Malnutrition in England

Cases of ricketts in 0-9 year olds have decreased since 2011-12, when there were 724, so I doubt if Covid has had any influence.

I think the evidence for universal free school meals is very interesting, I was involved in some training from a school that had run such a pilot scheme, it was fascinating in terms of the impact it had on attainment.
I think to some extent our culture around food is also quite
different to some European countries, particularly around lunch hours etc.

Maizie Interestingly, cases of malnutrition haven't doubled for 0-9 year olds (the group which has free school meals), but it has jumped from 102 to 304 for 10-19 year olds.

I live in an area , which is considered to be relatively posh - a sea of 1930's semis and detached houses with parks and open spaces .

I'm increasingly shocked and appalled at the state of the elderly people , who shop in Iceland on Tuesdays .

First of all , most of them are struggling to physically do their shop .
I watch them juggling with baskets and walking sticks .
And then , having selected items they are often returned to the shelf as too expensive .

I'm only sorry that I can't help them -physically and financially .

growstuff

Maizie Interestingly, cases of malnutrition haven't doubled for 0-9 year olds (the group which has free school meals), but it has jumped from 102 to 304 for 10-19 year olds.

I was puzzled by the detail you provided on age groups until I realised that the dataset you linked to was published 2 years ago and finishes in 2021, whereas the set I linked to , published this year, with provisional figures for 2023, only breaks the data into under 18y olds and over 18 year olds.

Certainly, the figures for rickets and scurvy vary from year to year and don't show an over all increase in the period. But the figures for malnutrition, as a primary or secondary cause of admission, are startling.

The figures are this:
2007/8.......... 2,702
2022/3......... 10,896

In this period
Under 17s

from 177 -> 312 (which perhaps bears out the effect of FSM, and somewhat negates claims of poor parenting)

18+

from 2.250 -> 10,259

Unknown ages

from 5 -> 325

Bearing in mind that all the issues posters have cited existed at the start of this series in 2007/8, how do we account for the massive increase in adult malnutrition admissions?

Are they admissions with malnutrition as the main cause for admission though, or people admitted for other conditions who are found to be malnourished? I wonder if the pandemic is related in that people let their conditions get worse than they would otherwise have done before seeing a doctor, and took less exercise so became more unfit. Also lot of older and vulnerable people were left to their own devices through this period and were unable to, or were too frightened to shop.

Some elderly people just can't be bothered to eat even if they have meals delivered and food in the fridge and cupboards.

Primary and secondary causes, Casdon.

Primary figures go from 391 to 800 over the same period.

The figures are in the link I posted yesterday. growstuff's link is for an earlier dataset, but gives a more detailed breakdown by age.

I wonder if the pandemic is related in that people let their conditions get worse

There's no noticeable acceleration of the admissions rate post C19. The rise is steady over the whole 2008 to 2023 period.

Interesting MerylStreep, about autism. Autistic children are not being offered access to children's mental health services from what I've read in the press, I imagine eating problems are not being helped.

too many mothers more concerned with nails and pink/blue hair. They buy ready mashed potatoes don't know how to buy fresh meat and veg. Don't know how to shop for reduced items. Too easy to order deliveroo et al

When my grandchildren received free school meals because of low income, my daughter wouldn't let her have them after the first month as they were not balanced or nutritious. Children were allowed to pick what they wanted and would go for things like Pizza or Sausage Roll but vegetables, such as they were (peas), would be left behind. After my DGD picked a plain jacket potato for 3 days in a row because she didn't like the spicy toppings, my daughter went to see her school but was told that there wasn't much they could do about it!
My Mum is in hospital now and we have to make sure she eats safely or at all. For the last week she has eaten sausages and mash followed by jelly, ice-cream and yogurt. Yesterday, for a change she had sausages and chips. She has no idea what she ordered for her meals or how often she has had the same thing so the caterers could ring the changes to see she had a more balanced diet but they appear more interested in clearing the trays as quickly as they can. Another 100 year old lady whose board says "soft food" only and can't feed herself, is often given more difficult food to eat. As she can't manage it, she doesn't eat it. She spends the rest of the time crying that she is hungry which the ward staff ignore (they are obviously bored with her) and another lady feeds her Jaffa cakes to keep her going.
It doesn't surprise me that there is an increase in malnutrition.

