Nutrition unit 1

Atul Yadav
Atul YadavTeacher em Home
 Presented By –
Atul Yadav(RN,RM)
 Introduction to nutrition
 Definition of nutrition
 Role of nutrition in maintaining health
 Importance of nutrition in Nursing
 Nutritional problem in India
 Factor affecting food and nutrition
 Role of food and its medicinal value
 Classification of foods
 Food standards
 Elements of nutrition
 National nutritional policy
 BMR
 Next to air we breath and the water we drink,
food has been basic to our existence. In fact
food has been the primary concern of human
kind in its physical environment throughout
all recorded history. People must eat to live,
and what they eat will affect in a high degree
to their ability to keep well, to work, to be
happy and to live longer. Food is the primary
necessity of life.
 Nurse as important members of health team are
committed for maintaining the good health
status of the people. In community , nurse
encounters a variety of problems and needs
related to nutrition, perhaps another person
needs instructions in preparing food for sick
person in a family, while on other hand another
needs counseling so that the food conforms to
religious beliefs. Some of these situation make
nutrition as an integral part of their nursing
practice in the hospital and community, they
need to study nutrition, principles of nutrition,
food values, assessment, nutrition deficiency
disease and therapeutic diet.
 Nutrition : It is a branch of science that deals
with food and their nutritive values in relation
to maintain health.
 Health : According to WHO (1948) Health is a
state of complete physical, mental , social
and spiritual well being and not merely an
absence of disease and infirmity.
 Nutrient : A substance essential for the
growth, maintenance, function and
reproduction of a cell or of an organism.
 Dietetics : Practice application of the principles of
nutrition, including the planning of meals for well and
sick.
 Good nutrients : Means maintaining a nutritional
status that enables us to grow well and enjoy good
health.
 Macronutrients : Proteins, fats and carbohydrates are
macronutrients. These are called proximate principles
because they form the bulk of our food. In India
diets, they contribute to the total energy. E.g,
carbohydrate, proteins, fat.
 Micronutrients : Vitamins and minerals are
micronutrients because they are require in small
amounts e.g, vitamins, and minerals.
 Food has been recognized as important for human beings in
health and sickness through centuries. The newer knowledge of
nutrition has been built upon the observations made by several
pioneers (settler) during the 19th century and early part of 20th
century.
 Proteins, fats and carbohydrates had been used early in 19th
century as energy yielding foods and much attention was paid to
their metabolism and contribution to energy requirements.
 Then nutrition gained recognition as a scientific discipline with
its roots in physiology and biochemistry.
 Specific nutritional disease were identified in the first decade of
the century and technologies development to control them e.g,
PEM (Protein energy malnutrition), endemic goiter and nutritional
anemia etc.
 New concepts in nutrition such as nutritional assessment, dietary
surveys, growth monitoring, nutritional indicators and nutritional
intervention have been developed.
 Traditionally, health care has been concerned
primarily with healing the sick and helping
them to maintain health. But now a days,
more emphasis is being given on prevention
and public health. Adequate nutrition is the
foundation of good health. Good nutrition is
considered as a basic component of health.
Nutrition affects human from birth to death.
Relationship
of nutrition
with health
Growth and Development
Resistance
to Infection
Mortality and
Morbidity
Specific
Deficiency
Disease
 Good nutrition is essential for attainment of
normal growth and development during foetal
life and childhood. Physical growth, intellectual
development, learning and behavior, all are
affected by malnutrition. Adequate nutrition is
also needed in adult life for the maintenance of
optimum health and efficiency. Elder people need
special nutrition due to their physiological and
chronological changes. Pregnant and lactating
mothers require more proteins, calories and
some others nutrients to prevent abortion,
growth retardation and low birth weights babies.
 Malnutrition is directly responsible for certain
specific nutrition deficiency diseases. The
commonly reported ones in India are protein
energy malnutrition, blindness, goiter,
anaemia, beri beri and rickets. There is
increased incidence of abortion, prematurity,
still birth and low birth weights in
malnourished mothers. So good nutrition is
essential for prevention of specific nutritional
deficiency diseases, promotion of health and
treatment of deficiency disease.
 Nutrition rich in proteins, vitamins and
minerals prevents infections like tuberculosis.
Infection in turn may aggravate malnutrition
by affecting the food intake, absorption and
metabolism of nutrients. So we need well
balanced diet throughout life to protect
ourselves from such opportunistic infection.
Good nutrition also enhances wound healing
in the patients with different types of surgical
operation.
 Health indicators show high death rate and
sickness rates in the developing countries
including India than developing countries a lot to
general death rate, infant mortality rates, still
births and premature deliveries. Prematurity is
the main cause of infant deaths. Poor nutrition
also lower the expectation of life. On the other
hand, over nutrition, which is another type of
malnutrition, is responsible for obesity, diabetes,
hypertension, cardiovascular and renal disease,
liver disorders and gall bladder disease.
 To the incidents of nutritional deficiency disease, our
government has launched several nutritional
programmers', e.g, Mid day school meal, Integrated
child development scheme, Anemia control
programme and Iodine deficiency disorders control
programme, etc
 Subject of nutrition is beings tough to all Nursing
educational programmers (diploma and degree
course) and paramedical course to enhance the staff
with knowledge and skill regarding nutrition so that
they may be able to contribute in promotion of
health, prevention of deficiency diseases and to
prepare therapeutic diets by applying principles of
nutrition and dietetics, and they will be able to teach
the community about nutrition.
 Nurses constitute an important component of
health care system and they are supposed to
provided comprehensive services to
community. When we say nursing is meeting
the health needs of the people, we must
know the health and factors affecting it.
Today’s nutrition is considered as one of the
important factors affecting the human health
and malnutrition is one of the leading cause
of mortality and morbidity in India.
 After completion of the study of nutrition,
student nurse will be able to :
 1. Apply the principles of nutrition and dietetics
in health and sickness.
 2. Make the nutrition as an integral part of their
daily nursing practices.
 3. Recognize the values of nutrition in
maintaining personal and patients health.
 4. Educate the patient and his family about
normal and therapeutic diets.
 5.Plan and prepare the normal and therapeutic
diets for different types of patients.
 1. Promotion of health
 2. Specific protection
 3. Prevention of nutritional deficiency disease
 4. Early detection and treatment of deficiency
disease
 5. Modification of diets.
 6. Preparation of therapeutic diets
 7. Health education and counseling.
 Health Promotion is the process of enabling the people
to increase control over and improve health. Nutrition
is an important factor affecting our health. So, nursing
efforts should be directed towards pregnant and
lactating mothers. These efforts will includes
education, distribution of supplements, extra protein,
calcium, iron, and folic acid. These can contribute to
promotion of health by the following ways :-
 Promotion of breast feeding
 Development of low cost feeding
 Measures to improve family diet
 Encouragement for kitchen gardens and home
economies
 Guide about cheap and best source of nutrition,
methods of cooking and preservation and feeding
practices of the people.
 While guiding the parents, nurse should make
sure that child’s diet must contain body
building and protective foods in required
amounts, i.e. milk, cheese, eggs, and fresh
fruits if possible.
 Nurses can guide them about the methods of
food fortification to supplement the
nutrients. Proper immunization along with
vitamin A prophylaxis can prevent vitamin A
deficiency disease and provide immunity.
