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Derek is 52 and has Down syndrome. He lives alone with his pets and has difficulty cooking and understanding how a diet works. He often sits home alone and orders takeaways or will buy unhealthy foods which are easy to cook. He has a sister which regularly visits him and will take him food shopping and meal plan for him when she has the chance. Other than this Derek barely has friends and finds it hard to interact with other people. As he barely meets up with his friends it's led to him forming an addiction to his Xbox. Due to his being inactive, he has developed type 2 diabetes and is yet to have any medical help.

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Meredith is 36 and lives with her husband and children. she lives a very healthy lifestyle and exercises 4-5 times a week. She works as a fitness coach Monday - Friday and helps individuals to reach their desired goals. She is also lactose intolerant meaning She cannot have dairy so she has to have a specific diet. Due to her having a healthy and special diet she meal preps with her husband and plans healthy and balanced diets which fit her needs. She also attends her children's award assemblies and takes them to the park. Being active as she is it helps her to be at no risk of developing food-related health problems.

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P1: Effects of food processing and preparation methods affect health and well-being ?

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P1: Effects of food processing and preparation methods affect health and well-being ?

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Food processing:
Food processing is essentially any process which changes the food from its natural state. Frying is one of the main types of food processing, and it involves multiple ways of doing so e.g. shallow frying and deep frying (Nourish, 2017). All methods of frying are done by cooking the food in hot fats or oils and are usually done in a shallow oil bath in a pan, or the food can be submerged completely in deeper baths of oil which is known as deep fat frying. Frying can have a serious effect on health if consumed in high amounts. According to Nourish (2017) fried foods are High in calories, fat, and salts, due to a report being taken place in 2014 fried foods have been linked to the main course of serious health problems such as type 2 diabetes and heart disease. If fried foods were to be consumed regularly then it would cause a build-up of fatty deposits in the arteries which can harden causing the arteries to narrow. If it happens over a longer period of time then weight gain can occur and could lead to mental health problems such as anxiety and depression.

Preparation methods:
Preparation methods are a process in which raw ingredients are prepared in ready for consumption. There are many preparation methods some of the main ones are roasting, baking and boiling. Boiling is one of the main types of food preparation methods, and it involves heating up a liquid to boiling point and is mainly used when cooking meats, vegetables or pasta in the liquid. Boiling can reduce the vitamin C content in food more than any other preparation method. Green foods like broccoli, spinach and lettuce can lose up to 58% of their vitamin content when boiled, due to vitamins being water-soluble. If this happens then it could lead to malnutrition as the individual may not get all of the nutrients they need.

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P1: How does malnutrition affect health and well-being?

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P1: How does malnutrition affect health and well-being?

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Malnutrition:
Malnutrition is the phrase in which both undernutrition and overnutrition is referred to and both can cause severe health problems if a healthy balanced diet isn't been kept.

Over-nutrition:
Over-nutrition is a form of malnutrition which is associated with the imbalance of nutrition, overnutrition is essentially the consumption of nutrients if an individual was to consume too many nutrients over a longer period of time then it can lead to weight gain and increase the risk of developing type 2 diabetes.

Under-nutrition:
Undernutrition is when there is not enough nutrition is consumed or it can be associated with not getting enough of the right foods which the body needs. If the body is lacking the nutrients it needs for a prolonged period of time it can cause health problems such as rickets in children and osteoporosis in adults (NHS inform, 2023).
(NHS inform, 2023).

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P1: how does a healthy eating and a balanced diet affect health and well-being?

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P1: how does a healthy eating and a balanced diet affect health and well-being?

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The EatWell guide represents how much of each food we should be eating in order to keep healthy and balanced. It is recommended that we eat at least 5 portions of fruit and vegetables a day combined with 60 minutes a day of moderate exercise to maintain good health and well-being. Eating a healthy and balanced diet is important as it helps to keep us physically and mentally healthy. If individuals were to have a healthy diet it would not only keep them healthy it would also lower the risk of them developing health conditions such as obesity and high blood pressure.

However, if an individual was to only consume little fruit and veg and consumed more high sugar and fatty foods they will be at more risk of developing obesity and type 2 diabetes. Not only would it increase the risk of developing physical health conditions it would also increase the risk of them developing mental health problems like anxiety and depression. According to Columbia University (2015), refined foods such as bread, sugar and soda trigger a hormonal response in the body which reduces blood sugar levels and may cause a response in which mood changes, fatigue, and other symptoms of depression. This evidence shows that individuals who eat healthy foods are better physically and mentally.

