Demi
Sun, May-06-07, 04:32
The Independent on Sunday
London, UK
6 May, 2007
Junk food nation
3.6 million people in Britain suffer from malnutrition
Hospitals see 44% rise in cases as cost to the NHS hits £7.3bn
By Marie Woolf, Political Editor
Alarming levels of malnutrition have been recorded in Britain, The Independent on Sunday has learned, prompting further medical concern at the effects of the nation's addiction to salty, fatty, junk food.
Despite high-profile campaigns by the Government and celebrity chefs to improve eating habits, new figures reveal that there has been a 44 per cent increase in hospital cases of malnutrition over the past five years.
Amid estimates that up to 3.6 million people are suffering from malnutrition, including conditions found in sub-Saharan Africa, MPs and doctors last night called for action to tackle poor diets, and for all patients to be screened for malnutrition. They called for the Government's National Institute for Health and Clinical Excellence (Nice) guidelines to be made compulsory.
In 2002, 2,729 people in English hospitals were diagnosed with malnutrition. Last year, the number had risen to 3,931.
The British Association for Parenteral and Enteral Nutrition estimates malnutrition costs the NHS more than £7.3bn a year, double the annual obesity bill. Doctors estimate that up to 6 per cent of the population could be suffering from malnutrition and serious vitamin and mineral deficiencies caused by poor diet. Most do not have their conditions identified.
Experts said a reliance on pre-prepared food and failure to eat enough fresh fruit and vegetables is depleting levels of essential micro-nutrients. The deficiencies are found in teenagers, the elderly, adults and babies as young as 18 months. They warn the balance of nutrients is also disturbed by binge drinking, excess sugar and drug use.
The Conservative peer Lord Hanningfield, who obtained the hospital figures, said it was "deeply disturbing that the number of patients suffering from malnutrition has almost doubled in the last five years. Far too many patients leave hospital less nourished than when they were admitted.
"It is time patients were routinely screened for malnutrition, and offered specialist nutritional support."
Dr Mike Stroud, senior lecturer at the Institute of Human Nutrition, University of Southampton, who chaired the group that drew up the Nice malnutrition guidelines, says the health service is not taking the problem seriously enough. "The modern diet is not providing enough vitamins. Malnourishment is going to make you more vulnerable to illnesses and less able to cope with them. The medical profession is only just beginning to take on board the implications of nutrition in patients."
The hospital figures show malnutrition is found in all age groups. Forms of malnutrition found among famine victims in the developing world, typified by wasted limbs and pot bellies, are being diagnosed in UK hospitals. Symptoms are also being picked up in pregnant women and newborn babies.
Anna Denny, a nutrition scientist, said she was surprised at the acute diagnoses of malnutrition in British hospitals. "We don't often see overt nutritional deficiencies. You only see these diagnoses normally in the developing world.
http://news.independent.co.uk/uk/health_medical/article2516769.ece
We are eating ourselves ill: Treating malnutrition costs NHS more than obesity
We are continually warned about the need to watch our weight, but many of us are not eating enough nutrients to stay healthy. Cole Moreton on the hidden sickness in our fast-food nation
Britain is fat. We know that. Chefs and doctors, footballers and even pop stars tell us over and over again, in campaigns against the obesity epidemic. But now, as The Independent on Sunday reveals, new data show that an alarming number of Britons actually suffer from malnutrition.
Doctors estimate that more than three million people are malnourished. Most do not realise it, although diagnosis rates in hospitals have soared by 44 per cent over the past five years. The most extreme cases echo symptoms found among famine victims in the developing world. Wasted limbs and pot bellies are being seen in British hospitals, where 40 per cent of patients are thought to be malnourished. Marasmus, the protein deficiency most often seen in Africa, has been found among anorexic women here.
But the majority of cases are people who lack the vitamins and nutrients vital for the body to function properly. Malnourishment has recently been recognised as a major problem for the sick, elderly and frail, but new statistics gathered for the Department of Health show it affects pregnant women and newborn babies, schoolchildren and adults who believe themselves to be healthy.
One woman who vomited frequently during pregnancy developed a vitamin deficiency that went undiagnosed. She suffered brain damage. The calcium shortage found in 8 per cent of young people can lead to crumbling or brittle bones.
