Nagesh Gym Final Project Work2

" Reference of Gym movers towards nutrition product
in Ghazipur city
SURVEY PROJECT REPORT
Submitted to
Veer bahadur singh purvanchal University, Jaunpur

In partial fulfillment of the requirements for the degree of
BACHOLER OF BUSINESS ADMINISTRATION
Submitted by: Under the Supervision of:

Nagesh Paswan Miss Neetu Singh
BBA 4th Semester Assistant Professor,
Roll No.20141025614 Department of Business Administration
Enrollment No.PU19/001476
2021
Technical Education & Research Institute

Post-Graduate College, Ravindrapuri
Ghazipur – 233001
Certificate
This is to certify that Nagesh Paswan, pursuing BBA 4thSemester from

this institute, has prepared the research project report entitled
“Preference of gym movers towards nutrition product in Ghazipur
city” in partial fulfillment of the requirements of the degree of Bachelor
of Business Administration from Veer bahadur singh purvanchal
University, Jaunpur, for the session 2020-21.
This report is based on Survey project undertaken by Nagesh Paswan
under my supervision during the course of fourth semester and fulfills the
requirements of regulations relating to the nature and standard of BBA
course of Veer bahadur singh purvanchal University.
I recommend that this project report may be sent for evaluation.
Dr. Neetu Singh Miss Neetu Singh

Associate Professor& Head, Assistant Professor,
Dept. of Business Administration Dept. of Business Administration
Declaration
I, Nagesh Paswan, hereby declare that this research project report

entitled “Preference of gym movers towards nutrition product in
Ghazipur city” has been prepared by me on the basis of survey done
during the course of my fourth semester of BBA programme under the
supervision of Miss Neetu Singh Assistant Professor, Department of
Business Administration, TERI, Ghazipur.
This survey project report is my bona fide work and has not been
submitted in any form to any University or Institute for the award of any
degree or diploma prior to the under mentioned date. I bear the entire
responsibility of submission of this project report.
20th
September 2021 Nagesh Paswan
BBA 4th Semester
Department of Business Administration
Technical Education & Research Institute
P.G. College, Ghazipur
TABLE OF CONTENTS
Chapter-1
 Introduction of the topic 1-30
 Literature review 31-34
Chapter-2
 Problem 35
 Objective 36
 Scope 37
 Importance 38
Chapter-3
●Research Methodology 39-43
Chapter-4
●Data analysis & Interpretation 44-60
Chapter-5
●Finding & Recommendation 61-63
Chapter-6
●Conclusion & Limitation 64-66
● Bibliography 67
●Questioner 68-71
Preface
The first real insight of an organization for management student comes only during his
preparation of project work because student first interacts with real practical work. This is first
introduction to industry and its working. This project work synthesize the theoretical concept
learn in the class room and its practical orientation in organization.
In my project I have studied the “Preference of gym movers towards nutrition product
in Ghazipur city”
The First chapter introductory stage of this survey report is based on introduction of the
topic it founders, objective, mission, strength, technologies and services as well as contains about
the Literature Review.
The Second chapter; contains about the Problem, Objectives, Scope, and Importance of
the study.
The Third chapter deals with research methodology. The process of carrying out the
whole research problem is defined in it. It contains information about the objectives of the
research, methods of data collection, sampling and sample design.
The Fourth chapter is data analysis and interpretation. This is the most important section
of the project work. This section contains the analysis of all the data collected so far and they are
interpreted to produce the final conclusion. It contains all the tables and charts which depicts the
result.
The Fifth chapter contains the finding and recommendation of the research. This is based
on the data analyzed and interpreted in the previous chapter. This is the most important section of
the research report for a report is evaluated on the validity ad correctness of findings.
The Sixth chapter depicted conclusion which concludes the whole report, that is, gives a
brief description of the process employed so far. And later chapters contain bibliography. Which
describes the list of sources from where the matter and information is collected? It contains the
list of books, authors, web sites use etc.
Nagesh Paswan
Acknowledgement
It is my pleasure to be indebted to various people, who directly or indirectly contributed in the
development of this work and who influenced my thinking, behavior, and acts during the course
of study.
I express my sincere gratitude to Dr. Neetu Singh, worthy Principal for providing me an
opportunity to undergo summer training at Business Standard.
I am thankful to Miss Neetu Singh for his support, cooperation, and motivation provided to me
during the preparing for survey project report for constant inspiration, presence and blessings.
Lastly, I would like to thank the almighty and my parents for their moral support and my friends
with whom I shared my day-to-day experience and received lots of suggestions that improved my
quality of work.
Nagesh Paswan
Introduction of the topic

I´m often asked questions about nutritional supplementation in regards to both general health and
performance matters, and have experimented over the years with varying degrees of success. Here
I will share some of my experiences and try to simplify what is often made out to be a complex
field. As I often allude to, much of the complexity surrounding training and nutrition advice is
intended as a smokescreen by individual companies to make money selling needless products.
Before I start, there isn’t much need to consider supplements for training and performance
purposes if you haven’t got your house in order with regards to a proper diet, adequate sleep, and
sensible exercise. There are NO shortcuts to good health and fitness through over the counter
supplements. It is that simple. Eat crap, live a stressed out and sleep deprived life, and struggle
down to the gym for an aerobic session or run 3 times a week will not allow ANY fancy
supplement to improve your life other than burning a bigger hole in your wallet.
Ok, got that out of the way. I will not go into detail about the need to eat natural, whole, fresh,
nutrient dense foods here. I will not go into detail about how important getting 8-9hrs of GOOD
sleep every night is. Read this if you wonder why. I will not mention the dangers of eating
processed, man-made “foodstuffs”, concentrated sources of fructose, gluten containing grains and
refined vegetable oils. Kurt Harris will tell you so in both a legit and serious way. And I will not
go into the importance of eating animals as your most important source of nutrient rich protein
and fat. Read this if you want to geek out a bit.
So, assuming you have your ship steered in the right direction, give or take the usual bumps and
grinds that come with living a modern life of course, then what about some optional extras that
can lift your performance a notch or two, and help in your path to achieving certain goals?. Here
are a few supplements I have kept using over the years, remembering that personal
experimentation is just that: a personal endeavour. What makes one gal laugh might make the
other cry. One shoe doesn’t fit all.
Nutrients are substances required by the body to perform its basic functions. Most nutrients must
be obtained from our diet, since the human body does not synthesize or produce them. Nutrients
have one or more of three basic functions: they provide energy, contribute to body structure,
and/or regulate chemical processes in the body. These basic functions allow us to detect and
respond to environmental surroundings, move, excrete wastes, respire (breathe), grow, and
reproduce.
There are six classes of nutrients required for the body to function and maintain overall health.
These are: carbohydrates, lipids, proteins, water, vitamins, and minerals. Nutritious foods provide
nutrients for the body. Foods may also contain a variety of non-nutrients. Some non-nutrients
such as as antioxidants (found in many plant foods) are beneficial to the body, whereas others
such as natural toxins (common in some plant foods) or additives (like certain dyes and
preservatives found in processed foods) are potentially harmful.
Proteins are macromolecules composed of chains of basic subunits called amino acids. Amino
acids are composed of carbon, oxygen, hydrogen, and nitrogen. Food sources of proteins include
meats, dairy products, seafood, and a variety of different plant-based foods, most notably soy. The
word protein comes from a Greek word meaning “of primary importance,” which is an apt
description of these macronutrients; they are also known colloquially as the “workhorses” of life.
Proteins provide the basic structure to bones, muscles and skin, enzymes and hormones and play a
role in conducting most of the chemical reactions that take place in the body. Scientists estimate
that greater than one-hundred thousand different proteins exist within the human body. The
genetic codes in DNA are basically protein recipes that determine the order in which 20 different
amino acids are bound together to make thousands of specific proteins. Because amino acids
contain carbon, they can be used by the body for energy and supply 4 kilocalories of energy per
gram; however providing energy is not protein’s most important function
Carbohydrates
Provide a ready source of energy for the body (4 kilocalories/gram) and structural constituents for
the formation of cells.
Fat
Provides stored energy for the body (9 kilocalories/gram), functions as structural components of
cells and also as signaling molecules for proper cellular communication. It provides insulation to
vital organs and works to maintain body temperature.
Protein
Necessary for tissue and organ formation, cellular repair and hormone and enzyme production.
Provide energy, but not a primary function (4 kilocalories/gram)
Water
Transports essential nutrients to all body parts, transports waste products for disposal and aids
with body temperature regulation
Minerals
Regulate body processes, are necessary for proper cellular function, and comprise body tissue.
Vitamins
Regulate body processes and promote normal body-system functions.
Micronutrients are also essential for carrying out bodily functions, but they are required by the
body in lesser amounts. Micronutrients include all the essential minerals and vitamins. There are
sixteen essential minerals and thirteen essential vitamins (See Table 1.1.1 and Table 1.1.2 for a
complete list and their major functions).
In contrast to carbohydrates, lipids, and proteins, micronutrients are not sources of energy
(calories) for the body. Instead they play a role as cofactors or components of enzymes (i.e.,
coenzymes) that facilitate chemical reactions in the body. They are involved in all aspects of body
functions from producing energy, to digesting nutrients, to building macromolecules.
Micronutrients play many essential roles in the body.
.
There is one other nutrient that we must have in large quantities: water. Water does not contain
carbon, but is composed of two hydrogen atoms and one oxygen atom per molecule of water.
More than 60 percent of your total body weight is water. Without water, nothing could be
transported in or out of the body, chemical reactions would not occur, organs would not be
cushioned, and body temperature would widely fluctuate. On average, an adult consumes just
over two liters of water per day from both eating foods and drinking liquids. Since water is so
critical for life’s basic processes, total water intake and output is supremely important.
Proteins are macromolecules composed of chains of basic subunits called amino acids. Amino
acids are composed of carbon, oxygen, hydrogen, and nitrogen. Food sources of proteins include
meats, dairy products, seafood, and a variety of different plant-based foods, most notably soy. The
word protein comes from a Greek word meaning “of primary importance,” which is an apt
description of these macronutrients; they are also known colloquially as the “workhorses” of life.
Proteins provide the basic structure to bones, muscles and skin, enzymes and hormones and play a
role in conducting most of the chemical reactions that take place in the body. Scientists estimate
that greater than one-hundred thousand different proteins exist within the human body. The
genetic codes in DNA are basically protein recipes that determine the order in which 20 different
amino acids are bound together to make thousands of specific proteins. Because amino acids
contain carbon, they can be used by the body for energy and supply 4 kilocalories of energy per
gram; however providing energy is not protein’s most important function
Lipids are also a family of molecules composed of carbon, hydrogen, and oxygen, but unlike
carbohydrates, they are insoluble in water. Lipids are found predominantly in butter, oils, meats,
dairy products, nuts, and seeds, and in many processed foods. The three main types of lipids are
triglycerides (triacylglycerols), phospholipids, and sterols. The main job of triacylglycerols is to
provide or store energy. Lipids provide more energy per gram than carbohydrates (9 kilocalories
per gram of lipids versus 4 kilocalories per gram of carbohydrates). In addition to energy storage,
lipids serve as a major component of cell membranes, surround and protect organs (in fat-storing
tissues), provide insulation to aid in temperature regulation. Phospholipds and sterols have a
somewhat different chemical structure and are used to regulate many other functions in the body.
Carbohydrates are molecules composed of carbon, hydrogen, and oxygen that provide energy to
the body. The major food sources of carbohydrates are milk, grains, fruits, and starchy vegetables,
like potatoes. Non-starchy vegetables also contain carbohydrates, but in lesser quantities.
Carbohydrates are broadly classified into two forms based on their chemical structure: simple
carbohydrates (often called simple sugars) and complex carbohydrates.
Simple carbohydrates consist of one or two basic sugar units linked together. Their scientific
names are "monosaccharides" (1 sugar unit) and disaccharides (2 sugar units). They are broken
down and absorbed very quickly in the digestive tract and provide a fast burst of energy to the
body. Examples of simple sugars include the disaccharide sucrose, the type of sugar you would
have in a bowl on the breakfast table, and the monosaccharide glucose, the most common type of
fuel for most organisms including humans. Glucose is the primary sugar that circulates in blood to
provide energy to cells. The terms "blood sugar" and "blood glucose" can be substituted for each
other.
Complex carbohydrates are long chains of sugars units that can link in a straight chair or a
branched chain. During digestion, the body breaks down digestible complex carbohydrates into
simple sugars, mostly glucose. Glucose is then absorbed into the bloodstream and transported to
all our cells where it is stored, used to make energy, or used to build macromolecules. Fiber is
also a complex carbohydrate, but it cannot be broken down by digestive enzymes in the human
intestine. As a result, it passes through the digestive tract undigested unless the bacteria that
inhabit the colon or large intestine break it down.
One gram of digestible carbohydrates yields 4 kilocalories of energy for the cells in the body to
perform work. In addition to providing energy and serving as building blocks for bigger
macromolecules, carbohydrates are essential for proper functioning of the nervous system, heart,
and kidneys. As mentioned, glucose can be stored in the body for future use. In humans, the
storage molecule of carbohydrates is called glycogen, and in plants, it is known as starch.
Glycogen and starch are complex carbohydrates.
The food pyramid is a simple practical guide to selecting varied foods for meals. The Australian
Nutrition Foundation Inc. (Nutrition Australia) has developed its own food pyramid. The rationale
behind the food pyramid emphasises the need to include generous amounts of plant-based foods
(cereals, legumes, fruits and vegetables) and moderate amounts of animal products (meat, fish,
milk, eggs) in our diets. Furthermore, our diet should contain only small amounts of energy-dense
foods (e.g. sugar, fats and oils). The base of the pyramid (plant-based foods) is broad, and the top
(animal products) is narrow. Eating according to the structure of the food pyramid ensures we
consume a healthy diet. With care the food pyramid can also assist vegetarians and vegans to
consume a nutritionally balanced diet, although some people will require dietary supplements
(e.g. vegans will require vitamin B12).
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Overview of the global fitness products and services market
With the alarming rise in obesity-related problems in adults and health risks of a sedentary
lifestyle, there is a need to stay fit now more than ever. Healthy and active living has been
encouraged across the globe, and the fitness products and services market has grown rapidly.
Large-scale modernization, rising spending capacity in developing countries, opening of fitness
clubs and gyms, affordable training equipment available, personal coaches, and cost-effective and
highly-advanced wireless healthcare technologies have fueled the growth of the market
significantly. In addition, physical activity recommendations by the World Health Organization,
government efforts to promote healthy lifestyle, and the consolidation of the entertainment
industry into health and well-being to encourage exercising have further propelled the global
fitness products and services market.
While the U.S. leads the worldwide fitness market, Asia-Pacific is seen as the pace setter.
Treadmills dominate the physical fitness equipment segment due to rising popularity of home
gym exercising.
Companies mentioned in the global fitness products and services market
The research report consists of a detailed section on the various companies that function in the
diverse global fitness products and services market. Some of the key players in each segment are
as follows:
Physical fitness equipment: Reebok International Ltd., Body Solid Inc., Johnson Health Tech Co.
Ltd., Life Fitness Inc., Heinz Kettler GmbH & Co. KG, PowerSport International Limited, ICON
Health & Fitness Inc., Keys Fitness Products L.P.
Apparel and footwear: Nike, Inc., Reebok International Limited, Adidas AG, Puma SE, Kappa,
The Gap, Inc., Fila, and ASICS America Corporation
Nutrition food and drinks: GlaxoSmithKline Plc, Abbott Laboratories Inc., PepsiCo Inc., Coca-
Cola Co., Nestlé SA, Dr Pepper Snapple Group Inc., The Quaker Oats Company Inc., and Yakult
Honsha Co., Ltd
Gyms, clubs and fitness centers: Gold’s Gym International, Fitness International LLC, Contours
Express, Amazonia, Konami Corporation, and Health City
Mobile apps: Endomondo ApS, Azumio Inc., MapMyFitness Inc., FitnessKeeper Inc., and
Runtastic GmbH
Wearable technologies: Google, Fibit, Nike, Neptune Pine, and Reebok
Wireless devices: Adidas AG, Abbott Laboratories, Bosch Healthcare, Inc., Beuer GmbH, and
Entra Health Systems LLC
This study by TMR is all-encompassing framework of the dynamics of the market. It mainly
comprises critical assessment of consumers' or customers' journeys, current and emerging
avenues, and strategic framework to enable CXOs take effective decisions.
Our key underpinning is the 4-Quadrant Framework EIRS that offers detailed visualization of
four elements:
Customer Experience Maps

