HUMAN FOOD REQUIREMENTS Notes

LECTURE NOTES ON HUMAN NUTRITION AND HEALTH
HUMAN NUTRITION
Introduction
Many children do not get enough of the right food to eat. They do not grow well, they become ill,
many die or they do not grow up as clever and as healthy required. Causes and consequences of
poor nutrition are better understood only now, and so are the ways to prevent and manage it. Low
food intake and infections are the immediate causes of malnutrition. The underlying causes are
insufficient household food security, inadequate childcare and insufficient basic health services in
the community. It includes poor living conditions, lack of education, heavy physical work, and
frequent childbearing. And the basic causes are economic structure, political and ideological
superstructure.
The mortality among preschool children is extremely high in developing countries in general and in
Cameroon in particular. It is quite clear that malnutrition in combination with infection, more often
than not is, the cause of high morbidity and mortality in Cameroon. Micronutrient deficiencies such
as vitamin A, iodine and iron are the most prevalent in Cameroon and it affects mothers and
children at large.
The entire efforts in the preparation of this lecture note require that the elements of nutrition should
be understood by Health Extension Students and their Instructors for the implementation of
nutrition interventions
Definitions of terms
Food: - is defined as any solid or liquid which when ingested will enable the body to carry out any
of its life function.
Most foods are made up of several simple substances, which we call nutrients. There are six
nutrients each of which has specific function in the body.
1. Those that supply energy are the carbohydrates and fats.
2. Those responsible for growth and repair of tissues cells are proteins.
3. Those, which regulate chemical process in the body, are the vitamins and minerals.
4. Water is present in most foods and is an indispensable component of our bodies. It is the
means of transportation for most nutrients and is needed for all cellular activities.
Nutrition: - is the sum total of the process by which living things receive and utilize the necessary
materials for survival, growth and maintenance of worn out tissues.
Malnutrition: - is the condition that results from an imbalance between dietary intake and
requirements. It includes under nutrition, which results from less food intake and hard physical
work and over nutrition results from excess food intake and less physical activities.
Diet: - is defined as food containing all the nutrients in a sufficient amount and in proper ratio.
Roughage: - is defined as food fires which enable the body to get rid of waste products, which
would otherwise become poisonous to the body. It prevents gastrointestinal disorders (gastritis,
appendicitis, gallbladder stone and constipation) and metabolic disorders (diabetes mellitus,
hypertension, ischemic heart disease and colon cancer).
Dietary guidelines
BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com
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1. Eat a wide variety of foods
2. Maintain healthy weight
3. Choose a diet low in fat, saturated fat, and cholesterol
4. Choose a diet with plenty of vegetable, fruits and grain products
5. Use sugar in moderation 6. Use salt and sodium in moderation 7. If you drink alcoholic
beverage, do so in moderation.
Food groups
♦ Milk, cheese, yoghurt
♦ Meat, poultry, fish and alternates
♦ Fruits and vegetables
♦ Bread and cereals
♦ Fats, sweets and alcohols
Why human beings need food?

Human beings need food to provide energy for the essential physiological functions like:
 Respiration
 Circulation
 Digestion
 Metabolism
 Maintaining body temperature.
 Growth and repair body Tissues
An adequate supply of nutrients is needed to maintain all the functions of the body and daily
activities at maximum efficiency, thus ensuring healthy living. Health and nutrition are closely
linked and to ensure proper development and life quality they must be adequate from early
childhood on and most vulnerable groups are infants, young children, pregnant women and
lactating mothers.
Major causes of malnutrition

 Lack of knowledge in selecting foodstuff with high nutritive value
Poverty and infectious diseases
 Drought
 Uneven distribution of the available foods
 Social arrest and civil conflicts,
 Transport problems (inaccessibility)
 Increased populations
Inadequate weaning
Farming technique-insufficient
Poor management of resources
Topographical differences in different regions (variation in productivity)
 Loss of food through destruction by insects
Exploited land due to planting the same type of food crop for many years, erosion because
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of overgrazing and moreover the farmers could not use the fertilizers due to many
reasons.
Harmful traditional practices with regard to nutrition

 During period of fasting important nutrients are not eaten, such as milk, eggs, butter, meat,
fish, meal pattern, etc.
 Pork is forbidden for religious and cultural reasons
 Lack of sun light (lack of Vitamin D) during infancy to protect the child from the “evil
eyes”
 Discrimination in feeding among family members, adults before children, adult males over
adult females
 Practising heavy meals once, may be twice a day
 Giving butter to neonate to swallow, hoping to keep the intestine smooth
 Delay to start complementary food
 Refusing to give the child meat for fear of infection
 Feeding children with diluted milk
 Feed children with left over and may be contaminated food
Best practices which favor nutrition

 Breast feeding
 Traditional use of dark green leaves “Hbesha Gommen.”
 Eating cereals in the form of kolo (roasted) and nefro (cooked)
 Additional high calories and high protein diet for pregnant and lactating mothers
 After the 7th day of delivery the mother and the child warm in the sun every morning
 Eating inset (false banana) which prevents constipation
 Special care for children and lactating mothers
 Drinking sour milk and cured milk
 Local beverages are constituted from different cereals
 Eating wild fruits from the forest e.g. Enjory, Kega, Sholla,
 Honey mixed with butter is eaten in the morning
 Eating of raw vegetables and cereals
 Taking care of elders.
Good nutrition must meet the needs of varying ages and activities and always with individual
differences. Therefore, the planning of food to meet especial needs begins with:
 Pregnant women
 Nursing mothers
 Infants
 Adolescents and
 Adults
 A well-nourished individual:-
 Is alert mentally and physically fit
 Has optimistic outlook on life
 Has good resistance to infection
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 Shows numerous other signs of good health such as an increased life span extending the
active and vigorous period of life.
The energy requirements of individuals depend on
 Physical activities
 Body size and composition
 Age may affect requirements in two main ways
– During childhood, the infant needs more energy because it is growing
– During old age, the energy need is less because aged people are engaged with activities
that requires less energy.
 Climate: Both very cold and very hot climate restrict outdoor activities.
In general feeding is dependent on the controlling centres, appetite and satiety in the brain. There
are a variety of stimuli, nervous, chemical and thermal, which may affect the centres and so alter
feeding behaviour.
Daily calorie requirements of individuals

Š Infants 1 - 3 years need 1,000 cal/day
Š Children 5 years need 1,500 cal/day
Š Children 5 – 8 years need 1,800 cal/day
Š Children 10 – 12 years need 2,000 cal/day
Š For adolescents and adults calorie requirements depend on the degree of physical activities
From 13 – 20 years of
age
Office worker Heavy work