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The Eatwell Guide is a policy tool used to define government recommendations on eating healthily and achieving a balanced diet.

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The UK's national food guide has been updated in light of recent recommendations made by the Scientific Advisory Committee on Nutrition ( SACN) in their report on Carbohydrates and Health published in July 2015.

The Eatwell Guide has replaced the eatwell plate and continues to define the government's advice on a healthy balanced diet. The Eatwell Guide is a visual representation of how different foods and drinks can contribute towards a healthy balanced diet.

The Eatwell Guide is based on the 5 food groups and shows how much of what you eat should come from each food group.

Public Health England encourages organisations and individuals to use the Eatwell Guide to make sure everyone receives consistent messages about the balance of foods in a healthy diet. This publication provides guidance on using the Eatwell Guide in promotional materials.

The Carbon Trust sustainability assessment indicated that the Eatwell Guide shows an appreciably lower environmental impact than the current UK diet.

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The Eatwell Guide is a policy tool used to define government recommendations on eating healthily and achieving a balanced diet.

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P1: How do genetically modified foods affect health and well-being?

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P1: How do genetically modified foods affect health and well-being?

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Genetically modified foods are defined as organisms as that are not natural and are altered in a way which is not natural (man-made). This can have many side effects such as:
- Allergic reactions can be more severe
- In some cases, they can be linked to cancers
- Loss of nutrition (Center for food safety 2023).

While Genetically modified foods can taste better than the average natural foods and have use of less pesticide, as well as producing more foods in a shorter amount of time. There are certain things that should be deeply investigated as according to medline plus (2023) they have been associated with the cause of allergies and can be associated with some cancers and genetic conditions.

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Genetic engineering can be done with plants, animals, or bacteria and other very small organisms. Genetic engineering allows scientists to move desired genes from one plant or animal into another. Genes can also be moved from an animal to a plant or vice versa. Another name for this is genetically modified organisms, or GMOs.

The process to create GE foods is different than selective breeding. This involves selecting plants or animals with desired traits and breeding them. Over time, this results in offspring with those desired traits.

One of the problems with selective breeding is that it can also result in traits that are not desired. Genetic engineering allows scientists to select one specific gene to implant. This avoids introducing other genes with undesirable traits. Genetic engineering also helps speed up the process of creating new foods with desired traits.

The possible benefits of genetic engineering include:

More nutritious food

Tastier food

Disease- and drought-resistant plants that require fewer environmental resources (such as water and fertilizer)

Less use of pesticides

Increased supply of food with reduced cost and longer shelf life

Faster growing plants and animals

Food with more desirable traits, such as potatoes that produce less of a cancer-causing substance when fried

Medicinal foods that could be used as vaccines or other medicines

Some people have expressed concerns about GE foods, such as:

Creation of foods that can cause an allergic or toxic reaction

Unexpected or harmful genetic changes

Inadvertent transfer of genes from one GM plant or animal to another plant or animal not intended for genetic modification

Foods that are less nutritious

These concerns have thus far been unfounded. None of the GE foods used today have caused any of these problems. The US Food and Drug Administration (FDA) assesses all GE foods to make sure they are safe before allowing them to be sold. In addition to the FDA, the US Environmental Protection Agency (EPA) and the US Department of Agriculture (USDA) regulate bioengineered plants and animals. They assess the safety of GE foods to humans, animals, plants, and the environment.

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Genetic engineering can be done with plants, animals, or bacteria and other very small organisms. Genetic engineering allows scientists to move desired genes from one plant or animal into another. Genes can also be moved from an animal to a plant or vice versa. Another name for this is genetically modified organisms, or GMOs.

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P1 : How does self-prescribed supplements affect health and well-being?

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P1 : How does self-prescribed supplements affect health and well-being?

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Self-prescribed supplements are when an individual uses substances and medication is used for treating health problems without a consultation. Supplements are safe when they are given by a professional with instructions and precautions. However, things like vitamin and mineral supplements are over-the-counter supplements so they come with instructions on how many you should be taking. In some cases overusing certain supplements both over the counter and prescribed e.g. overusing vitamin A supplements can cause damage in the liver and may even lead to liver damage (Henry ford health, 2023). If this was to be ignored and they carrie d on it may lead to permanent damage meaning it cannot be treated.

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Supplements are everywhere: in grocery stores, health food stores and online. Wellness influencers share their daily supplement regimens on social media, and followers clamor to follow suit. But while certain supplements may have benefits, too much of a good thing really might be bad for you.

