1. Health Promotion and Education
    2. 1. Introduction
    2. Health Education in Health and Medical Care Settings (HMCS)
    3. Patient Health Education Counseling, Planning and Facilitating
    4. Methods and Media of Health Educaiton or Counseling in Medical Care Setting
    5. Communication in Patient Education Process
  2. Family Health and Nutrition
    3. 6. Food and Nutrition
    7. Nutriotional Problems
    8. Nutriotional Assessment
    9. Miscellaneous
    10. Concept of Family Health
    11. Child Health
    12. Adolescent Health
    13. Reproductive Health
    14. Maternal Health
    15. Ageing and Health
  3. Environmental and Occupational Health
Family Health and Nutrition
6. Food and Nutrition
DEFINITIONS
  1. Nutrition is a nourishment or energy that is obtained from food consumed.
  2. The process of consuming the proper amount of nourishment or energy
  3. Nutrition is the organic process by which an organism assimilates food and uses it for growth and maintenance.
FUNCTIONS_OF_GOOD_NUTRITION
  1. Helps children grow
  2. Promotes human development
  3. Advances economic growth and eradication of poverty.
CLASSIFICATION_OF_FOOD
on_the_basis_of_predominant_function
on_the_basis_of_chemical_composition
carbohydrates
fats
proteins
vitamins
minerals
NUTRIENTS
definition
Nutrients are organic and inorganic compounds contained in food.
classification
macronutrients
about
  1. forms main bulk of food
items
  1. carbohydrates
  2. fats
  3. proteins
micronutrients
about
  1. required in small amount
items
  1. vitamins
  2. minerals
nutrient_elements
carbohydrates
chemical
  1. Hydrates of Carbon
  2. Polyhydroxy aldehyde and ketons
energy_supply
4 KCal/g
functions
  1. Provide energy
  2. Essential for oxidation of fats
  3. Build macromolecules
  4. Spare protein and fat for other uses
sources
  1. Cereals
  2. Rice
  3. Sugarcane
  4. Potato
fats
about
  1. Chief storage form of energy in body.
  2. Yiels fatty acid and glyverol on hydrolysis.
classification
essential_fatty_acids
non_essential_fatty acids
functions
  1. Provide energy
  2. Help in absorption of fat soluble vitamin
  3. Store fat for subsequent use
  4. Maintain proper body temperature
  5. Support viscera like heart, kidney and intestine and that beneath skin produces insulation
  6. Precursor of different steroid hormones
sources
animal_sources
  1. Ghee
  2. Butter
  3. Milk
  4. Egg
plant_sources
  1. Goundnut
  2. Sesame
  3. Mustard
proteins
definition
Proteins are complex organic nitrogenous compounds, composed of carbon, hydrogen, oxygen, sulphur and nitrogen in varying amounts.
functions
  1. Body building
  2. Repair and maintenance of body tissues
  3. Maintenance of osmotic pressure
    4. ● synthesis_of_substances:
    1. Antibodies
    2. Plasma proteins
    3. Hemoglobin
    4. Enzymes
    5. Hormones
    6. Coagulation factors
sources
animal_sources
  1. Milk
  2. Meat
  3. Egg
  4. Fish
  5. Cheese
plant_sources
  1. Pulses
  2. Cereals
  3. Soyabean
  4. Oil
  5. Seeds
dietary_fibers
definition
Dietary fiber is the remnant of the edible parts of plants and analogous carbohydrates that are resistant to digestion and absorption in human small intestine with complete or partial fermentation in the human large intestine.
includes
  1. Polysaccharides
  2. Disaccharides
  3. Lignin
  4. Associated plant substances
functions
  1. Absorb water and increase the bulk of stool.
  2. Help reduce tendency to constipation by encouraging bowel movement
    3. ● increases_intestinal_transit_time:
    1. Reduces possibility of putrefaction
    2. Reduces the formation of gases and toxic substances
  3. Low dietary fiber can causes cancer of stomach and colon.
  4. Reduces incidence of coronary heart diseases.
  5. Plays role in weight reduction.
vitamins
classification
fat_soluble_vitamins
  1. Vitamin A
  2. Vitamin D
  3. Vitamin E
  4. Vitamin K
water_soluble_vitamins
  1. Vitamin B
  2. Vitamin C
vitamin_A
definition
Vitamin A is a group of unsaturated nutritional organic compounds that include
  1. Retinol
  2. Retinal
  3. Retinoic acid
  4. several provitamins A carotenoids and B carotene
functions
  1. Vitamin A is indispensible for normal vision contributes in production of retinal pigments which are needed for vision in dim light.
