1. Prepared By,
Selesty Christian
M.sc. Nursing
Department of Psychiatric
JG College of Nursing

3. UNIT-I INTRODUCTION
Nutrition: History and Concept
Role of Nutrition in Maintaining Health
Nutritional Problems in India
National Nutritional Policy
Factors Affecting Food and Nutrition
Role of Food and its Medicinal value
Classification of Food
Food Standards
Elements of Nutrition: Macro & Micro
Calorie, BMR

4. TERMINOLOGIES
Health:
According to WHO “Health is a state of complete physical, mental, and social well-
being and not merely the absence of disease or infirmity.”
Nutritional status:
It is state of our body as a results of food we consume.
Nutrition:
Nutrition as define as the scientific study of food and its relation to health.
 Nutritionist:
A person who advices about various aspects of nutrition.
Nutritional Requirement:
Refer to amount of various nutrients needed for an individual to sustain a healthy
life.

5. Nutritional Surveillance:
Define as the regular collection of information related to nutrition that is used for
making decision about actions and policies that will affect nutrition.
Imbalance:
Pathological state resulting from disproportion of the nutrients.
Antioxidants:
These are natural or synthetic occurring substances found in food that help in boosting
the immunity of the body.
Nutrients:
Nutrients are substance essential Growth,
maintenance, function and reproduction of a cell or of an
organism.

6. Food:
Any substances that are consumed For maintaining the health and well- being of the
body other than water and drugs.
Malnutrition:
It is an impairment of health resulting from a deficiency, excess or imbalance of
nutrients.
• Undernutrition: Undernutrition in children is defined as low weight for age, low weight for
age and low weight for height.
• Underweight: It refers to a deficit in weight and is defined as low weight for age
Nutrition Security:
It is the physical, economic and social access to and a
utilization of an appropriate balanced diet, safe drinking water,
environmental hygiene and primary health care for all.

7.  BMI:
It is ratio of weight for height, which is often used to estimate body fat. It is obtained by
dividing the weight in kilograms by the square of height in meters.
Macronutrients:
Carbohydrate, proteins and fats are considered macronutrients. They form the bulk of
our food.
Micronutrients:
They do not supply energy but form a vital part of our diet. Vitamins and minerals are
called micronutrients because they are required in small amounts.
Chronic Energy Deficiency:
It is commonly used to describe a condition of
underweight among adults as a result of prolonged negative
energy balance. It is measured through body mass index (BMI). A
BMI value less than 18.5 inch indicates CED in adults.

8.  Basal Metabolic Rate (BMR):
It is the rate of metabolism when an individual is at complete rest in a warm
environment and is in post absorptive state (12 hours after taking a meal).
Wasting:
It refers to the result of weight loss associated with an acute period of food storage or
disease and is defined as low weight for height.
Metabolism:
The sum of all the chemical and physical changes that take place within the body that
enables its continued growth and functioning.
Probiotic:
It is derived from the Greek word for life. It refers to organisms like acidophilus, which
 Kilocalorie (kcal):
It is the amount of heat required to raise the
temperature of 1 liter of water by 1 degree Celsius; 1 kcal= 1000
cal.

9. INTRODUCTION
• Food is the basic necessity of life.
• Everybody eats food and most people
enjoy it.
• From the beginning, scientists were
curious about the food they
consumed, its passage in the body
and its effects.
• This curiosity led to the development
of the science of NUTRITION.

10. In the late 18th century, Lavoisier
began study in nutrition.
Lavoisier- “The father of nutrition
nutrition science”.
He studied the role of respiration in
metabolism of food.

11. DEFINITION OF
Nutrition is defined as the scientific study of food and its
relation to health.
OR
Nutrition is science which deals with those processes by
which body utilizes food for energy, growth and maintenance
of health.

12. HISTORY OF
400 BC: BC Hippocrates said, let food be the medicine and
medicine be the food
1500 AD: Leonardo da Vinci, an artist and a scientist, compared
the metabolism of the body to the burning of the candle
1747 AD: Dr. James Lind, a physician in the British Navy, performed the
first experiment on nutrition.
1770 AD: Antoine Lavoisier, the father of nutrition, discovered the
process of metabolism and demonstrated where the animal heat
comes from.
Early 1880s: Important discoveries were made that foods are
composed of carbon, hydrogen, nitrogen and oxygen,
and methods were developed in determining these
elements.