Researchers have found that overuse of dietary supplements may increase your risk for cancer. In this study, they found that excessive use of beta carotene increased the risk of developing heart disease and lung cancer, while excessive use of selenium supplements increased the risk for developing skin cancer. Overuse of vitamin E led to an increase in developing prostate cancer, and overuse of folic acid was connected to an increased risk of colon cancer.

In fact, colorectal cancer rates are rising in young people-those born around 1990 are twice as likely to develop colon cancer and four times as likely to develop rectal cancer than those born in 1950, says the American Cancer Society -and excessive use of dietary vitamins and supplements is one theory as to why this is.

"If your doctor prescribes a certain supplement because of a nutritional deficiency, you should definitely take it," says Marjan Moghaddam, D.O., a family medicine physician with Henry Ford Health. "People who are iron or vitamin B12 deficient, for example, would likely benefit from taking these supplements. This warning only concerns those who are, on their own, ingesting excessive amounts of supplements, perhaps because they feel that it's healthy to do so, or because it's the health trend of the moment."

Other things to keep in mind before continuing your daily supplement routine:

Unlike prescription medications, supplements are not regulated by the Food and Drug Administration (FDA), so you cannot always be sure that what is on the label is actually what is inside the bottle.

Overuse of certain supplements, like vitamin A, can be taxing on the liver and lead to liver damage.

Overloading on mineral supplements (such as magnesium and zinc) can cause gastrointestinal problems such as nausea, vomiting and diarrhea.

The biggest takeaway, here? It's best to ingest supplements in moderation-as recommended by your doctor-and if you don't need to take a supplement, try to get your nutrition from a well-rounded, healthy diet loaded with fresh fruits and vegetables.
To find a doctor at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).
Marjan Moghaddam, D.O., is a family medicine physician who sees patients at Henry Ford Medical Center in Capitol Park and Harbortown.

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Self-Prescribing Supplements? Here's Why You Should Think Again

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Supplements are everywhere: in grocery stores, health food stores and online. Wellness influencers share their daily supplement regimens on social media, and followers clamor to follow suit. But while certain supplements may have benefits, too much of a good thing really might be bad for you.

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Carbohydrates are a type of macronutrients. There is 2 types of carbs simple and complex. Simple carbs are basic sugars which involves sweets and chocolate. Complex include multiple simple sugars which are used for energy.

Function in the body:
Carbohydrates are associated with providing the body with energy. The carbs consumed are turned into glucose which is the body's primary energy source and this energy is used for digestion and other processes and it can be used as a heat source (Medline plus, 2022) .

Dietary sources:
Carbohydrates consist of good and bad sugars:
Good (consumed regularly):
- Bread, noodles, pasta, crackers
Bad (consumed in moderation):
- Cakes, cookies, candy, and other desserts

Dietary deficiencies:
If individuals do not consume enough carbs then it would lead to them developing low blood sugar levels which will lead to symptoms such as fatigue and dizziness. This commonly occurs for individuals who are diabetic as they will have a problem producing glucose and insulin meaning they will need increased carbs.

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What are carbohydrates?

Carbohydrates, or carbs, are sugar molecules. Along with proteins and fats, carbohydrates are one of three main nutrients found in foods and drinks.

Your body breaks down carbohydrates into glucose. Glucose, or blood sugar, is the main source of energy for your body's cells, tissues, and organs. Glucose can be used immediately or stored in the liver and muscles for later use.

What are the different types of carbohydrates?

There are three main types of carbohydrates:

Sugars. They are also called simple carbohydrates because they are in the most basic form. They can be added to foods, such as the sugar in candy, desserts, processed foods, and regular soda. They also include the kinds of sugar that are found naturally in fruits, vegetables, and milk.

Starches. They are complex carbohydrates, which are made of lots of simple sugars strung together. Your body needs to break starches down into sugars to use them for energy. Starches include bread, cereal, and pasta. They also include certain vegetables, like potatoes, peas, and corn.

It is also a complex carbohydrate. Your body cannot break down most fibers, so eating foods with fiber can help you feel full and make you less likely to overeat. Diets high in fiber have other health benefits. They may help prevent stomach or intestinal problems, such as constipation. They may also help lower cholesterol and blood sugar. Fiber is found in many foods that come from plants, including fruits, vegetables, nuts, seeds, beans, and whole grains.

Which foods have carbohydrates?

