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Module on “Anorexia” by Dr. Vaibhav Jaiswal

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Anorexia in children

In today’s world there is much gap in between the two type of society; one having tons of food in houses but more wastage and on another hand there is scarcity of food. Western world have very much influences in our society especially urban populations.

Eating disorders are the third most common chronic illness among adolescents, after obesity and asthma. The peak age of onset occurs between 14 and 18 years. Anorexia is a condition in which a child refuses to eat adequate calories sometimes out of an intense and irrational fear of becoming fat.

Anorexia can lead to several serious health problems. Those problems include:

Anorexia can lead to Nutritional anemia. Nutritional anemia is caused by a lack of iron, protein, Vitamin B12, and other vitamins and minerals that needed for the formation of hemoglobin. Folic acid deficiency is a common association of nutritional anemia and iron deficiency anemia is the most common nutritional disorder.

Micronutrient deficiency leads to hidden hunger. Consequences of hidden hunger are serious. Micronutrient deficiencies lead to a cycle of poor health, poor educability, poor productivity and consequent economic losses.

Understanding children’s eating attitudes and behavior is important in terms of children’s health. Evidence also indicates that dietary habits acquired in childhood persist through to adulthood

Parental attitudes must certainly affect their children indirectly through the foods purchased for and served in the household influencing the children’s exposure and their habits and preferences.

Children find themselves amidst a complex society that is undergoing breathtaking changes. Concepts, relationships, lifestyles are metamorphisised to accommodate the new jet-setting age. Food is no exception. Healthy nutritious foods have been replaced by the new food mantra – JUNK FOOD! Junk food comprises of anything that is quick, tasty, convenient and fashionable. Wafers, colas, pizzas and burgers are suddenly the most important thing. It seems to have engulfed every age; every race and the newest entrants are children.

Traditional food skills are not passed on automatically from parent to child. Most people have forgotten that the primary reason for eating is nourishment. In the not so distant past, food was treated with reverence because of its life sustaining quality. Enjoying a meal was sharing experience with the others. Today family dinners are rare. In many ways, our culture is structured to foster poor eating habits. Television commercials and supermarkets are propagating a wide variety of enticing junk foods, attractively packaged and often tagged with a tempting sop. We should be constructing an environment that protects our children. Instead we have a highly seductive environment that undermines eating habits.

Management

In Ayurveda food is consider as life. Anna is responsible for the production and growth of all living being. It is called so, because if consumed by the individual in a proper manner, then it confers Deerghaayu (long life) and increases the swastha. (health) On the other hand, improper consumption leads to alpaayu(less age) and aswastha(ill health). Ahara being a part of the daily routine, if one concentrates a little more on its quantity and quality, then the overall effect of health can be enhanced.

The correct way of eating or taking diet is consider as Ashtaaharavidhivisheshaayatana (Dietary rules of eating). It is the most ideal way of taking Ahara i.e food by an individual and should be followed by all children to keep them healthy not only physically but also mentally.

Ashtaaharavidhivisheshaayatana is the most ideal in today’s life style, especially since we are lacking in the time sense, neglecting the capacity of digestive fire, using the meal irrespective of the digestive capacity etc. all of which lead to the manifestation of disease. Proteins, Carbohydrates, minerals, fats etc form the basic bodily constituents, which must be essentially present in a diet in the requisite amount. The present age of these essentials is imprinted on the respective package, thus giving the consumer a fair idea about ‘what’ and ‘howmuch’ he is consuming.

The eight factors which determine the of the consumer are:

  1. Prakriti
  2. Karana

3.Samyoga

  1. Raashi

5.Desha

6.Kaala

7.Upayoga Samstha

  1. Upayokta

Especially in children for the management of anorexia following points should be followed so that growth of the child will improve.

  1. Supplementation
  2. Food fortification
  3. Dietary diversification
  4. Bio fortification
  1. Supplementation– Supplementation means taking a capsule, tablet, or injection containing the needed micronutrient(s). Many types of Multivitamin syrups are been given to children as food supplementation to overcome micro nutrient deficiencies.        For example mega doses of vitamin A are given every 6 months in some areas in form of syrup or capsules to children age between 9 months to 5 years.
  2. Food fortification means adding extra nutrients to foods to increase micronutrient value. Fortification of minerals, vitamis in food like folate in wheat flour, Iodised salt, Vitamin D in vegetables oils etc.
  3. Dietary diversification is Changing household diets to include micronutrient-rich foods. Increasing access to nutrient-dense foods by adding different verities of milk, frits, non-veg, wheat, rice and others. It is mostly achieved through social and behavior programs.
  4. Bio fortification means growing foods with more total micronutrient content.

Ayurvedic measures like

Theses above measures are to followed in children to outcome Anorexia and to achive optimum growth.

Study material-

Pandey Kashinath, Chathurvedi Ghorakhnathji, Charaka Samhitha, Vidhyotini tika (vol 1),Varanasi, Choukumba Bharathi Academy ,2009

Sushruta samhita hindi commentary by Kaviraj Dr Amballika Dutta shastri ; 3rd edition ; chaukhambha saskrit series office,

https://www.webmd.com/mental-health/eating-disorders/features/eating-disorders-children-teens#1

The Micronutrient Initiative and UNICEF. Vitamin & mineral deficiency a global progress report. 2010. Available at: http://www.unicef.org/media/files/vmd.pdf.

Children’s eating attitudes and behaviour: a study of the modelling and control theories of parental influence,Rachael Brown, Jane Ogden, Health Education Research, Volume 19, Issue 3, 1 June 2004, Pages 261–271,

https://www.stanfordchildrens.org/en/topic/default – id=anorexia-nervosa-in-children-90-P02554

MCQs

Q1.  The peak age of Eating disorder is?

  1. 2 to year
  2. 5 to 10 year
  3. 10 to 12 year
  4. 14 to 18 year

Q2. Anorexia can lead to several serious health problems in children except?

  1. Bone deformity
  2. Obesity
  3. PEM
  4. Low BP

Q3. In Nutritional anemia there is deficiency of which elements?

  1. Iron
  2. Folic acid
  3. B12
  4. All of above

Q4. Ashtaaharavidhivisheshaayatana contain all below except?

  1. Prakriti
  2. Desh
  3. Vikriti
  4. Kala

Q5. What is Karana in Ashtaaharavidhivisheshaayatana signify?

  1. Processing of food
  2. Quality of food
  3. Quantity of food
  4. Type of food

Q6. Children should be given Vitamin A from which age as in immunization schedule?

  1. 1 months
  2. 3 months
  3. 6 months
  4. 9 months

Q7.  Iodised salt is a form of ?

  1. Food fortification
  2. Food supplementation
  3. Complementary food
  4. Dietary diversification

Q8. Which type of Ahara dravya are Agni Dipak?

  1. Guru
  2. Laghu
  3. Ushna virya
  4. Both B and C

Q9. Balchaturbhadra churana contain all below except?

  1. Chitrak
  2. Pippali
  3. Ativisha
  4. Nagarmotha

Q10.  Organic foods are example of which type?

  1. Food supplementation
  2. Food fortification
  3. Bio fortification
  4. Complementary food

 

Question Answer
1 d
2 b
3 d
4 c
5 a
6 d
7 a
8 d
9 a
10 c

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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