13.  1840 AD: Justus Liebig of Germany declared
that carbohydrates were composed
of sugars, fats of fatty acids and
Proteins or amino acids.
 1897 AD: Christian Eijkman, a Dutch physician, discovered that
brown rice when given to natives of Java were cured of beriberi.
Nutritionists later discovered that unpolished rice, which
contains bran is rich in vitamin B1 (Thiamine)
1912 AD: E.V McCollum discovered the first fat-soluble vitamin,
vitamin A.
1912 AD: Dr. Casmir Funk was the first to coin the term vitamin.
 1930s : William Rose discovered essential amino acids, the
building blocks of protein.
1940s : Water soluble vitamins, B and C, were discovered.

14. 1950s : Vitamins and minerals and their role
as components of enzymes and
hormones in effective functioning of
the body were discovered.
1968 AD: Linus Pauling created the term orthomolecular nutrition.
He proposed that by giving optimum nutrition to the body, better
health and prolonged life can be achieved.

15. ROLE OF NUTRITION IN
MAINTAINING HEALTH
Health is defined as the complete state of physical,
mental and social health and not merely the absence of
disease or infirmity.
A diet has to be balanced and should contain different
food groups comprising all the macro and micronutrients.

16. ROLE OF NUTRITION IN
MAINTAINING HEALTH
Carbohydrates Proteins Fat

17. ROLE OF NUTRITION IN
MAINTAINING HEALTH
Vitamins and
Minerals
Water Dietary fiber

18. NUTRITIONAL PROBLEMS IN INDIA
Good nutritional status is important for the national
development and nutritional security is vital for the
development of the country.
Vitamin A deficiency, goiter, under nutrition and obesity
are some common nutritional problems of India.

19. MALNUTRITION
Malnutrition is a state in which a prolonged lack of one or
more nutrients retards physical development or causes specific
clinical disorders.
It can also be defined as an impairment of health resulting
from a deficiency, excess or imbalance of nutrients.

20. MALNUTRITION
Statistics:
•22% of children are born with low birth weight, less than 2.5
kg.
•42.5% of our nation’s children under the age of five are
underweight.
•48% of the children are stunted (low height for age)
•19.8% are wasted (refers to the result of weight loss associated
with an acute period of food shortage and disease)
•In some economically backward states, 50% of the children are
underweight.

21. Factors that affects
Malnutrition
• Inadequate and poor-quality diet
• Poor nutrition of adolescent girls
• Maternal malnutrition and anemia
• Late initiation of breastfeeding
• Delayed and inadequate complimentary feeding
• Ignorance about nutritional needs of infants
• Poor hygiene practices in feeding infants
• Female illiteracy
• Teenage pregnancies which cause low birth-
weight babies
• Poor socioeconomic status

22. Important Identified Properties in
the Area of Nutrition
Micronutrient
supplements
Micronutrient
fortification
Biofortification
Deworming
Nutritional
programs at
schools
Community
nutritional
programs

23. ANAEMIA
• Anemia impairs cognitive development, which
affects general efficiency and increases morbidity.
Women of reproductive age face uncommon risks
from anemia during pregnancy and childbirth.
• Anemia is also related to low birth weight. Anemia
due to iron deficiency is more prevalent in India.
• Anemia from inadequate nutrition is common
among the adolescent girls.
• Adolescence is a rapid period of growth, and
optimal growth and development cannot be
achieved without proper nutrition.

24. NATIONAL NUTRITIONAL POLICY

25. INTRODUCTION
• India adopted the National Nutritional Policy (NNP) in early 1993 under the
guidance of the Department of Women and Child Development.
• It is a comprehensive policy covering all the areas and aspects that affect the
nutrition of the people and the linkage between the nutritional status of the
population and the development and well-being of the nation.
• The NNP recognizes that nutrition affects the development and vice versa,
and advocates strategy as the multifaceted problem of nutrition needs to be
tackled at various levels.
• The NNP contains both direct and indirect instruments.