Common foods with carbohydrates include:

Grains, such as bread, noodles, pasta, crackers, cereals, and rice

Fruits, such as apples, bananas, berries, mangoes, melons, and oranges

Dairy products, such as milk and yogurt

Legumes, including dried beans, lentils, and peas

Snack foods and sweets, such as cakes, cookies, candy, and other desserts

Juices, regular sodas, fruit drinks, sports drinks, and energy drinks that contain sugar

Starchy vegetables, such as potatoes, corn, and peas

Some foods don't have a lot of carbohydrates, such as meat, fish, poultry, some types of cheese, nuts, and oils.

Which types of carbohydrates should I eat?

You do need to eat some carbohydrates to give your body energy. But it's important to eat the right kinds of carbohydrates for your health:

When eating grains, choose mostly whole grains and not refined grains:

Whole grains are foods like whole wheat bread, brown rice, whole cornmeal, and oatmeal. They offer lots of nutrients that your body needs, like vitamins, minerals, and fiber. To figure out whether a product has a lot of whole grain, check the ingredients list on the package and see if a whole grain is one of the first few items listed.

Refined grains are foods that have had some parts of the grains removed. This also removes some of the nutrients that are good for your health.

Eat foods with lots of fiber. The Nutrition Facts labels on the back of food packages tells you how much fiber a product has.

Try to avoid foods that have a lot of added sugar. These foods can have many calories but not much nutrition. Eating too much added sugar raises your blood sugar and can make you gain weight. You can tell if a food or drink has added sugars by looking at the Nutrition Facts label on the back of the food package. It tells you how much total sugar and added sugar is in that food or drink.

How many carbohydrates should I eat?

There is no one-size-fits-all amount of carbohydrates that people should eat. This amount can vary, depending on factors such as your age, sex, health, and whether or not you are trying to lose or gain weight. On average, people should get 45 to 65% of their calories from carbohydrates every day. On the Nutrition Facts labels, the Daily Value for total carbohydrates is 275 g per day. This is based on a 2,000-calorie daily diet. Your Daily Value may be higher or lower depending on your calorie needs and health.

Is it safe to eat a low-carb diet?

Some people go on a low-carb diet to try to lose weight. This usually means eating between 25 g and 150 g of carbs each day. This kind of diet can be safe, but you should talk to your health care provider before starting it. One problem with low-carb diets is that they can limit the amount of fiber you get each day. They can also be hard to stay on for the long term.

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Carbohydrates, or carbs, are sugar molecules. Along with proteins and fats, carbohydrates are one of three main nutrients found in foods and drinks. Your body breaks down carbohydrates into glucose. Glucose, or blood sugar, is the main source of energy for your body's cells, tissues, and organs.

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Proteins are a type of macronutrient which are often called polypeptides and are large complex molecules which are made up of amino acids. There are 2 types of amino acids: essential amino acids and non-essential amino acids, and there are over 20 of these in total which helps the tissues and cells with growth and repair.

Function in the body:
Proteins in the body are an important part of our diet as they contain amino acids which are used to build and repair muscles and bones, they are also essential when regulating hormone levels and when producing enzymes. As well as all these roles they can also be used as an energy source and provide the body with a "boost" (Better Health 2022).

Dietary sources:
Protein can be found in these foods:
- Beef, lamb, fish, prawns, milk, cheese

Dietary deficiencies:
Individuals who are within the ethnic minority, vegan and vegetarian will often avoid foods which are associated with animals e.g. red meats, chicken eggs etc. This means they will most likely have to find alternative foods which have protein in them. While they are still consuming protein they may not get enough causing them to have lowered protein levels this might cause symptoms such as weakness, slow metabolism, and brittle hair and nails.

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Introduction to proteins and amino acids | Biology foundations | High school biology | Khan Academy

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What is it
Vitamins are a type of Micronutrients that our body needs in order to grow, develop and function properly.

Function in the body
Vitamins are associated with helping to fight infections, heal minor wounds and help strengthen bones. There are a number of vitamins which include:
A - Helps with vision, immune system, reproduction and helps with growth and development.
B - There are 8 types of vitamin B which come together to form a complex (group of vitamins) they are all associated with helping to break down carbohydrates and carry nutrients through the body.
C - It is used with the formation of collagen and is mainly associated with helping the body absorb iron, and it maintains the cartilage, bones and teeth strong and healthy.
D - Is commonly paired with vitamin C and together they help the body reduce inflammation and help cells with growth.
E - Acts as an antioxidant, and helps with the formation of red blood cells.
K - Acts as a helper by creating a blood clot which helps to heal wounds.