Insights and Tools based on data-driven research
Actionable Results to meet all the business priorities
Strategic Frameworks to boost the growth journey
The study strives to evaluate the current and future growth prospects, untapped avenues, factors
shaping their revenue potential, and demand and consumption patterns in the global market by
breaking it into region-wise assessment.
The following regional segments are covered comprehensively:
North America
Asia Pacific
Europe
Latin America
The Middle East and Africa
The EIRS quadrant framework in the report sums up our wide spectrum of data-driven research
and advisory for CXOs to help them make better decisions for their businesses and stay as
leaders.
Below is a snapshot of these quadrants
1. Customer Experience Map
The study offers an in-depth assessment of various customers’ journeys pertinent to the market
and its segments. It offers various customer impressions about the products and service use. The
analysis takes a closer look at their pain points and fears across various customer touchpoints. The
consultation and business intelligence solutions will help interested stakeholders, including
CXOs, define customer experience maps tailored to their needs. This will help them aim at
boosting customer engagement with their brands.
2. Insights and Tools
The various insights in the study are based on elaborate cycles of primary and secondary research
the analysts engage with during the course of research. The analysts and expert advisors at TMR
adopt industry-wide, quantitative customer insights tools and market projection methodologies to
arrive at results, which makes them reliable. The study not just offers estimations and projections,
but also an uncluttered evaluation of these figures on the market dynamics. These insights merge
data-driven research framework with qualitative consultations for business owners, CXOs, policy
makers, and investors. The insights will also help their customers overcome their fears.
3. Actionable Results
The findings presented in this study by TMR are an indispensable guide for meeting all business
priorities, including mission-critical ones. The results when implemented have shown tangible
benefits to business stakeholders and industry entities to boost their performance. The results are
tailored to fit the individual strategic framework. The study also illustrates some of the recent case
studies on solving various problems by companies they faced in their consolidation journey.
4. Strategic Frameworks
The study equips businesses and anyone interested in the market to frame broad strategic
frameworks. This has become more important than ever, given the current uncertainty due to
COVID-19. The study deliberates on consultations to overcome various such past disruptions and
foresees new ones to boost the preparedness. The frameworks help businesses plan their strategic
alignments for recovery from such disruptive trends. Further, analysts at TMR helps you break
down the complex scenario and bring resiliency in uncertain times.
The report sheds light on various aspects and answers pertinent questions on the market. Some of
the important ones are
Nutrition is the biochemical and physiological process by which an organism uses food to support
its life. It includes ingestion, absorption, assimilation, biosynthesis, catabolism and excretion.[1]
The science that studies the physiological process of nutrition is called nutritional science (also
nutrition science).
Nutritional groups
Main article: Primary nutritional groups
Organisms primarily provide themselves with carbon in one of two ways: autotrophy (the self-
production of organic food) and heterotrophy (the consumption of existing organic carbon).
Combined with the source of energy, either light (phototrophy) or chemical (chemotrophy), there
are four primary nutritional groups for organisms.[2]
Nutrients
Main article: Nutrient
Nutrients are substances used by an organism to survive, grow, and reproduce. The seven major
classes of relevant nutrients for animals (including humans) are carbohydrates, dietary fiber, fats,
proteins, minerals, vitamins, and water. Nutrients can be grouped as either macronutrients
(carbohydrates, dietary fiber, fats, proteins, and water needed in gram quantities) or
micronutrients (vitamins and minerals needed in milligram or microgram quantities).
Diet
Main article: Diet (nutrition)
In nutrition, the diet of an organism is the sum of foods it eats, which is largely determined by the
availability and palatability of foods.
Human nutrition
Main article: Human nutrition
Human nutrition deals with the provision of essential nutrients from food that are necessary to
support human life and good health.[3]
In humans, poor nutrition can cause deficiency-related diseases such as blindness, anemia, scurvy,
preterm birth, stillbirth and cretinism,[4] or nutrient excess health-threatening conditions such as
obesity[5][6] and metabolic syndrome;[7] and such common chronic systemic diseases as
cardiovascular disease,[8] diabetes,[9][10] and osteoporosis.[11][12][13] Undernutrition can lead
to wasting in acute cases, and stunting of marasmus in chronic cases of malnutrition.[4]
Animal nutrition
Main article: Animal nutrition
Animal nutrition focuses on the dietary nutrients needs of animals, often in comparison (or
contrast) to other organisms like plants. Carnivore and herbivore diets are contrasting, with basic
nitrogen and carbon proportions vary for their particular foods. Many herbivores rely on bacterial
fermentation to create digestible nutrients from indigestible plant cellulose, while obligate
carnivores must eat animal meats to obtain certain vitamins or nutrients their bodies cannot
otherwise synthesize. Animals generally have a higher requirement of energy in comparison to
plants.[14]
Plant nutrition
Main article: Plant nutrition
Plant nutrition is the study of the chemical elements that are necessary for plant growth.[15]
There are several principles that apply to plant nutrition. Some elements are directly involved in
plant metabolism. However, this principle does not account for the so-called beneficial elements,
whose presence, while not required, has clear positive effects on plant growth.
A nutrient that is able to limit plant growth according to Liebig's law of the minimum is
considered an essential plant nutrient if the plant cannot complete its full life cycle without it.
There are 16 essential plant soil nutrients, besides the three major elemental nutrients carbon and
oxygen that are obtained by photosynthetic plants from carbon dioxide in air, and hydrogen,
which is obtained from water.
Plants uptake essential elements from the soil through their roots and from the air (consisting of
mainly nitrogen and oxygen) through their leaves. Green plants obtain their carbohydrate supply
from the carbon dioxide in the air by the process of photosynthesis. Carbon and oxygen are
absorbed from the air, while other nutrients are absorbed from the soil. Nutrient uptake in the soil
is achieved by cation exchange, wherein root hairs pump hydrogen ions (H+) into the soil through
proton pumps. These hydrogen ions displace cations attached to negatively charged soil particles
so that the cations are available for uptake by the root. In the leaves, stomata open to take in
carbon dioxide and expel oxygen. The carbon dioxide molecules are used as the carbon source in
photosynthesis.
Although nitrogen is plentiful in the Earth's atmosphere, very few plants can use this directly.
Most plants, therefore, require nitrogen compounds to be present in the soil in which they grow.
This is made possible by the fact that largely inert atmospheric nitrogen is changed in a nitrogen
fixation process to biologically usable forms in the soil by bacteria.[16]
Plant nutrition is a difficult subject to understand completely, partially because of the variation
between different plants and even between different species or individuals of a given clone.
Elements present at low levels may cause deficiency symptoms, and toxicity is possible at levels
that are too high. Furthermore, deficiency of one element may present as symptoms of toxicity
from another element, and vice versa.[citation needed]
Nutrition is defined as the processes by which an animal or plant takes in and utilises food
substances. Essential nutrients include protein, carbohydrate, fat, vitamins, minerals and
electrolytes. Normally, 85% of daily energy use is from fat and carbohydrates and 15% from
protein
Nutrition is essential for growth and development, health and wellbeing. Eating a healthy diet
contributes to preventing future illness and improving quality and length of life. Your nutritional
status is the state of your health as determined by what you eat. There are several ways of
assessing nutritional status, including anthropometric (i.e. physical body measurement), food
intake and biochemical measurement.
Nutrients can be described as the chemical components of food and can be classified into six
broad groups: carbohydrates, proteins, fats, vitamins, minerals and water. Water is not technically
a nutrient, but it is essential for the utilisation of nutrients. Nutrients perform various functions in
our bodies, including energy provision and maintaining vital processes such as digestion,
breathing, growth and development.
Energy balance
Your energy requirement depends on your age, size and activity level. If your energy intake
equals the amount of energy you expend, then you are in energy balance. If your intake exceeds
your expenditure, the excess energy is converted to body fat and you gain weight. On the other
hand, if your intake is less than your expenditure, your body uses up fat stores and you lose
weight. Therefore, for weight to remain stable, the total amount of calories that are consumed
must not exceed the total that is used up through metabolic processes (e.g. exercising, sweating,
breathing). Energy intake must match energy output. The average energy intake is about 2800
kcal/day for men and 1800 kcal/day for women, although this varies with body size and activity
level.
Carbohydrates
Carbohydrates can be classified as monosaccharide (e.g. glucose, fructose, galactose),