26. DIRECT INSTRUMENTS
• Universalize the Integrated Child Development Services (ICDS) scheme by the year 2000, by
extending it to the children in the age group of 0-6 years.
• Reduce the incidence of severe and moderate malnutrition in children by half the year 2000.
• Nutrition and health education of mothers to be a key intervention to initiate the appropriate
behavioral changes to manage the nutritional needs of their children.
• Improving nutritional status of adolescent girls through iron and folic acid supplementation.
• Fortification of essential food with appropriate nutrients.
• Popularization of low- cost nutritious foods.
• Controlling micronutrient deficiencies.
• Reducing anemia in expectant women by 25%
• Distribution of iodized salt should cover all areas of the country

27. INDIRECT POLICY INSTRUMENTS
A. FOOD SECURITY
• Ensuring per capital availability of 215 kg of food grains per person per year by producing 230 million tons of food grains per
year by 2000 AD and maintaining a buffer stock of 30-50 million
• Improvement of dietary pattern through production and demonstration.
• Public distribution
• Improving purchasing power
• Health and family welfare
• Land reforms
• Policies to improve the income of the rural and urban poor.
• Knowledge of basic health and nutrition
• Nutrition surveillance
• Improvement of the status of women
• Education and literacy
• Minimum wage administration
• Equal remuneration

28. INDIRECT POLICY INSTRUMENTS
B. Monitoring of National Nutrition Policy
• The NNP identifies a series of actions for several ministries and departments of the
government and nongovernment organizations.
• It has also documented that several special working groups be constituted in relation to
nutrition, agriculture, rural development, health, education, food and women, and the
proposals and nutritional policies be analyzed and incorporated.
• The ministry of Human Resource Development with a coordination committee comprises
ministers from several portfolios oversees and reviews the implementation of nutrition
intervention measures.

29. INDIRECT POLICY INSTRUMENTS
C. Strengths of the Policy
• Identified that nutrition is a key to country’s development.
• Identified that malnutrition has to be tackled at various levels through a multi sectorial
approach.
• Identified a series of actions in different sectors like food production, distribution, education,
empowerment of women and nutrition surveillance.
• Both direct and indirect interventions were identified.

30. FACTORS INFLUENCING
Family
Age
Religion
Culture
Economic
status
Community
Tradition
Genetics
Medicine
Health
Agriculture
Science &
Technology
Education
Climate

31. ROLE OF FOOD AND ITS
MEDICINAL VALUE

32. Increases
digestibility
Enhances Immunity
Protects against
intestinal infections
Lowering
cholesterol
Preventing
constipation

33. Heart diseases and
stroke
Relieves flatulence
Antibacterial
Properties
Stomach
disorders
Anti-inflammatory
properties

34. Protects Digestive
and Respiratory
Infections
Anti-carcinogenic
properties
Relieves
Respiratory
Infections
Anti-inflammatory
properties

35. Helps to promote
health
Reduce the risk of
diseases
Reduces risk of uterine
cancer and
menopausal symptoms
Reduces bad cholesterol

36. CLASSIFICATION OF FOOD

37. A. Energy Yielding

38. B. Body Building

39. C. Protective Foods

40. ELEMENTS OF NUTRITION
 MACRONUTRIENTS:
• Consumed in large quantities
• Form the major portion of food
 MICRONUTRIENTS:
• Required in small amounts
• Vital for the optimal functioning of the
body

41. FOOD STANDARDS
Food standards are formulated and enforced to regulate the quality of food.
It is important to ensure that the food we consume is of good quality, hygienic and free
from contaminants. It should not cause any diseases.
Types of food regulations:
A. Compulsory regulations
B. Voluntary Regulations

42. A. Compulsory Regulations
Prevention of
Food
Adulteration
Act,1954
Essential
Commodities
Act,1954
Fruit Product
Act,1955
Milk and Milk
Products
Act,1992

43. 1. PREVENTION OF FOOD
ADULTERATION ACT, 1954
• Regulated to prevent the supply of
adulterated food products
• Tries to ensure that no person shall
manufacture, sell, store and
distribute any adulterated or
misbranded food products
• The Central Committee and the
Directorate General of Food
Services are responsible for the
enforcement of the Act.

44. MANUFACTURE SELL
DISTRIBUTE STORE

45. 2. ESSENTIAL COMMODITIES ACT, 1954
• To regulate manufacture or
production, commerce or
trading and distribution of
the essential commodities
including the food
products.

46. 3. FRUIT PRODUCTS ACT, 1955
• Every manufacturer must
obtain license for
vegetable oil products,
and fruits and vegetables
should conform to the
standards prescribed
under the Act.