 Number of nutritional disease can be
prevented in the community by nursing
efforts. Premature deliveries, low birth
weight, abortion and congenital malformation
and still births can be prevented by improving
the diet of pregnant women. There are
number of National Nutrition Programmers'
but people are not aware of it. Nurses and
others community workers can provide
proper awareness about these supplemental
programmers'.
 Because the nurses are directed care providers in
the hospital, health center’s and in the families
as well as in the baby clinics, antenatal and
postnatal clinics. School health nurse have good
opportunity to detect undernourished children.
There are number of anthropometric
measurements such as weight, height, arm
circumference, head circumference, etc. which
can be used to assess nutritional status of the
children. After diagnosis, nurse can play a vital
role in the treatment of such cases.
 The normal hospital diet which provides a patient
with the energy and nutrients intended for the
patient whose condition do not require a
therapeutic diet. These modification of diet are
liquid diet, soft diet, and semisolid diet. Nurse
should know different types of modifications of
diet in the hospital because they are responsible
to prepare and administer the nutritional needs
according to types of disease, age, income,
region, customs and food habits of individual
patients.
 For every one, eating food is an enjoyment. When
the person is sick, the food intake becomes a
problem.
 A) Assisting the patients with special problems in
preparing and accepting therapeutic diets, i.e.,
salt free diet and bland diet.
 B) Assisting the patient to obtain nourishment
either through feeding or assisting helpless
patient in eating.
 C) For motivating the patient to eat in therapeutic
environment, nurse must know the principles of
meal therapy.
 The aim of education is to guide people to
choose optimum and balanced diets, to remove
prejudices can be minimized by nutrition
education and counseling in case of delayed
weaning, ignorance about breast feeding and our
traditional misconception about certain foods. In
the recent, years, the link between dietary habits
and certain chronic disease has been recognized,
i.e. obesity, diabetics and cardiovascular disease.
So, nutritional education is a major intervention
in the hands of nurses for prevention of such
disease.
1. Protein energy malnutrition
2. Low birth weight
3. Vitamin – A deficiency
4. Nutritional anemia
5. Iodine deficiency disorders
6. Fluorosis
7. Lathyrism
8. Obesity
 Malnutrition is the major nutritional problem
widespread among children under five year of
age in India. A majority of them suffer from
varying (various) grades of malnutrition. The
most of the children suffers from moderate
grade of PEM. The prevalence (no. of cure pt.)
has increase now a days due to various
program's run by government of India. E.g;
Mid day meals .
 Pregnant women
 Lactating women
 Infants
 Preschool children
 Adolescent girls
 Elderly
 Socially deprived
1. Marasmus : This is due to insufficient of
calories intake body. It mostly affect the
children under 1 year.
2. Kwashiokor : This disease is due to the
protein deficiency in the body. It mostly
occurs in children between 2-3 years of age.
 This is due to insufficient of calories intake in
the body. Common type of PEM observed
among children below 1 year of age. It is
caused by severe deficiency of nearly all
nutrient especially protein and calories.
Conditions are characterized by extreme
wasting of the muscles and a daunt
expression.
Sign and symptoms
Extensive tissue and muscle wasting
Dry skin
Loose skin folds hanging over gulutie and axilla
Fat wasting
Sparse hair that is dull brown or reddish yellow
Mental retardation
Behavioral retardation
Low body temperature
Slow pulse and breathing rates
Absence of edema
 This disease is due to the protein deficiency
in the body
1. Kwashiorkor occurs in mostly children
between 2-3 years of age
2. Acute form of PEM due to deficiency of
protein in the diet
3. Deficiency of micronutrient
4. Kwashiorkor is identified as swelling of the
extremities and belly, which is deceiving to
their actual nutritional status.
 Malnourished child with pedal edemas
 Growth failure
 Moon face
 Distended abdomen
 Acitis
 Enlarged liver with fatty infiltrates, thinning of
hair, loss of teeth, skin depigmentation
 Dermatitis
 Irritability
 Anorexia
Sign and Symptoms
Malnourished child with pedal edemas
Growth failure
Moon face
Distended abdomen
Acitis
Enlarged liver with fatty infiltrates, thinning of hair,
loss of teeth, skin depigmentation
Dermatitis
Irritability
Anorexia
 In this condition child weight is not sufficient
according to height and age wise.
 Causative factors :-
 Maternal malnutrition and anemia
 Illness and infection during pregnancy
 High parity
 Close birth intervals
 Prevention :-
 More hospital deliveries
 Immunization
 Increase number of ANC
 Nutritional blindness affects over seven million
children in India per year and it result mainly from
the deficiency off vitamin A. In its severest from, it
often results in loss of vision and it has been
estimated that around 60,000 children become blind.
 Disease :-
 Night blindness – This is due to lack of the vitamin A,
person is unable to see in the dim light.
 Xerophthalmia : Absence of tears in eyes. It is most
common in children aged 1-3 years. It is mostly seen
in rice eating population.
 Bitot’s spots :- Collection of dried epithelium,
microorganism, etc. forming shiny grayish white spot
on the cornea.
 A condition in which the Hb content of blood
lower than normal as a result of a deficiency
of one or more essential nutrients. It occur
due to decrease iron In diet and excessive
loss of iron.
 Treatment :- Iron and folic acid supply
 Dose – Each Tablet contains 80 mg iron, 200
mg iron sulphate , 0.5 mg of folic acid .
 In India, meanly 35 million person are estimate to
be suffering from goiter and 140 million are
living in the known goiter endemic regions. The
prevalence of goiter is more in hilly areas
endemic regions such as Assam, Mizoram.
 Disease :- Goiter is also called Derbyshire Neck.
 Enlargement of thyroid gland causing swelling in
front part of the neck. Common among girls than
boys
 Treatment :-
 Iodized salt is widely used in India
 Due to excessive amounts of fluorine in
drinking water, endemic fluorosis has been
reported to be an important health problem
in certain part of India., e.g Haryana, Kerala,
Punjab etc. symptoms of fluorosis are dental
fluorosis, skeletal fluorosis.
 Lathyrism is a parlaying disease of human
and animals. In humans, it is referred to as
neurolathyrism characterized by gradually
developing spastic paralysis of lower limbs.
This occurs due consumption of khesari dhal.
1. Basal Metabolic Rate :-BMR is the main factor
which influences our nutritional requirement. It
is defined as the amount of energy required to
carry on the involuntary activities of the body.
Generally for an approximate determination of
BMR, simple method is used, i.e. one k cal per
kilogram per hour, so BMR = 1 k cal body
weight (in kg) x 24 hours.
2. Factors affecting BMR:- Body surface area, age,
sex, sleep, climate and secretions of ductless
glands.
 2. Weight :- Total metabolism includes work done in
moving one's own weight from place to place.
Therefore, the heavier the individual, the more energy
is required for movements.
 3. Age :- Young children need more energy and
protein in their growing age and adolescents require
more calories than the adults. The energy
requirement with the age decreases because of a fall
in BMR and decreased physical activities.