2, 800 cal/day 3,500 cal/day
Adults
2,700 cal/day
2,300-cal/day
Very heavy work up to 4,000 cal/day
For pregnant woman, the daily figure must be increased by 150 calories for the first trimester and
350 for the second and third trimester. For the nursing mother the daily figure must be increased by
800 calorie.
Staple foods
Staple foods are foods, which form the largest part of a nation’s diet. They are of plant origin and
are classified into three main groups :
 The grain and cereals
 The roots and tubers
 The starchy fruits
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FOOD NUTRIENTS
1. CARBOHYDRATES
Carbohydrates provide a great part of the energy in all human diets. In the diet of poor people,
especially in the tropics, up to 85% of the energy may come from this source. On the other hand, in
the diet of the rich people in many countries the proportion may be as low as 40%. However, the
cheapest and easily digestible fuel of humans is carbohydrate.
Carbohydrates are components of body substances needed for the regulation of body processes.
Heparin, which prevents blood from clotting, contains carbohydrate. Nervous tissue, connective
tissue, various hormones, and enzymes also contain carbohydrate. Ribose, another carbohydrates
are part of Deoxyribonucleic acid (DNA) and ribonucleic acid RNA), the substance that carry the
hereditary factors in the cell. Carbohydrate is also a component of a compound in the liver that
destroys toxic substances.
Types of carbohydrates
Monosaccharides:
 Glucose
 Fructose
 Annose
 Galactose
Disaccharides:
 Sucrose (a disaccharide present taste sugar)
 Lactose (a disaccharide present in milk)
 Maltose (a disaccharide present in starch)
Sugar alcohol: is found in nature and also prepared commercially. Mannitol and dulcitol are
alcohol derived from mannose and galactose. Both have a variety of uses in medicine and food
manufacture.
Honey: is a mixture of glucose and fructose. It is a balanced diet as it contains all the nutrients in
sufficient amount and proper ratio. Honey has also medicinal effect. The bees first cover the
beehive with antibiotics to prevent the growth and multiplications of microorganisms. If you keep
honey for a long time, it will not be spoiled because of antibiotics.
Glycogen: is the animal equivalent of starch present in the liver and muscle. In most foods of
animal origin it is a negligible source of dietary carbohydrate. The glycogen in the liver is a reserve
fuel and it serves between meals and over night. The breakdown of glycogen in the liver is
facilitated by the hormone glucagons.
Starch: is one form of carbohydrate that is stored in granules in the roots and seeds of plants.
PROTEINS
These are organic compounds composed mainly of Carbon, Hydrogen, Oxygen and Nitrogen. Some
may also contain Sulphur and Phosphorus. During digestion, protein is broken down into their
simplest form called amino acids. There are 22 amino acids: 8 essential and 14 non essential amino
acids.
Proteins may also be classified into:
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First class proteins: containing all essential amino acids in their correct proportions. They are
derived almost entirely from animal sources including fish, meat, eggs chicken, milk products
monkey chimpanzees, etc and soya beans.
Second class proteins: they do not contain all the essential amino acids in their correct proportions
and are mainly of vegetable origin e.g. beans, peas, vegetables, etc.
Functions of proteins
1. They build up and repair body tissues.
2. They mqintain osmotic equilibrium between blood and tissue fluid
3. They provide energy and heat but only when there is insufficient carbohydrates in the diet.
4. They are essential for normal secretions e.g. enzymes, hormones, etc.
5. They regulate acid base balance.
FATS
These are organic molecules composed of Carbon, Hydrogen and Oxygen. They include:
 Triglycerides (fats and oils)
 Phospholipids
 Steroids (cholesterol)
a) Animal fats are in dietary products like milk, cheese, butter, eggs, meat, and oily fish
(whale).
b) Vegetable fats are found in margarine where vitamin A and D are addaed and in nuts (e.g.
ground nuts)
Types of fats
 Saturated. No double bonds between the carbon atoms in the fatty acid chains. Most animal
fats (e.g., butter) are highly saturated.
 Monounsaturated. Have a single double bond in the fatty acid chains. Examples are olive,
peanut, and rapeseed (canola) oil.
 Polyunsaturated. Have two or more double bonds in their fatty acid chains. Examples:
corn, soy bean, cottonseed, sunflower, and safflower oils.
 Trans Fats. Have been partially hydrogenated.
Functions of Fats
1. They produce energy and heat, yielding twice as many calories as carbohydrates and
proteins.
2. They support certain organs of the body e.g. eyes, kidneys, etc.
3. They transport fat soluble vitamins (ADEK)
4. They prevent excess loss of heat from the body. I.e. they act as insulator, conserving body
heat.
5. They assist in the functioning of the gall bladder by stimulating its contraction when present
in the diet.
6. It provides a satiety value i.e. provides appetite for longer periods
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7. Fats are required for nerve sheaths, cholesterol in the bile and secretions of sebaceous
glands of the skin.
VITAMINS
They are organic nutrients that are required by the body in smaller quantities. They do not produce
energy but are necessary to facilitate body processes.
CLASSIFICATION OF VITAMINS
 Vitamin A (Retinol)
 Vitamin B1 (Thiamine)
 Vitamin B2 (Riboflavin)
 Vitamin B6 (pyridoxine)
 Vitamin B12 (Cyanocobalamine)
 Niacin
 Panthotonic Acid
 Folacin
 Biotin
 Vitamin C (Ascorbic acid)
 Vitamin D (Cholecalciferol)
 Vitamin E (Tocopherol)
 Vitamin K (Antihemorrhagic vitamin)
These vitamins are found in wholesome foods, milk, vegetables, fruits, eggs, meat, beans,
wholegrain cereals etc.
FUNCTION OF VITAMINS
1. To promote Growth
2. To promote Reproduction
3. To promote Health & vigor
4. To promote Nervous activity
5. To promote Normal appetite
6. To promote Digestion
7. To promote resistances to infection.
GROUPS OF VITAMINS
A. FAT SOLUBLE VITAMINS: they are soluble in fats and solvents and are not readily
excreted, thus, can readily build up to toxic levels in the blood. Fat soluble vitamins include
vitamins A, D, E and K (ADEK).
Characteristics of fat - soluble vitamins
1. Metabolize along with fats
2. Resistance to heat
3. Stored in the liver and adipose tissue
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4. Slow to develop deficiency syndrome
5. Present only in certain foods, mostly in animal products, oil foods, yellow and green
vegetable Excess can be toxic to the body.
B. WATER SOLUBLE VITAMINS: They are soluble in water and insoluble in fats. They
are composed of the Vitamin B complex and Vitamin C. They are less likely to reach toxic
levels because they are readily excreted.
Characteristics of water soluble vitamins
1. They are widely distributed in natural foods
2. B12 is found only in animal products
3. Soluble in water and absorbed in the intestine
4. Excess will be excreted, thus not toxic.
5. Most functions of these vitamins are as co-enzymes
6. They are important for energy production
7. They are heat labile
FAT SOLUBLE VITAMINS

