1. Dr. ABDULLAH ERDİL Pediatrician Ordu University/TURKEY
Assessment of General Characteristics of Children according to Anorexia Status
Dr. ABDULLAH ERDİL
Pediatrician
Ordu University/TURKEY
Good morning ladies and gentelmen…
I am pediatrician doctor Abdullah Erdil. I have been working in Turkey Ordu University as an asisstant professor for almost 3 years.
I am very exited to have this opportunity to share our study with you. Our study is about general socio-demographic features and symptoms of children having complaints of loss of appetite.
As you will see at the end of my presentation, we came up with some strange ın fact unexpected results in our study.

2. Outline Introduction /Aim Material /Methods Result Conclusions
Before presenting our study and its results I will give you a very short reminding information about loss of appetite and inappropriate eating behavior.

3. Loss of appetite Introduction The unwillingness to eat
Lets start wıth the definion of loss of appetite.
The unwillingness to eat is defined as loss of appetite.
The appetite is affected either by the experience with the food before, by the appearance of the food, positively or negatively.
the most important result of lack of appetite is negative Influence of children's growth.
Influence of children's growth

4. Introduction
Nutrition influences the growth and development of the child
Nutrition influences the growth and development of the child (2).
Over the years, children learn to eat solid food, get more variety of food, and start feeding themselves (2).
Motor development must be completed at certain times during this process (3).
If problems occur during developmental stages, inappropriate eating behaviors may occur (4-6).aq

5. Organic causes of inappropriate eating behavior
Malabsorption
Gastroesophageal reflux
Vomiting and diarrhea due to gastroenteritis
Oral-motor anatomical defects
Dysphagia, High Palate
Chronic diseases
Macroglossia, Malocclusion
Metabolic diseases
Gastric motility disorders
You can see on the slide main organic causes of inappropriate eating behavior.
Malabsorption,
Gastroesophageal reflux,
Vomiting and diarrhea due to gastroenteritis,
Oral-motor anatomical defects,
Dysphagia, high palate, macroglossia, malocclusion,
Metabolic diseases, gastric motility disorders and chronic diseases (7-9).

6. Assessing inappropriate eating behaviors
Development
Nutrition
Family history
Development, and family storytelling
Development, nutrition and family history are important in assessing inappropriate eating behaviors (4,10,11).
Nutrition story; How the child is fed with breast milk or formulas,
The transition time to solid food,
The person who feeds the baby,
Information about the feeding of the family, the position of the baby, and defecation or vomiting features associated with feeding (7,11).

7. Aim of the study
Determination of general socio-demographic and disease symptoms of children who applied to polyclinic with complaints of loss of appetite
In this study, we aimed to Determine general socio-demographic and disease symptoms of children who applied to polyclinic with complaints of loss of appetite in some respects like;
Etiologic,
Sociodemographic and nutritional characteristics and behaviors,
Growth and development performances,
Parents' nutritional deficiencies and misapplications.
And thus we also aimed to contribute to the realization of the training activities for this purpose.
contribute to the training activities for this purpose

8. Material –methods
n-198
Had not acute infection and gastrointestinal system disease
Had at least one-month loss of appetite
Volunteered to participate between
Now I wıll show the summary of our Material –methods.
In our study we worked on 198 children who did not have acute infection and gastrointestinal system disease,
had at least one-month loss of appetite,
volunteered to participate in the study between February and August 2015.

9. Material –methods
Weight /Height and Relative weight measurements of patients according to age
Three categorizations were made according to the 3-day diet list and Evaluation of the questionnaire forms
SPSS Windows 21.0
The height and weight’s of patients measured. And according to age, these measurements together wıth Relative weigt values were recorded. Thus, growht development is assesed
Three categorizations were made according to the 3-day diet list and the evaluation of the questionnaire forms requested families of the children.
Data were analyzed using the SPSS Windows 21.0

10. Questionnaire Form 56 Questions General personnel information
In thıs form we asked 56 diffrent questıons whıch includes maınly;
General personnel information
Family hıstory
Loss of appetite and other symptoms history
Feeding habits
General personnel information
Family hıstory
Loss of appetite and other symptoms history
Feeding habits

11. Three categorizations
real appetite = insufficient calorie intake
normal appetite= adequate and balanced calorie intake
selective appetite = adequate-calorie intake but unbalanced diet
As I told before Three categorizations were made according to that form and 3-day diet list which is preaperad and evaluated in coordination with dietician.
In thıs categorization real appetite ıs used for insufficient calorie intake, normal appetite is for adequate balanced calorie intake and lastly selective appetite is for adequate-calorie intake but unbalanced diet).
At the end of the study, by SPSS chi-square analysis it was determined whether the other characteristics of the children changed according to the loss of appetite.
Chi-square analysis: Whether the other characteristics of the children changed according to the loss of appetite.

12. Results 01 Feb.- 01 Aug 2015 n-198 Gender 6 months – 15 years %60 %40
Real appetite %39
Normal appetite %26
Selective appetite %35
From now on I will share with you the results of our study.
As I mentioned before, this study was conducted among 198 children who visited the our Hospital Between February and August All 198 children ranged in age from 6 mounts to 15 years.
Forty percent of the children were girls, sixty percent were boys.
Amoung these Three categorizations we had results for real appetite = %39, for normal appetite= %26 and for selective appetite = %35 .