disaccharide (e.g. sucrose, lactose, maltose) and polysaccharide (e.g. starch, fibre). Carbohydrates
must be reduced to the simplest form of glucose (through digestion) before your body can make
use of them. Carbohydrates should make up at least 55% of your total energy intake. The brain is
a special part of the body that depends primarily on glucose for its energy and requires about 100
g/day of glucose for fuel. In some situations, the body can compensate for decreased levels of
carbohydrates by using alternative energy pathways such as burning fatty acids.
Protein
Protein is important for the production, maintenance and repair of tissues in the body. When
energy intake is insufficient, protein intake must be raised. This is because ingested proteins are
preferentially directed towards glucose (sugar) synthesis and oxidation. The tissues and organs in
the body are made up of protein and protein compounds. Enzymes (biological catalysts),
antibodies and hormones also consist of protein. The building blocks of protein are called amino
acids. The body can make all of the 20 amino acids except eight, which are termed essential
amino acids. These are isoleucine, leucine, lysine, methionine, phenylalanine, threonine,
tryptophan and valine. Histidine is essential only for infants. The number and nature of amino
acids present in a particular protein determines that protein’s characteristics.
For adults, the recommended dietary allowance of protein is about 0.75 g/kg body weight per day.
Animal products tend to have the highest amount of proteins, followed by legumes (beans),
cereals (rice, wheat, corn) and roots. Animal protein (from meat, eggs, fish, milk) contains all the
essential amino acids and is normally referred to as ‘complete’ or ‘high biological value’ protein.
Protein derived from plants lack one or two essential amino acids. However, a good combination
of plant-based protein can be of equal value to animal protein. For example, legumes lack
methionine but have adequate amounts of lysine. Cereals, on the other hand, lack lysine but have
a lot of methionine. Therefore, a mixture of rice and beans will supply all the essential amino
acids.
Excess protein cannot be stored in the body, so we need to consume protein daily. Consuming too
much protein is not recommended because it promotes increased calcium excretion through urine,
which increases the risk of developing osteoporosis. Additionally, too much protein intake may
lead to a greater concentration of the amino acid homocysteine in the blood, and the subsequent
conversion to thiolactone. Thiolactone is associated with increased levels of atherosclerosis and
endothelial damage.
Fats and oils

NutritionMost of the fats we consume occur in foods as triglycerides. A triglyceride is comprised
of three fatty acid molecules attached to a glycerol molecule. Fatty acids are made up of carbon
and hydrogen atoms and can be either saturated or unsaturated. Saturated fatty acids (SFA) have
the maximum number of hydrogen atoms attached to the carbon chain, while unsaturated fatty
acids have less than the required hydrogen atoms. For example, monounsaturated fatty acids (e.g.
oleic acid) have two hydrogen atoms missing. Monounsaturated fats are found mainly in nuts,
avocados, olive oil, canola oil, grapeseed oil, peanut oil, flaxseed oil, sesame oil, corn oil,
safflower oil, sunflower oil, etc.
Polyunsaturated fatty acids (PUFA) have more than two hydrogen atoms missing (e.g. linoleic
acid and linolenic acid). Linoleic and linolenic acids are regarded as essential fatty acids (EFAs)
because the body cannot make them. There are two categories of EFAs: omega-3 and omega-6.
The number that comes after “omega-” represents the position of the first double bond, counting
from the terminal methyl group on the molecule. Omega-3 fatty acids are derived from linolenic
acid and omega-6 from linoleic acid. Alpha linolenic acid (ALA) is converted into
eicosapentaenoic acid (EPA), and later into docosahexaenoic acid (DHA) in the body. Sources of
omega-3 fats include salmon, mackerel, sardines, anchovies, tuna, flaxseed oil, walnuts, etc.
Sources of omega-6 fats include palm oil, soybean oil, canola oil, sunflower oil, nuts, etc.
Evidence from research indicates that omega-3 fatty acids reduce inflammation and help prevent
certain chronic diseases such as heart disease and arthritis. Omega-3 fatty acids are highly
concentrated in the brain and appear to be crucial to brain function as well as normal growth and
development. Infants who do not get enough omega-3 fatty acids from their mothers during
pregnancy are at risk of mental impairment.
Generally, saturated fatty acids raise blood cholesterol levels, whereas unsaturated fatty acids
lower them. Saturated fats are found in foods such as butter, meat and dairy fats. Trans fats are
artificially created during food processing. In the body, trans fats act in a similar way to saturated
fats and may raise cholesterol levels. These fats are considered to be harmful to your health. Trans
fats are found mainly in deep-fried fast foods and processed foods made with margarine.
Fats are a concentrated and rich source of energy. It is recommended that your total fat intake is
no more than 30% of your energy (calorie/kilojoule) intake. Polyunsaturated fat should be less
than 10% of energy, and saturated fat and trans fat together should be less than 10%. The rest of
your fat intake should consist of monounsaturated fat.
Vitamins
Vitamins constitute a group of nutrients that are needed in small quantities. Like amino and fatty
acids, most vitamins cannot be made in the body and must be obtained from dietary sources. Only
vitamin D can be manufactured by the body. Essential vitamins are grouped into two families:
water soluble and fat soluble. Water soluble vitamins can dissolve in water (thiamine, riboflavin,
niacin, vitamin C, folic acid). These cannot be stored by the body and need to be consumed every
day. Fat soluble vitamins can dissolve in a fat medium (vitamins A, D, E, K). These are taken into
our bodies when we consume fat-containing foods. Vitamins are needed for various reasons,
including the formation of hormones and blood cells. They generally act as coenzymes. An
inadequate supply of vitamins in our diet leads to the development of diseases.
Vitamin A: Derived from carotene, vitamin A affects vision, reproduction, and the formation and
maintenance of skin, mucous membranes, bones and teeth. Deficiency results in night blindness
(difficulty in adapting to darkness). The body obtains vitamin A from either carotene (vitamin A
precursor) or by absorbing ready-made vitamin A from plant-eating organisms. Carotene is found
in dark green leafy vegetables and yellow-orange fruit/vegetables. Pre formed vitamin A is found
in milk, butter, cheese, egg yolk, liver, and fish-liver oil.
Vitamin B complex: The vitamin B complex is a mixture of eight essential vitamins necessary to
enhance immune and nervous system function, and promote cell growth and division. Pregnant or
lactating women, alcoholics and the elderly are more likely to suffer from vitamin B deficiency.
Vitamin B1 (thiamine): Thiamine, or vitamin B1, acts as a catalyst in carbohydrate metabolism.
Thiamine deficiency causes beriberi, a vitamin deficiency disorder characterised by muscular
weakness, swelling of the heart and leg cramps. In severe cases, beriberi may lead to heart failure
and death. The richest dietary sources of thiamine are organ meats (liver, heart, and kidney),
brewer’s yeast, lean meats, eggs, leafy green vegetables, whole or enriched cereals, wheat germ,
berries, nuts, and legumes.
Vitamin B2 (riboflavin): Riboflavin, or vitamin B2, acts as a coenzyme in the metabolism of
carbohydrates, fats, and respiratory proteins. The best sources of riboflavin are liver, milk, meat,
dark green vegetables, whole grain and enriched cereals, pasta, bread and mushrooms.
Vitamin B6 (pyroxidine): Pyridoxine, or vitamin B6, is necessary for the absorption and
metabolism of amino acids. It also plays a role in the body’s use of fats and in the formation of
red blood cells. The best sources of pyridoxine are whole grains, cereals, bread, liver, avocados,
spinach, green beans and bananas.
Folic acid (vitamin B9 or folacin): Folic acid is a coenzyme needed for forming body protein and
haemoglobin. Folic acid deficiency is associated with neural tube defects. Dietary sources are
organ meats, leafy green vegetables, legumes, nuts, whole grains and brewer’s yeast. Folic acid is
lost in foods stored at room temperature and during cooking.
Minerals
Minerals are essential, acting as cofactors of enzymes (i.e. enzymes would not exist or function
without minerals). Some of the minerals necessary for health are:
Calcium: Calcium is a very important mineral in the diet, especially for women at menopause.
The major function of calcium is to build and help maintain strong bones. It can stop the onset of
osteoporosis and reduce bone loss and fragility. It is involved in blood clotting. Calcium
deficiency can develop when there is a lack of vitamin D.
Iron: Iron in food exists as haem and non-haem iron. Haem iron, found in red meat, is relatively
well (20–30%) absorbed. Non-haem iron, found mostly in cereals, pulses, certain vegetables (e.g.
spinach) and eggs, is generally less well absorbed. Non-haem iron absorption depends on other
factors in the diet. For example, vitamin C and animal protein enhance non-haem iron absorption,
while tea, coffee and phytates inhibit it.
Zinc: Zinc represents only 0.003% of the human body, but is essential for synthesising protein,
DNA and RNA. It is required for growth in all stages of life. Sources include meats, oysters and
other seafood, milk, and egg yolk.
Nutritional supplements
Anika Niambi Al-Shura BSc, MSOM, PhD, in Herbal, Bio-Nutrient and Drug Titration
According to Disease Stages in Integrative Cardiovascular Chinese Medicine, 2020
Regulations for future practices

