this compare to the actual values?

Answer 24

Recommended is less than 5%
In 4-10yrs old this is actually 13,5%
in 11-18yrs old this is 14.1%

Question 25

What is the sugar tax?

Answer 25

A financial charge on companies that sell drinks that contain too much sugar
24p per litre if more than 8 grams of sugar per 100ml
18p per litre is between 5-8grams of sugar per 100ml

Decrease production and consumption of sugary drinks due to price on consumers and manufactureres.

Question 26

What is the purpose of traffic light nutrition on food labels?

Answer 26

Colour code and give percentage of recommended intake for fat, saturates, sugars and salt in one serving of food
Also contains calories in one serving
Provide easy to access and see information to guide food choices.
Traffic lighting is based on the amount in 100grams

Question 27

What are the recomended daily intakes of fat, free sugar and salt?

Answer 27

Fat - total 70g saturated 20grams
Free sugars - less than 5% of total dietary energy
Salt - 6 grams per day

Question 28

What are the traffic light values for total fat, saturated fat, sugars and salt on nutritional labelling

Answer 28

Values shown are medium values (orange), above this is red and below this is green
Total fat - 3-17grams per 100 grams
Starurated fat - 1.5 -5 grams per 100 grams
Sugars - 5-22.5 grams per 100 grams
Salt 0.3-1.5grams per 100 grams.

Question 29

What is the eatwell guide recommended daily intakes?

Answer 29

Over 1/3 vegetables and fruit 40%
Over 1/3 carbohydrates 38%
12% protein
8% dairy
1% oils and spreads

Question 30

What are the different factors being considered in the whole system approach to reduce obesity?

Answer 30

Create an environment that promotes physical activity
Education of healthy eating and physical activity
Promote local opportunities and community engagement
Provide access to weight management support
Creating healthier food environment
Utilse schools and childcare setting
increasing healthy food consumption
Creating healthy workspaces
Increasing active travel.

Question 31

How common is vitamin D deficiency?

Answer 31

Most prevelent in autumn and winter
More common in older individuals but still affects 19% of 4-10 yrs old

Question 32

What are the different thresholds that indicate vitD deficiency?

Answer 32

less than 25nmol/l of calcidiol - defiency
25-50nmol/L is insufficiency
Above 50 nmol/L is adequate

Question 33

What can be used to prevent vitamin D deficiency?

Answer 33

Recommend daily intake of 10 micrograms per day (400IU) supplement for those at risk of deficiency including 4yrs+ and pregnant or breastfeeding women
8.5-10micrograms is recommended for people aged below 1yrs

Question 34

What mortality can vitamin D deficienct help prevent?

Answer 34

Bone disorders
Renal osteodystrophy
Cancer

Question 35

What is the link betwee meat and cancer?

Answer 35

Group 1 carcinogen (tobacco) - salami, sausages and hot dogs, bacon - cancer causing
Group 2 - probably causes cancer - pork, beef and lamb

Question 36

What are greenhouse gas emission like across the food chain?

Answer 36

Highest release from beef farming
Then lamb and mutton
Plant based farming can be 10-20 times lower Co2 emissions than animal based
Nuts can have negative values as are often land use changes to replace croplands - nut trees store more carbon

Question 37

What diet is best for the environment?
The planetary health plate

Answer 37

50% vegetables
20% whole grains
15% legumes
Small amounts of unsaturated plant oilds, dairy foods, animal source protein, added sugars and starchy vegatables.