"If you are young and well, you can still end up malnourished," said Dr Alistair McKinlay, consultant gastro-enterologist at Aberdeen Royal Infirmary and one of the country's leading authorities on the condition. "In 75 per cent of people, the problem is not identified."
Malnutrition costs the NHS £7.3bn a year according to the British Association for Parenteral and Enteral Nutrition, the experts in the field. That figure is more than double the estimated cost of obesity.
Alcohol and drugs can disturb the balance of our bodies - but the main cause, doctors believe, is a poor diet. So how can this be? When there is so much food about, from low-fat diet meals to high-fat takeaways, how can so many people be short of the nutrients essential for a healthy life? What has gone wrong between the British and our food?
Gordon Ramsay, one of the best chefs in the world, blames habits learned in the home. "If we are going to be a healthy nation then you've got to discipline the parents," he told the IoS in a rare interview. "The only way to implement severe standards now is if their kids become obesely overweight and out of control. Then I would seriously fine [the parents] and threaten them with a court appearance, because they often don't realise what they're doing."
Children need to be given a strong lead, he said. "Children eat with their eyes. They're lazy. If you don't tell them about what they're eating, trust me, they will eat as much crap as they can when they get home. They get connected to junk food in a way that becomes obsessive."
The Michelin-star winning father of four gave his children tripe the other week, in a stew with red peppers, tomato and garlic. He didn't tell them what it was. "It was absolutely delicious. They said, 'What was that?' I showed them a picture of a cow, and took out the stomach bag, and their faces dropped. But they asked for it again."
Ramsay was full of praise for the efforts of Jamie Oliver to improve school dinners. "He helped to make every parent feel guilty, for the first time, about what their children were eating at school. He woke everyone up."
Oliver said: "I think many parents are unaware of how much junk their kids are eating and drinking." He added: "As well as the frightening rise in obesity there's a growing number of kids, of whatever shape and size, that simply aren't getting fed enough nutrients like iron, calcium and vitamins. It's having a huge effect on their brainpower, behaviour and ability to concentrate and learn at school."
Adults may not realise they have serious problems. The national diet and nutrition surveys carried out by the Department of Health show two-thirds of women are short of vitamin B2, riboflavin, which can cause a range of illnesses (so are nearly a quarter of pre-school infants). Young men and women alike have high levels of the amino acid homocysteine, which indicates their vitamin levels are disturbed. Doctors believe our drinking culture must take part of the blame.
People are eating less home-cooked food and more junk, said Dr Colin Waine, chairman of the National Obesity Forum formed to tackle the epidemic. Fast food can not only make you fat, it can also leave you malnourished. "I would definitely question the vitamin and mineral trace of some fast food outlets."
Hospital food also came under severe attack last year when the Government admitted that many elderly people were not getting enough vitamins, nutrients and fatty acids. The trouble is that most doctors were trained during a time when malnutrition appeared to have died out, said Dr Waine. "The best diet we had was during the First World War when we had a good rationing system - people had the right nutrients in the right amounts."
Bianca Incocciati's GP did not realise her patient's skin problems were a result of micronutrient malnutrition. "You think it happens to starving children in the third world," said Ms Incocciati. "You don't expect it to happen to you. It's scary."
The doctor she went to for a second opinion asked what she had been eating. Ms Incocciati was studying English at Warwick University and waitressing at a French restaurant in the evenings, scoffing late at night and unable to face breakfast. After closing, the restaurant's chefs sometimes whipped up a rich dinner, heavy on cheese and creamy sauces, for the staff. At other times she would snack at home on pasta or toast. She was also a self-confessed crisp addict.
"I felt I had no energy at all," she said. "I was always tired and constantly had a cold. I had spots all the time too." Ms Incocciati was shocked to be told she had very low levels of vitamin A, vitamin B12 and iron. "Eating late, you're not digesting food properly. Getting up late, having a coffee, you're running on empty."
After two weeks of increasing her fruit and vegetable intake and eating more regularly Ms Incocciati had more energy and felt more "with it". After four months she had lost weight. Eighteen months since she was diagnosed, she is a reformed character. "Where I'd been going wrong was that I wasn't cooking food at home, wasn't making sure I was having vegetables and fruit."