By the 1990s federal regulators needed to make distinctions between food additives and
nutritional supplements. In 1990, Congress introduced the Nutrition Labeling and Education Act
(NLEA) of 1990 to address the increase of unsubstantiated claims of disease cure and erroneous
advice despite medical and scientific knowledge of effects of certain substances on the human
body. According to regulators, the 1970s and 1980s involved enough cases of serious illness,
cardiac arrest, and infant deaths due to the increase of self-help dieting and parenting books. In
addition, manufacturers and nutritional products were increasing and expanding to include new
substances such as amino acids, which were starting to blur the lines more about what could be
considered health-enhancing, like a drug. Consumers and healthcare workers had reported l-
tryptophan supplements were connected to eosinophilia-myalgia syndrome, even though other
amino acids were increasingly being used by fitness enthusiasts for enhancing workouts and
physical body results. Ultimately, under the passage of NLEA in 1993, regulators authorized
health claims on nutritional supplement labels despite adverse cases in the public. The authorized
health claims allowed for food and nutritional supplements due to a relationship between specific
nutrients and certain health conditions if the claims were approved by the FDA under the Dietary
Supplement and Health Education Act (DSHEA), which was passed by U.S. Congress into law in
1994. Artificial/alternative sweeteners such as stevia and aspartame became popular as well as
various fruit, nut, and other plant-based oils and essences and needed to be defined under DSHEA
as well. Under DSHEA, consumers have certain protected rights. Nutritional supplements can be
defined as dietary and necessary for wellness promotion. Therefore, they can be considered as
food based on the intended use of the supplement.
The new millennium has considered past experiences of manufacturing practices and consumer
demand, justification for keeping a watchful eye on products, and single vitamin, mineral, and
botanicals picking up momentum in the market. Though the FDA does not have the authority to
impose safety regulations on products or single supplements, or the authority to recall them from
consumer use, they do have authority to warn the public when it could have the ability to collect
enough publicly known information to do so. Examples include ephedra, pinellia, mutong,
comfrey, and foxglove. In 2003, GMPs for the production of dietary supplements for safety from
heavy metals, improper raw materials, pesticides, microorganisms, and possibly endangered or
protected species were imposed by the FDA under the DSHEA.
Role of Liquid Dietary Supplements

ANNE COBLE VOSS, KATHLEEN E. MAYER, in Nutrition in the Prevention and Treatment of
Disease, 2001
V. SUMMARY
Medical nutritional supplements cost effectively improve outcomes across the continuum of care
as well as in different disease states. Disease-specific MNSs are specifically formulated and
scientifically studied to effectively help manage symptoms and improve outcomes. Concerns that
MNSs displace energy and nutrients from meals have not been substantiated by the research
reviewed in this chapter. Medical nutritional supplements are convenient and provide an
alternative to meals when time or medical symptoms are an issue. Demonstration of improved
outcomes with MNSs is an exciting area of research and can add to the health care provider's
arsenal of effective disease management options.
Nutritional, Herbal, and Homeopathic Supplements

Joel J. Gagnier, in Evidence-Based Management of Low Back Pain, 2012
Description
Nutritional supplements are products used to improve the diet and often contain vitamins,
minerals, herbs or amino acids. Nutritional supplements are often associated with CAM, which
encompasses a group of diverse medical and health care systems, practices, and products that are
not considered part of conventional medicine. The main types of nutritional supplements
reviewed here include herbal medicines, vitamins and minerals, and homeopathic remedies. The
use of nutritional supplements has gained popularity in recent years among individuals with
CLBP and these products are widely available in the United States. Supplements can be
purchased from a number of sources, including retail stores such as pharmacies, health food
stores, or grocery stores. Nutritional supplements can also be obtained directly from the health
care providers who prescribe their use, including some naturopaths, doctors of Chinese medicine,
homeopaths, chiropractors, and physicians.
Diabetes mellitus and sarcopenia

Pearl G. Lee, MengHee Tan, in Diabetes Mellitus, 2020
Nutrition therapy
Nutritional supplement may have some benefits to preserve muscle function, but the evidence
remains weak. A 13-week intervention of a vitamin D and leucine-enriched whey protein oral
nutritional supplement resulted in improvements in muscle mass and lower-extremity function
among older adults with sarcopenia [106]. Vitamin D declines with aging, and supplementation
enhances muscle function when deficient [107]. The five RCTs reviewed by Arai et al. [100]
involving older adults included the administration of essential amino acids, tea catechin,
combination of essential amino acids and tea catechin daily, and protein and essential amino acids
daily. However, the ability of this treatment approach to improve long-term outcomes is not yet
clear [100]. As a nutritional intervention, essential amino acid supplementation was observed to
be effective for improving knee extension muscle strength (0.11 Nm/kg 3 months after) [108].
However, no significant differences were observed with respect to skeletal muscle mass, fat free
mass, grip strength, knee extension muscle strength, gait speed or Timed Up and Go test
performance, which were examined in many combinations, including use of other nutritional
supplementation methods. These results showed that nutritional interventions extending for at
least 3 months might contribute to improvement in muscle strength. However, further studies to
confirm the findings are still needed.
Overview of Biologically Based Therapies in Rehabilitation
Susan Gerik, John Maypole, in Complementary Therapies for Physical Therapy, 2008
Macular Degeneration
Nutritional supplements such as lutein and zinc have contradictory evidence regarding their
potential health benefit; however, they are likely safe.100,101 Ginkgo biloba may help early-stage
macular degeneration according to a small preliminary study.102
Beta-carotene orally when combined with vitamin C, vitamin E, and zinc seemed to provide a
27% risk reduction for visual loss resulting from macular degeneration and may contribute to
arresting progression to advanced macular degeneration.103,104 Similarly, lutein seems to be
related to a lower risk of macular degeneration, particularly when it is consumed through dietary
intake.105 Taking 10-mg lutein per day for 12 months may improve some symptoms of macular
degeneration in preliminary trials.106
CALCIUM | Properties and Determination
K.A. Cockell, in Encyclopedia of Food Sciences and Nutrition (Second Edition), 2003
Supplements
Nutritional supplements and antacid medications can make a significant contribution to calcium
intakes for some people. Calcium supplements are available in a number of forms, including
carbonate, phosphate, lactate, or citrate salts of calcium, among others. Calcium carbonate is
found in many over-the-counter antacid preparations. Multivitamin and multimineral supplements
may also contain calcium, though frequently in smaller amounts. Natural source supplements
include oyster shell and dolomite, though it should be noted that concerns have been raised with
the potential for lead contamination of these forms. It has been estimated that, among supplement
users in the USA (who represent approximately 20% of the population), an average of 300 mg of
Ca per day is consumed from supplements. In addition, calcium-containing antacids, supplying
200–400 mg of Ca per tablet, are consumed by about 18% of USA adults.
Calcium: Properties and Determination

L.J. Harvey, in Encyclopedia of Food and Health, 2016
Supplements
Nutritional supplements and antacid medications can make a significant contribution to calcium
intakes for some individuals. Over 40% of the US population (including almost 70% of older
women) uses dietary supplements containing calcium. Calcium carbonate is found in many over-
the-counter antacid preparations, which can provide up to 400 mg of calcium per day. However,
calcium citrate, which is absorbed similarly when taken with or without food, is beneficial for
people with achlorhydria, inflammatory bowel disease, or absorption disorders. Other forms of
calcium in supplements or fortified foods include gluconate, lactate, and phosphate. Multivitamin
and multimineral supplements may also contain calcium, though usually in smaller amounts.
Natural source supplements include oyster shell and dolomite, although concerns have been raised
concerning the potential for lead contamination in both forms, along with aluminum, arsenic,
mercury, and nickel in the latter.
Respiratory disorders
Derek G. Waller BSc (HONS), DM, MBBS (HONS), FRCP, Anthony P. Sampson MA, PhD,
FHEA, FBPhS, in Medical Pharmacology and Therapeutics (Fifth Edition), 2018
Treatment of malabsorption
Nutritional supplements are important because of the frequency of fat malabsorption and impaired
absorption of fat-soluble vitamins. Pancreatic enzyme supplements (Pancreatin) are used from the
diagnosis of pancreatic insufficiency. Pancreatin contains protease, lipase and amylase, enzymes
which are inactivated by gastric acid and by heat. Supplements should be taken with food (but not
mixed with very hot food) and either with gastric acid suppression therapy (e.g. given 1 hour after
a histamine H2 receptor antagonist such as ranitidine; see Chapter 33) or as enteric-coated
formulations to protect them from gastric acid. Pancreatin preparations in clinical use are all of
porcine origin. Dosage is adjusted according to the size, number and consistency of stools.
Unwanted effects include irritation of the mouth and perianal skin, nausea, vomiting and
abdominal discomfort. Some higher-strength formulations of pancreatin should be avoided in
children under 15 years of age with cystic fibrosis, since they have been associated with the
formation of large bowel strictures.
Pancreatin is also used for pancreatic exocrine insufficiency following pancreatectomy,