Dietary source
- Citrus fruits, red and green peppers
- Strawberries, blueberries, blackberries

Dietary deficiencies
There are a number of deficiencies which can occur from a lack of vitamins and can cause symptoms such as dizziness and pale or yellowish skin.  If an individual has a lack of vitamin C in their diet for over 3 months can lead to scurvy.
Some symptoms of scurvy are:
- Having severe joint and leg pain
- Skin that bruises easily
If an individual has a lack of Vitamin D or calcium in their diet then it can lead to rickets.
Some symptoms of rickets are:
- Pain in the bones
- Skeletal deformation - thickening of ankles, wrists and knees.

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Older adults may have different vitamin and mineral needs than younger adults. Find recommended amounts and information on calcium, sodium, vitamin D, and more.

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Fats and oils are macronutrients which are classed as lipids and contain saturated fats polyunsaturated fats and monounsaturated fats, cis fatty acids and trans fatty acids. Fats are greasy substances which are found both in animals and some plants and oils are foods which contain a slippery consistency.

Function in the body:
Essential Fats and oils help the body absorb vitamins and are a main source of food storage, and can be used as a longer-lasting energy reserve. Triglycerides, cholesterol and other essential fatty acids store energy insulate us and help to protect our organs (National Institute of general medical sciences 2010).

Dietary source:
Fat and Oils:
Plant:
- canola oil, peanut oil, avocados, and olive oil
Animal:
- Fish, butter, lard and goose fat

Dietary deficiencies:
If an individual consumes too many saturated fats and oils then the body will store all these extra fats causing higher cholesterol. The unbalanced levels can cause increased blood pressure and might even cause fats to harden in the arteries increasing the risk of a heart attack or stroke.

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What is it
Minerals are a type of micronutrient which are natural elements with are found on Earth and in foods that our bodies need in order to function (Medline Plus, 2022), there are also main 3 minerals which are Calcium, iron and sodium.

Function in the body
There are 3 main functions of minerals which are helping with digestion, immunity and helping to maintain healthy nervous systems.
Sodium - Helps to stimulate nerve impulses, contract and relax muscles, and help maintain the body's balance of water.
Iron - It is used to make a certain protein which is in the red blood cells which helps to carry oxygen from our lungs to all different parts of the body.
Calcium - It helps the body to build muscle, and move them so that nerves can be passed between the brain and other parts of the body.

Dietary source:
- Cereals, bread, milk
- Nuts, Fruit, and meats

Dietary deficiencies
If an individual has lowered iron intake for a certain period of time then they will develop anaemia which occurs when an individual has lowered iron levels, the individuals will take iron tablets or will be advised to eat iron-rich foods in order to maintain these.  If an individual had lowered iron it would also increase the risk of them developing osteoporosis as iron helps to strengthen bones so individuals with lower iron will have weakened bones exposing them to the risk.

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Why Are Minerals Important? | Functions Of Minerals | The Dr Binocs Show | Peekaboo Kidz

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What is it?
Water is a clear liquid and is a type of macronutrient which is to be consumed in large amounts so the body can carry out basic functions.

Function in the body
Water is used in the body for a number of things such as helping to keep a normal temperature, lubricating and cushioning joints, protecting the spinal cord and helping the body get rid of waste through urination.

Dietary source
- Apples, celery, lettuce, peaches
- Cucumber, tomatoes, watermelon, semi-skimmed milk

Dietary deficiencies
If an individual was to not consume enough water then they would experience things like constipation, abdominal pain and cramps, and may even experience "ashy skin". In other severe cases, they will experience higher-risk symptoms such as not weakened immunity and not being able to urine frequently.

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What is it
Fibre is a type of micronutrient and is a type of carbohydrate that is found in plants and the body cannot digest. There are 2 types of fibres insoluble and soluble. Insoluble fibres are the certain part which parts of food which is not affected by the digestive process. Soluble fibres are things that dissolve in water for example bread would be soluble fibres.

Function in the body
Fibre is an undigestable nutrient which is made of plants and passes through the stomach and intestine and is mainly a form of carbohydrate which helps to keep our digestive system healthy, regulates how the body uses and stores sugars, and helps to keep the body's hunger and sugar levels in check. This means that fibre is a slow-releasing nutrient which makes sure our bodies are aware of what we need, e.g. water and food.