 4. Sex :- Sex also makes variation in energy
requirements. The BMR of women is 6 - 10% lower
than the men. For example a moderate man requires
2875 k cal whereas a moderate woman needs 2225 k
cal.(in compression to weight and height)
 5. Climate and environment :- Poor environment may lead
to infections, especially in children. Infection and hot
temperature both increase BMR, which increases our
nutritional requirement. Our body must have sufficient
food to make up for heat loss. The amount of heat loss
depends on the amount of work done and the
temperature. This is the reason that in persons living in
tropical climates, the BMR is about 10% less than those
living in low temperate zone.
 6. Physical activities :- Activity of in addition to the total
BMR. The type of activity and total time spent in each
activity determines to a large extent of body's need of
total energy. So, energy requirement depends on the type
of work or occupation, i.e. a sedentary worker (man of 60
kg)needs 2425 k cal per day, moderate worker 2875 and a
heavy worker requires 3800k cal.
 7. Specific Dynamic Action of food (SDA) :- It has been
found that there is 8%increase in the production of energy in
the form of heat after taking food. This is not due to any
work done (digestion or absorption) but it is due to
stimulating effect of food on the basal metabolism. This
stimulating effect is known as Specific Dynamic Action of
food. It varies according to different nutrients, e.g., SDA of
Carbohydrate is 5 - 6%, of Protein is 30%, of Fat is 4% and of
mixed diet is 12%.
 8. Physiological state :-, There is increased demand of food
in certain physiological conditions because of increased
BMR. The energy requirements of women are increased in
pregnancy by 300 k cal daily throughout pregnancy, and in
lactation 550 k cal extra daily during the first six months
and 400 k cal during the next 6months. The need of extra
energy is associated with deposition of tissues during
pregnancy and secretion of milk during lactation.
 9. Socio-economic factors :- Nutritional status is
largely affected by some socio-economic factors
like income, level of education, sanitation, family
size, knowledge regarding the nutritive values of
foods. These factors bear most directly on the
quality of life and are the true determinants of
nutritional status of society. Malnutrition is the
product of poverty, ignorance, lack of education,
large family size in India. In short, the causes of
malnutrition are built into the very nature of
society, in the socio-economic and political
structure.
 10. Cultural factors :- Cultural factors in
health and nutrition have engaged the
attention of medical scientists and
sociologists. Every culture has its own
customs and beliefs regarding nutritional
practices. It is now widely recognized that
cultural factors are deeply involved in all
affairs of man including health and nutrition.
Not all cultural factors are bad, some are
based on centuries of trial and error and have
positive values while other may be useless.
 11. Life style and Food habits :- what kind of
life style we live it directly impact our health
e.g, sedentary life style leads to obesity and
Food habit also plays an important role in
health as we know bad food habits leads to
various kind of disease. E.g, hypertension ,
Diabetes etc.
 12. Food Fads :- A fad diet is a diet that is
popular for a time, similar to fads in fashion,
without being a standard dietary
recommendation, and often promising
unreasonable fast weight loss or nonsensical
health improvements.
 13. Cooking practice :- The methods of
cooking like draining away the rice water at
the end of cooking, prolonged boiling,
peeling of vegetables, all influence the
nutritive value of foods.
 11. Religious :- Religion has a powerful influence
on the food habits of the people. Hindus do not
eat beef and Muslims pork. Some orthodox
Hindus do not eat certain vegetables like onion,
and garlic is not eaten by Janis and Braham
kumaris. Vegetarian is given a place of honour in
Hindu society. These food habits are known as
food taboos and have a religious sanction from
early days. The seafood taboos prevent people
from consuming nutritious foods even when
these are easily available. Muslim observe fasts
during Ramzan and Hindus on several occasions.
 12. Traditional factors :- Food is a subject of
widespread traditional beliefs and customs which
vary from country to country and from one
region to another. The concept of hot and cold
food is widely prevalent in the country. Foods
such as meat, fish, eggs and jaggery are
considered to generate heat in the body and are
known as hot foods. On the other hand, foods
such as curd, milk, bananas and lemon are
considered cold foods. In some rural areas,
people avoid their children from hot and cold
foods, which leads to malnutrition.
 13. Food production and distribution :- The rate of
food production and distribution is another important
factor influencing the nutritional status of a country.
Increased food production should lead to increased
food consumption. Given the best technology known
at present, most developing countries could increase
their food production several fold but increased food
production will not solve the basic problem of hunger
and malnutrition. It is a problem of uneven
distribution between the countries and within the
countries. It is said that there will be very little
malnutrition in India today if all foods available can
be equally distributed in accordance with
physiological needs.
Nutrition unit 1
 It nourishes the skin and protects arteries.
 It helps to maintains healthy skin as it
contributes to proper skin hydration and
tone.
 It also use in skin dryness and aging, vision,
Arteriosclerosis, lows cholesterol level and it
also in diuretic in nature so use in
hypertension
 It stimulates the immune system. It prevents
cold and flu.
 It increase the blood due to iron, vit. C,
copper and folic acid so it prevents anemia.
 It are recommended for pregnant mothers as
they stimulate immune system and prevent
anaemia.
 Due to its excess solution fiber, it reduce the
cholesterol and prevents arteriosclerosis and
hypertension.
 Relieves constipation.
 Increase stamina in athletes.
 It contains a fair amount of minerals and vit.
A,B1,B2,Folic acid and vit. C. 100 g oranges
supply 40-60 mg iron, which is more than
our daily requirements. So it use in pregnant
women.
 Its fiber is in the form of pectin. It reduces
cholesterol.
 Its citric acid enhances the activity of
vitamin-C and facilitates the elimination of
toxic substance, such as uric acid .
 It highly recommended for infectious disease
 All citrus fruits prevent cancer.
 The flavinoids (flvonoids exhibit high
biological activity and display antioxidant,
anti-inflammatory and antiallergic
properties)contained in the grapes are
phenols which act as powerful antioxidants.
 Phenolioc substance act as fungicidal.
 Act as powerful anticarcinogen.
 Grapes highly recommended in cardiac
disease.
 It increase the bile production; is very useful
in cirrhosis and ascites.
 They are mild laxative that relieves chronic
constipation.
 They maintain intestinal flora also.
 They are highly recommended in renal failure.
 They have anti-tumour properties.
1. Aniseed(Sounf): Aniseed is used for expelling
wind or air or gas, for treating insomnia, for
removing lice.
2. Ajwain (omum): It relieves indigestion, colic.
3. Asafoetida (Hing): It is used for expelling gas
to reduce distension of abdomen and relives
toothache.
4.Cardamom (Chhoti Elaichi): Cardamom
relieves gas and heart burn and is used to
prevent indigestion.
5. Garlic (Lahsan): Garlic boiled in milk is
effective in asthma, and lowers high blood
pressure and prevents heart attack.
 Food contains organic and inorganic complex
known as elements of nutrition.
 These are also called nutrients or food
factors.
 They are needed to build and maintain body
cells, regulate body processes and supply
energy.
 These elements may be classified into two
groups:-
 These are proteins, fats, and carbohydrates.
They form the main bulk of food in the Indian
dietary.
 Proteins - 7 to 15 %
 Fat - 10 to 30 %
 Carbohydrate - 65 to 80 %
 This group includes vitamins and minerals.
 They are required in a small amounts which
may vary from a fraction of milligram to
several grams. That’s why they are called
micronutrients.
 Proteins are required for growth in children
and maintenance of body weight in adults.