1. VITAMIN A (RETINOL PALMITATE, ANTI-INFECTIVE VITAMIN)
A. sources:
Animal source : The best sources of vitamin A is animal products such as organ meat like
liver, whole milk and milk products, eggs, butter, cheese, and fish liver oils. The best source of
vitamin A for infants is breast milk.
Plant source of vitamin : A Plants contain beta-carotene that can be converted into vitamin A
by the body. The best plant sources of vitamin A are orange, yellow colour fruits and vegetables
(papaya, mango, pumpkin, tomatoes, carrots, yellow sweets potatoes) and dark green vegetables
such as spinach (Kosta), kale (Gommen) and Swiss chard.
B. Function of vitamin A
1. It controls the general state of the epithelial cells and reduces the risk of infection.
2. It is required for the regeneration of two pigments, visual purple in the rods of retina
and visual violet in the cones of the retina. These two pigments are responsible for
vision in dim and bright light
3. It aids growth and development during childhood
4. It helps to keep the cornea of the eye in healthy condition.
5. Dietary Vitamin A is required for the growth and survival of all animals and it is
present in most biological tissues.
6. In the visual system the retina is dependent on Vitamin A and its metabolites.
7. In the auditory system vitamin A plays a role in the maintenance of the middle and
inner ear and it also helps the olfactory system,
8. It is required for reproduction, embryonic development and bone formation.
C. Vitamin A deficiency
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1. Night blindness: The child cannot see in the dark. He/she has to go in to the house
early in the evening.
2. Conjuctival xerosis: The conjuctival covering the white surface of the eyeballs
become dry and rough instead of being moist, smooth and shining. The child cannot
open and close his/her eyes because it is painful.
3. Bitot’s spots: A foamy or cheesy accumulation, which forms in the inner quadrant
of the cornea in the eyes. The cornea the central transparent part of the eye becomes
cloudy. It reflects more advanced vitamin A deficiency, but tends to be reversible
with treatment.
4. Corneal ulceration: an ulcer on the cornea may leave scar, which can affect vision.
5. Keratomalacia: The eyeballs become opaque and soft, jelly like substance;
hereafter there will be a rapid destruction of the eyeball and no hope of recovery
after the condition reached the stage of keratomalacia.
D. Toxicity of Vitamin A (Retinol)

1. Hepatomegally and spleenomegally
2. Dry skin
3. Bone and joint pain
4. Irritability
E. Prevention of vitamin A deficiency

1. A diet containing plenty of vitamin A is the best.
2. Breast-feed infants for at least one year. Do not discard the 1st breast milk soon after
delivery.
3. At 6 months start to feed infants with dark green vegetables, yellow and orange
fruits and if possible, some finely chopped and well cooked liver.
4. Include some fats in the child’s diet.
5. Children with diarrhea, measles, respiratory and other serious infections need extra
vitamin A.
6. Pregnant and lactating mothers should eat foods rich in vitamin A every day.
7. Tell families that night blindness is an early warning sign of xerophthalmia (Vitamin
A deficiency).
8. Teach school children to look for night blindness in young children.
9. Learn which vitamin A rich food is available in the locality.
Strategies to control and eliminate vitamin A deficiency

 Universal supplementation of vitamin A
 Food fortification
 Food diversification
Universal supplementation of vitamin a capsules (short term strategy)

1. Children 6-59 months of age
2. Lactating mothers
3. Pregnant women
4. Targeted diseases i.e. Measles, diarrhea, acute respiratory infection, xerophthalmia and
PEM.
Fortification of foods
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Fortification of a widely consumed centrally processed staple food with a nutrient is one way of
controlling deficiencies of certain nutrients such as iron, vitamin B1 and vitamin A in many
countries. Fortification of a nutrient is the addition of the deficient nutrient supplements in
processed dietary components in factories. In industrialized countries the most commonly fortified
food products are:
 Wheat flour
 Bread
 Milk products
 Infant formulas
 Weaning food
Food diversification
Food diversification is an important strategy, which is considered as a long term and sustainable
strategy for the prevention of vitamin A deficiency. In this regard, people should be encouraged to
grow and consume vitamin A rich foods at a vast scale in all regions.
2. VITAMIN D (CHOLECALCIFEROL)
Vitamin D is known as the antirachtic vitamin and chemically as calciferol. The two most important
vitamin D compounds are ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). These
substances are formed from precursors in plants, animal and in the skin and are converted to
vitamin D by the ultraviolet rays of the sun. Vitamin D is stored in the liver mainly; some is stored
in the brain, bones and skin as well. It undergoes changes in the liver, and in the kidneys that
convert it to active, hormone-like form.
Functions of vitamin D
1. Absorption of calcium and phosphorous
2. The presence of vitamin D is essential to the activity of the
parathyroid hormone in removing calcium and Phosphorous from the bone in order to
maintain normal serum levels of calcium.
3. Stimulates the reabsorption of Calcium by the kidney when serum calcium level is low.
4. Bone formation
Source of vitamin D
 Fish liver oil is a rich source of vitamin D.
 A nonfood source is the sunlight for the action of sunlight on the skin changes the
cholesterol to vitamin D.
Deficiency of vitamin D
It leads to rickets, which is characterized by weakness and deformity of bones. Rickets generally
occurs between the six months to the second year of life, during the weaning period. On
examination the skull bone of rachitic child, we will find the following characteristics:
 Depression will be seen along the suture
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 The forehead is prominent
 The anterior fontanel remains wide open
 The abnormalities give the head the general appearance of a box
 If you press the skull bone with your thumb of a rachitic child, it will remain depressed and
this known as craniotabus.
 The chest is narrow and deformed
 The long limbs curve and may take the shape of a bow and the
sufferers are referred as bowlegs or it may take the opposite shape i.e. the knees may knock
together and the sufferers may be described as knock-knees.
 The vertebral column may curve, causing Kyphosis.
 Rickets in adults is known as osteomalacia, the bones become soft and very painful.
 In women it causes difficult labor, as the pelvis becomes contracted, thus narrowing the
birth canal.
3. VITAMIN E (Tokoferol)
Sources: Pea nuts, lettuce, egg yolk, milk butter.
Functions: Maintains healthy muscular system
Dietary requirement: 8-10mg/day.
Toxicity: It may interfere with blood coagulation
Deficiency: Erythrocyte hemolysis.
4. VITAMIN K (ANTIHEMORRHAGIC VITAMIN)

Sources: This vitamin can be synthesized by the action of bacteria in the intestinal tract of a
healthy person. It is also found in liver, fish, and green vegetables.
Daily requirement is 60-80ᵤ/day. Cooking does not destroy it.
Functions: The liver requires vitamin K for the formation of prothrombin a substance
needed for clotting mechanism of blood.
Deficiency of vitamin K
A person deficient in Vitamin K shows a tendency to bleed profusely whenever blood
vessels are injured. The treatment and prevention is to provide with high content of vitamin
K foods and give vitamin K injection to stop active bleeding.
WATER SOLUBLE VITAMINS

They are soluble in water and are composed mainly of the Vitamin B complex and Vitamin C.
1. VITAMIN B1 (Thiamine)
The vitamin B1 (thiamine) plays an important part in the utilization of carbohydrates, cereals, roots
and tubers are especially rich in carbohydrates and if these foods are to be properly utilized, it is
essential that the daily food intake should supply sufficient vitamin B1. It occurs particularly in
cereals but it is localized on the outer surface of the grain close to the sheath.
Dietary requirement is 1.1 - 1.5mg/day
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Functions of Vitamin B1
1. Essential for carbohydrate metabolism
2. Stimulates appetite
3. Regulates normal functioning of the nervous system
4. Help control water balance in the body
Vitamin B1 deficiency
1. Acute Beriberi (Dry Beriberi)
Symptoms:
 Epigastric pain
 Nausea & Vomit
 Urgent Cardiac sign of cardiac failure & death
2. Wet Beriberi
Symptoms:
 Gradual onset
 Loss of power of limbs
 Gradually develops edema and ascitis
3. Chronic Beriberi
Symptoms:
 Paralysis of the lower extremities
 Cramping of the calf muscles
 Coldness of the feet Stabbing pain on walking
 Absence of knee and ankle jerks.
2. VITAMIN B2 (Riboflavin)
Vitamin B2 is found in many foods, especially in milk, certain vegetables and meat. It plays a very
important role in assisting the various chemical activities, which are essential to life such as cellular
oxidation, co-enzymes, and function of the nervous system
Functions of Vitamin B2:

1. Associated with the oxidation of all foods
2. Associated with the mechanism of vision
3. Necessary for growth of all tissues
Dietary requirements: 1.2 – 1.7mg/day.
Deficiency of vitamin B2 is characterized by:

 Angular Stomatits with fissuring at the angle of the mouth
 Cheilosis (Red shiny lips)
 Glossitis (inflammation of the tongue)
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 Scrotal dermatitis
 Lacrimation
 Corneal vascularization
3. VITAMIN B3 (Niacin)
Sources: - Meat poultry and fish
- Enriched bread and cereals
- Green leafy vegetables, mushrooms
Functions:
o It is a co-enzyme that assists in energy metabolism
o Aids normal functioning of the CNS
o Maintains healthy skin and mucus membranes
Dietary requirement is 15 – 19 mg/day.
Deficiency diseases of Vitamin B3.
1. Pellagra (rough painful skin). Symptoms include the 4Ds (i.e. Dementia, Diarrhea,
Dermatitis and Death).
2. Gastrointestinal disturbance
3. Glosstis
Toxicity:
 Leads to blood vessel dilatation (flushing), caused by increased blood flow.
 Headache
 Nausea and vomiting
4. PANTOTHENIC ACID
Sources: liver, eggs, whole grain legumes and potatoes (both white and sweet)
Functions
1. Helps in the metabolism of proteins fat and carbohydrates for energy
2. As a co-enzyme, it initiates fatty acid synthesis
3. It helps the formation of bones and nerves regulating substances.
Dietary requirement is 4 – 7 mg/day
Deficiency diseases includes:
 Poor muscle co-ordination
 Fatigue, headache and nausea
 Paresthesia of hands and legs
4. VITAMIN B6 (Pyridoxine)
Sources: - Animal sources include meat, fish poultry
- Plant sources includes fruits and vegetables
Functions
1. It is involved in carbohydrate, fat and protein metabolism
2. Helps in the synthesis of hemoglobin and neurotransmitters
3. It regulates blood glucose.
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Dietary requirement is 1.8 – 2mg/day
Deficiency
 Weakened immune system
 Weakness, insomnia, anemia, glossitis, dermatitis.
Toxicity
 Sensory nerve damage leading to numbness at extremities and walking difficulties.
5. FOLATE (Folacin or folic acid)

Sources: liver, dark green leafy vegetables and fruits (oranges, orange juice).
Functions
1. Assist in protein and DNA formation
2. Manufactures RBCs.
Dietary requirement is 180 – 200ᵤ/day
Deficiency
1. Megaloblastic anemia
2. Impaired cell division
3. GIT deterioration
4. Birth defects (spinal bifida)
5. VITAMIN B12 (Cobalamin)

According to the present evidence this vitamin is found only in animal products.
Source of vitamin B12

The content of liver and kidney is high, the content of fish, milk and meat is medium, and however,
the source of B12 has not been widely investigated.
Deficiency of vitamin B12:

The red blood cells are abnormally large and are reduced in number Stomatits Lack of appetite Poor
coordination in walking & mental disturbance.
Note: The body effectively regulates the vitamin from bile and other secretions. This accounts for
its long biologic effectiveness. Vegetarians who eat no animal products develop a vitamin B12
deficiency only after 20 to 30 years.
Functions
1. Assists folate metabolism
2. Maintains myelin sheath and insulate nerve endings
3. Necessary for proper functioning of all cells.
Deficiency
It may occur in strict vegetarians. Pernicious anemia, with symptoms including weakness, sore
tongue, etc.
6. VITAMIN C (ASCORBIC ACID)

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 Found in fresh vegetables and citrus fruits
 Vegetables and fruits should not be left soaked in water for a long time since it is soluble in
water
 Cooking itself destroys about half of the vitamin C present in the food
 The best way to make sure of a regular intake of vitamin C is to eat raw fruits or salad every
day.
Functions of vitamin C
1. Helps the formation of various body tissues, particularly connective tissues, bones, cartilage
and teeth.
2. Stimulates the production of red blood cells,
3. Helps resistance to infection and neutralizes poisons.
4. Promotes iron absorption
5. Protects the body from infection
Vitamin C is unstable and easily destroyed. Foods lose almost half of their vitamin C content when
they are cooked and when the foods are kept hot after they have been cooked. Drying, storage,
bruising, cutting, and chopping of fruits and vegetables lead to the loss of vitamin C. Potatoes
boiled in their skin retain most of their Vitamin C. Therefore, to ensure a regular intake of vitamin
C is to take fruits and vegetable every day.
Deficiency of Vitamin C
 Weakness of the wall of the capillaries,
 Gum bleeding, Loosening of the teeth,
 Browsing of the skin and petechia
 The bones become painful, swollen and brittle
 General weakness and anemia may result if the disorder is not treated
 Skin abnormalities such as adult acne may be the earliest sign of scurvy
 Hardening and scaling of the skin surrounding the hair follicles and hemorrhages
surrounding the hair follicles also point to scurvy
 The skin of the forearm, legs and thighs is most affected
 Scurvy: symptoms include weakness, fatigue, restlessness, and neurotic behavior, aching
bones, joints, and muscles.
Toxicity
1. Symptoms include abdominal cramps, nausea and diarrhea.
2. It may lead to Fe toxicity
3. Obscures results use to detect diabetes.
Discussion questions for chapter review

1. Define vitamins.
2. State the general functions of vitamins.
3. What are the characteristics of water and fat soluble vitamins?
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4. Why vitamin A deficiency disease is a very serious health problem?
5. How can we control and prevent vitamin deficiency diseases?
MINERAL SALTS
Minerals are inorganic elements occurring in nature. They are inorganic because they do not
originate in animal or plant life but rather from the earth’s crust. Although minerals make up only a
small portion of body tissues, they are essential for growth and normal functioning of the body. The
body can make most of the things it needs from energy foods and the amino acids in proteins but it
cannot make vitamins and minerals.
Benefits of minerals
1. Minerals are essentials both as structural components and in many vital processes,
2. Some form hard tissues such as bones and teeth
3. Some are in fluids and soft tissues
4. For normal muscular activity the ratio between potassium and calcium in the extra cellular
fluid is important.
5. Electrolytes, sodium and potassium are the most important factors in the osmotic control of
water metabolism
6. Some minerals may act as catalysts in the enzyme system, or as integral parts of organic
compounds in the body such as:
 Iron in hemoglobin
 Iodine in thyroxin
 Cobalt in vitamin B12.
 Zinc in insulin and
 Sulfur in thiamine.
Plants, animals, bacteria, and other one celled organisms all require proper concentration of certain
minerals to make life possible.
The principal minerals, which the body requires.