gastrectomy or chronic pancreatitis.
Enteral Nutrition
Andrew R. Davies, Anthony J. Hennessy, in Critical Care Nephrology (Third Edition), 2019
Immunonutrition
Enteral nutrition products with a mixture of arginine, nucleotides, and omega-3 fatty acids have
been considered to modulate immune function and therefore considered “immunonutrition.”
Despite more than a decade of research, these products still remain controversial in critical care
practice as they appear to elicit harmful effects in patients with sepsis and septic shock.6 Of the
various substrates, arginine appears to be the sole culprit of the substrates; a recent study in
animals demonstrated the scientific rationale for the potential lethality of arginine in septic
shock.76
Given immunonutrition had no effect in the largest of all the heterogeneous ICU patient
studies,77 the pragmatic view is that if immunonutrition causes harm in septic patients
(presumably resulting from arginine), it therefore may have a beneficial effect in nonseptic
patients (presumably resulting from omega-3 fatty acids). The way of the future must be to study
the individual nutrients in specific disease states rather than the immunonutrition package in
heterogeneous populations.78 The present recommendation is not to administer immunonutrition
products containing arginine to ICU patients.
Abstract
Nutritional problems in children constitute the major health problem in developing countries.
Impact of a factors leading to different kinds of nutritional problems in developing countries are
reviewed. Prevention and treatment of some special disease states are discussed. Outlines for
some solutions to the greatest nutritional problems are presented.
PIP: Poor nutrition among children is the primary health problem plagueing developing countries.
The problem stems primarily from the social and economic inequalities extant in the world today
and could be ameliorated by reducing unemployment and urban migration through rural and
village level development keyed to the needs and desires of the community. The major nutritional
problems facing the developing countries are described and suggestions for preventing the
problems and for treating specific nutritional diseases are made. Major nutritional problems
include: 1) Maternal nutritional anemia; 2) protein energy malnutrition; 3) vitamin A deficiency;
4) lactation failure; 5) addiction to milk feeding; and 6) inadequate preparation and use of
artificial milk products. Maternal nutritional anemia increases the frequency of low weight births
in developing countries. Protein energy malnutrition afflicts approximately 100 million children
under the age of 5 and can permanently affect the physical and mental development of these
children. Vitamin A deficiency is one of the major causes of preventable blindness. The economic
loss resulting from preventable blindness is tremendous; this loss could be prevented by spending
only 10 cents a day to supplement the diet of each malnourished child. Lactation failure is
especially devasting for babies born to poor women and all practices, such as temporary bottle
feeding, which contribute toward lactation failure should be halted. Inappropriate use of artificial
milk products increases nutritional deficiency and gastrointestional problems among babies in the
developing countries.
Nutrition Problems and Their Solutions

If your appetite and taste have been affected by illness, medications or other health issues, you
may have trouble eating and getting proper nutrition. These changes can affect your overall
health. Here are tips to help get you the nutrition you need.
What are nutritional problems and how can they affect me?
A variety of medical problems can affect your appetite. Your illness, medicines or surgery can
cause these problems. Many people become frustrated when they know they need to eat to get
well but they aren't hungry, or when they gain weight because they are fatigued and unable to
exercise.
Each of the following sections describes a nutritional problem and suggests possible solutions.
Not all solutions will work for everyone. Talk with your healthcare provider if you have
questions.
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our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Decreased appetite
Lack of appetite, or decreased hunger, is one of the most troublesome nutrition problems you can
experience. Although it's a common problem, its cause is often unknown. Appetite-stimulating
medicines are available. Ask your provider if such medicines would help you.
Solutions:
Eat smaller meals and snacks more frequently. Eating six or seven or eight times a day might be
more easily tolerated than eating the same amount of food in three meals.
Talk to your provider. Sometimes, poor appetite is due to depression, which can be treated. Your
appetite is likely to improve after depression is treated.
Avoid non-nutritious beverages such as black coffee and tea; instead choose milk and juices.
Try to eat more protein and fat, and less simple sugars.
Walk or participate in light activity to stimulate your appetite.
Meal guidelines
Drink beverages after a meal instead of before or during a meal so you do not feel as full.
Plan meals to include your favorite foods.
Try eating the high-calorie foods in your meal first.
Use your imagination to increase the variety of food you're eating.
Take advantage of times of the day when your appetite is best. For example, some people have a
better appetite in the morning and can eat a larger breakfast.
Snack guidelines
Don't waste your energy eating foods that provide little or no nutritional value (such as potato
chips, candy bars, colas and other snack foods).
Choose high-protein and high-calorie snacks.
Dining guidelines
Make food preparation an easy task. Choose foods that are easy to prepare and eat.
Make eating a pleasurable experience, not a chore.
Liven up your meals by using colorful place settings.
Play background music during meals.
Eat with others. Invite a guest to share your meal or go out to dinner.
Use colorful garnishes such as parsley and red or yellow peppers to make food look more
appealing and appetizing.
Weight loss
If your doctor tells you that you have lost too much weight, or if you are having difficulty
maintaining a healthy weight, here are some tips:
Drink milk or try one of the "high-calorie recipes" listed below instead of drinking low-calorie
beverages.
Ask your doctor or dietitian about nutritional supplements. Sometimes, supplements in the form
of snacks, drinks (such as Ensure® or Boost®), or vitamins might be prescribed to eat between
meals. These supplements help you increase your calories and get the right amount of nutrients
every day. Note: Do not use supplements in place of your meals.
Avoid low-fat or low-calorie products unless you have been given other dietary guidelines. Use
whole milk, whole milk cheese and yogurt.
Use the "Calorie Boosters" listed below to add calories to your favorite foods.
High-calorie snacks
Ice cream.
Cookies.
Pudding.
Cheese.
Granola bars.
Custard.
Sandwiches.
Nachos with cheese.
Eggs.
Crackers with peanut butter.
Bagels with peanut butter or cream cheese.
Cereal with half and half.
Fruit or vegetables with dips.
Yogurt with granola.
Popcorn with margarine and parmesan cheese.
Bread sticks with cheese sauce.
High-calorie recipes
Chocolate Peanut Butter Shake
1/2 cup heavy whipping cream

3 tablespoons creamy peanut butter
3 tablespoons chocolate syrup
1 1/2 cups chocolate ice cream
Directions:
Put all ingredients into a blender. Mix well.

Makes one serving; 1090 calories per serving.
Super Shake
1 cup whole milk

1 cup ice cream (1-2 scoops)
1 package Carnation Breakfast Essentials® (formerly Carnation Instant Breakfast)
Directions:
Super Pudding
2 cups whole milk

2 tablespoons vegetable oil
1 package instant pudding
3/4 cup non-fat dry milk powder
Directions:
Blend milk and oil. Add pudding mix and mix well. Pour into dishes (1/2 cup servings).
Makes four 1/2 cup servings; 250 calories per serving.
Great Grape Slush
2 grape juice bars

1/2 cup grape juice or 7-Up
2 tablespoons corn syrup
1 tablespoon corn oil
Directions:
Calorie Boosters
Egg yolk or whole egg
Before cooking, add egg yolk or whole egg to foods such as meat loaf, rice pudding or macaroni
and cheese.
(To prevent illness, avoid the use of uncooked eggs.)
Non-fat powdered milk or undiluted evaporated milk

Add to beverages (including milk) or to these foods:
Creamed soups, yogurt.

Scrambled eggs, casseroles.
Pudding mashed potatoes.
Custard gravies.
Hot cereal sauces.
Cream cheese or shredded, melted, sliced, cubed or grated cheese
Add to sandwiches, snacks, casseroles, crackers, eggs, soups, toast, pasta, potatoes, rice or
vegetables, or serve as a snack.
Vegetable oils, mayonnaise, butter, margarine or sour cream
Add margarine or mayonnaise to sandwiches. Add any of these items to bread, casseroles, soups,
eggs, cooked cereals, pasta, potatoes, rice, vegetables or pudding.
Peanut butter (creamy or crunchy)
Spread on bread, crackers, apples, bananas or celery. Or add to cereal, custard, cookies or milk
shakes.
Nut "dust" (Grind any type of nuts in a blender or food processor.)
Add to puddings, gravy, mashed potatoes, casseroles, salad or yogurt cereals.
Miscellaneous foods (Limit to one serving per day.)
Add:
Sugar, jelly, jam, preserves.