 Proteins constitute about 20% of the body
weight.
 Carbohydrates form the bulk of our food and
are the main source of energy for doing work.
 About 50-70% of energy value in the average
diets is provided by Carbohydrates.
 Oils and fats serve mainly as the source of
energy. They contains some essential
nutrients like essential fatty acids and fat
soluble vitamins.
 Excessive fats leads to obesity.
 Human body contains more than 50
chemicals elements which are required for
growth, repair and regulation of vital body
functions.
 The important minerals are calcium,
phosphorus, sodium chloride, potassium,
iron, copper, iodine, fluorine and zinc.
 Vitamins are a class of organic compounds
categorized as essentials nutrients. They fall
in category of micronutrients.
 Vitamins are divide into two groups vitamin
A,D,E,K are fat soluble and B group and
vitamins C are water soluble.
 1. On bases of origin:
 A) Foods of animals origin, e.g milk, and eggs
etc.
 B) Foods of vegetables origin, e.g pulses,
cereals and fruits etc.
 On chemical composition of foods:
 Proteins
 Fats
 Carbohydrates
 Vitamins
 Minerals
 On nutritive values of foods:
 Cereals
 Pulses
 Vegetables
 Nuts
 Fruits
 Animals foods
 Fats and oils
 Sugar and jaggery
On predominant function:
1) Body building foods: Foods rich in proteins are
called body building foods because they are
responsible for building and repair of body
tissues. E.g- milk, fish, eggs, pulses
2) Energy yielding foods: Foods rich in
carbohydrates and fats are called energy
yielding foods. E.g – cereals, dried fruits, sugars,
oils and fats.
3) Protective foods: Foods rich in proteins,
vitamins are minerals are called protective
foods. E.g – fruits and green leafy vegetables.
 Bureau of Indian standards (ISI standards) –
Various committees including
representatives from the govt., consumers
and industry formulate the Indian and
standards (ISI) for vegetables and fruit
products, spices, animal products and
processed foods. Once these standards are
accepted, manufacture whose products
conforms to these are allowed to use. An ISI
label on each unit of their products is a
guarantee of good quality.
 The AGMARK standards :- These standards
were set up by the Directorate of Marketing
and Inspection of Govt. of India by
introducing an Agricultural production Act in
1937. This act defines quality of cereals,
spices, oil seeds, oil, butter, ghee, egg, etc.
and provides various grades depending upon
the degree of purity in each case.
 CODEX Alimentarius:- The Codex
Alimentarius commission, which is the
principle organ of the joint FAO (Food and
Agriculture) and WHO food standards
programme, formulates food standards for
international market. The food standards in
India are based on the standards of the
Codex Alimentarius.
 PFA Standards:- Standards have been
established under the Prevention of Food
Adulteration Act (1954) and are revised from
time by the ‘Central Committee’ for food
standards. The purpose of PFA standards is
to obtain a minimum quality of food stuffs
attainable under Indian standards.
 Standards of Weights and Measures :- The
standards of weights and measure Act (1985)
contains provision for effective legal control
on weights, measures and
weighing/measuring instruments used in
industrial production and protection of public
health and human safety. This ensure that the
consumer gets the correct inspection of
weight and measure.
 Misbranding :- It is also forbidden by law. A
food may be considered as misbranded if it
has a label which gives false or misleading
information about the product failure to
specify weight, measure, name of additives,
limitations in use of the product, name of the
manufacturer, as well as misleading the
consumer in terms of size are all considered
as misbranding of food.
 Adulteration is define as the process by which
the quality of the product is reduced through
addition of baser substance or removal of a
vital element.
Food material Adulterations
Wheat, rice Mud
Haldi powder Lead chromate powder
Dhania powder Cow dung or horse dung powder
Chilli powder Brick powder
 Enacted by the Indian Parliament in 1954,
with the objective of ensuring pure and
wholesome food to the consumers and to
protect them from fraudulent and deceptive
trade practices, the Prevention and Food
Adulteration (PFA) Act was amended in 1964,
1976 and lately in 1986 to make the Act
more stringent.
 Consumer rights have become an important
issue. The CPA is a piece of comprehensive
legislation and recognized six rights of the
consumers namely-
 1. Right to safety
 2. Right to choose
 3. Right to heard
 4. Right to seek redressal
 5.Right to information
 6. Right to consumer education
 Adequate and sufficient nutrition is a fundamental
right of every human being. Improving the nutritional
status of people is one of the prime duties of the
government and is an essential factor in improving
their health status and the quality of life. The World
Health Report 2002 clearly describes how child and
maternal underweight are the greatest risk factor that
affect people's health and disease status. In this
report, underweight has been adopted as a key
indicator of poverty and hunger. From these points of
view, it is recognized that policies, programs and
processes for nutrition improvement have a great role
to play in promoting healthy lives and development
across the globe.
 Aim: The general objective of the National Nutrition Policy is to improve
the nutritional status of the people. Achieving nutritional well-being of
all people in India so that they can maintain a healthy life and contribute
to the socio-economic development of the country, through improved
nutrition-program implementation in collaboration with relevant sectors.
 Objectives
 To promote the practices, that is favourable to the improvement of the
nutritional status of human being.
 To reduce the prevalence of diseases linked to nutritional malnutrition,
deficiencies and excesses.
 To prevent mother-to-child transmission of HIV through appropriate
breastfeeding and infant and young child feeding practices.
 To assure adequate treatment and rehabilitation of malnutrition due to
nutritional deficiencies and excesses.
 To provide nutritional care, education, counselling and support for
people living with HIV/AIDS.
 The Human rights: Accesses to nutritionally adequate and safe food
and services for nutrition education are the rights of each individual.
 Pre-condition for development: Nutritional well-being should be a key
objective for progress in human development.
 Healthy life style: Nutritional improvement has to be enhanced to ensure
the healthy life of all people.
 Primary education: Under nutrition in infancy and early childhood affects
school enrolment and on cognitive and behavioural development.
 Venerable groups: Infants, young children, pregnant and nursing
women, disabled people and the elderly within poor households are the
most nutritionally vulnerable groups.
 Community participation: People-focused policies for nutritional
improvement must acknowledge the fact that people's own knowledge,
practices and creativity are important driving forces for social change.
 Gender: Special attention should be given to the nutrition of women
during pregnancy and lactation.
 Promotion of optimal infant and young child
feeding.
 Scaling up of community-based nutrition
programs.
 Food fortification.
 Promotion of household food security.
 Prevention and management of malnutrition
and related diseases.
 Nutritional support to their families.
 Communication for behaviour change.
 To ensure effective implementation of planned activities, monitoring
and evaluation is essential in all development programs. In addition,
periodic and continuous evaluations are necessary for establishing level
of objective achievement in the programme and policy.
 The follow up implementation of nutrition programs properly and data
will be collected on regularly basis at the health centre and community
level, In addition, other opportunities for nationwide surveys will be
identified and utilized.
 Nutritional surveys and epidemiologic surveillance will be conducted
regularly and periodically, with appropriate indicators, to evaluate the
progress and impact of nutritional interventions.
 Operational research will also be carried out to address specific
nutritional and other problems identified during the implementation of
nutritional activities.