icanhandthemback

When my grandchildren received free school meals because of low income, my daughter wouldn't let her have them after the first month as they were not balanced or nutritious. Children were allowed to pick what they wanted and would go for things like Pizza or Sausage Roll but vegetables, such as they were (peas), would be left behind. After my DGD picked a plain jacket potato for 3 days in a row because she didn't like the spicy toppings, my daughter went to see her school but was told that there wasn't much they could do about it!
My Mum is in hospital now and we have to make sure she eats safely or at all. For the last week she has eaten sausages and mash followed by jelly, ice-cream and yogurt. Yesterday, for a change she had sausages and chips. She has no idea what she ordered for her meals or how often she has had the same thing so the caterers could ring the changes to see she had a more balanced diet but they appear more interested in clearing the trays as quickly as they can. Another 100 year old lady whose board says "soft food" only and can't feed herself, is often given more difficult food to eat. As she can't manage it, she doesn't eat it. She spends the rest of the time crying that she is hungry which the ward staff ignore (they are obviously bored with her) and another lady feeds her Jaffa cakes to keep her going.
It doesn't surprise me that there is an increase in malnutrition.

When my mother was in hospital she stopped eating and had the dietician visit her because she had lost so much weight. She was given a liquid food supplement which came in small plastic bottles. Because she was lactose intolerant she couldn't have the one usually given but had a special one. It was disgusting, even my mum who had a sweet tooth complained it was too sweet. So she wouldn't drink it. I believe there was some arrangement going on with the company manufacturing the stuff as they had a large advertising display in the hospital foyer. I think perhaps feeding the elderly is becoming big business.
We had to take in lunches for my mum because she wouldn't eat the hospital food.

There is a large retirement complex next to the local Waitrose , the residents do struggle round the store, one had a funny turn just yesterday.
Some elderly are painfully thin, they dont feed themselves properly, on the other hand they are very independent, most are not short of money, they just don’t like spending it, the saving for a rainy day mindset.

Totally agree with jane1956. Many people's priorities are wrong. And you only have to look around to see how many calories some people have obviously consumed! Part of the problem is laziness. However these days with two parents working and tired at the end of the day it must be so easy to reach for microwaveable convenience food whereas when I was growing up women didn't work so had time to cook a healthy meal.

My late MiL likely had malnutrition; she just didn't feel like cooking for herself, and unless she ate with us, she made do with a cup of tea and a bit of cake to fill her up. After a fall, admission to a residential home turned life around for her with regular, small meals. Also, my late DM had a B12 deficiency which is quite common in the elderly and leads to complete loss of appetite.

These points are not making any excuses for the statistics, just giving an illustration of what can be behind them.

maddyone

Every child in the country gets free school meals up to the end of Year 2. All children from nursery to their fifth birthday get free milk daily. Every child in the country in primary schools receives a piece of free fruit each day. Children who live in low income families are eligible for free school meals throughout their school career, unless their family situation changes and they are no longer a low income family. Add to that food banks where low income families can get free food. Why give children who do not live in a low income family free school meals?
If children are malnourished in Britain today it is unlikely to be because they don’t get free school meals (have you actually seen the quality of school meals provided? I have and it’s pretty dire!) Perhaps City/County Councils not giving licences to more and more junk food outlets such as certain burger or pizza places might help as this type of food contains little nourishment and is available on almost every street corner these days. I’m concerned about the quality of many children’s diet, not the amount of calories they consume.

My DGC do not get free fruit or milk! Yes children up to end of key stage 1 get free school lunches but not sure why you think free milk and fruit is universally provided!!

A little while ago the BBC interviewed a single mother of three who said she couldn’t afford to pay her bills. She admitted that they lived on take away food.
When I was a child in the 1920s, 30, and 40, we never ate out, and the only ready cooked meal we had was fish and chips now and then. School meals were well balanced meat and two veg and there was a third of a pint of milk free.
Nowadays children would not be addicted to fast food if they weren’t introduced to it to start with.

These points are not making any excuses for the statistics, just giving an illustration of what can be behind them.

I'm sure that we all know what lies behind them, HPQ.

What we don't know is why, in a supposedly rich country, the number of admissions for malnutrition, or malnutrition related illness, has been dramatically increasing over the past 15 years.

