diet, body weight & mental

wellbeing in adolescents

DIANE EDWARDS & ED FRESHWATER

04/12 BSC MENTAL HEALTH NURSING

a straw poll

Psychiatric medication causes

weight gain - true or false?

mental illness & weight change

Weight change as a

cause of mental ill health

vs.

Mental ill health as a

cause of weight change

outlining the problem

Overweight

Poor nutrition

Higher mortality

Physical health problems

Inactivity

Maladaptive coping strategies

mental illness & weight change

Delusions about food

Social withdrawal

Somnolence

Lack of motivation

Cognitive impairment

Hospital admission

Obesogenic environment

Comfort eating

energy requirements

Age Males Females

 Kcal (kcal)

11-14 2220 (1845)

15-18 2755 (2110)

COMA, 1991

energy requirements

Age Males Females

kcal kcal

 11 years  2127  2032

 12 years  2247  2103

 13 years  2414  2223

 14 years  2629  2342

 15 years  2820  2390

 16 years  2964  2414

 17 years  3083  2462

 18 years  3155  2462

SACN, 2011

diet routine

Breakfast 0800

Snack 1030

Lunch 1200

Snack 1515

Dinner 1730

Supper 2030

diet routine

Day Breakfast Lunch Dinner Snacks Calories / sugar

Mon Cereal,Squash x2

¼ cheese baguetteIce cream2 x Squash

Pasta & Tomato sauceBlack forest Gateau2 x Squash

4 chocolate bourbons,Crisps x 2Cake3 x hot Chocolate

Tue Declined  DeclinedPasta & CheeseIce Cream2 x Squash

Giant cookieCrispsKit KatHaribo (x4)3x Squash

Wed4 toast with jam2 x squash 

Refused Refused

AeroCrispsChocolate cake2 x Squash

diet routine

Day Breakfast Lunch Dinner Snacks Calories / sugar

Mon Cereal,Squash x2

¼ cheese baguetteIce cream2 x Squash

Pasta & Tomato sauceBlack forest Gateau2 x Squash

4 chocolate bourbons,Crisps x 2Cake3 x hot Chocolate

2948226

Tue Declined  DeclinedPasta & CheeseIce Cream2 x Squash

Giant cookieCrispsKit KatHaribo (x4)3x Squash

1785169

Wed4 toast with jam2 x squash 

Refused Refused

AeroCrispsChocolate cake2 x Squash

161489

nutrition & mental health

Symptom May be lacking…

Anxiety Folic acid, magnesium

Poor concentration or attention Vitamin B1

Depression Vitamins B3, B6 & C, Folic acid, magnesium, selenium, zinc, Omega3 fatty acids, tryptophan, tyrosine, GABA

Loss of appetite Zinc

Irritability Vitamin B6, magnesium, selenium

Stress Vitamins B6 & B3, magnesium

Lack of motivation Zinc, tyrosine

Insomnia Magnesium

what sugar does

barriers

Fixed timetable

Kitchen - food production

- lack of creativity

- teenager-friendly

food

- awareness

Involving the young people

Policy

Monitoring bodies

Infection control

Inedible gloop

Apathy

clinical procedures

Food & fluid charts

Food and mood diaries

CCBT

CPA

MDT

challenges for nurses

Advocacy

Sustaining lifestyle change

Maladaptive strategies

Cultural or religious needs

Challenging practice

Systemic issue

any ideas?

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Hamel, L. & Robbins, L. (2012) Computer- and web-based interventions to promote healthy eating among children and adolescents: a systematic review. Journal of Advanced Nursing 69:1, pp16-30Maayan, L. & Correll, C.U. (2011) Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents. Journal of Child & Adolescent Pharmacology 21(6), pp517-535Mulrooney, H. (2012) The effect of weight on mental health. Practice Nursing 23:7, pp339-343NMC (2008) The code: standards of practice for nurses and midwives. London, NMCPark, E. (2009) Gender as a moderator in the association of body weight to smoking and mental health. American Journal of Public Health 99:1, pp146-151Rees, R., Oliver, K., Woodman, J. & Thomas, J. (2009) Children’s views about obesity, body size, shape and weight. Journal of Advanced Nursing 67:5, pp954-960SACN (2011) Scientific Advisory Commission on Nutrition Available from Nutrition.org.uk Accessed 17.Mar.2014Tosh, G., Clifton, A.V., Xia, J. & White, M.M. (2014) Physical health care monitoring for people with serious mental illness. Cochrane Database of Systematic Reviews 2014