Calcium, Chlorine, Iron, Phosphorus, Sodium, Iodine, Magnesium, Potassium and Sulfur.
Animals, in trace quantities, use minerals and these are: Copper, Manganese, Cobalt, Zinc, and
Fluorine.
Other trace elements are present in animal tissues, but their functions are uncertain and these are
Aluminum, Arsenic, Boron, Cadmium, and Silicon.
In natural foods, minerals present in various forms mixed or combined with: Protein Fats and
Carbohydrate.
1. CALCIUM
Calcium is the most abundant of all the mineral salts in the body.
Sources: - Dairy products; milk, yogourt, cheese
- Calcium fortified fruit drinks
- Calcium supplements
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Functions
1. Forms and maintain bones and teeth
2. Aids in blood clotting
3. Assists in muscle contraction
4. Maintain normal functioning of nerves
5. Regulates cellular metabolism
Dietary reauirement is 800mg/day
Deficiency: women are more likely to be at risk. Signs and symptoms include the following
 Tetany
 Stunted growth in children, rickets
 Osteoporosis in adults
 Hypertension
2. PHOSPHORUS
It is the second most abundant mineral in the body.
Sources: Milk, cheese, bakery products and meat
Functions
1. Assists in the formation of bone and teeth
2. Involves in the production and transfer of high energy phosphates
3. Regulates acid – base balance
4. Releases energy from carbohydrates, proteins and fats metabolism
Dietary requirement is 800mg/day
3. MAGNESIUM
Sources: Nuts, legumes, whole grains, dark green leafy vegetables.
Functions
1. Relaxes muscles after contraction
2. Assists in mineralization of bones and teeth
3. Aids transmission of nerve impulses
4. Assists in production of energy
Dietary requirement is 350mg/day
Deficiency : Risk is greater amongst women. Symptoms inmlude:
Vomiting , diarrhea, tetany, weakness and convulsions.
5. POTASSIUM
Sources: Fresh fish and vegetables, milk, meat, whole grain dried beans.
Functions
1. Assists in the transmission of nerve impulses
2. Maintains fluid/electrolyte balance
3. Maintain cell integrity
4. Aids in muscle contraction including heart muscles
5. Assists in carbohydrates and protein metabolism
Deficiency diseases are caused by dehydration, diabetic acidosis, vomiting, diarrhea, atc.
Symptoms include: muscle weakness, cramps, loss of appetite, constipation, mental confusion.
Toxicity
 Muscle weakness
 Cardiac arrest.
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6. SODIUM
Sources: Table salts and processed foods.
Functions
1. Retains body water
2. Together with Calcium and Potassium, help to maintain acid base and fluid balance.
3. Facilitates transmission of nerve impulses and muscle contraction.
Dietary requirement is 500mg/day.
Deficiencies
 Mostl occurs in people with Sodium intake restriction
 Symptoms include muscle cramps, dizziness, nausea, decreased appetite.
7. Iron
Sources of Iron: Beef, liver, egg yolk, wheat, Dark green vegetables, onions & fresh fruits.
Daily requirements for men and women are 8 to 10mg and 10 to 18mg respectively. For pregnant
and lactating mother the requirement increases to 20mg. Absorption of iron is enhanced in the
presence of Vitamin C.
Functions of Iron
It is an essential component of hemoglobin, responsible for the red coloring of blood and for the
transportation of oxygen to the tissues.
Causes of Iron Deficiency
 Insufficient iron in diet
 Blood loss during menstruation
 Hook worm infestation
Consequences of anemia
 Delayed psychomotor development and cognitive performance in children and adolescence
 Neurological manifestation in children and adolescents.
 In adults, anemia with hemoglobin concentration reduces work capacity, mental
performance and tolerance to infections.
 When the level of hemoglobin concentration falls below 4g/ld it may cause death from
anemic heart failure.
 can also cause increased maternal mortality due to adverse immune reaction,
 Maternal anemia can cause prenatal infant loss, low birth weight and prematurity,
 Prenatal deaths
 Reduces work capacity in adults and learning ability in children.
Strategies for prevention and treatment of iron deficiency

 Supplementation of iron tablets (with folates) preferably with vitamin B12 and vitamin C
 Dietary improvement of iron rich foods
 Changing of dietary habits and food preparation practices through nutrition education
 Fortification of foods with iron
 Control of malaria infection
 Control of febrile and chronic diseases,
 Promotion of hygiene and sanitation,
 Education, information and communication on iron supplementation,
 Networking and collaborating with relevant sectors on issue,
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ROUGHAGE
This is the undigested part of the diet found in cellulose of vegetables.
Functions
1. Provides a bulk of the diet and also help satisfy appetite
2. It stimulates peristalsis
3. It also stimulate bowel movements
WATER
It is the main constituent of the body. It comprises 50 – 60 % of the total body weight. Most body
water is located in cells (intracellular fluids) while the other part is extracellular fluids.
Importance of water
 Water, next to oxygen is the body’s most urgent need. It is more essential than food.
Without water, nutrients are of no value to the body.
 Failure to understand the role of body water contributes to health problems such as
indigestion and constipations and even to needless death.
 Infant and children have a greater proportion of water than old persons, and obese persons
have proportionately less water than lean persons,
 Water is taken in the form of water itself, beverages, such as coffee, tea, fruit juices, and
milk; and soups,
 Solid foods contribute the next largest amount of water, as much as 25% to 50% of water
requirements,
 Fresh vegetables and fruits are 80% to 90% water; meat is 50% to 60% water, and even
bread is about 35% water,
 The sensation of thirst usually is a reliable guide to water intake. Except in infants and sick
persons, especially comatose person who cannot respond to the thirst stimulus.
 If losses are not replenished, heat exhausting and possibility heat stroke may occur
 Dehydration can occur rapidly in comatose patients and in disabled or elderly persons with
brain impairment that are unable to respond to the sensation of thirst,
 Other conditions, such as fever, diabetes mellitus, vomiting, diarrhea, and the use of drugs
such as diuretics also increase water need.
HUMAN FOOD REQUIREMENTS

Human beings require food and other essential factors to be able to carry out the following
functions:
1. To perform his daily activities be it physical or intellectual work.
2. To repace the wear and tear of the body
3. To be able to grow and develop
4. To reinforce resistance agaisnt possible infection.
In this regards, the human body requires the following nutrients in correct quantities to perform
thier various functions :
a) Proteins for growth and repairs
b) Carbohydrates for energy and heat
c) Fats for energy and heat
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d) Vitamins to promote resistance against infection
e) Mineral salts to supply missing factors as well as functions in growth and development.
FOOD RATIONING
This refers to the quantity of food an individual requires on a daily basis to enable him/her carry
out normal daily activities. This tend to varry with individuals depending o factors such as:
occupation, age, sex, body weight, nature of activity, climate, pregnancy and lactation, etc.
The energy obtained from foods can be expressed interms of calories. Fats produce more than twice
as many calories as either carbohydrates and proteins.
1g of fat produces 9 calories
1g of carbohydrate produces 4 calories
1g of proteins produce 4 calories
Thus, a sedentary worker may be satisfied with about 2200 calories a day while a heavy manual
worker will need about 3000 calories.
A BALANCED DIET
It is a diet that contains the right quantity, quality and proportion of all the food reauirements of the
body ie
 Proteins for repairing the wear and tear of tissues as well as growth of tissues
 Fats and carbohydrates for energy
 Vitamins for reinforcement of resistance and
 All mineral salts.
The various combination of a balanced diet should be as follows:
Carbohydrate (50 – 55%)
Fats (30 - 33%)
Protein (12 - 15%)
Water (1 – 1.5L)
RULES TO BE OBSERVED IN ORDER TO OBTAIN A BALANCED DIET