 To prevent nutritional emergencies, nutrition unit will reinforce
collaboration with all existing structures that collect and analyze
bioclimatic, environmental, demographic and agricultural data for early
warning and timely intervention measures against disasters that can
negatively affect the nutrition.
 Short note on national nutritional policy ?
 Short note on nutritional problem in India ?
 Define BMR ?
 Define nutrition and role of nutrition in
health?
 Factor affecting food and nutrition ?
 Short on food adulteration ?
Nutrition unit 1
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Nutrition unit 1

  • 1.  Presented By – Atul Yadav(RN,RM)
  • 2.  Introduction to nutrition  Definition of nutrition  Role of nutrition in maintaining health  Importance of nutrition in Nursing  Nutritional problem in India  Factor affecting food and nutrition  Role of food and its medicinal value  Classification of foods  Food standards  Elements of nutrition  National nutritional policy  BMR
  • 3.  Next to air we breath and the water we drink, food has been basic to our existence. In fact food has been the primary concern of human kind in its physical environment throughout all recorded history. People must eat to live, and what they eat will affect in a high degree to their ability to keep well, to work, to be happy and to live longer. Food is the primary necessity of life.
  • 4.  Nurse as important members of health team are committed for maintaining the good health status of the people. In community , nurse encounters a variety of problems and needs related to nutrition, perhaps another person needs instructions in preparing food for sick person in a family, while on other hand another needs counseling so that the food conforms to religious beliefs. Some of these situation make nutrition as an integral part of their nursing practice in the hospital and community, they need to study nutrition, principles of nutrition, food values, assessment, nutrition deficiency disease and therapeutic diet.
  • 5.  Nutrition : It is a branch of science that deals with food and their nutritive values in relation to maintain health.  Health : According to WHO (1948) Health is a state of complete physical, mental , social and spiritual well being and not merely an absence of disease and infirmity.  Nutrient : A substance essential for the growth, maintenance, function and reproduction of a cell or of an organism.
  • 6.  Dietetics : Practice application of the principles of nutrition, including the planning of meals for well and sick.  Good nutrients : Means maintaining a nutritional status that enables us to grow well and enjoy good health.  Macronutrients : Proteins, fats and carbohydrates are macronutrients. These are called proximate principles because they form the bulk of our food. In India diets, they contribute to the total energy. E.g, carbohydrate, proteins, fat.  Micronutrients : Vitamins and minerals are micronutrients because they are require in small amounts e.g, vitamins, and minerals.
  • 7.  Food has been recognized as important for human beings in health and sickness through centuries. The newer knowledge of nutrition has been built upon the observations made by several pioneers (settler) during the 19th century and early part of 20th century.  Proteins, fats and carbohydrates had been used early in 19th century as energy yielding foods and much attention was paid to their metabolism and contribution to energy requirements.  Then nutrition gained recognition as a scientific discipline with its roots in physiology and biochemistry.  Specific nutritional disease were identified in the first decade of the century and technologies development to control them e.g, PEM (Protein energy malnutrition), endemic goiter and nutritional anemia etc.  New concepts in nutrition such as nutritional assessment, dietary surveys, growth monitoring, nutritional indicators and nutritional intervention have been developed.
  • 8.  Traditionally, health care has been concerned primarily with healing the sick and helping them to maintain health. But now a days, more emphasis is being given on prevention and public health. Adequate nutrition is the foundation of good health. Good nutrition is considered as a basic component of health. Nutrition affects human from birth to death.
  • 9. Relationship of nutrition with health Growth and Development Resistance to Infection Mortality and Morbidity Specific Deficiency Disease
  • 10.  Good nutrition is essential for attainment of normal growth and development during foetal life and childhood. Physical growth, intellectual development, learning and behavior, all are affected by malnutrition. Adequate nutrition is also needed in adult life for the maintenance of optimum health and efficiency. Elder people need special nutrition due to their physiological and chronological changes. Pregnant and lactating mothers require more proteins, calories and some others nutrients to prevent abortion, growth retardation and low birth weights babies.
  • 11.  Malnutrition is directly responsible for certain specific nutrition deficiency diseases. The commonly reported ones in India are protein energy malnutrition, blindness, goiter, anaemia, beri beri and rickets. There is increased incidence of abortion, prematurity, still birth and low birth weights in malnourished mothers. So good nutrition is essential for prevention of specific nutritional deficiency diseases, promotion of health and treatment of deficiency disease.
  • 12.  Nutrition rich in proteins, vitamins and minerals prevents infections like tuberculosis. Infection in turn may aggravate malnutrition by affecting the food intake, absorption and metabolism of nutrients. So we need well balanced diet throughout life to protect ourselves from such opportunistic infection. Good nutrition also enhances wound healing in the patients with different types of surgical operation.
  • 13.  Health indicators show high death rate and sickness rates in the developing countries including India than developing countries a lot to general death rate, infant mortality rates, still births and premature deliveries. Prematurity is the main cause of infant deaths. Poor nutrition also lower the expectation of life. On the other hand, over nutrition, which is another type of malnutrition, is responsible for obesity, diabetes, hypertension, cardiovascular and renal disease, liver disorders and gall bladder disease.
  • 14.  To the incidents of nutritional deficiency disease, our government has launched several nutritional programmers', e.g, Mid day school meal, Integrated child development scheme, Anemia control programme and Iodine deficiency disorders control programme, etc  Subject of nutrition is beings tough to all Nursing educational programmers (diploma and degree course) and paramedical course to enhance the staff with knowledge and skill regarding nutrition so that they may be able to contribute in promotion of health, prevention of deficiency diseases and to prepare therapeutic diets by applying principles of nutrition and dietetics, and they will be able to teach the community about nutrition.
  • 15.  Nurses constitute an important component of health care system and they are supposed to provided comprehensive services to community. When we say nursing is meeting the health needs of the people, we must know the health and factors affecting it. Today’s nutrition is considered as one of the important factors affecting the human health and malnutrition is one of the leading cause of mortality and morbidity in India.
  • 16.  After completion of the study of nutrition, student nurse will be able to :  1. Apply the principles of nutrition and dietetics in health and sickness.  2. Make the nutrition as an integral part of their daily nursing practices.  3. Recognize the values of nutrition in maintaining personal and patients health.  4. Educate the patient and his family about normal and therapeutic diets.  5.Plan and prepare the normal and therapeutic diets for different types of patients.
  • 17.  1. Promotion of health  2. Specific protection  3. Prevention of nutritional deficiency disease  4. Early detection and treatment of deficiency disease  5. Modification of diets.  6. Preparation of therapeutic diets  7. Health education and counseling.
  • 18.  Health Promotion is the process of enabling the people to increase control over and improve health. Nutrition is an important factor affecting our health. So, nursing efforts should be directed towards pregnant and lactating mothers. These efforts will includes education, distribution of supplements, extra protein, calcium, iron, and folic acid. These can contribute to promotion of health by the following ways :-  Promotion of breast feeding  Development of low cost feeding  Measures to improve family diet  Encouragement for kitchen gardens and home economies  Guide about cheap and best source of nutrition, methods of cooking and preservation and feeding practices of the people.