Her parents had given her an example Gordon Ramsay would approve of. "They were always really good about having dinner together and having cooked meals." But despite their best efforts she grew into bad habits. "Once you leave home, it's easy to buy rubbish."
Ms Incocciati was not alone. Despite all the campaigns to educate people about healthy eating, as our reports today show, for three million malnourished people the message still hasn't got through.
What is malnutrition?
Malnutrition is caused by a deficiency, excess or imbalance of energy, protein and other nutrients. The condition may result from an inadequate or unbalanced diet, digestive difficulties, absorption problems or other medical conditions. It is a chronic condition, which can injure the spleen and stomach. Malnutrition can occur because of a chronic lack of one key vitamin or because the body isn't getting enough food. Starvation is an extreme form of malnutrition and can occur even in people who are clinically obese.
The symptoms of malnutrition include acute weight loss, losing hair, muscle wastage, a swollen abdomen, a dull yellow complexion and dry, crinkled skin. Sufferers also have dull eyes, listlessness, tiredness, cravings and brown stained teeth. In extreme cases it can be fatal and lead to anaemia, beri-beri, goitre, scurvy and rickets.
Student diet that led to malnutrition
Caffeine, crisps and takeaways fuelled student Bianca Incocciati's days of university work and late nights waitressing, but left her malnourished. This was her diet on an average week.
MONDAY
No breakfast. Black coffee, two sugars. Can of regular Coke at midday. Lunch of sandwich and salt and vinegar crisps. Dinner of takeaway pizza with a couple of glasses of wine.
TUESDAY
No breakfast. Lunchtime at restaurant. Black coffee, two sugars, at 11.30am. No lunch, but snack of bread and butter. Pie from dessert trolley, Coke, at end of shift. Buttered toast and Marmite after the pub.
WEDNESDAY
No breakfast. Orange juice and black coffee, two sugars. Lunchtime shift at restaurant, snacks of bread then meal with staff, Coke. Afternoon snack, crisps, Coke. Evening shift at restaurant. Bread and butter at 11.30pm.
THURSDAY
No breakfast. Lunch of jacket potato. Coke and crisps in afternoon. Coffee. Dinner of Chinese takeaway, wine.
FRIDAY
No breakfast. Coke. Baguette for lunch. Afternoon snack, crisps. Dinner, cheese on toast. Evening - four or five beers, Big Mac with fries and Coke .
SATURDAY
Breakfast at 11am - two fried eggs, fried bread, two rashers of bacon, two sausages. Black coffee with two sugars. No lunch. Late afternoon, cheese and tomato on toast. At restaurant from 6.30pm. Bread and butter, then at 11.30pm banoffee pie with cream from dessert trolley.
SUNDAY
Breakfast of bacon sandwich and coffee. Dinner of roast chicken, roast potatoes, carrots, gravy. Wine. Evening at restaurant. Bread and butter, cheeseburger and chips on the way home.
Sadie Gray
Changing diet over the decades (if you're lucky)
2007
Breakfast: fruit salad, muesli, yoghurt, smoothie, coffee
Lunch: chicken caesar salad/ chorizo and roast pepper sandwich/lentil pasta salad, passion fruit juice, mango
Dinner: Stir-fried noodles with organic chickenand crispy vegetables. Tomato and onion salad on the side.
1997
Breakfast: banana, breakfast bar, toast and Marmite, sugar-coated cereal/bacon sandwich, orange juice
Lunch: bacon, lettuce and tomato roll/coronation chicken sandwich, crisps, nectarine
Dinner: lasagne, green salad, rhubarb crumble.
1987
Breakfast: toast and jam eggs, bacon and fried tomato, orange juice
Lunch: hamburger and fries, Mars bar, Coke, an orange
Dinner: microwave meal: macaroni cheese/frozen breadcrumbed turkey burgers, Wall's vanilla ice cream an apple.
1977
Breakfast: Quaker porridge oats with full-fat milk, a boiled egg and toast.
Lunch: canned ham and pickle sandwiches, followed by an apple.
