The general notion that the study of nutrition is merely aimed at
providing a balanced diet for the populace is no longer adequate. Concepts of what constitutes a 'balanced diet' have changed markedly and it is not even an issue relating to the achievement of the 'recommended levels' of nutrients in the diet. Nutrition is a complex subject that biologically relates to nutrientgene interactions and the induction of such diseases as diabetes mellitus, coronary heart disease (CHD), and cancers, and even to such conditions as asthma and impaired brain development. Nutrition also deals with the social, economic, and cultural issues related to making the right food choices and to purchasing and eating the 'correct' types of food in the 'appropriate' quantities, as well as the factors that determine this aspect of essential daily human activity and behavior. Fluctuations in disease rates depend on environmental factors that include food and nutrition as one of the primary determinants Nutrition is now recognized as a major determinant of a wide range of diseases of public health importance worldwide. In the developing world, numerous deficiency diseases persist, especially in the rural areas, which are the result of essential nutrient deficiencies in the daily diet. These now coexist with the increasing presence of diet-related chronic diseases in the adult typically seen only in industrialized, developed countries Diseases Influenced By Diet Are 1. Intrauterine Growth Restriction: the definition of IUGR should be infants born at term (i.e. > 37 weeks of gestation) with a low birth weight (i.e. < 2500 g).Common in developing Countries Multifactorial in cause but environmental factor is highest with nutrition being the most important cause of it. Poor maternal nutritional status at conception and inadequate
maternal nutrition during pregnancy can result in IUGR. Short
maternal stature, low maternal body weight and body mass index (BMI) at conception, and inadequate weight gain during pregnancy are factors that are associated with IUGR. In developing countries IUGR is closely related to conditions of poverty and chronic under nutrition of economically disadvantaged mothers. 2. Proteinenergy malnutrition The clinical conditions of childhood malnutrition are widely recognized as kwashiorkor, marasmus, and the mixed condition of marasmic kwashiorkor Children are characteristically oedematous with a moon face, a scaling crazy-pavement pigmentation, and ulceration of the skin with sparse thin reddish hair. Clinically, they are morose and lethargic, and they have a large liver and often appreciable amounts of trunkal and limb fat, which obscures an atrophied muscle mass. The marasmic form of protein energy malnutrition is that of a wizened, shrivelled, growthretarded, and skeletal child who is often alert and with normal-coloured but shrivelled skin 3. Diarrhoeal disease and malnutrition. How to Assess Nutrition in adults 1 BMI 2. Waist Hip Ratio 4. Cognitive and mental development and malnutrition selective nutrient deficiencies can lead to impaired brain function and this, therefore, raises the issue of whether fooddeprived, stunted children in the Third World are capable of being rehabilitated with a complete diet 5. Iron deficiency: Iron deficiency is probably the most common nutritional deficiency disorder in the world. The highest prevalence figures for iron deficiency are found in infants, children, teenagers, and women of childbearing age. Hence it is a major public health problem with adverse
consequences especially for women of reproductive age and
for young children 6. Iodine deficiency: The term 'iodine deficiency disorder' (IDD) refers to a complex of effects arising from iodine deficiency. The mountainous areas of the world are likely to be iodine deficient because the rain leaches the iodine from the rocks and soils. The most severely deficient areas are the Himalayas, the Andes, the European Alps, and the vast mountainous regions of China excessive intakes of goitrogens in food (due to the excessive consumption of cassava may interfere with the uptake and metabolism of iodine in the body and can thus cause or amplify the effects of iodine deficiency. 7. Vitamin A deficiency 8. Vitamin A deficiency leads to night blindness and xerosis (dryness) of the conjunctiva and cornea, disrupts the integrity of their surface and causes corneal clouding and ulceration, and may lead to blindness in children.
Adult under nutrition
The nutritional world has concentrated for the last 50 years on the vulnerable groups in society (i.e. children, pregnant and nursing mothers, and the elderly) Diet and chronic non-communicable diseases Diet and cardiovascular diseases The most common cardiovascular diseases that are dietrelated are CHD and hypertension. High intake of cholesterol and smoking are the most important nutritional factor, too much intake of salt for hypertension. Diet and cancers Cancers of the gastrointestinal tract may be influenced by the diet. The intake of alcohol appears to be an independent risk factor for oral, pharyngeal, and oesophageal cancer. Consumption of salted fish, preserved, and fermented foods containing nitrosamines as weaning foods or from early childhood may introduce a substantial risk of
nasopharyngeal cancer. Several studies have demonstrated
a positive association between oesophageal cancer and several dietary factors, which include low intakes of vitamins A and C, riboflavin, nicotinic acid, calcium, and zinc. In dietary terms the associations are with low intakes of lentils, green vegetables, and fresh fruits. Like nasopharyngeal cancers, the risk of oesophageal cancers is also positively related to increased intakes of highly salted foods and fermented, mouldy foods containing N-nitroso compounds. Stomach cancer is also associated with diets comprising large amounts of smoked and salt-preserved foods, which may contain precursors of nitrosamines, and low levels of fresh fruit and vegetables, which may contain nutrients that possibly inhibit the formation of nitrosamines. Colon cancer is the third most common form of cancer and the incidence rates are high in western Europe and North America, whereas they are low in sub-Saharan Africa (Boyle et al. 1985). Almost all the specific risk factors of colon cancer are of dietary origin Vegetarian diets seem to provide a protective effect from the risk of colon cancer and the effects may be mediated by intakes of vitamin A and its precursor bcarotene. Primary liver cancers have been correlated worldwide with mycotoxin (aflatoxin) contamination of foodstuffs The primary causal factor for lung cancer, a leading cause of death among men, is cigarette smoking. Breast cancer intake of calories and dietary fat, and specific sources of dietary fat such as milk and meat Non-insulin-dependent diabetes mellitus: too much intake of all types of food especially carbohydrate Diet and osteoporosis Calcium intake is a likely dietary determinant that may contribute to the onset and degree of osteoporosis. Diet and dental caries: too much intake of sugar. Diet and non-cancerous conditions of the large bowel
There are several chronic disorders of the large bowel that
are frequently associated with a typical 'affluent' diet, which is low in dietary fibre content. This includes diverticular disease, haemorrhoids, and constipation. Constipation occurs when the daily faecal weight falls below 100 g and is associated with slower intestinal transit times