Honey.
Corn syrup.
Maple syrup.
To:
Hot cereal.
Fruit.
Sweet potatoes.
Winter squash, cold cereal, fruit salad.
Heartburn
Heartburn can occur for many reasons, including overeating, eating certain foods, taking
medicines or as a result of surgery.
Solutions:
Avoid foods that have caused heartburn before. Some foods commonly associated with heartburn
are highly seasoned foods, greasy or fried foods, chocolate, alcohol and beverages that contain
caffeine (coffee, tea and soft drinks).
Eat five or six smaller meals a day instead of three large meals. Decreasing the amount of food in
your stomach eases digestion and reduces the chances of heartburn.
Remain standing or sitting for at least two hours after eating. If you lie down, keep your upper
body raised at a 45-degree angle.
Eat your last meal several hours before going to bed.
Take an antacid one hour after meals to relieve heartburn. You can also try taking antacids before
going to bed. If you take antacids frequently, tell your doctor or dietitian.
Changes in how food tastes
How food tastes often determines what you like to eat. If food begins to taste different — if it
becomes too sweet, too bland, bitter or metallic-tasting — your appetite can be affected.
Medicines often cause these taste changes.
Solutions:
Brush your teeth after meals and snacks. Good oral hygiene helps control bad taste. Ask your
doctor or dietitian if using a mouthwash would help.
Cold or room-temperature food might taste better.
Eat alternatives to red meat. Try turkey, chicken, fish, eggs or dairy products such as yogurt,
cheese or cottage cheese.
Use marinades to add flavor to poultry, red meat or fish. Fruit juice, teriyaki sauce, Italian
dressing, beer or wine will also add flavor.
Add spices, such as herbs, onions, bacon bits or almonds to flavor plain foods.
Use strong seasonings to improve the flavor of meats and vegetables. Rosemary, oregano, basil,
tarragon or mint are good options.
Eat snacks that leave a refreshing, pleasing aftertaste: fresh fruit, chewing gum, hard candy or
cinnamon, or mint-flavored foods or beverages.
Sore mouth or throat
A sore mouth or throat can make eating difficult. Medicines or mouth infections can cause
soreness.
Solutions:
Eat bland, mild-flavored foods. Spicy or salty foods can irritate soreness.
Eat lukewarm or cold foods. Hot food can irritate soreness.
Puree foods before you eat them. Most cooked foods can be pureed in a blender or food
processor.
Avoid carbonated beverages or drink them only after they have gone flat. Carbonation can irritate
soreness.
Drink soups or other liquids from a straw or a cup instead of a spoon to keep foods away from
sore spots in your mouth.
Talk with your provider about using an anesthetic mouthwash to help relieve discomfort.
Have your provider examine your mouth to see whether you have a fungal infection. Such
infections are treatable and often occur in people who are ill, especially those taking steroids or
antibiotics.
Avoid rough foods that might be hard to swallow, such as hard breads, toast, popcorn, raw
vegetables, nuts and seeds.
Eat soft foods that are easy to chew. Try casseroles, meat with gravy, mashed potatoes, cooked
cereal, ice cream, eggs, pudding or cottage cheese.
Eat foods that are less acidic. Try bananas, canned pears and peaches, applesauce or fruit nectars.
Avoid tomatoes, oranges, grapefruits and pineapples.
Drink plenty of liquids all day to keep your throat moist and to help prevent dehydration. Try
milk shakes, eggnog, juices and soups.
Dryness in the mouth
Dryness in the mouth can make certain foods more difficult to eat. Fever, medicines, or mouth
infections can cause dryness.
Solutions:
Drink eight or more cups of liquid each day; 10 or more cups if you are feverish.
Dunk or moisten breads, toast, cookies, or crackers in milk, hot chocolate, or coffee to soften
them.
Take a drink after each bite of food to moisten your mouth and to help you swallow.
Add sauces to foods to make them softer and more moist. Try gravy, broth, sauce, or melted
butter.
Eat sour candy or fruit ice to help increase saliva and moisten your mouth.
Don't use a commercial mouthwash. Commercial mouthwashes often contain alcohol that can dry
your mouth. Ask your doctor or dentist about alternative mouthwash products.
Ask your doctor or dentist about artificial saliva products. These products are available by
prescription.
Nausea
Nausea (an upset or "queasy" stomach) is a feeling of sickness that is sometimes accompanied by
vomiting. Medicines, pain, constipation or the flu can cause nausea. Many medicines are available
to treat nausea. Ask your provider if there is a medicine that can help you.
Solutions:
Eat dry foods when you wake up and every few hours during the day. Nausea is often worse on an
empty stomach, and dry foods can relieve some of the discomfort. Try pretzels, plain crackers or
cookies, dry cereal or toast.
Drinking liquids on an empty stomach can add to the feeling of nausea. Try sipping beverages
slowly during your meals or drinking 30 to 60 minutes after eating solid foods.
If the smell of food bothers you, avoid foods with unpleasant or strong odors. Eat somewhere
other than the kitchen, where the odors might be strongest.
Avoid greasy, fried or spicy foods. These foods take longer to digest and can make you feel
bloated, uncomfortable and more nauseous.
Avoid large meals and infrequent meals. The smaller and more frequent your meals and snacks
are, the more comfortable you will be.
Eat foods and supplements that are high in calories and protein to maintain your nutrition when
you cannot eat a lot.
It is important to replace liquids if vomiting occurs. If you can, drink eight or more cups of liquid
each day. Add an additional 1/2 cup to 1 cup of liquid for each episode of vomiting.
Fresh ginger is sometimes helpful in reducing nausea. Do not eat fresh ginger if you are taking
anti-coagulant (blood-thinning) medicines, such as warfarin (Coumadin®). Also do not eat fresh
ginger prior to surgery.
Avoid your favorite food when you have nausea so you don’t create an aversion to that food.
Diarrhea
Diarrhea is an increase in either the number of stools, the amount of liquid in the stools, or both.
Medicines, a reaction to certain foods, stress, and ordinary colds or flu can cause diarrhea.
Prolonged diarrhea can cause dehydration, weakness, fatigue and weight loss. When you have
diarrhea, important nutrients such as calories, protein, vitamins, water, sodium and potassium are
lost. This loss can be serious if you are already ill or trying to recover from an illness. Your
provider must know the cause of diarrhea to treat it correctly.
Try the following solutions for two days. If after that time you are still having diarrhea, call your
provider. Liquids and nutrients are lost quickly, and treatment must begin before prolonged
diarrhea causes harm.
Solutions:
Drink eight or more cups of liquids per day.
Add one to two cups of liquids to the daily eight cups for every episode of loose, watery stool to
replace losses.
Talk with your doctor or dietitian about increasing or decreasing the amount of fiber you eat.
Drink a variety of beverages to help replace lost liquids and nutrients. Try water, coffee, tea, iced
tea, lemonade or fruit-flavored drinks, fruit or vegetable juice, broth, milk, cream soup or a sports
drink with electrolytes.
Eat soft foods that contain large amounts of liquid, such as sherbet, gelatin, yogurt and pudding.
Use less sugar and fat. Limiting sugar and fat might decrease the amount of water in the intestine
and reduce the number of episodes of diarrhea.
Ask your provider whether adjusting your medicines might help relieve the diarrhea. Do not
change your medicines without first talking to your provider.
Don't take over-the-counter (non-prescription) drugs for diarrhea without talking to your provider.
Constipation
Constipation occurs when bowel movements become difficult or infrequent, usually more than 48
hours apart. Constipation can be caused by medicines and by not drinking or eating enough
liquids or food, and inactivity.
Solutions:
Drink eight or more cups of fluids per day, such as water, coffee, tea, juice or flavored beverages.
Drink something hot as the first beverage in the morning, such as hot water, coffee, tea or hot
apple cider. Hot liquids might stimulate a bowel movement.
Drink 1/2 to 1 cup of prune juice in the morning to stimulate a bowel movement.
Increase the fiber in your foods. Try whole grain breads, fresh fruits, whole grain cereals and
fresh vegetables.
Emphasize fruits that stimulate the bowels, such as watermelon, plums and other summer fruits,
and avoid fruits that constipate, such as bananas.
Add two to four tablespoons of unprocessed wheat bran to foods and drink plenty of liquids.
(Liquids help bran to be effective.) Try bran sprinkled over hot or cold cereal, casseroles, or
mixed with applesauce, pancake batter, pudding, muffin batter, milk shakes or cookie dough.
Activity such as walking helps normalize bowel function.
Plan trips to the bathroom immediately after meals since eating is a natural stimulus for having a
bowel movement.
If constipation continues, call your provider, who might prescribe a stool softener or laxative.
Don't take any medicines, including over-the-counter (non-prescription) medicines, to treat
constipation without talking to your provider.
Weakness in the muscles of your mouth might make it difficult for you to chew and manage solid
foods. A delay in the swallowing process in either your throat or pharynx (the digestive tube
between the esophagus and mouth) might also make it difficult for you to swallow without
coughing or choking.
Solutions:
Swallow evaluation: Ask your provider about a swallowing evaluation to determine safest
swallow techniques.
Positioning: Sit upright at a 90-degree angle, tilt your head slightly forward, and/or remain sitting
or standing upright for 45 to 60 minutes after eating a meal.
Dining environment: Minimize distractions in the area where you eat. Stay focused on the tasks
of eating and drinking. Do not talk with food in your mouth.
Amount and rate: Eat slowly. Cut your food into small pieces and chew it thoroughly. Do not try
to eat more than 1/2 teaspoon of your food at a time.
Swallowing: You might need to swallow two or three times per bite or sip. If food or liquid
catches in your throat, cough gently or clear your throat, and swallow again before taking a
breath. Repeat if necessary.
Concentrate on swallowing frequently: It might help to alternate a bite of food with a sip of
liquid. If you have difficulty sucking liquid all the way up a straw, cut the straw down so there is
less distance for the liquid to travel. Change the temperature and texture of liquids. (Make the
liquids colder. Try carbonated beverages.)
Saliva management: Drink plenty of fluids. Periodically suck on popsicles, ice chips, lemon ice
or lemon-flavored water to increase saliva, which will increase swallowing frequency.
Difficulty chewing: If chewing is difficult or tiring, minimize (or eliminate) foods that require
chewing, and eat more soft foods. Puree your foods in a blender.
Coughing: If thin liquids cause you to cough, use a liquid thickener. (Your speech pathologist
can recommend one for you.) You can also substitute thin liquids with thicker liquid choices such
as nectars for juices and cream soups for plain broths.
Taking medicines: Crush your pills and mix them with applesauce or pudding. Ask your
pharmacist for recommendations on which pills should not be crushed and which medicines can
be purchased in a liquid form.
Objective
• To know the various method brand of gym movers towards the nutrition product
available in Ghazipur city
• To know the consumer purchase decision towards nutrition product
• To analyses factors that influence the purchase decision of consumers
• To mprove cardiorespiratory and muscular fitness. Decrease levels of body fat.

Reduce symptoms of depression. Improve cognitive skills.
Scope
• To find out the problem regarding and non-selling of some brands which have
good market potential.
• To increase the knowledge of sales to person influence consumer to buy product.

• To understand how factor like "How,when,why,what, who effects in what way.
Importance
• The study will help the marketers to sale of nutrition product to create focused market strategic
• This will help to understand the consumers decision towards the purchase of nutrition product
and their satisfaction.
• This help to understand the basic purchase termilogics based on different situation
Research Methodology
Methodology for Selection and Interpretation of Health-Related Fitness Measures

in Youth
This chapter describes the methodology followed by the committee in reaching

conclusions and making recommendations on the most appropriate health-related
physical fitness test items for youth. Before reviewing the scientific literature, the
committee developed a conceptual framework to illustrate its thinking on the
theoretical associations among the various components of fitness, their modifiers,
and relevant health markers. The chapter begins by describing this framework. It
then describes the committee’s approach to the selection of test items for each of
the four fitness components—body composition, cardiorespiratory endurance,
musculoskeletal fitness, and flexibility. Included is a description of the literature
review and the set of criteria that guided the selection process. The next section
examines potential modifiers of fitness or of the associations between fitness and
health, examples of which are included in the committee’s conceptual framework.
Just as the extent of the evidence on the association of each fitness component and
test item with health markers varies, so, too, does the evidence for the effect of
potential modifying factors. In general, there is more evidence on the importance of
gender and age, while less is known about the effect of developmental maturity,
motor skill, and practice. Similarly, there is a dearth of information about the
influence of some demographic factors, such as ethnicity and race or socioeconomic
status, on performance on fitness tests and its interaction with health markers. The
final section of the chapter presents the committee’s guidance for establishing cut-
points (cutoff scores) for use in interpreting the results of youth fitness tests.
Interpretation of test results is one of the
Suggested Citation:"3 Methodology for Selection and Interpretation of Health-

Related Fitness Measures in Youth." Institute of Medicine. 2012. Fitness Measures
and Health Outcomes in Youth. Washington, DC: The National Academies Press.
doi: 10.17226/13483.×
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most crucial aspects of such testing because it serves as a way of communicating
with participants, health and school officials, and parents about their risk of
negative health outcomes based on test performances.
CONCEPTUAL FRAMEWORK
To illustrate the overall challenge of its task and create a model for physical fitness
measures that are most clearly associated with health outcomes in youth, the
committee developed a conceptual framework (Figure 3-1). This framework guided
the committee’s analysis of research findings. Figure 3-1 depicts the potential
relationships between physical fitness components—which can be measured by a
variety of fitness test items represented by the smaller embedded boxes—and
markers of health.
As illustrated in Figure 3-1, these relationships can be affected by both modifying

factors and risk factors. As defined by the committee, modifying factors are those
that can independently affect an individual’s level of fitness. They include both
factors that are measurable in the field (e.g., gender, race, ethnicity, maturity) and
those that are not (e.g., heredity, practice level, skill level). Likewise, health
outcomes are modified by certain risk factors that characterize an individual (e.g.,
low HDL cholesterol is a risk factor for cardiovascular disease). In the case of
youth, health outcomes (i.e., diseases or conditions) are defined in terms of health
markers or risk factors since youth are unlikely to experience a disease or condition
(e.g., heart disease) as a result of their fitness level. The potential health outcomes
that result from a specified level of performance on a fitness test are depicted within
five categories: four categories of (positive or negative) markers of health-related
outcomes (i.e., cardiovascular/respiratory health, metabolic health and obesity,
mental and cognitive health, and musculoskeletal health) and a category that
includes adverse events. Note that in this report, the terms health marker and health
risk factor are used in a broad sense and interchangeably to refer to indicators of
health outcomes.
The committee included body composition as a component of fitness, even though
perspectives on this categorization vary. Body composition is also considered a
modifier of performance on fitness tests and a health marker. Thus, it appears in all
three categories of variables in the framework—fitness components, modifying
factors, and health markers—and is highlighted in a different color from that of the
other fitness components because of this unique nature.
The next section describes the approach used by the committee to select the best
youth fitness test items, considering (1) the strength of their association with health
markers in youth, (2) their integrity (validity and reliability), and (3) the relative
feasibility of their administration in the field.

doi: 10.17226/13483.×
Figure Physical fitness measures and health outcomes: Conceptual framework.