  • 19.  While guiding the parents, nurse should make sure that child’s diet must contain body building and protective foods in required amounts, i.e. milk, cheese, eggs, and fresh fruits if possible.  Nurses can guide them about the methods of food fortification to supplement the nutrients. Proper immunization along with vitamin A prophylaxis can prevent vitamin A deficiency disease and provide immunity.
  • 20.  Number of nutritional disease can be prevented in the community by nursing efforts. Premature deliveries, low birth weight, abortion and congenital malformation and still births can be prevented by improving the diet of pregnant women. There are number of National Nutrition Programmers' but people are not aware of it. Nurses and others community workers can provide proper awareness about these supplemental programmers'.
  • 21.  Because the nurses are directed care providers in the hospital, health center’s and in the families as well as in the baby clinics, antenatal and postnatal clinics. School health nurse have good opportunity to detect undernourished children. There are number of anthropometric measurements such as weight, height, arm circumference, head circumference, etc. which can be used to assess nutritional status of the children. After diagnosis, nurse can play a vital role in the treatment of such cases.
  • 22.  The normal hospital diet which provides a patient with the energy and nutrients intended for the patient whose condition do not require a therapeutic diet. These modification of diet are liquid diet, soft diet, and semisolid diet. Nurse should know different types of modifications of diet in the hospital because they are responsible to prepare and administer the nutritional needs according to types of disease, age, income, region, customs and food habits of individual patients.
  • 23.  For every one, eating food is an enjoyment. When the person is sick, the food intake becomes a problem.  A) Assisting the patients with special problems in preparing and accepting therapeutic diets, i.e., salt free diet and bland diet.  B) Assisting the patient to obtain nourishment either through feeding or assisting helpless patient in eating.  C) For motivating the patient to eat in therapeutic environment, nurse must know the principles of meal therapy.
  • 24.  The aim of education is to guide people to choose optimum and balanced diets, to remove prejudices can be minimized by nutrition education and counseling in case of delayed weaning, ignorance about breast feeding and our traditional misconception about certain foods. In the recent, years, the link between dietary habits and certain chronic disease has been recognized, i.e. obesity, diabetics and cardiovascular disease. So, nutritional education is a major intervention in the hands of nurses for prevention of such disease.
  • 25. 1. Protein energy malnutrition 2. Low birth weight 3. Vitamin – A deficiency 4. Nutritional anemia 5. Iodine deficiency disorders 6. Fluorosis 7. Lathyrism 8. Obesity
  • 26.  Malnutrition is the major nutritional problem widespread among children under five year of age in India. A majority of them suffer from varying (various) grades of malnutrition. The most of the children suffers from moderate grade of PEM. The prevalence (no. of cure pt.) has increase now a days due to various program's run by government of India. E.g; Mid day meals .
  • 27.  Pregnant women  Lactating women  Infants  Preschool children  Adolescent girls  Elderly  Socially deprived
  • 28. 1. Marasmus : This is due to insufficient of calories intake body. It mostly affect the children under 1 year. 2. Kwashiokor : This disease is due to the protein deficiency in the body. It mostly occurs in children between 2-3 years of age.
  • 29.  This is due to insufficient of calories intake in the body. Common type of PEM observed among children below 1 year of age. It is caused by severe deficiency of nearly all nutrient especially protein and calories. Conditions are characterized by extreme wasting of the muscles and a daunt expression.
  • 30. Sign and symptoms Extensive tissue and muscle wasting Dry skin Loose skin folds hanging over gulutie and axilla Fat wasting Sparse hair that is dull brown or reddish yellow Mental retardation Behavioral retardation Low body temperature Slow pulse and breathing rates Absence of edema
  • 31.  This disease is due to the protein deficiency in the body 1. Kwashiorkor occurs in mostly children between 2-3 years of age 2. Acute form of PEM due to deficiency of protein in the diet 3. Deficiency of micronutrient 4. Kwashiorkor is identified as swelling of the extremities and belly, which is deceiving to their actual nutritional status.
  • 32.  Malnourished child with pedal edemas  Growth failure  Moon face  Distended abdomen  Acitis  Enlarged liver with fatty infiltrates, thinning of hair, loss of teeth, skin depigmentation  Dermatitis  Irritability  Anorexia
  • 33. Sign and Symptoms Malnourished child with pedal edemas Growth failure Moon face Distended abdomen Acitis Enlarged liver with fatty infiltrates, thinning of hair, loss of teeth, skin depigmentation Dermatitis Irritability Anorexia
  • 34.  In this condition child weight is not sufficient according to height and age wise.  Causative factors :-  Maternal malnutrition and anemia  Illness and infection during pregnancy  High parity  Close birth intervals  Prevention :-  More hospital deliveries  Immunization  Increase number of ANC
  • 35.  Nutritional blindness affects over seven million children in India per year and it result mainly from the deficiency off vitamin A. In its severest from, it often results in loss of vision and it has been estimated that around 60,000 children become blind.  Disease :-  Night blindness – This is due to lack of the vitamin A, person is unable to see in the dim light.  Xerophthalmia : Absence of tears in eyes. It is most common in children aged 1-3 years. It is mostly seen in rice eating population.  Bitot’s spots :- Collection of dried epithelium, microorganism, etc. forming shiny grayish white spot on the cornea.
  • 36.  A condition in which the Hb content of blood lower than normal as a result of a deficiency of one or more essential nutrients. It occur due to decrease iron In diet and excessive loss of iron.  Treatment :- Iron and folic acid supply  Dose – Each Tablet contains 80 mg iron, 200 mg iron sulphate , 0.5 mg of folic acid .
  • 37.  In India, meanly 35 million person are estimate to be suffering from goiter and 140 million are living in the known goiter endemic regions. The prevalence of goiter is more in hilly areas endemic regions such as Assam, Mizoram.  Disease :- Goiter is also called Derbyshire Neck.  Enlargement of thyroid gland causing swelling in front part of the neck. Common among girls than boys  Treatment :-  Iodized salt is widely used in India
  • 38.  Due to excessive amounts of fluorine in drinking water, endemic fluorosis has been reported to be an important health problem in certain part of India., e.g Haryana, Kerala, Punjab etc. symptoms of fluorosis are dental fluorosis, skeletal fluorosis.
  • 39.  Lathyrism is a parlaying disease of human and animals. In humans, it is referred to as neurolathyrism characterized by gradually developing spastic paralysis of lower limbs. This occurs due consumption of khesari dhal.
  • 40. 1. Basal Metabolic Rate :-BMR is the main factor which influences our nutritional requirement. It is defined as the amount of energy required to carry on the involuntary activities of the body. Generally for an approximate determination of BMR, simple method is used, i.e. one k cal per kilogram per hour, so BMR = 1 k cal body weight (in kg) x 24 hours. 2. Factors affecting BMR:- Body surface area, age, sex, sleep, climate and secretions of ductless glands.