1. A diet containing large quantities of sugar and starchy foods require foods rich in vitamin B
to balance it.
2. A diet made up largely of proteins needs a lot of green vegetables and fruits to balance it.
3. A diet containing food rich in phosphates (fish, meat, cereals) requires foods rich in calcium
(milk, carrots, oranges carbbages) to balance it.
NUTRITIONAL REQUIREMENTS THROUGHOUT THE LIFECYCLE

OUTLINE
 Describe the food needs of pregnant and breastfeeding mothers.
 Describe the nutrient requirements during infancy and childhood.
 Describe the nutritional requirements of adolescents and adults.
 Describe the nutrient needs of older people.
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The nutrient requirements during the four main stages of the human lifecycle vary considerably.
What infants and children require is different from what adults and the elderly need. In addition,
there might be specific nutrients which a pregnant women and lactating mothers need in higher
amounts than adult men. Therefore, as a Health Extension Practitioner, this study session will help
you to give the appropriate messages to different population groups.
WHY IT IS IMPORTANT TO KNOW NUTRITIONAL REQUIREMENTS

You need to know nutritional requirements of an individual or group for two major reasons:
Prescriptive reasons: that is, to provide or dispense food supplies; for example:
 to procure food for national consumption
 to secure food for institutional consumption
 to run nutritional supplementation programmes.
Diagnostic reasons: mainly to identify whether a group or an individual is suffering from

malnutrition of any kind; for example:
 to evaluate nutritional intervention programmes
 to determine whether the food available in the stock is adequate to feed the household or
nation for a certain duration of time.
In order to estimate nutritional requirements of individuals or groups, we need to consider the
following factors:
 Physical activity — whether a person is engaged in heavy physical activity
 The age and sex of the individual or group
 Body size and composition — what the general build is of a person or group
 Climate — whether a person or group is living in hot or cold climate
 Physiological states, such as pregnancy and lactation.
Based on these factors, nutritional requirements in the different segments of the population can be
classified into four groups. These correspond to different parts of the lifespan, namely (a)
pregnancy and lactation, (b) infancy and childhood (c) adolescence and adulthood, and (d) old age.
You are now going to look at each of these in turn.
NUTRITION DURING PREGNANCY AND LACTATION

An unborn child needs a healthy and well-nourished mother to grow properly. Therefore, a mother
needs to gain weight during pregnancy to help nourish her growing baby. Women who do not gain
enough weight often have babies that weigh too little (low birth weight). A baby weighing less
than 2.5 kg has an increased chance of both physical and mental health problems. It may also suffer
more from infection and malnutrition compared with babies of normal weight. The increased
requirement of nutrients during pregnancy and lactation
Increased requirements: energy, protein, essential fatty acids, vitamin A, vitamin C, B vitamins
(B1, B2, B3, B5, B6, B12, folate), calcium, phosphorus, iron, zinc, copper and iodine.
Women should gain at least 11 kg during pregnancy (Figure 3.1). If the mother gains less than this,
the baby’s chances of survival and health declines. If a mother is overweight, she still needs to gain
for her baby’s health. She should not try to lose weight while she is pregnant.
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Figure 3.1 Gaining weight during pregnancy.
Gaining weight in pregnancy

A pregnant mother should gain weight smoothly and steadily. If weight gain occurs suddenly, she
should see a health professional.
 During the first three months, she should expect to gain a total of 1–2 kg.
 During the last six months, she needs to gain about 0.5 kg each week.
 If she has already gained 11 kg after six–seven months, she should continue to gain
moderately until delivery.
Eating during pregnancy

Women’s nutrition during pregnancy and lactation should focus on the three micronutrients
(vitamin A, iron and iodine) and extra energy intake/reduction of energy expenditure. Therefore the
following are essential nutrition actions related to maternal nutrition:
 A pregnant or breastfeeding woman needs extra foods, especially those that are good
sources of iron.
 Pregnant women need at least one additional meal (200 Kcal) per day during the pregnancy.
 A pregnant woman needs to cut down her energy expenditure. She should reduce her
involvement in strenuous household tasks that lead to higher energy expenditure.
 Pregnant women should eat iodised salt in their diet.
 Pregnant women should take vitamin A rich foods (such as papaya, mango, tomato, carrot,
and green leafy vegetable) and animal foods (such as fish and liver).
 In the malarious areas, pregnant women should sleep under an insecticide-treated bed net.
 Pregnant women during the third trimester of pregnancy should be de-wormed using
mebendazole or albendazole (you will learn about the doses for this in Study Session 7 of
this Module).
 Pregnant women need a well balanced diet containing mixture of foods. This should include
as far as possible food from the different food groups (animal products, fruits, vegetables,
cereals and legumes).
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Preventing anaemia in pregnancy
Some women feel weak and tired when pregnant. They may be anaemic, which in turn means that
they may have difficulty in pregnancy and childbirth. Common problems linked to the mother’s
anaemia include:
 Babies will be born without three to six months iron supply

 Breastmilk may have insufficient iron.
A pregnant or breastfeeding mother should have enough iron to keep herself and her baby healthy.
She should eat plenty of iron-rich foods every day such as dried beans, legumes, dark green leafy
vegetables, liver, kidney and heart.
A pregnant mother should go for her first antenatal care visit at the latest by the fourth month of her
pregnancy. At the clinic, check her urine for excess sugar and proteins, and her blood for malaria (if
she is showing signs of infection).
You diagnose anaemia in the following way:
Examine the lower eyelids, the inside of the lips and the palms which should be bright pink; if there
is anaemia, all of these will be pale whitish.
 Give the mother iron tablets or tablets with iron and folate to build strong blood
 Remind the mother to take the tablets after a main meal. She should not take iron tablets
with tea, coffee or milk
 If the iron tablets upset the mother or cause side effects, she should not stop taking iron, but
eat more leafy vegetables.
Pregnant women with special needs

Some pregnant women in your community will be particularly vulnerable. As a Health Extension
Practitioner it is important that you identify the women who may need extra help and support.
Pregnant women who might need special help include:
 Women from poor families, or who are unemployed

 Women who are widows/separated, and have no support
 Mothers who have given birth to many babies over a short time
 Women who are ill from diseases like Tuberculosis (TB)
 Women who look thin and depressed
 Mothers whose previous babies were small and malnourished
 Teenagers
 Women with a history of their baby or babies dying in their first year of life
 Mothers overburdened with work
 Mothers who are very worried, particularly first time pregnancies.
The Nusrs or Health Extension Practitioner’s role in helping pregnant mothers with special
needs:
 Visit the pregnant women often

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 Encourage them to eat as good mixture of foods as they can afford (fruits, vegetables,
animal source foods)
 Let them be the first ones to receive iron or food supplements, when available
 Help them to get proper healthcare
 Encourage other members of the household to do some of the work and lessen the work
burden on the woman.
NUTRITION DURING LACTATION (BREASTFEEDING)