Dinner: homemade meatloaf with boiled potatoes, boiled cabbage, a bowl of homemade rice pudding.
http://news.independent.co.uk/uk/health_medical/article2516741.ece
London, UK
6 May, 2007
Junk food nation
3.6 million people in Britain suffer from malnutrition
Hospitals see 44% rise in cases as cost to the NHS hits £7.3bn
By Marie Woolf, Political Editor
Alarming levels of malnutrition have been recorded in Britain, The Independent on Sunday has learned, prompting further medical concern at the effects of the nation's addiction to salty, fatty, junk food.
Despite high-profile campaigns by the Government and celebrity chefs to improve eating habits, new figures reveal that there has been a 44 per cent increase in hospital cases of malnutrition over the past five years.
Amid estimates that up to 3.6 million people are suffering from malnutrition, including conditions found in sub-Saharan Africa, MPs and doctors last night called for action to tackle poor diets, and for all patients to be screened for malnutrition. They called for the Government's National Institute for Health and Clinical Excellence (Nice) guidelines to be made compulsory.
In 2002, 2,729 people in English hospitals were diagnosed with malnutrition. Last year, the number had risen to 3,931.
The British Association for Parenteral and Enteral Nutrition estimates malnutrition costs the NHS more than £7.3bn a year, double the annual obesity bill. Doctors estimate that up to 6 per cent of the population could be suffering from malnutrition and serious vitamin and mineral deficiencies caused by poor diet. Most do not have their conditions identified.
Experts said a reliance on pre-prepared food and failure to eat enough fresh fruit and vegetables is depleting levels of essential micro-nutrients. The deficiencies are found in teenagers, the elderly, adults and babies as young as 18 months. They warn the balance of nutrients is also disturbed by binge drinking, excess sugar and drug use.
The Conservative peer Lord Hanningfield, who obtained the hospital figures, said it was "deeply disturbing that the number of patients suffering from malnutrition has almost doubled in the last five years. Far too many patients leave hospital less nourished than when they were admitted.
"It is time patients were routinely screened for malnutrition, and offered specialist nutritional support."
Dr Mike Stroud, senior lecturer at the Institute of Human Nutrition, University of Southampton, who chaired the group that drew up the Nice malnutrition guidelines, says the health service is not taking the problem seriously enough. "The modern diet is not providing enough vitamins. Malnourishment is going to make you more vulnerable to illnesses and less able to cope with them. The medical profession is only just beginning to take on board the implications of nutrition in patients."
The hospital figures show malnutrition is found in all age groups. Forms of malnutrition found among famine victims in the developing world, typified by wasted limbs and pot bellies, are being diagnosed in UK hospitals. Symptoms are also being picked up in pregnant women and newborn babies.
Anna Denny, a nutrition scientist, said she was surprised at the acute diagnoses of malnutrition in British hospitals. "We don't often see overt nutritional deficiencies. You only see these diagnoses normally in the developing world.
http://news.independent.co.uk/uk/health_medical/article2516769.ece
We are eating ourselves ill: Treating malnutrition costs NHS more than obesity
We are continually warned about the need to watch our weight, but many of us are not eating enough nutrients to stay healthy. Cole Moreton on the hidden sickness in our fast-food nation
Britain is fat. We know that. Chefs and doctors, footballers and even pop stars tell us over and over again, in campaigns against the obesity epidemic. But now, as The Independent on Sunday reveals, new data show that an alarming number of Britons actually suffer from malnutrition.
Doctors estimate that more than three million people are malnourished. Most do not realise it, although diagnosis rates in hospitals have soared by 44 per cent over the past five years. The most extreme cases echo symptoms found among famine victims in the developing world. Wasted limbs and pot bellies are being seen in British hospitals, where 40 per cent of patients are thought to be malnourished. Marasmus, the protein deficiency most often seen in Africa, has been found among anorexic women here.
But the majority of cases are people who lack the vitamins and nutrients vital for the body to function properly. Malnourishment has recently been recognised as a major problem for the sick, elderly and frail, but new statistics gathered for the Department of Health show it affects pregnant women and newborn babies, schoolchildren and adults who believe themselves to be healthy.
One woman who vomited frequently during pregnancy developed a vitamin deficiency that went undiagnosed. She suffered brain damage. The calcium shortage found in 8 per cent of young people can lead to crumbling or brittle bones.