  • 41.  2. Weight :- Total metabolism includes work done in moving one's own weight from place to place. Therefore, the heavier the individual, the more energy is required for movements.  3. Age :- Young children need more energy and protein in their growing age and adolescents require more calories than the adults. The energy requirement with the age decreases because of a fall in BMR and decreased physical activities.  4. Sex :- Sex also makes variation in energy requirements. The BMR of women is 6 - 10% lower than the men. For example a moderate man requires 2875 k cal whereas a moderate woman needs 2225 k cal.(in compression to weight and height)
  • 42.  5. Climate and environment :- Poor environment may lead to infections, especially in children. Infection and hot temperature both increase BMR, which increases our nutritional requirement. Our body must have sufficient food to make up for heat loss. The amount of heat loss depends on the amount of work done and the temperature. This is the reason that in persons living in tropical climates, the BMR is about 10% less than those living in low temperate zone.  6. Physical activities :- Activity of in addition to the total BMR. The type of activity and total time spent in each activity determines to a large extent of body's need of total energy. So, energy requirement depends on the type of work or occupation, i.e. a sedentary worker (man of 60 kg)needs 2425 k cal per day, moderate worker 2875 and a heavy worker requires 3800k cal.
  • 43.  7. Specific Dynamic Action of food (SDA) :- It has been found that there is 8%increase in the production of energy in the form of heat after taking food. This is not due to any work done (digestion or absorption) but it is due to stimulating effect of food on the basal metabolism. This stimulating effect is known as Specific Dynamic Action of food. It varies according to different nutrients, e.g., SDA of Carbohydrate is 5 - 6%, of Protein is 30%, of Fat is 4% and of mixed diet is 12%.  8. Physiological state :-, There is increased demand of food in certain physiological conditions because of increased BMR. The energy requirements of women are increased in pregnancy by 300 k cal daily throughout pregnancy, and in lactation 550 k cal extra daily during the first six months and 400 k cal during the next 6months. The need of extra energy is associated with deposition of tissues during pregnancy and secretion of milk during lactation.
  • 44.  9. Socio-economic factors :- Nutritional status is largely affected by some socio-economic factors like income, level of education, sanitation, family size, knowledge regarding the nutritive values of foods. These factors bear most directly on the quality of life and are the true determinants of nutritional status of society. Malnutrition is the product of poverty, ignorance, lack of education, large family size in India. In short, the causes of malnutrition are built into the very nature of society, in the socio-economic and political structure.
  • 45.  10. Cultural factors :- Cultural factors in health and nutrition have engaged the attention of medical scientists and sociologists. Every culture has its own customs and beliefs regarding nutritional practices. It is now widely recognized that cultural factors are deeply involved in all affairs of man including health and nutrition. Not all cultural factors are bad, some are based on centuries of trial and error and have positive values while other may be useless.
  • 46.  11. Life style and Food habits :- what kind of life style we live it directly impact our health e.g, sedentary life style leads to obesity and Food habit also plays an important role in health as we know bad food habits leads to various kind of disease. E.g, hypertension , Diabetes etc.
  • 47.  12. Food Fads :- A fad diet is a diet that is popular for a time, similar to fads in fashion, without being a standard dietary recommendation, and often promising unreasonable fast weight loss or nonsensical health improvements.  13. Cooking practice :- The methods of cooking like draining away the rice water at the end of cooking, prolonged boiling, peeling of vegetables, all influence the nutritive value of foods.
  • 48.  11. Religious :- Religion has a powerful influence on the food habits of the people. Hindus do not eat beef and Muslims pork. Some orthodox Hindus do not eat certain vegetables like onion, and garlic is not eaten by Janis and Braham kumaris. Vegetarian is given a place of honour in Hindu society. These food habits are known as food taboos and have a religious sanction from early days. The seafood taboos prevent people from consuming nutritious foods even when these are easily available. Muslim observe fasts during Ramzan and Hindus on several occasions.
  • 49.  12. Traditional factors :- Food is a subject of widespread traditional beliefs and customs which vary from country to country and from one region to another. The concept of hot and cold food is widely prevalent in the country. Foods such as meat, fish, eggs and jaggery are considered to generate heat in the body and are known as hot foods. On the other hand, foods such as curd, milk, bananas and lemon are considered cold foods. In some rural areas, people avoid their children from hot and cold foods, which leads to malnutrition.
  • 50.  13. Food production and distribution :- The rate of food production and distribution is another important factor influencing the nutritional status of a country. Increased food production should lead to increased food consumption. Given the best technology known at present, most developing countries could increase their food production several fold but increased food production will not solve the basic problem of hunger and malnutrition. It is a problem of uneven distribution between the countries and within the countries. It is said that there will be very little malnutrition in India today if all foods available can be equally distributed in accordance with physiological needs.
  • 52.  It nourishes the skin and protects arteries.  It helps to maintains healthy skin as it contributes to proper skin hydration and tone.  It also use in skin dryness and aging, vision, Arteriosclerosis, lows cholesterol level and it also in diuretic in nature so use in hypertension
  • 53.  It stimulates the immune system. It prevents cold and flu.  It increase the blood due to iron, vit. C, copper and folic acid so it prevents anemia.  It are recommended for pregnant mothers as they stimulate immune system and prevent anaemia.
  • 54.  Due to its excess solution fiber, it reduce the cholesterol and prevents arteriosclerosis and hypertension.  Relieves constipation.  Increase stamina in athletes.
  • 55.  It contains a fair amount of minerals and vit. A,B1,B2,Folic acid and vit. C. 100 g oranges supply 40-60 mg iron, which is more than our daily requirements. So it use in pregnant women.  Its fiber is in the form of pectin. It reduces cholesterol.
  • 56.  Its citric acid enhances the activity of vitamin-C and facilitates the elimination of toxic substance, such as uric acid .  It highly recommended for infectious disease  All citrus fruits prevent cancer.
  • 57.  The flavinoids (flvonoids exhibit high biological activity and display antioxidant, anti-inflammatory and antiallergic properties)contained in the grapes are phenols which act as powerful antioxidants.  Phenolioc substance act as fungicidal.  Act as powerful anticarcinogen.  Grapes highly recommended in cardiac disease.
  • 58.  It increase the bile production; is very useful in cirrhosis and ascites.  They are mild laxative that relieves chronic constipation.  They maintain intestinal flora also.  They are highly recommended in renal failure.  They have anti-tumour properties.
  • 59. 1. Aniseed(Sounf): Aniseed is used for expelling wind or air or gas, for treating insomnia, for removing lice. 2. Ajwain (omum): It relieves indigestion, colic. 3. Asafoetida (Hing): It is used for expelling gas to reduce distension of abdomen and relives toothache.
  • 60. 4.Cardamom (Chhoti Elaichi): Cardamom relieves gas and heart burn and is used to prevent indigestion. 5. Garlic (Lahsan): Garlic boiled in milk is effective in asthma, and lowers high blood pressure and prevents heart attack.
  • 61.  Food contains organic and inorganic complex known as elements of nutrition.  These are also called nutrients or food factors.  They are needed to build and maintain body cells, regulate body processes and supply energy.  These elements may be classified into two groups:-
  • 62.  These are proteins, fats, and carbohydrates. They form the main bulk of food in the Indian dietary.  Proteins - 7 to 15 %  Fat - 10 to 30 %  Carbohydrate - 65 to 80 %
  • 63.  This group includes vitamins and minerals.  They are required in a small amounts which may vary from a fraction of milligram to several grams. That’s why they are called micronutrients.
  • 64.  Proteins are required for growth in children and maintenance of body weight in adults.  Proteins constitute about 20% of the body weight.
  • 65.  Carbohydrates form the bulk of our food and are the main source of energy for doing work.  About 50-70% of energy value in the average diets is provided by Carbohydrates.