NOTE: The variety of fitness tests that can measure a particular fitness component
is represented by the embedded boxes under each component.

doi: 10.17226/13483.×
SELECTION OF APPROPRIATE FITNESS TEST ITEMS
Review of the Literature
The committee used various resources to collect scientific data to inform its
selection of fitness test items. A main source of information for the committee was
a systematic review of the literature conducted by the Centers for Disease Control
and Prevention (CDC). The CDC search criteria and vocabulary are described in
Box 3-1. The committee supplemented this systematic search with selected
publications based on the members’ knowledge of the scientific literature.
For the purposes of its review, the CDC defined health as a “human condition with
physical, social, and psychological dimensions, each characterized as a continuum
with positive (i.e., the absence of disease, along with a capacity to enjoy life and
withstand its challenges) and negative (i.e., illness and premature death) aspects.”
The CDC defined health-related fitness as the fitness components that have an
association with health-related outcomes and are typically identified as aerobic
fitness (i.e., cardiorespiratory endurance), muscular strength, muscular endurance,
body composition, flexibility, and balance. Only the literature on cardiorespiratory
endurance, muscle strength, and muscle endurance was examined systematically,
further selected based on the inclusion/exclusion criteria presented in Box 3-1, and
abstracted (only experimental and longitudinal studies were abstracted). The CDC
considered that the relationship between body composition and health outcomes is
well established and therefore conducted a systematic review of it only as a health
outcome. Although the CDC performed a systematic search for flexibility, the
articles on this component were not abstracted because of limited time and
resources. When studies addressing cardiorespiratory endurance or musculoskeletal
strength or endurance also included flexibility as a fitness component, however, the
CDC abstracted such information. A breakdown of the total number of studies that
satisfied the CDC search criteria in Box 3-1 and were abstracted is as follows:
Cardiorespiratory endurance: 47 experimental, 29 quasi-experimental, 35
experimental (no control), 24 longitudinal
Musculoskeletal strength: 23 experimental, 12 quasi-experimental, 22 experimental
(no control), 6 longitudinal
Musculoskeletal endurance: 12 experimental, 6 quasi-experimental, 15
experimental (no control), 5 longitudinal
Flexibility: 7 experimental, 5 quasi-experimental, 9 experimental (no control), 4
longitudinal
Page 53
doi: 10.17226/13483.×
Identification and Selection of Test Items
The committee followed the criteria listed in Box 3-2 in a stepwise fashion to select
test items for the various components of fitness. Although the search for studies on
tests measuring musculoskeletal strength and endurance was conducted separately
by the CDC, the committee discusses those tests in Chapter 6 since they all measure
dimensions of the same component, musculoskeletal fitness. As Box 3-2 shows, the
committee applied five broad criteria in filtering and selecting the best test items for
each fitness component: (1) the test item has been described and is currently being
utilized; (2) the quality of the research of individual studies showing the
relationship between a test item and a health marker is high; (3) based on all the
evidence, there is an association between performance on the test item and one or
more health markers; (4) the test item has adequate integrity (validity and
reliability); and (5) administering the test item in the field is feasible.
The selection of high-quality studies for cardiovascular endurance, musculoskeletal

fitness, and flexibility test items was based on the following criteria: (1) study
design (e.g., randomized controlled trials versus longitudinal studies), (2)
representativeness of the population (e.g., age range), (3) freedom from bias, (4)
sample size, (5) validity of health markers, (6) adequacy of description of the
intervention, (7) relationship between performance on the test item and one or more
health markers, (8) statistical rigor, and (9) adjustment for confounders. Limitations
of the scientific literature with regard to these criteria are described in the chapters
on the fitness components that were assessed for their relationship to health in
youth (Chapters 5, 6, and 7).
Attempting to find associations between performance on fitness tests and health in

youth entails important limitations that can help in understanding the committee’s
approach to reviewing the evidence. In addition to challenges inherent in using
field-based (as opposed to laboratory-based) fitness tests, two important challenges
arise in analyzing associations between fitness performance and health in youth.
First, health constructs in youth are not as well defined as they are in adults; for
example, there are questions about whether elevated blood pressure in youth is
directly associated with a poor health outcome. Second, diseases that typically are
related to low levels of fitness in adults are found with low frequency in youth;
therefore, finding an association between performance on fitness tests and health in
youth is not highly probable, particularly in studies with small sample sizes.
Consequently, studies that investigate the association between performance on a
fitness test and health in youth often use health markers rather than health outcomes
as health variables. Finding health markers with good ability to predict a future
negative health outcome is in itself difficult. Although biological significance and
strength of association are typical
Date analysis & Interpretation
Data analysis and interpretation is the process of assigning meaning to

the collected information and determining the conclusions, significance,
and implications of the findings. ... The standard deviation, in
conjunction with the mean, provides a better understanding of the data.
Data analysis and interpretation is the process of assigning meaning to

the collected information and determining the conclusions, significance,
and implications of the findings. The steps involved in data analysis are a
function of the type of information collected, however, returning to the
purpose of the assessment and the assessment questions will provide a
structure for the organization of the data and a focus for the analysis.
The analysis of NUMERICAL (QUANTITATIVE) DATA is represented

in mathematical terms. The most common statistical terms include:
Mean – The mean score represents a numerical average for a set of

responses.
Standard deviation – The standard deviation represents the distribution of
the responses around the mean. It indicates the degree of consistency
among the responses. The standard deviation, in conjunction with the
mean, provides a better understanding of the data. For example, if the
mean is 3.3 with a standard deviation (StD) of 0.4, then two-thirds of the
responses lie between 2.9 (3.3 – 0.4) and 3.7 (3.3 + 0.4).
Frequency distribution – Frequency distribution indicates the frequency
of each response. For example, if respondents answer a question using an
agree/disagree scale, the percentage of respondents who selected each
response on the scale would be indicated. The frequency distribution
provides additional information beyond the mean, since it allows for
examining the level of consensus among the data.
Higher levels of statistical analysis (e.g., t-test, factor analysis,
regression, ANOVA) can be conducted on the data, but these are not
frequently used in most program/project assessments.
The analysis of NARRATIVE (QUALITATIVE) DATA is conducted by

organizing the data into common themes or categories. It is often more
difficult to interpret narrative data since it lacks the built-in structure
found in numerical data. Initially, the narrative data appears to be a
collection of random, unconnected statements. The assessment purpose
and questions can help direct the focus of the data organization. The
following strategies may also be helpful when analyzing narrative data.
Focus groups and Interviews:
Read and organize the data from each question separately. This approach
permits focusing on one question at a time (e.g., experiences with
tutoring services, characteristics of tutor, student responsibility in the
tutoring process).
Group the comments by themes, topics, or categories. This approach
allows for focusing on one area at a time (e.g., characteristics of tutor –
level of preparation, knowledge of content area, availability).
Documents
Code content and characteristics of documents into various categories
(e.g., training manual – policies and procedures, communication,
responsibilities).
Observations
Code patterns from the focus of the observation (e.g., behavioral patterns
– amount of time engaged/not engaged in activity, type of engagement,
communication, interpersonal skills).
The analysis of the data via statistical measures and/or narrative themes
should provide answers to the assessment questions. Interpreting the
analyzed data from the appropriate perspective allows for determination
of the significance and implications of the assessment.
Finding & Recommendation
Recommendations should be one-sentence, succinct, and start

with an action verb (create, establish, fund, facilitate, coordinate,
etc.). They should use a “SMART” format (Specific,
Measurable, Attainable, Realistic, Timely). Each
recommendation should be followed by a few sentences of
explanatory text.
Formulate Findings and Recommendations

The next step involves proposing solutions to address constraints
or opportunities uncovered during analysis. Keep in mind that
you’re constructing an argument—a narrative that nudges key
stakeholders toward a set of proposed recommendations. Your
argument will be vetted and challenged and it’s likely that
choices will have to be made regarding which recommendations
can be implemented. That said, it’s important to remember that
you’re providing data for decision making and proposing
changes, so you’ll need to back up your advice with good
reasoning.
2.1 Findings
Findings emerge from the qualitative and quantitative analyses.
Findings are typically divided into sections by technical area,
following the outline established in the field guide. Be sure to
highlight gender-relevant findings. Furthermore, be prepared for
new or surprising findings that may emerge, as these may require
modifications to the original outline. Every assessment report
includes a description of the private health sector, sometimes
referred to as the private sector “landscape.” Though there are
many ways the information can be presented, it is useful to have
a visual graphic to illustrate the myriad actors and organizations.
Key questions to be addressed in the description of the private

health sector include:
Who are the key actors in the private health sector?

