Nutrition & Diet: Issues for People who have Learning Disabilities
The aim of this learning contract is to enhance my knowledge on the importance of a well balanced, varied and healthy diet among the people with whom I work. I will look at addressing what constitutes a good diet, which nutrients are important to us in terms of promoting health and wellbeing and specific issues, which may be associated with people who have learning disabilities. I will then hopefully come to some conclusions about the importance of promoting and supplying a healthy diet to the people with whom we work. I will conclude with an evaluation of the learning contract. The nutritional status of people is seen as of particular importance in the field of nursing, not only in the physical sense of health, but as LeMay (1996) stresses also the influence it has on the persons psychological and social wellbeing. Bond (1997) emphasises the fact that significant expertise is needed to assess problems associated with eating and in the provision of appropriate interventions. Sarah Mullally, England’s Chief Nursing Officer said recently: ‘Every nurse is responsible for ensuring that people receive dietary care appropriate to their needs’ (Dinsdale 2000). To begin lets look at what is needed to provide a good diet. A healthy diet should consist of all five of the following nutrients, carbohydrates, fat, protein, vitamins and minerals. Carbohydrates are important as they provide the body with energy, there are two sources of carbohydrates, sugars such as in sweets, and starches found in bread, cereals, potatoes, rice and pasta. Fats provide fat soluble vitamins such as A, D, E and K and also essential fatty acids. Fats are the most concentrated form of energy and there are three main types, saturated fats found in animal and dairy products, monounsaturated and polyunsaturated fats which have origins in plants and vegetables. Protein is essential for growth and repair of body tissues, and has its source in meat, fish, poultry, eggs, milk, beans, pulses, nuts and cereals. Vitamins and Minerals both have essential roles in the regulation of different processes within the body. For example vitamin C is important in the maintenance of healthy tissue and is found in fruit and vegetables, vitamin A improves vision in dim light and has its source in carrots, green leafy vegetables, oily fish and liver. Minerals such as iron and calcium also play a role. Iron prevents anaemia and is found in red meats, liver, kidney, egg yolks and green vegetables. Calcium is vital for the development of strong bones and teeth, and is found in foods such as milk, yoghurt, cheese and bony fish. Dorset healthcare NHS trust (1999) comment that a healthy diet should have plenty of variation, include all foods that are enjoyed, as well as giving all the nutrients needed for good health. To achieve a healthy lifestyle you should eat foods that are high in fibre, this prevents constipation, reduce your intake of fat and fatty foods in order to control weight gain and don’t eat sugary foods to often as they can cause tooth decay and obesity. So what are the issues surrounding nutrition and diet for people who have learning disabilities? Many authors have commented upon the need for frequent monitoring of the nutritional status and problems of people with learning disabilities (Dahl et al 1996), and all agree that not enough research has been done in this area. Problems such as being overweight (obese) and underweight due to dysphagia or dependence on carers are common among people who are learning disabled. I will look at each problem individually in order not to confuse the reader. Some people with a learning disability have a greater chance of becoming overweight/obese. Obesity can be defined as a body mass index (BMI) above thirty (Perry 1996). The incidence of morbid obesity (BMI above 40) is higher in people with learning disabilities than the general public (DoH 1995). The...
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