Dietary source
- Cereals, wholemeal bread, brown pasta
- Peas, nuts, seeds, potatoes

Dietary deficiencies
If an individual doesn't get enough fibre then they could develop symptoms like constipation and for individuals who suffer from health conditions like irritable bowel syndrome then eating too much fibre can trigger them to develop worsened IBS symptoms.

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Specific Conditions (Type 2 diabetes)
Type 2 diabetes is a condition that is caused by individuals eating too many sugary and fatty foods over a long period of time, which causes the sugar levels to become too high.
Derek is 52 and has recently been diagnosed type 2 diabetes and often finds it hard to understand how a healthy and balanced diet works so due to his down-syndrome.
There are a lot of risks when dealing with diabetes which are being severely overweight and inactive are the main ones to watch, it is to be expected that Derek is inactive as he has no social interactions and barely leaves his house for exercise. The lack of exercise is also adding to Derek being overweight as well as the consumption of bad foods, these contributing factors will be the main reasons for Derek's type 2 diabetes. It will be expected that he previously experienced symptoms such as Increased urination, feeling tired, and itching in the penis or vaginal area (NHS, 2020). Having type 2 diabetes can cause an increased risk of developing other health conditions such as strokes, infertility, high blood pressure and hypertension. If Derek continues to lack exercise and consumes convenience foods then he will be at a higher risk of developing these other health concerns.

Food Allergies intolerance (Lactose intolerant)
Being lactose intolerant means that you will get symptoms which will be uncomfortable when eating foods which contain lactose, which is a sugar found in dairy products. These symptoms can be avoided if smaller amounts of dairy are consumed, or avoiding them completely (NHS, 2023). Meredith is 26 years old and lives with her husband, she suffers from lactose intolerance and lives a very healthy lifestyle and meal prep with him in order to maintain her digestive problem. Due to her meal prepping with her husband, helps her to have a balanced diet and will allow her to keep track of her daily and weekly calorie intake. As well as this will also help to keep track of how much dairy she is consuming which will give her the choice of substitutions of dairy products. Before being diagnosed and told she is lactose intolerant she will have experienced symptoms such as Tummy pains or discomfort, Flatulence, and Diarrhea. If Meredith was to consume dairy frequently after being diagnosed it would cause her to have severe bowel problems and it might potentially ruin the lining of her small intestine causing her to lose nutrients from the food she consumes.

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P3/M2/D1: How dietary habits affect nutritional health

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P3/M2/D1: How dietary habits affect nutritional health

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Meal patterns:
Derek has no set meals plans and often sits at home eating unhealthy foods and take away's meaning he will often choose when he eats. He has no set meal times and often stays up till early hours of the morning playing his Xbox and often snacks whenever he wants. Due to him eating whenever he wants he has developed a binge eating disorder which has lead to him developing type 2 diabetes. If he carries on eating like this and has no set meal times it will lead to him developing a slower thinking, irritability and low energy levels. If he was to carry on like this it would cause his physical and mental well-being worsen and may cause him to develop things like anxiety and depression.

Meredith has a very active lifestyle as she works as a fitness coach in a gym. She meal preps with her husband so she can eat healthily and maintain her lactose intolerance. Due to her having set meals times and not eating past 10 pm it allows her body to use the food as fuel so she will not be storing unused fats and energies. This helps to make sure she is healthy and will decrease the risk of her gaining weight. Due to her active lifestyle and meal planning it allows her to be safe from developing health concerns such as obesity and high blood pressure.

Snacking
Derek has recently developed an addiction to his Xbox and has ruined his meal patterns which has led to him developing a binge eating disorder which leaves him snacking in between meals and till late at night. Due to him been up to early hours of the mornings its caused him develop type 2 diabetes, if Derek carries on with these bad food habits it could potentially lead to his type 2 diabetes worsening. Alongside this, Derek also has a down syndrome which has left him unable to understand how a healthy diet works. He struggles to make friends so when he has a problem he has no one else to help him. If he has no help understanding things he may feel helpless which may affect his mental health possibly causing him to develop anxiety or even isolate himself even more.

Meredith lives a healthy lifestyle and likes to meal plan what she is consuming for the week. Due to her living a healthy lifestyle, she will have already planned what snakes she will have throughout the week, she does eat unhealthy food as well but does it within moderation. Due to her planning her weekly meals, she will be more likely to eat low-calorie snacks so she stays within her daily calorie intake. Due to her eating healthier she has minimised risk factors which are:
- Less likely to be lazy
- More likely to have increased life expectancy
- Less likely to get certain cancers (Centers for disease control and Prevention, 2022).