I thought that was the point of this thread...

I agree with you Maizie. It's the increase which is puzzling. Apparently, the government itself holds records for overweight/obesity, but not malnutrition. People can, of course, be both overweight and malnourished. The NHS itself doesn't appear to have (or at least doesn't publish) the underlying causes of malnutrition. In some cases, there are health issues, such as not being able to swallow or absorb nutrients, but I would expect those health issues to have remained constant, so the increase remains unexplained.

Given that the patients tend to be older, it doesn't appear that the "young can't cook and only eat take-aways" claim is correct.

Another point worth mentioning is that these figures are based on hospital admissions. Charities working with food insecurity reckon that the cases of malnutrition are many times higher than these figures show. I'm concerned that there seems to be so little hard data and so much speculation, much of it blaming the malnourished for their own predicament.

Combatting the increasing prevelance of scurvy, ricketts or diabetes 2 which none of you have mentioned could be done, for the next generation at least, by teaching school children to cook!

I believe in most countries of the western world, only those of us who are over retirement age were actually taught to cook and even amongst my comtempories, a lot of people never make a meal from scratch.

Some buy ready prepared frozen meals, many buy pre-frozen vegetables, which quite frankly, taste nothing like fresh ones and have a lower nutrional value.

Teaching children to cook and to do so healthily could mean that the next generation drops fast food, tinned foods, pre-frozen food and entire pre-frozen meals, most of which contain far too much salt, sugar and other additives and are generally speaking not so good for you.

Yes, eating fruit is healthy, but with the prices fresh fruit is sold for, no-one can afford to eat it every day, a fact that those who advise on a healthy diet consistently ignore.

jane1956

too many mothers more concerned with nails and pink/blue hair. They buy ready mashed potatoes don't know how to buy fresh meat and veg. Don't know how to shop for reduced items. Too easy to order deliveroo et al

Wow judgemental, sweeping generalisation!

How many people have come to live here in the last 15 years?
Increased population often doing low paid work and many working illegally as well in nail bars and restaurants may account for increased malnutrition, tho I expect the fact that people are living longer , so an increased elderly population as well, not eating properly as well as all the many other reasons.

growstuff

I agree with you Maizie. It's the increase which is puzzling. Apparently, the government itself holds records for overweight/obesity, but not malnutrition. People can, of course, be both overweight and malnourished. The NHS itself doesn't appear to have (or at least doesn't publish) the underlying causes of malnutrition. In some cases, there are health issues, such as not being able to swallow or absorb nutrients, but I would expect those health issues to have remained constant, so the increase remains unexplained.

Given that the patients tend to be older, it doesn't appear that the "young can't cook and only eat take-aways" claim is correct.

Another point worth mentioning is that these figures are based on hospital admissions. Charities working with food insecurity reckon that the cases of malnutrition are many times higher than these figures show. I'm concerned that there seems to be so little hard data and so much speculation, much of it blaming the malnourished for their own predicament.

Just look at the crisis in care for the elderly/disabled and you will have your answer. It is useless trying to get Social Care or support in many areas. In our area, the Adult Social Services agree that my daughter needs help in producing meals for her and her family but haven't got the budget. Those with medical problems aren't getting the financial help from the CHC who have changed their framework so that they are only helping those next to death's door even though legally they should be paying out well before this. People don't always know what care they are entitled to so don't ask for it and it isn't advertised well because nobody wants to pay for it.
There appears to be an explosion in mental health problems with young people where food is the only control they have along with more neuro-diverse people who often have sensory issues with food. Getting help is a real struggle and by the time you get it, so much damage has been done.
In both areas, my family have experience and we have been completely taken aback by the struggle to get early intervention which would have probably cost the country less than waiting for the need of in-patient care with lengthy treatment.

MaizieD

^I wonder if the pandemic is related in that people let their conditions get worse^

There's no noticeable acceleration of the admissions rate post C19. The rise is steady over the whole 2008 to 2023 period.

By the sounds of it there are lots and lots of impacting factors, which is going to make it tough for initiatives to have an impact. There must be a percentage that is going to prove very difficult to eradicate too with an aging population. There’s a Malnutrition Taskforce, and publicity on Age UK, hopefully for older people we will see raised awareness as a consequence.