  2. It plays important role in gene transcription
  3. Enhance immunity
  4. It helps in skin and cellular reproduction
  5. It has antioxidant activity
sources
animal_sources
  1. Liver
  2. Eggs
  3. Butter
  4. Cheese
  5. Milk
  6. Fish
  7. Meat
plant_sources
  1. Green leafy vegetables
  2. Green and yellow fruits like Papaya, Mango, etc
fortified_foods
  1. Vanaspati
  2. Margarine
  3. Milk
deficiency
ocular_manifestations
night_blindness
conjunctival_xerosis
bitot's_spot
corneal_xerosis
keratomalacia
extra_ocular_manifestation
follicular_hyperkeratosis
anorexia
growth_retardation
respiratory_and_intestinal_infection
treatment
  1. Administration of massive dose of Retinol palmitate orally on 2 successive days.
toxicity
  1. Nausesa
  2. Vomiting
  3. Skin desquamation
  4. Enlarged liver
  5. Papillary edema
vitamin_D
other_name
Sunlight vitamin
definition
Vitamin D refers to a group of fat soluble steroids responsible enhancing intestinal absorption of calcium, magnesium, iron, phosphorus, zinc.
composition
  1. vitamin D3 (Cholecalciferol)
  2. vitamin D2 (Ergocalciferol)
functions
intestine
  1. Promotes intestinal absorption of calcium and phosphorus.
bone
  1. Stimulates normal mineralization.
  2. Enhances bone resorption, affects collagen maturation.
kidney
  1. Increases tubular reabsorption of calcium.
sources
sunlight
  1. UV rays convert 7 dehydrocholesterol present in skin to vitamin D.
foods
  1. Liver
  2. Egg
  3. Yolk
  4. Butter
  5. Cheese
deficiency
rickets
incidence
Disease of childhood
characteristics
  1. Impeded growth and soft, weak, deformed long bones that bend and bow under their weight as children start to walk.
other_features
  1. Deformed pelvis
  2. Pigeon chest
  3. Kyphoscoliosis
osteomalacia
incidence
Disease of adult
characteristcs
  1. Softening of bone, leading to
  2. Bending of the spine
  3. Bowing of the legs
  4. Proximal muscle weakness
  5. Bone fragility and
  6. Increased risk for fractures.
vitamin_E
other_name
  1. Beauty vitamin
  2. Anti-sterility vitamin
definition
Vitamin E refers to a group of compounds that includes both tocopherols and tocotrienols.
source
  1. Vegetable oils
  2. Cotton seed
  3. Sunflower seed
  4. Egg yolk
  5. Butter
function
  1. Acts as an antioxidant.
  2. Act as an enzyme activity regulator.
  3. Promotes lipids and prevents the oxidation of polysaturated fatty acids.
deficiency
  1. Spinocerebellar ataxia
  2. Myopathies
  3. Peripheral neuropathy
vitamin_K
definition
Vitamin K refers to group of structurally similar fat soluble vitamins the human body needs for complete synthesis of certain proteins that are required for blood coagulation.