13. Results p<0,05 Statistical significance Socioeconomic status 0,003
Loss of Appetite
Real
Normal
Selective
Total P n %
Gender
Male 48
40,3 36
30,3 35
29,4
119
61%
0.085
Female 30 38 15 19 34 43 79
40%
Socioeconomic status
Low 41
55.4 13
17,6 20 27 74
38%
0,003
Average 28 21
25,6 33
40,2 82
42%
High 9
21,4 17
40,5 16
38,1 42
21%
Mother working status
Yes
23,7
39,5 14
36,8
19%
0,04 No 69
43,1
22,5 55
34,4
160
82%
Sequnce of birth 1.
44,6
21,7 31
33,7 92
47%
0,428 2. 24
37,5 25 64
33%
>2.
35,7
33,3
Family structure
Core 61
38,6
27,2 54
34,2
158
81%
0,648
Crowded
42,5 8 40
20%
Family history about loss of appetite
Not 45
26,2
126
64%
0,515
Brother/ sister 22
42,3
26,9
30,8 52
27%
Mother/ Father 11 4 5
10%
Constipation 26
46,4 12 18
32,1 56
29%
0,425
36,6 39
27,5 51
35,9
142
72%
Who feeds child
Mother 72
39,8
24,9
35,4
181
92%
0,826
Grandmother
28,5 7%
Carer 1 2 50 2%
Behavior disorder 59
41,3 53
37,1
143
73%
0,105
34,5
36,4
29,1
28%
Duration of breast feeding
<6 months
21,1
42,1 57
0,541
6-12 months 32
42,7
29,3 75
13-24 months
27,8 10
22,2
23%
>24 months
28,1
23,8
11%
Anemia
46,1 23 76
39%
0,311
35,2 46
37,7
122
62%
Weight percentile
<3 p
95,8
4,2
12%
<0,001
3-10 p
68,7 3
4,5 67
34%
11-50 p
11,1
49,4 81
41%
>50 p
57,7
13%
Relative weight
< %80 96
26%
%80-90
23,5
47,1
%91-110
15,5
44,3 97
49%
25OH D vit level
<15 md/dl
75,9
5,6
18,5
15-30 mg/dl
28,8
43,2
118
60%
>30 mg/dl
11,5
p<0,05
Statistical significance
p<0,05
Statistical significance
Socioeconomic status
0,003
Mother working status
0,04
Weight percentile
<0,001
Relative weight
25OH D vit level
Merging together Spss analysis and Questıonner results, we came up wıth that table…In thıs table there are 14 different parameters. And amoung these 14, 5 of them you can see on the rıght resulted as having Statistical significance.
In the following slides you will see details.

14. > Results 43% 29.4% Loss of appetite
Not show a statistically significant change according to sex (p = 0.085)
Felective anorexia rate
>
It was determined that the loss of appetite in the study did not show a statistically significant change according to sex but the selective anorexia rate (43%) was higher in girls than in boys (29.4%).
43%
29.4%

15. Results Loss of appetite changes according to the…
Level of income (P = 0,003),
Maternal working status (P = 0,040),
Serum 25 OH-D vitamin levels (P <0,001),
Growht development(Weight-Relative weight percentil) (P <0,001)
Significant differences were found in the study between the level of income, maternal working status, serum vitamin D levels , growth development

16. Results Loss of appetite found a higher rate for:
As a result of the study, children with lower income levels and those with non-working mothers found a higher rate of loss of appetite.
Those with non-working mothers
Children with lower income levels and

17. Results Lower rate for children without real appetite
In addition, body weight percentile and relative weighing values ​​by age were lower in children without real appetite.
Lower rate in relative weight values
Lower rate in Body weight percentile

18. Results Higher rate of loss of appetite
Patients with serum 25OH-Dvitamin levels <15 mg / dL
Again, patients with serum 25OH-Dvitamin levels <15 mg / dL had a higher rate of loss of appetite.

19. Results There is no significant effect of factors such as;
Family Structure,
Lack of Appetite in Family
Who is fed by the individual
It has been found that there is no significant effect of factors such as family structure, lack of appetite in family and who is fed by the individual
(P> 0,05)

20. 20-35% 33-90% Results Children with developmental delay
Children having loss of appetite and eating problems
Conclusion: In childhood, the proportion of normal children who apply for a doctor due to loss of appetite and eating problems varies between 20-35%.
This rate is reported to be 33-90% in children with developmental delay (1).
Various studies have been carried out in our country (Turkey) and in other parts of the world, investigating the loss of appetite and the factors affecting it

21. Conclusions
Loss of appetite is seen also in the group with a percentage between 3 and 10 weight percent and a relative weight between 80 and 90 percent
it is an obvious that loss of appetite mostly seen in those with low weight percentile and relative weight values. In the study, we also find that Loss of appetite is seen in the group with a percentage between 3 and 10 weight percent and a relative weight value between 80 and 90 percent.

22. Conclusions
Patients close to the lower limit of the normal percentage and relative weight loss should be followed closely.
Suggestions in terms of balanced nutrition and nutritional behavior of patients with selective appetite.
In this sense, the patients with close to the lower limit of the normal percentage and relative weight loss with respect to growth retardation, an important result of loss of appetite, should be followed closely.
In addition, suggestions should be made in terms of balanced nutrition and nutritional behavior of patients with selective appetite.

23. Dr. ABDULLAH ERDİL Pediatrician Ordu University/TURKEY
Assessment of General Characteristics of Children according to Anorexia Status
Dr. ABDULLAH ERDİL
Pediatrician
Ordu University/TURKEY