Approach to nutrition

1. APPROACH TO
NUTRITION
DR.Bilal Natiq Nuaman,MD
C.A.B.M. , F.I.B.M.S. , D.I.M. , M.B.Ch.B.
Lecturer in Al-Iraqia Medical College
2018-2019

5. B2
B3
B1
B9

15. Loss of Appetite (ANOREXIA)
When a patient complains of diminished
appetite, a useful pointer to the importance
and clinical significance is the presence and
amount of accompanying weight loss.
Without confirmed weight loss or other
evidence of illness, it is inappropriate to pursue
investigations of loss of appetite.

16. • Gastrointestinal causes of anorexia include:
the prodromal stage of viral hepatitis,
gastric carcinoma,
gastric ulcer ,
celiac disease, and
Patients with roundworm infestation( ascaris).

17. • Anorexia may be a prominent feature of chronic
diseases such as:
advanced malignant disease,
Chronic alcoholism,
Chronic renal failure,
severe congestive heart failure,
chronic pulmonary disease and cirrhosis of the liver.
• Adrenal insufficiency is constantly associated with
anorexia and loss of weight.
• On the other hand, both thyrotoxicosis and diabetes
mellitus may lead to a marked loss of body weight in
the absence of any impairment of appetite.

18. Anorexia may feature prominently in patients with
psychiatric illness, including anxiety, stress and
depression.
However, there are two psychiatric illnesses in which a
disorder of eating features prominently, namely
ANOREXIA NERVOSA AND BULIMIA, which may
affect 5–10 percent of adolescent girls and young
women, with a significant morbidity and mortality. It
is rare for these syndromes to occur in males.

19. • Increased appetite
An increase in appetite will occur normally in
individuals exercising strenuously, and
transiently in those recovering from an
illness.
An increased appetite can occur in mania and
hyperthyroidism.
Bulimia is characterized by recurrent episodes
of binge eating.

20. • Perverted appetite (pica)
A perverted appetite may be a striking
manifestation of iron-deficiency anemia.
Affected individuals may crave earth or clay
(geophagia), starch (amylophagia) or ice
(pagophagia).
Pica may also occur during the course of
pregnancy, and is of no special significance.

21. osteoporosis

32. Categories of obesity
Generalized
Central

33. • Measurement of generalized obesity
Body Mass Index (BMI):
Weight (kg) /height² (m²)

35. Central Obesity -Phenotypes

36. • Measurements of Central obesity:
1-Waist circumference(cm):
2-Waist-to-Height ratio (WtHR)= waist circumference
(cm) / height (cm)
WtHR> 0.5

40. Weight loss