  • 66.  Oils and fats serve mainly as the source of energy. They contains some essential nutrients like essential fatty acids and fat soluble vitamins.  Excessive fats leads to obesity.
  • 67.  Human body contains more than 50 chemicals elements which are required for growth, repair and regulation of vital body functions.  The important minerals are calcium, phosphorus, sodium chloride, potassium, iron, copper, iodine, fluorine and zinc.
  • 68.  Vitamins are a class of organic compounds categorized as essentials nutrients. They fall in category of micronutrients.  Vitamins are divide into two groups vitamin A,D,E,K are fat soluble and B group and vitamins C are water soluble.
  • 69.  1. On bases of origin:  A) Foods of animals origin, e.g milk, and eggs etc.  B) Foods of vegetables origin, e.g pulses, cereals and fruits etc.
  • 70.  On chemical composition of foods:  Proteins  Fats  Carbohydrates  Vitamins  Minerals
  • 71.  On nutritive values of foods:  Cereals  Pulses  Vegetables  Nuts  Fruits  Animals foods  Fats and oils  Sugar and jaggery
  • 72. On predominant function: 1) Body building foods: Foods rich in proteins are called body building foods because they are responsible for building and repair of body tissues. E.g- milk, fish, eggs, pulses 2) Energy yielding foods: Foods rich in carbohydrates and fats are called energy yielding foods. E.g – cereals, dried fruits, sugars, oils and fats. 3) Protective foods: Foods rich in proteins, vitamins are minerals are called protective foods. E.g – fruits and green leafy vegetables.
  • 73.  Bureau of Indian standards (ISI standards) – Various committees including representatives from the govt., consumers and industry formulate the Indian and standards (ISI) for vegetables and fruit products, spices, animal products and processed foods. Once these standards are accepted, manufacture whose products conforms to these are allowed to use. An ISI label on each unit of their products is a guarantee of good quality.
  • 74.  The AGMARK standards :- These standards were set up by the Directorate of Marketing and Inspection of Govt. of India by introducing an Agricultural production Act in 1937. This act defines quality of cereals, spices, oil seeds, oil, butter, ghee, egg, etc. and provides various grades depending upon the degree of purity in each case.
  • 75.  CODEX Alimentarius:- The Codex Alimentarius commission, which is the principle organ of the joint FAO (Food and Agriculture) and WHO food standards programme, formulates food standards for international market. The food standards in India are based on the standards of the Codex Alimentarius.
  • 76.  PFA Standards:- Standards have been established under the Prevention of Food Adulteration Act (1954) and are revised from time by the ‘Central Committee’ for food standards. The purpose of PFA standards is to obtain a minimum quality of food stuffs attainable under Indian standards.
  • 77.  Standards of Weights and Measures :- The standards of weights and measure Act (1985) contains provision for effective legal control on weights, measures and weighing/measuring instruments used in industrial production and protection of public health and human safety. This ensure that the consumer gets the correct inspection of weight and measure.
  • 78.  Misbranding :- It is also forbidden by law. A food may be considered as misbranded if it has a label which gives false or misleading information about the product failure to specify weight, measure, name of additives, limitations in use of the product, name of the manufacturer, as well as misleading the consumer in terms of size are all considered as misbranding of food.
  • 79.  Adulteration is define as the process by which the quality of the product is reduced through addition of baser substance or removal of a vital element. Food material Adulterations Wheat, rice Mud Haldi powder Lead chromate powder Dhania powder Cow dung or horse dung powder Chilli powder Brick powder
  • 80.  Enacted by the Indian Parliament in 1954, with the objective of ensuring pure and wholesome food to the consumers and to protect them from fraudulent and deceptive trade practices, the Prevention and Food Adulteration (PFA) Act was amended in 1964, 1976 and lately in 1986 to make the Act more stringent.
  • 81.  Consumer rights have become an important issue. The CPA is a piece of comprehensive legislation and recognized six rights of the consumers namely-  1. Right to safety  2. Right to choose  3. Right to heard  4. Right to seek redressal  5.Right to information  6. Right to consumer education
  • 82.  Adequate and sufficient nutrition is a fundamental right of every human being. Improving the nutritional status of people is one of the prime duties of the government and is an essential factor in improving their health status and the quality of life. The World Health Report 2002 clearly describes how child and maternal underweight are the greatest risk factor that affect people's health and disease status. In this report, underweight has been adopted as a key indicator of poverty and hunger. From these points of view, it is recognized that policies, programs and processes for nutrition improvement have a great role to play in promoting healthy lives and development across the globe.
  • 83.  Aim: The general objective of the National Nutrition Policy is to improve the nutritional status of the people. Achieving nutritional well-being of all people in India so that they can maintain a healthy life and contribute to the socio-economic development of the country, through improved nutrition-program implementation in collaboration with relevant sectors.  Objectives  To promote the practices, that is favourable to the improvement of the nutritional status of human being.  To reduce the prevalence of diseases linked to nutritional malnutrition, deficiencies and excesses.  To prevent mother-to-child transmission of HIV through appropriate breastfeeding and infant and young child feeding practices.  To assure adequate treatment and rehabilitation of malnutrition due to nutritional deficiencies and excesses.  To provide nutritional care, education, counselling and support for people living with HIV/AIDS.
  • 84.  The Human rights: Accesses to nutritionally adequate and safe food and services for nutrition education are the rights of each individual.  Pre-condition for development: Nutritional well-being should be a key objective for progress in human development.  Healthy life style: Nutritional improvement has to be enhanced to ensure the healthy life of all people.  Primary education: Under nutrition in infancy and early childhood affects school enrolment and on cognitive and behavioural development.  Venerable groups: Infants, young children, pregnant and nursing women, disabled people and the elderly within poor households are the most nutritionally vulnerable groups.  Community participation: People-focused policies for nutritional improvement must acknowledge the fact that people's own knowledge, practices and creativity are important driving forces for social change.  Gender: Special attention should be given to the nutrition of women during pregnancy and lactation.
  • 85.  Promotion of optimal infant and young child feeding.  Scaling up of community-based nutrition programs.  Food fortification.  Promotion of household food security.  Prevention and management of malnutrition and related diseases.  Nutritional support to their families.  Communication for behaviour change.
  • 86.  To ensure effective implementation of planned activities, monitoring and evaluation is essential in all development programs. In addition, periodic and continuous evaluations are necessary for establishing level of objective achievement in the programme and policy.  The follow up implementation of nutrition programs properly and data will be collected on regularly basis at the health centre and community level, In addition, other opportunities for nationwide surveys will be identified and utilized.  Nutritional surveys and epidemiologic surveillance will be conducted regularly and periodically, with appropriate indicators, to evaluate the progress and impact of nutritional interventions.  Operational research will also be carried out to address specific nutritional and other problems identified during the implementation of nutritional activities.  To prevent nutritional emergencies, nutrition unit will reinforce collaboration with all existing structures that collect and analyze bioclimatic, environmental, demographic and agricultural data for early warning and timely intervention measures against disasters that can negatively affect the nutrition.
  • 87.  Short note on national nutritional policy ?  Short note on nutritional problem in India ?  Define BMR ?  Define nutrition and role of nutrition in health?  Factor affecting food and nutrition ?  Short on food adulteration ?