"If you are young and well, you can still end up malnourished," said Dr Alistair McKinlay, consultant gastro-enterologist at Aberdeen Royal Infirmary and one of the country's leading authorities on the condition. "In 75 per cent of people, the problem is not identified."
Malnutrition costs the NHS £7.3bn a year according to the British Association for Parenteral and Enteral Nutrition, the experts in the field. That figure is more than double the estimated cost of obesity.
Alcohol and drugs can disturb the balance of our bodies - but the main cause, doctors believe, is a poor diet. So how can this be? When there is so much food about, from low-fat diet meals to high-fat takeaways, how can so many people be short of the nutrients essential for a healthy life? What has gone wrong between the British and our food?
Gordon Ramsay, one of the best chefs in the world, blames habits learned in the home. "If we are going to be a healthy nation then you've got to discipline the parents," he told the IoS in a rare interview. "The only way to implement severe standards now is if their kids become obesely overweight and out of control. Then I would seriously fine [the parents] and threaten them with a court appearance, because they often don't realise what they're doing."
Children need to be given a strong lead, he said. "Children eat with their eyes. They're lazy. If you don't tell them about what they're eating, trust me, they will eat as much crap as they can when they get home. They get connected to junk food in a way that becomes obsessive."
The Michelin-star winning father of four gave his children tripe the other week, in a stew with red peppers, tomato and garlic. He didn't tell them what it was. "It was absolutely delicious. They said, 'What was that?' I showed them a picture of a cow, and took out the stomach bag, and their faces dropped. But they asked for it again."
Ramsay was full of praise for the efforts of Jamie Oliver to improve school dinners. "He helped to make every parent feel guilty, for the first time, about what their children were eating at school. He woke everyone up."
Oliver said: "I think many parents are unaware of how much junk their kids are eating and drinking." He added: "As well as the frightening rise in obesity there's a growing number of kids, of whatever shape and size, that simply aren't getting fed enough nutrients like iron, calcium and vitamins. It's having a huge effect on their brainpower, behaviour and ability to concentrate and learn at school."
Adults may not realise they have serious problems. The national diet and nutrition surveys carried out by the Department of Health show two-thirds of women are short of vitamin B2, riboflavin, which can cause a range of illnesses (so are nearly a quarter of pre-school infants). Young men and women alike have high levels of the amino acid homocysteine, which indicates their vitamin levels are disturbed. Doctors believe our drinking culture must take part of the blame.
People are eating less home-cooked food and more junk, said Dr Colin Waine, chairman of the National Obesity Forum formed to tackle the epidemic. Fast food can not only make you fat, it can also leave you malnourished. "I would definitely question the vitamin and mineral trace of some fast food outlets."
Hospital food also came under severe attack last year when the Government admitted that many elderly people were not getting enough vitamins, nutrients and fatty acids. The trouble is that most doctors were trained during a time when malnutrition appeared to have died out, said Dr Waine. "The best diet we had was during the First World War when we had a good rationing system - people had the right nutrients in the right amounts."
Bianca Incocciati's GP did not realise her patient's skin problems were a result of micronutrient malnutrition. "You think it happens to starving children in the third world," said Ms Incocciati. "You don't expect it to happen to you. It's scary."
The doctor she went to for a second opinion asked what she had been eating. Ms Incocciati was studying English at Warwick University and waitressing at a French restaurant in the evenings, scoffing late at night and unable to face breakfast. After closing, the restaurant's chefs sometimes whipped up a rich dinner, heavy on cheese and creamy sauces, for the staff. At other times she would snack at home on pasta or toast. She was also a self-confessed crisp addict.
"I felt I had no energy at all," she said. "I was always tired and constantly had a cold. I had spots all the time too." Ms Incocciati was shocked to be told she had very low levels of vitamin A, vitamin B12 and iron. "Eating late, you're not digesting food properly. Getting up late, having a coffee, you're running on empty."
After two weeks of increasing her fruit and vegetable intake and eating more regularly Ms Incocciati had more energy and felt more "with it". After four months she had lost weight. Eighteen months since she was diagnosed, she is a reformed character. "Where I'd been going wrong was that I wasn't cooking food at home, wasn't making sure I was having vegetables and fruit."