If all babies are to be healthy and grow well, they must be fed breast milk. When a baby sucks at
the nipple, this causes the milk to come into the breast and continue to flow. Breast milk is food
produced by the mother’s body especially for the baby, and it contains all the nutrients
(nourishment) a healthy baby needs.
A lactating woman needs at least two extra meals of whatever is available at home. In addition a
dose of vitamin A (200,000IU) should be given once between delivery and six weeks after delivery.
This will enable the baby to get an adequate supply of vitamin A for the first six months. During the
first six months the best way of feeding the baby is for the mother to breastfeed exclusively. You
will learn more about this in Study Session 4 of this Module. Box 3.3 shows the nutrients required
during lactation.
Box 3.3 Increased nutrients required during lactation

Increased requirements: vitamins A, C, E, all B vitamins, and sodium (applies only to individuals
under age 18).
In addition to extra meals and one high dose of vitamin A, a breastfeeding woman also needs:
 Iodised salt in her diet

 At least one litre of water per day
 Vitamin A rich foods (such as papaya, mango, tomato, carrot and green leafy vegetables)
and animal foods (such as fish and liver).
You have learnt what pregnant and lactating women require to be healthy and well for themselves
and their babies. Now you are going to look at the nutritional requirements of infants, children and
adolescents.
NUTRITIONAL REQUIREMENTS IN INFANCY, CHILDHOOD AND ADOLESCENCE
The common feature of infancy, childhood and adolescence is that all these age groups are
undergoing rapid growth and development. This in turn poses a heavy demand on their nutritional
requirements. Small children and infants do not have a well developed body nutrient store, and
therefore are more vulnerable to infection. In addition they have a larger surface area compared to
their body size. All these factors increase their basal metabolic rate (BMR), resulting in an
increased requirement for nutrients.
Adolescent growth spurt

Adolescents also undergo a very rapid growth during their puberty (called the pubertal growth
spurt). During the pubertal growth spurt, they increase rapidly both in weight and height.
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Therefore, they need a nutrient intake that is proportional with their rate of growth. The growth rate
is very high right after birth (infancy). Then the growth rate slows down until the age of 12–14
years. At about 15–16 years (the pubertal period) there is a sharp rise in growth rate/velocity. After
that, the growth rate slows down again.
Requirements for macronutrients (proteins, carbohydrates and fats) and micronutrients are higher
on a per kilogram basis during infancy and childhood than at any other developmental stage. These
needs are influenced by the rapid cell division occurring during growth, which requires protein,
energy and fat. Increased needs for these nutrients are reflected in daily requirements for these age
groups, some of which are briefly discussed below.
Increased need for nutrients

Energy
While most adults require 25–30 calories per kg, a 4 kg infant requires more than 100 kilocalories
per kg (430 calories/day). Infants of four to six months who weigh 6 kg require roughly 82
kilocalories per kg (490 calories/day). Energy needs remain high through the early formative years.
Children of one to three years require approximately 83 kilocalories per kg (990 calories/day).
Energy requirements decline thereafter and are based on weight, height, and physical activity.
As an energy source, breastmilk offers significant advantages over manufactured formula milk.
Breastfeeding is associated with reduced risk for obesity, a wide range of allergies, hypertension,
and type 1 diabetes. It is also linked with improved cognitive development; and with decreased
incidence and severity of infections. It is also less costly than formula feeding. The list below
outlines the nutrients and other constituents of breastmilk:
 Water = 87–89%
 Vitamins (particularly vitamin A)
 Fat = 3–5%
 Energy = 60–70 kcal/100 ml
 Carbohydrate (lactose) = 6.9–7.2%
 Mineral = 0.2%
 Protein = 0.8–0.9%
Higher intakes of protein and energy for growth are recommended for adolescents. For most
micronutrients, recommendations are the same as for adults. Exceptions are made for certain
minerals needed for bone growth (e.g. calcium and phosphorus). Evidence is clear that bone
calcium accretion increases as a result of exercise rather than from increases in calcium intake.
Since weight gain often begins during adolescence and young adulthood, young people must
establish healthy eating and lifestyle habits that reduce the risk for chronic disease later in life.
Water
Infants and children need plenty of water to drink, particularly when ill, or exposed to extreme
temperatures.
Total water requirements (from beverages and foods) are also higher in infants and children than for
adults. Children have a larger body surface area per unit of body weight and a reduced capacity for
sweating when compared with adults, and therefore are at greater risk of morbidity and mortality
25
from dehydration. Parents may underestimate these fluid needs, especially if infants and children
are experiencing fever, diarrhoea or exposure to very cold or very hot temperatures.
Essential fatty acids

Requirements for fatty acids or fats on a per kilogram basis are higher in infants than adults (see
Box 3.4). Some fatty acids play a key role in the central nervous system. However infants and
children should not ingest large amounts of foods that contain predominantly fats, so it is important
to get the balance right.
Infancy and childhood

Increased requirements of energy, protein, essential fatty acids, calcium and phosphorus.
Adolescence
Increased requirements of energy, protein, calcium, phosphorus and zinc.
NUTRITIONAL REQUIREMENTS DURING ADULTHOOD

The nutritional needs in adults of 19–50 years of age differ slightly according to gender. Males
require more of vitamins C, K, B1, B2 and B3, and zinc. Females require more iron, compared with
males of similar age.
You have already seen that pregnant women and lactating mothers have particular nutrient
requirements that are necessary for their own health as well as the health of their baby.
NUTRITIONAL REQUIREMENTS DURING LATER YEARS

Elderly people are especially vulnerable to nutritional problems due to age related changes in their
body (impaired physiological and anatomical capacity). Box 3.5 overleaf sets out some of the
problems an older person might experience which could impact on their diet.
Possible nutritional issues in old age

 Problems of procuring and preparing foods
 Psychosocial problems
 Digestion problems
 Nutrient absorption problems
 Renal changes
 Memory loss (senile dementia), which may include forgetting to eat
 Sensory changes
 Physical problems like weakness, gouty arthritis and painful joints.
SPECIFIC NUTRIENT REQUIREMENTS IN OLD AGE