sources
vitamin_K1
  1. Fresh green vegetables, fruits
vitamin_K2
  1. Synthesiszed by intestinal bacteria.
function
  1. Stimulation, production and/or release of certain coagulation factors (VI, VII, IX, X)
deficiency
  1. Decreased prothrombin content of blood.
  2. Coagulopathy
  3. Bruising and bleeding of the gums or nose.
  4. Heavy menstrual bleeding in women.
vitamin_B
vitamin_B1
othername
Thiamine
definition
function
  1. Essential for the utilization of carbohydrates.
  2. Thiamine pyrophosphate (TPP) act as coenzyme in activation of enzyme involved in the oxidative pathway of glucose.
requirement
sources
  1. Whole grain cereals
  2. Wheat
  3. Gram
  4. Pulses
  5. Milk
  6. Meat
  7. Fish
  8. Vegetables
  9. Fruits
deficiency
beriberi
dry_beriberi
  1. Peripheral neuropathy
wet_beriberi
  1. Mental confusion
  2. Muscular atropy
  3. Edema
  4. Tachycardia
  5. Cardiomegaly
infantile_beriberi
In infants between 2 and 4 months of age
gastrointestinal_beriberi
wernike's_encephalopathy
seen_in
Alcoholics
characterized_by
  1. Opthalmoplegia
  2. Polyneuritis
  3. Ataxia
  4. Mental deterioration
vitamin_B2
othername
Riboflavin
definition
It is the component of the cofactors FAD and FMN and as such required for a variety of flavoprotein enzyme reactions including activation of other vitamins.
function
  1. Involved in antioxidant activity.
requirement
sources
  1. Milk
  2. Egg
  3. Liver
  4. Kidney
  5. Green leafy vegetables
deficiency
  1. Stomatitis
  2. Cheelosis
  3. Glossitis
  4. Impaired neuromotor functions
vitamin_B3
othername
Niacin
definition
Niacin is an organic compound and considered as one of the 20 to 80 essential human nutrients.
function
Pharmaceutical and supplemental niacin are primarily used to treat hypercholesterolemia and pellagra.
requirement
children
2-12 mg/day
women
14mg/day
men
16 mg/day
sources
  1. Liver
  2. Heart and kidney
  3. Meat
  4. Poultry
  5. Fish
  6. Legumes
  7. Groundnut
deficiency
pellagra
  1. Diarrhoea
  2. Dermatitis
  3. Dementia hyper pigmentation
mental_changes
  1. Depression
  2. Amnesia
  3. Delirium
  4. Anxiety
  5. Fatigue
vitamin_B5
othername
Pantothenic acid
definition
function
  1. Synthesize Co-A
  2. Synthesize and metabolize proteins, carbohydrates and fats
requirement
5 mg/day
sources
  1. Meat
  2. Grains
  3. Avocardos
  4. Broccoli
  5. Cereal
  6. Condensed fish solution
deficiency
  1. Irritability
  2. Fatigue
  3. Apathy
  4. Numbness
  5. Paresthesia
  6. Hypoglycemia
vitamin_B6
othername
Pyridoxine
definition
function
It plays important role in metabolism of amino acid, fats and carbohydrates.
requirement
adults
2 mg/day
pregnancy_and_lactation
2.5 mg/day
sources
  1. Milk
  2. Liver
  3. Meat
  4. Egg
  5. Yolk
  6. Fish
  7. Legumes
  8. Vegetables
deficiency
Peripheral neuritis
vitamin_B7
othername
Biotin
definition
It is colourless water soluble vitamin.
function
  1. Helps body to convert food into glucose.
  2. Helps to produce fatty acids and amino acids
  3. Activate protein metabolism in hair roots, and finger nail cells.
requirement
sources
  1. Yeast
  2. Liver and Kidney
  3. Egg yolk
  4. Soya beans
  5. Nuts
  6. Cereals
deficiency
  1. Hair loss
  2. Dry scaly
  3. Cracking in corner of mouth
  4. Glossitis
vitamin_B9
othername
Folate
definition
function
requirement
normal_adults
200 μg/day
pregnancy
500 μg/day
lactation
300 μg/day
infants and children
80-120 μg/day
sources
  1. Liver
  2. Meat
  3. Dairy products
  4. Egg
  5. Milk
  6. Fruits
  7. Cereals
  8. Leafy vegetables
deficiency
  1. Commonly occurs in pregnancy and lactation.
  2. Megaloblastic anaemia.
  3. Glossitis
  4. Cheilosis
  5. Gastrointestinal disturbances such as diarrhoea, distension and flatulence
  6. Neural tube defects
vitamin_B12
othername
Cyanocobalamine
definition
It is the largest and most common of all the vitamins. It comprises the only cobalt containing molecules with biological activity in humans.