Her parents had given her an example Gordon Ramsay would approve of. "They were always really good about having dinner together and having cooked meals." But despite their best efforts she grew into bad habits. "Once you leave home, it's easy to buy rubbish."
Ms Incocciati was not alone. Despite all the campaigns to educate people about healthy eating, as our reports today show, for three million malnourished people the message still hasn't got through.
What is malnutrition?
Malnutrition is caused by a deficiency, excess or imbalance of energy, protein and other nutrients. The condition may result from an inadequate or unbalanced diet, digestive difficulties, absorption problems or other medical conditions. It is a chronic condition, which can injure the spleen and stomach. Malnutrition can occur because of a chronic lack of one key vitamin or because the body isn't getting enough food. Starvation is an extreme form of malnutrition and can occur even in people who are clinically obese.
The symptoms of malnutrition include acute weight loss, losing hair, muscle wastage, a swollen abdomen, a dull yellow complexion and dry, crinkled skin. Sufferers also have dull eyes, listlessness, tiredness, cravings and brown stained teeth. In extreme cases it can be fatal and lead to anaemia, beri-beri, goitre, scurvy and rickets.
Student diet that led to malnutrition
Caffeine, crisps and takeaways fuelled student Bianca Incocciati's days of university work and late nights waitressing, but left her malnourished. This was her diet on an average week.
MONDAY
No breakfast. Black coffee, two sugars. Can of regular Coke at midday. Lunch of sandwich and salt and vinegar crisps. Dinner of takeaway pizza with a couple of glasses of wine.
TUESDAY
No breakfast. Lunchtime at restaurant. Black coffee, two sugars, at 11.30am. No lunch, but snack of bread and butter. Pie from dessert trolley, Coke, at end of shift. Buttered toast and Marmite after the pub.
WEDNESDAY
No breakfast. Orange juice and black coffee, two sugars. Lunchtime shift at restaurant, snacks of bread then meal with staff, Coke. Afternoon snack, crisps, Coke. Evening shift at restaurant. Bread and butter at 11.30pm.
THURSDAY
No breakfast. Lunch of jacket potato. Coke and crisps in afternoon. Coffee. Dinner of Chinese takeaway, wine.
FRIDAY
No breakfast. Coke. Baguette for lunch. Afternoon snack, crisps. Dinner, cheese on toast. Evening - four or five beers, Big Mac with fries and Coke .
SATURDAY
Breakfast at 11am - two fried eggs, fried bread, two rashers of bacon, two sausages. Black coffee with two sugars. No lunch. Late afternoon, cheese and tomato on toast. At restaurant from 6.30pm. Bread and butter, then at 11.30pm banoffee pie with cream from dessert trolley.
SUNDAY
Breakfast of bacon sandwich and coffee. Dinner of roast chicken, roast potatoes, carrots, gravy. Wine. Evening at restaurant. Bread and butter, cheeseburger and chips on the way home.
Sadie Gray
Changing diet over the decades (if you're lucky)
2007
Breakfast: fruit salad, muesli, yoghurt, smoothie, coffee
Lunch: chicken caesar salad/ chorizo and roast pepper sandwich/lentil pasta salad, passion fruit juice, mango
Dinner: Stir-fried noodles with organic chickenand crispy vegetables. Tomato and onion salad on the side.
1997
Breakfast: banana, breakfast bar, toast and Marmite, sugar-coated cereal/bacon sandwich, orange juice
Lunch: bacon, lettuce and tomato roll/coronation chicken sandwich, crisps, nectarine
Dinner: lasagne, green salad, rhubarb crumble.
1987
Breakfast: toast and jam eggs, bacon and fried tomato, orange juice
Lunch: hamburger and fries, Mars bar, Coke, an orange
Dinner: microwave meal: macaroni cheese/frozen breadcrumbed turkey burgers, Wall's vanilla ice cream an apple.
1977
Breakfast: Quaker porridge oats with full-fat milk, a boiled egg and toast.
Lunch: canned ham and pickle sandwiches, followed by an apple.
Dinner: homemade meatloaf with boiled potatoes, boiled cabbage, a bowl of homemade rice pudding.
http://news.independent.co.uk/uk/health_medical/article2516741.ece