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P3/M2/D1: How lifestyle affects nutritional health 

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P3/M2/D1: How lifestyle affects nutritional health 

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Social eating and drinking
Derek doesn't really socialist with his friends and never leaves his house even when it comes to food shopping he stays at home, he will do anything to stay at home which has led to him developing an addiction to his Xbox. His online friends often go out drinking on Saturday and keep pressuring him to join them, so due to his having Down syndrome which limits his mental capacity, he is easily persuaded into joining in. Derek gets addicted to things easily so he could easily develop a drinking habit which could lead to his type 2 diabetes symptoms worsening and causing him to develop other health conditions like liver cancer.

Meredith has quite a busy life and always finds time to go out with her family and friends. She will often go out for meals with her family and have a few drinks and have a meal. She also goes out with her friends and drinks a fair amount of alcohol. If Meredith was to go out with her friends every day and consume alcohol then it may lead to the increased risk of her developing liver cancer as she would be drinking every day of the week.
healthy.

Exercise/ activity levels
Derek suffers from type 2 diabetes and never leaves his house. Due to Derek having been in his house for long periods of time, he never exercises which can cause his physical and mental well-being to decline. According to Mayo Clinic, 2023, it is recommended that an individual should aim to have at least 30 minutes of moderate physical activity every day, if an individual is aiming to lose weight then they should be doing more and if they are aiming to maintain it then they should be burning the same amount of calories as they are eating. In Derek's case, he does no form of exercise and eats unhealthy foods so he is more than likely going to gain weight which will cause his diabetes symptoms to worsen. If Derek was to carry on living the same lifestyle it is expected that it could decrease his life expectancy as he is not making any efforts to change his lifestyle. If Derek was to make an effort and even walk to the shop for his food then he would be meeting the recommended daily exercise.

Meredith works as a fitness coach and lives a very healthy lifestyle, she exercises 4-5 times a week, works in the gym helping individuals work out and takes her children to the park every other day. Due to her living a very healthy lifestyle, means she will have to have more calories than the recommended intake for a woman as her body will burn more calories and hardly store any body fat (NHS, 2022). However, if Meredith was to overwork herself and didn't have a rest day it could cause her to have burnout with is essentially when the body is being overworked (Mental Health Uk, 2023). If Meredith was to not meal plan or keep a healthy lifestyle then she would be more likely to develop health conditions.

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P3/M2/D1: How socioeconomic affects nutritional health 

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P3/M2/D1: How socioeconomic affects nutritional health 

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Cost of Food
There is a high gap in the prices of healthy and unhealthy food, healthy foods are 2x the price of convenience foods (NHS, 2022).  Derek often sits at home and orders takeaways or will turn to convenience foods. Due to Derek eating a lot of unhealthy foods, it has led to him developing type 2 diabetes. Due to convenience foods have been cheap, it has given him more money to buy games for his xbox which gives him another reason to not leave the house. If Derek's eating habits continue then it will lead to him developing other health conditions such as high blood pressure or even strokes.

Meredith lives a healthy lifestyle. She is lactose intolerant and is a fitness coach which means she eats healthy foods and lives a healthy lifestyle. While healthy foods are expensive she has made the choice to spend more money on them. Due to her buying healthy foods, it decreases the risk of developing any health conditions caused by food habits. However, she can only consume small amounts of lactose so she will need to buy dairy alternatives and sometimes they can be expensive. If they are expensive then she may not have enough money to buy them, if she doesn't have enough money to buy them it may lead to her consuming more dairy than she needs which will give her stomach pain.

Access to shopping facilities
Derek hardly ever leaves the house and relies on his sister to do this weekly shop. When she isn't able to shop for him he will order takeaways and will do online shops which gives him no access to shopping facilities. Derek also doesn't exercise which will cause him to have a more unhealthy lifestyle. When his sister shops for him she helps with the money and will often buy the cheapest foods, and when Derek shops online he will scroll past all the healthy foods and will buy the food he likes. Due to all of his favourite foods being unhealthy, he is more likely to put weight on which might cause him to isolate himself more and avoid leaving the house full stop. If he was to never leave the house it is likely he will have an increased risk of developing mental health problems such as anxiety and depression.

Meredith lives an active lifestyle and is always at work, and she does weekly shops with her husband. Due to her working and doing the weekly shopping, she is open to more shopping facilities. Due to her having access to more shopping facilities and working as a fitness coach, she is more likely to go shopping in other places and have a positive experience. Due to her having a positive experience, she is going to form more bonds with individuals which will increase her mental well-being as well as physical well-being, meaning she is less likely to develop things like depression and anxiety.