47. 4. MILK AND MILK PRODUCTS ACT, 1955
This Act lays down the
standards for the sanitation
and hygienic standards for
dairy plants, for the
production, distribution and
sale of milk and milk
products.

48. B. Voluntary Regulations
Agmark
Indian Standards
Institution (ISI)
Food Safety
and
Standards
Authority of
India

49. 1. AGMARK
• The Act defines the standards for
assessment of quality of cereals, spices,
oilseeds, oils, butter, ghee, pulses and
eggs.
• It covers the grading of the various raw
and finished agriculture produce
• The Agmark grades are statutory and
expressed through labels.
• The certification is voluntary and it helps
the manufacturer to market his products
better

50. 2. INDIAN STANDARDS INSTITUTION (ISI)
• It is prescribed by Bureau of Indian Standards
(BIS) and covers various processed foods and
their raw materials.
• The certification is voluntary and the standards
cover raw materials permitted, hygienic
conditions of manufacturing and product safety
with respect to microbial contaminants.
• Mandatory BIS certification is enforced for food
colors, food additives, preservatives, Vanaspati,
Milk products and infant foods.

51. 3. FOOD SAFETY AND STANDARDS
AUTHORITY OF INDIA
• FSSAI has been established under The
Food Safety and Standard Act’2006 which
replaces the various Acts such as:
Prevention of Food Adulteration Act,1954
Fruit Products Order,1955
Meat Food Products Order,1955
Vegetable Oil Products Order,1947
Edible oils Packaging Regulation
Order,1988
Milk and Milk Products Order,1992

52. • Aim:
Regulation, manufacture, storage, distribution,
sale and import of various food products by
laying down science-based standards to ensure
availability of safe and wholesome food for
human consumption.
This Act also enables the consumers and
manufacturers of food and food-related
establishments to have a single reference point
for food safety and standards, thus ensuring the
people will have access to safe food. The
headquarters of FSSAI is based at Delhi.

53. FSSAI has been mandated by the FSS Act, 2006, for
performing the following functions:
Farming of regulations to lay down the standard and guidelines
in relation to food and specifying appropriate system of
enforcing various standards thus notified.
Laying down mechanisms and guidelines for accreditation of
certification bodies engaged in the certification of food safety
management system for food businesses.
Laying down procedure and guidelines for accreditation of
laboratories and notification of the accredited laboratories.
Providing scientific advice and technical support to the central
government and state governments in the matters of farming
the policy and rules in areas which have a direct or indirect
bearing on food safety and nutrition.

54. Collecting and collating data regarding food consumption,
incidence and prevalence of biological risk, and residues and
contaminants in food products along with the identification of
emerging risks and introduction of rapid alert system.
Creating an information network across the country so that the
public, consumers, panchayats etc. receive rapid, reliable and
objective information about food safety and issues of concern.
Providing training programs for person who are involved or
intend to get involved in food businesses.
Contributing to the development of intentional technical
standards for food, sanitary and phyto-sanitary standards.
Promoting general awareness about food safety and food
standards.

55. The Act has set scientific standards and has
established guidelines that deal with various aspects
of food such as:
 Adulterants in food
 Claims made by food manufacturers
 Food labeling Contaminants in food
 Import of food substances
 Infant food
 Infant milk substitute
 Ingredients in food
 Misbranded food
 Food packaging
 Sale of food
 Unsafe food

56.  The Food authority consist of a chairperson and 22 members, of
which one-third are mandated to be women members.
 All the members are appointed by the central government.
 In the 22 member panel, 7 members are not below the rank of
Joint Secretary to the Government of India and represent the
ministries or departments of the central governments dealing
with:
 Agriculture
 Commerce
 Consumer affairs
 Food Processing
 Health
 Legislative Affair
 Small-Scale Industries

57. The other members are:
 Two representatives from food industries
 Two representatives from consumer organizations
 Three eminent food technologists or scientists
 Five members to be in rotation for every 3 years as
specified in the Act to represent specific states and
union territories
 Two representatives from farmers’ organizations
 One representative from retailers organizations

58. Basal metabolic rate (BMR)
BMR is the rate at which the body
uses calories or energy to meet its basal
metabolic needs.
It depends on the following factors:
Body weight
Sex
Age
Growth
Temperature
Fever
Stress