An elderly person requires less energy than a younger individual due to reductions in muscle mass
and physical activity. Some daily requirements for elderly people differ from those of younger
adults. For example, in order to reduce the risk for age related bone loss and fracture, the
requirement for vitamin D is increased from 200 IU/day to 400 in individuals of 51–70 years of age
and to 600 IU/day for those over 70 years of age. Suggested iron intakes reduce however from 18
mg per day in women aged 19–50 to 8 mg/day after age 50, due to better iron conservation and
decreased losses in postmenopausal women compared with younger women.
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Some elderly people have difficulty getting adequate nutrition because of age or disease related
impairments in chewing, swallowing, digesting and absorbing nutrients. Their nutrient status may
also be affected by decreased production of chemicals to digest food (digestive enzymes), changes
in the cells of the bowel surface and drug–nutrient interactions. Some elderly people demonstrate
selenium deficiency, a mineral important for immune function. Impaired immune function affects
susceptibility to infections and tumours (malignancies). Vitamin B6 helps to boost selenium levels,
so a higher intake for people aged 51–70 is recommended.
Nutritional interventions should first emphasise healthy foods, with supplements playing a
secondary role. Although modest supplementary doses of micronutrients can both prevent
deficiency and support immune functions, very high dose supplementation (example, high dose
zinc) may have the opposite effect and result in immune-suppression. Therefore, elderly people also
need special attention with regard to nutritional care.
Undernourishment and malnutrition
Over 800 million people, mostly in the developing world, are chronically undernourished, eating
too little to meet minimal energy requirements. Millions more suffer acute malnutrition during
transitory or seasonal food insecurity. Over 200 million children suffer from protein-energy
malnutrition (PEM) and each year nearly 13 million under fives die as a direct or indirect result of
hunger and malnutrition.
Malnutrition usually results from diets lacking specific nutrients but can also be caused by so-called
"diets of excess".
PEM is most common among young children and pregnant women in the developing world. It is
usually caused by energy-deficient diets (that may also lack protein) coupled with infections that
raise nutrient requirements while limiting the intake and utilization of food. It is the prime cause of
low birth weight and poor growth in the developing world where mothers themselves may have a
legacy of low birth weight, stunted growth and anaemia.
Malnutrition can have serious effects, right from conception. Vitamin A deficiency is associated
with increased child mortality, and is a prime cause of child blindness. Iodine deficiency leads to
slow growth and mental development and to goitre. Anaemia, largely due to iron deficiency, is the
most widespread nutritional problem, affecting 2 000 million worldwide. It can impede learning
and productivity and is a leading cause of maternal mortality in developing countries. Calcium
deficiency is a leading risk factor for osteoporosis, a condition where bones become fragile and
brittle. Inadequate vitamin C can lead to scurvy and has been linked to poor absorption of iron and
an increased risk of certain noncommunicable diseases.
Weight and health
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NUTRITIONAL DISORDERS
A healthy and balanced diet, enriched with all the essential nutrients, is a must for overall well-
being. Children and adults alike require proper nutrition for ensuring a healthy and long life.
Malnutrition and deficiency of these vital elements can lead to serious diseases and conditions.
DISEASES CAUSED BY NUTRITIONAL DEFICIENCIES
1. Rickets
Rickets is characterized by weak and soft bones, bowed legs and bone deformities. It is caused by
deficiency of Vitamin D along with calcium and potassium in the body. Fish, fortified dairy
products, liver, oil and sunlight are some rich sources of Vitamin D. One may need to resort to
dietary supplements for making up for the lack of the “sunshine vitamin” in the body.
2. Pellagra
Pellagra is a disease caused by the lack of Niacin or B3 in the body. It is characterized by
dementia, diarrhea, dermatitis and death are “the four Ds”. The deficiency of niacin is also
accompanied by a short supply of the amino acids, tryptophan and lysine or the excessive presence
of lysine in the body. Foods enriched with niacin are tuna, whole grains, peanuts, mushrooms,
chicken etc. These should be consumed regularly to ward off this disease.
3. Scurvy:
Alarmingly reduced levels of Vitamin C or ascorbic acid in the body can cause scurvy. Scurvy
basically inhibits the production of collagen in the body which is the structural protein that connects
the tissues. Decaying of the skin and gums, abnormal formation of teeth and bones, delay or
inability to heal wounds and bleeding are the effects of scurvy on the body. One must ensure
optimal consumption of Vitamin C by having citrus fruits like oranges, lemon, strawberry etc and
broccoli regularly.
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4. Beri Beri:
Lack of Vitamin B1 or thiamine in the body leads to the disease called beri beri. The most common
symptoms of this illness are altered muscle coordination, nerve degeneration and cardiovascular
problems. Meat, eggs, whole grains, dried beans etc are rich in thiamine and thus, should be
consumed in proper amounts everyday to avoid this painful ailment.
5. Xerophthalmia or Night Blindness:

Xerophthalmia or night blindness is characterized by blindness due to the poor growth, dryness and
keratinisation of epithelial tissue or chronic eye infection. The cause of this disease is attributed to
the deficiency of Vitamin A in the body. In worsened situations, night blindness can aggravate to
complete loss of vision. The safest way to enhance the Vitamin A levels in the body is by
consuming natural food sources like carrots, green and leafy vegetables, cantaloupes etc.
6. Goitre:
Iodine in the body is essential for normal cell metabolism in the body and deficiency of iodine may
cause goitre. Goitre leads to enlarged thyroid glands causing hypothyroidism, poor growth and
development of infants in childhood, cretinism and even mental retardation. This disease is
commonly found to occur in places having iodine deficit soil. Iodised salt and saltwater fish are rich
sources of iodine, and must be consumed regularly to avoid goitre.
7. Iron Deficiency Anaemia:

Iron deficiency anaemia is a disease caused by the deficiency of iron in the body. It is characterized
by a decrease in the red blood cell count or hemoglobin in the body, resulting in fatigue, weakness,
dyspnoea and paleness of the body. It can be easily treated by changing to a healthy diet and
consuming iron supplements on a regular basis. Squashes, nuts, tofu, bran etc are rich sources of
iron for the body.
8. Kwashiorkor:
Kwashiorkor is a deficiency disease caused by lack of protein and energy in the body. It is
characterized by anorexia, an enlarged liver, irritability and ulcerating dermatoses. These are the
one of the nutritional deficiencies in children, especially from famine-struck areas and places with
poor food supply, Kwashiokor is caused by malnutrition. A healthy and balanced diet enriched with
protein and carbohydrate sources like eggs, lentils, rice etc helps combat this problem.
9. Depression:
Problems of depression, hair loss, rashes and mental issues are caused by the deficiency of Vitamin
B7 or biotin. This deficiency can be fatal if present in an aggravated form. Consume poultry
products, dairy items, peanuts, nuts etc that are rich sources of biotin. These must be consumed
along with supplements to recover and prevent these illnesses.
10. Osteoporosis:
Deficiency of Vitamin D and calcium in the body can negatively affect the health of the bones and
spine. It leads to unhealthy, soft and brittle bones that are prone to fractures and defects in the spine
structure. Bananas, spinach, milk, okra, soy and sunlight are natural sources of Vitamin D and
calcium that act to eliminate this deficiency.
29
It is important to follow a healthy and balanced diet in order to lead a healthy and disease- free life.
Apart from a healthy diet, don’t forget to exercise every day. This can therefore help you stay away
from causes and signs of nutritional deficiencies. Stay safe, stay healthy! Leave us your comments
below
30

HUMAN FOOD REQUIREMENTS Notes

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LECTURE NOTES ON HUMAN NUTRITION AND HEALTH

Why human beings need food?

Major causes of malnutrition

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

Harmful traditional practices with regard to nutrition

Best practices which favor nutrition

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

Daily calorie requirements of individuals

Office worker Heavy work

Very heavy work up to 4,000 cal/day

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

FAT SOLUBLE VITAMINS

D. Toxicity of Vitamin A (Retinol)

E. Prevention of vitamin A deficiency

Strategies to control and eliminate vitamin A deficiency

Universal supplementation of vitamin a capsules (short term strategy)

4. VITAMIN K (ANTIHEMORRHAGIC VITAMIN)

WATER SOLUBLE VITAMINS

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

Functions of Vitamin B2:

Deficiency of vitamin B2 is characterized by:

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

5. FOLATE (Folacin or folic acid)

5. VITAMIN B12 (Cobalamin)

Source of vitamin B12

Deficiency of vitamin B12:

6. VITAMIN C (ASCORBIC ACID)

Discussion questions for chapter review

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

The principal minerals, which the body requires.

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

BY ERIC EPAH K. 2018/2019 SCHOOL YEAR (AHID) E-mail: kukuepah@gmail.com

Strategies for prevention and treatment of iron deficiency