function
  1. Helps to produce nucelic acids.
  2. Helps the body to maintain healthy nerve cells.
  3. Regulate, together with vitamin B9, the formation of red blood cells.
  4. Helps to convert food into glucose.
requirement
normal_adults
1 μg/day
pregnancy
1.2 μg/day
lactation
1.5 μg/day
infants and children
0.2 μg/day
sources
  1. Liver
  2. Kidney
  3. Meat
  4. Fish
  5. Eggs
  6. Milk
  7. Cheese
  8. Absent in food of vegetable origin.
deficiency
  1. Neurological damage
  2. Anaemia
  3. Tingling sensation in finger and toes
minerals
major_minerals
sodium
potassium
magnesium
calcium
phosphorus
minor_minerals
iron
definition
Plays vital role in performing various body functions.
requirement
10-18 mg/day
source
haem_iron
  1. Liver
  2. Meat
  3. Poultry
  4. Fish
non-haem_iron
  1. Cereals
  2. Green leafy vegetables
  3. Legumes nuts
storage
  1. 70% stored in hemoglobin
  2. 26% stored in liver, spleen and bones.
function
  1. Helps in formation of hemoglobin and brain development.
  2. Regulation of body temperature, muscle activity and catecholamine metabolism.
  3. Lack of iron affects immune system, it diminishes the number of T cells and antibodies
  4. Iron is also the component of myoglobin, cytochromes, catalase and certain enzymes
  5. Major function of iron is 'Oxygen transport' and cell respiration.
deficiency
iron_deficiency_anaemia
definition
It is a condition in which the hemoglobin content of blood is lower than what is regarded as normal for the particular age, sex, group due to deficiency of iron.
features
red_cells
  1. Microcytic
  2. Hypochromic
hemoglobin_level
  1. 10-22 g/dl causes early anaemia
  2. lower than 10 g/dl --> Marked anaemia
causes
increased_blood_loss
  1. Excessive menstruation in reproductive years, repeated miscarriages
  2. Hookworm infestations, peptic ulcer, hemorrhoids
  3. Hematuria, hemopysis
increased_requirements
during_growth_phase
  1. Infancy
  2. Childhood
  3. Adolescence
pregnancy
lactation
inadequate_dietary_intake
  1. Poor economic condition
  2. Poor dentition
  3. Anorexia like in pregnancy, young females
decreased_absorption
  1. Intestinal malabsorption
  2. Partial or total gastrectomy
clinical_features
  1. Pallor at palpebral conjunctiva
  2. Paleness of tongue, lips and mucus membrane
  3. Fatigue and reduced work capacity
  4. Nausea and anorexia
  5. Tachycardia and murmurs
  6. Breathlessness
management
  1. Iron supplementation of high risk group
    1. Oral iron --> For pregnant women ane pre-school
    2. Parenteral iron --> Anaemia in last trimester of pregnancy
  2. Iron fortification of foods and salts
  3. Control of parasites by deworming and improving sanitation
  4. Treatment of pathological conditions if present like peptic ulcers, hemorrhoids
iodine
requirement
adults
150 μg/day
pregnancy
250 μg/day
source
  1. Sea foods (Sea fish, Sea salt)
  2. Cord liver oil
function
  1. Synthesis of thyroid hormones
deficiency
iodine_deficiency_disorders
causes
  1. Inadequate dietary intake of iodine
  2. Presence of goitrogens in food
  3. Malabsorption
  4. Increased demand during growth
  5. Defects in iodine transport in thyroid cells
spectrum
  1. Goitre (Enlargment of thyroid)
  2. Hypothyroidism
  3. Retarded physical development and impaired mental function
  4. Increased rate of spontaneous abortion and still birth
  5. Cretinism
management
short_term
  1. Use of iodised oil as in injection or oral tablets.
long_term
  1. Iodization of salt
  2. Proper iodine monitoring
  3. Manpower training in all aspects for goitre control.
  4. Mass communication
national_strategies
target
To prevent and eradicate IDD by the end of 2017 AD
activities
  1. Monitoring the quality of iodized salt by ensuring iodization of common salt at 50 ppm at the production level and 30 ppm at retailer level.
  2. Since fiscal year (2060/61), child health decision decided to celebrate February as 'the month to create awareness about the use of iodized salt.'
  3. Provide iodized oil injections and capsules to supplement iodine in remote areas in case of goitre and cretinism.
  4. Adequate distribution of iodized salt in all parts of the country
  5. Creating awareness
fluorine
zinc