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P4 Nutritional measures and recommended dietary intake. 

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P4 Nutritional measures and recommended dietary intake. 

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Balancing energy requirements
The body needs energy in order to function properly, the basic smaller structures are Cells, tissues, organs and systems. and they all work together in order to perform special functions. BMI (body mass index) is essentially an individual's weight in kilograms or pounds divided by the square of height in meters or feet (Centers for disease control and Prevention, 2022). BMR (Basal metabolic rate) is the rate at which the body uses energy while at rest to maintain basic functions such as breathing and keeping warm (Oxford Dictionary, 2023).
To caluclate BMR it is 88.362 + (13.397 x weight in kg) + (4.799 x height in cm) - 5.677 x age in years)

According to the BMR calculator Derek and Meredith with be given an estimation of the number of calories they need in order to keep their body weight and health. Derek is 52 years old and is 5'9 (175cm) with a body weight of 152kg. Derek's BMR is roughly 2,170 kcal a day. It is this high because he does not exercise or eat healthy foods, so his body needs more energy while in the rest period. Derek should try to maintain his calorie consumption or start by changing the unhealthy foods are healthier options and then lowering the calorie intake slowly. It would help him make sure that is consumed is equal to his BMR. If individuals was like Derek and didn't make changes then it would lead to them developing health problems such as obesity and type 2 diabetes.

Meredith is 36 years old and is 5'6 (167 cm) with a body weight of 69kg. Meredith's BMR is roughly 1,447 kcal a day. This is above the average number due to her living a very active lifestyle and her being a fitness coach. She visits the gym 4-5 times a week to exercise and takes her children out as well as being a fitness coach, this means she will burn at least a quarter of what she consumes as will have a high metabolism due to how active she is. These calories are consumed so she can gain more muscle and keep physically fit and avoid developing malnutrition. In addition, it is important that the body's intake and energy levels are the same if too many calories are consumed it can lead to individuals gaining or losing weight if there is too little being consumed. Kilocalories and kilojoules are the main ways that energy is measured in (NHS, 2021).

BMI (Body mass index)
Body mass index is a measurement which uses an individual's height and weight to decide if they are healthy. By using this it helps professionals know whether an individual is at risk of being overweight or at risk of getting type 2 diabetes, by using this it helps them prevent any further risks and warns them before things become severe. The BMI can be useful in preventing and diagnosing health states it can be inaccurate as it doesn't include body fat and muscles. we can find out both Derek's and Meredith's BMI by using the BMI calculator.

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Derek:
Physical:
- Derek has type 2 diabetes, which means that he will have experienced symptoms such as; Discolouring of skin in certain areas of the body, stretch marks, and flattened feet.
- If Derek continues to eat unhealthy foods and not exercise it will cause his type 2 diabetes to get worse and may cause him to develop other health conditions such as high blood pressure.
- Derek also has down's syndrome which has affected his ability to learn how things work for example Derek struggles with understanding how a healthy diet works which have resulted in him developing type 2 diabetes.

Intellectual:
- Derek has down syndrome and often finds it hard to process simple things such as what food is healthy and unhealthy. He will often do an online food shop when his sister can't do his weekly shop or food prep so he often scrolls and looked at the picture icons on the food he likes.
- He has had no help from anyone due to him only having his sister who is busy which has resulted in him having a slight speech impairment and a slowed brain. Due to him having a slowed brain, it has resulted in him having anxiety about what other people might think of him.

Emotional:
- Due to Derek having type 2 diabetes it has resulted in him developing anxiety as he feels like other people with judging him. Due to him feeling embarrassed about what other individuals might think it has resulted in him isolating himself from other individuals. This will have a negative effect on his mental well-being and may cause his self-image and self-esteem to decrease.
- If he develops a bad self-image it might lead to him developing depression as he feels alone and embarrassed with himself.

Social:
- Due to Derek having trouble making social bonds with individuals it has resulted in him being on his own, He often sits at home all day on his Xbox. He has recently made some online friends which have peer pressured him into drinking on Saturdays because they do. As Derek has down syndrome he is easily persuaded and gets addicted to things easily. If Derek was to get addicted to drinking alcohol whilst having type 2 diabetes it would cause him to develop other health conditions such as liver cancer. This is why it's important for Derek to mix with the right individuals both online and in real-life friendships as they will be able to motivate him and help him instead of showing him new habits.