What specific health services and products are delivered by
private providers? At what price?
What population groups do they serve (gender, income,
urban/rural, special groups)?
How is the private health sector organized? What are the
linkages with the overall health system?
What are the sources of private health expenditures?
2.2 Recommendations
Recommendations are arguably the most important part of the

analysis phase—this is where you’ll suggest specific
interventions or strategies to address the issues and constraints
identified in the assessment.
Recommendations should directly respond to key findings
arrived at through data collection and analysis. A process of
prioritization is essential to narrowing down findings, and once
this is done, recommendations should be developed that align
with the most important findings. Use the abbreviated Gender
Analysis and Integration Matrix (GAIM) on 1.4 to prioritize
gender findings and determine at which level(s) you may wish to
intervene. Will your resulting program/project/strategy address a
root cause? Will it seek to accommodate or transform existing
gender norms?
Reviewing previous assessment reports may be helpful at this

stage, to learn what strategies were recommended to address
specific private sector constraints in other countries. This table
synthesizes key problems affecting service delivery in the private
sector, drawing from previous assessments, and links them to
potential interventions.
RESOURCE ► When examining the supply chain in Nigeria,

our assessment team identified weak regulation of drug vendors
as a main area of concern. This lack of enforcement was
compromising drug quality without increasing access where it
was most needed. Given this finding, we proposed designing a
pilot pharmaceutical network that would achieve the following:
Create a new scope of practice, with higher training levels but a

larger range of products and services authorized, with
supervision by pharmacists.
Conduct pooled procurement and distribution for network
members
Increase access to credit to establish and expand business
Strengthen supervision and quality monitoring of retail outlets by
a network franchisor
Conduct joint branding of all pharmacies in the network to
promote quality and increase clientele
Recommendations should be one-sentence, succinct, and start
with an action verb (create, establish, fund, facilitate, coordinate,
etc.). They should use a “SMART” format (Specific,
Measurable, Attainable, Realistic, Timely). Each
recommendation should be followed by a few sentences of
explanatory text.
In addition to being “SMART,” recommendations should be

feasible. Both operational feasibility and political feasibility (i.e.,
political will) should be considered when developing
recommendations. Experience has demonstrated that gauging
potential public sector receptivity to proposed private health
sector initiatives is essential.
A final consideration for recommendations is timing. Often

solutions to identified problems are sequential, building upon
intermediate steps. Teams sometimes frame recommendations as
near-term (e.g., 6 to 12 months) and longer term (e.g., one to
three years). This example from the Tanzania assessment report
illustrates near-term and longer-term recommendations.
Recommendations are typically summarized in the Executive

Summary, and presented in full within specific technical
sections, usually as a short list of bullets following the findings
summary. In some reports, there may be a section at the end of
the document that consolidates recommendations and highlights
the linkages across core areas (e.g., service delivery and health
financing) prior to the conclusion section.
TIP ► Recommendations stem from the findings. Link each of
your recommendations to the finding that supports it, to highlight
the direct connection between assessment and action. You can
show this link visually by using a two-columned table: the first
column lists the finding, and the respective recommendation is
listed adjacently in the second column.
2.3 Distilling Key Findings and Recommendations

By now it may be clear that private health sector assessments
generate a high volume of information. One of the challenging
aspects of conducting this type of assessment is sorting through
the voluminous information, weighing the relative import of each
finding, and determining which findings to highlight in terms of
their impact on private sector involvement in health. This process
of selecting the key findings is followed by developing
corresponding recommendations for improving or increasing the
private health sector’s role, or otherwise facilitating an
appropriate role for the sector.
SHOPS developed a template to help the assessment team assign

priority levels to the specific issues they have identified in the
analysis step. The team should work together to arrive at shared
judgments regarding the priority order of the top three to five
issues in each core area (i.e., Environment, Financing, Service
Delivery, Supply Chain, and Demand). Next, the team can record
the key determinants or causes of the main issues, either from
earlier root cause analysis, or from team brainstorming at this
time. This work should facilitate generating potential solutions to
address the causes behind the issues identified, which can be
entered in the column on the right
.
Conclusion & Limitations
• The sample area sample size has been limited due to time
constraints
• All the observation and recommendation will be made on

the feedback obtained from survey.
• The Meeting recognized that good nutrition is

fundamental for children’s current and future health, as
well as their development and learning. The benefits of
developing healthy dietary and lifestyle patterns from an
early age onwards can positively impact on people’s
nutrition and health throughout their adult lives, and
enhance the productivity of individuals and nations.
Nutrition education is an important element in an overall
strategy aimed at improving food security and preventing
all forms of malnutrition. Schools (from pre-school to
secondary) are ideal settings for promoting lifelong
healthy eating habits and lifestyles.
132. Most countries in the region implement school health

and nutrition programmes, including school feeding,
deworming, vitamin and mineral supplementation, etc.
Innovative, creative and effective school nutrition
education programmes exist in some countries in the
region. However, these are often small-scale and
implemented as pilot projects, focus on children with
special needs and prioritize the transfer of knowledge over
the promotion of active learning and the creation of
appropriate attitudes, life skills and behaviors. Generally,
nutrition education is not systematically integrated into
school curricula in the region.
Recommendations for country action
133. In order to build a comprehensive and sustainable

school nutrition programme that addresses all forms of
malnutrition, the Meeting recommended that countries:
Consolidate and strengthen ongoing school based nutrition

programmes, aiming at improved nutritional status and
learning of school children and creating an appropriate
learning environment through nutrition education, school
gardening and school meals, nutritional assessment, clean
water and sanitation, as well a physical activity education.
Apply a multi-disciplinary and multi-stakeholder holistic
approach to support effective school based nutrition
programmes and policies at national and local levels.
Promote the active involvement of parents, communities
and local government in the development and
implementation of school nutrition programmes.
Advocate for the integration of nutrition education into the
school curriculum for all age groups.
Promote the integration of nutrition training into the
course curriculum of teacher’s training institutes.
Review existing teaching/learning materials on school
nutrition education and promote the adaptation of
available, or the development of new materials in line with
local needs and conditions.
Promote the establishment of school gardens as an integral
part of school nutrition programmes.
Explore opportunities for appropriate public private
partnerships to support health and nutrition education and
improvements in the school environment.
Explore funding opportunities among bilateral, multi-
lateral donors and NGOs.
Encourage countries to work towards making all schools
nutrition-friendly with adequate political commitment and
funding.
Ensure that nutrition education in schools always applies
the tri-partite curriculum approach (i.e. link nutrition
education in the classroom with learning in the school
environment, home and community).
Nutrition education should always employ a wide range of
hands-on teaching/learning methods.
Bibliography
http://www.amazon.com/
http://www.bodybuilding.com/
http://www.gnc.com/
http://www.optimumnutrition.com/
http://www.vitaminshoppe.com/
http://www.tigerfitness.com/
http://www.netrition.com/
http://www.muscletech.com/
http://www.a1supplements.com/
Questioner
1. A substance needed by the body for growth,

energy, repair and maintenance is called a
_______________.
A: nutrient
B: carbohydrate
C: calorie
D: fatty acid
2. All of the following are nutrients found in food

except _____.
A: plasma
B: proteins
C: carbohydrates
D: vitamins
3. A diet high in saturated fats can be linked to

which of the following?
A: kidney failure
B: bulimia
C: anorexia
D: cardiovascular disease
4. Amylases in saliva begin the breakdown of

carbohydrates into __________.
A: fatty acids
B: polypeptides
C: amino acids
D: simple sugars
5. Your body needs vitamins and minerals

because ___________.
A: they give the body energy
B: they help carry out metabolic reactions
C: they insulate the body’s organs
D: they withdraw heat from the body
6. Food passes through the stomach directly by

_________.
A: the large intestine
B: the small intestine
C: the heart
D: the pancreas
7. About half of your diet should be made up of

__________.
A: grains and vegetables
B: fruits and milk
C: milk and cheese
D: fats and sugars
8. A mineral that the body needs to work properly

is _____________.
A: calcium
B: silver
C: gold
D: lead
9. According to the MyPyramind food guidance

system, a person should obtain most of their fat
from ____________.
A: beef, chicken, and fish
B: vegetables oils, nuts, and fish
C: fats, oils, and sweets
D: milk, yogurt, and cheese
10. A(n) ___________ is a unit of energy that

indicates the amount of energy contained in food.
A: label
B: food guide pyramid
C: calorie
D: basket
11. This food group is our body’s best

source of energy?
A. Meat Group
B. fats,oils and sweets
C. breads and cereals
D. milk and cheese
12. Which of these is NOT considered a

nutrient?
A. vitamins
B. minerals
C. fiber
D. fats
13. Which of these is added to the food
label because people sometimes don’t eat
ENOUGH of this?
A. fat
B. calcium
C. sodium
D. cholesterol
14. Which of these is required on the food

label?
A. total carbohydrate
B. sugars
C. iron
D. all of the above
15. The bread, cereal, rice and pasta
group is a good source of _______?
A. carbohydrate
B. vitamin C
C. calcium
D. vitamin D
16. Citrus fruits are an excellent source of

_______?
A. calcium
B. vitamin c
C. vitamin B
D. calories
17. Foods from the meat, poultry, fish dry
beans, eggs and nuts group are an
important source of ________?
A. iron
B. fiber
C. beta carotene
D. calcium
18. Which food contains the most fat?

A. graham crackers
B. brownies
C. pudding
D. angel food cake
19. The milk, cheese & yogurt group are

important for ________?
A. strong bones
B. teeth
C. muscles
D. all of the above
20. How many servings of vegetables do

we need each day?
A. 6-11
B. 2-3
C. 3-5
D. 1-2
21. Which of the following nutrients is
needed to build and maintain the
structural components of the body?
A. Carbohydrates
B. Protein
C. Fat
D. Fiber
22. Which of the following nutrients is

known as the sunshine vitamin?
A. Vitamin C
B. Vitamin A
C. Vitamin K
D. Vitamin D
23. All of the following are needed for

strong bones except:
A. Thiamin
B. Calcium
C. Magnesium
D. Vitamin D
24. Which of these nutrients is the

preferred energy source for the body?
A. B Complex Vitamins
B. Carbohydrates
C. Fats
D. Fiber
25. This nutrient is needed for a healthy

immune system and strong connective
tissue:
A. Fiber
B. Vitamin K
C. Vitamin C
D. Fluoride
26. Which of the following is the best

source for omega-3 fatty acids?
A. Corn oil
B. Wheat products
C. Pork
D. Sardines
27. This mineral is essential for healthy

red blood cells and a deficiency might
cause anemia.
A. Iron
B. Magnesium
C. Iodine
D. Chromium
28. This vitamin is needed to prevent a

birth defect called Spina Bifida
A. Vitamin D
B. Vitamin A
C. Folate
D. Vitamin E
29. This nutrient is needed for making

hormones, healthier skin, and to make cell
membranes:
A. Fat
B. Carbohydrate
C. Fiber
D. Vitamin B12
30. This nutrient is most important for

healthy vision:
A. Vitamin K
B. Iron
C. Calcium
D. Vitamin A
31. The United States Department of

Agriculture’s Daily Food Guide suggests
that the Fats, Oils and Sweets Group be
used ___.
A. once a week
B. four times a day
C. never on Sundays
D. sparingly
E. every Tuesday

Agriculture’s Daily Food Guide calls for
eating ___ servings of the Bread, Cereal,
Rice and Pasta Group.
A. 1-3
B. 4-5
C. 6-11
D. 12-15
E. 16-20

eating ___ servings of the Milk, Yogurt,
and Cheese Group.
A. 0-1
B. 2-3
C. 3-4
D. 5-6
E. 6-7

eating ___ servings of the Fruit Group
every day.
A. 0-1
B. 2-4
C. 4-5
D. 5-6
E. 6-7
35. Which of the following beverages has

no fat, sugar, or oils?
A. milk
B. root beer
C. coffee with cream
D. iced tea unsweetened
E. lemonade
36. What food doesn’t belong to this food

group?
A. noodles
B. crackers
C. scallion
D. macaroni
E. cous cous

group?
A. cookies
B. candy
C. sald dressing
D. cherries
E. butter

group?
A. chocolate milk
B. cream cheese
C. ice cream
D. salad dressing
E. yogurt
39. _________is an example of a

hydrogenated fat.
A. Butter
B. Margarine
C. Olive oil
40. If you order hot oatmeal in a

restaurant it may taste flat because
A. no sugar was added.
B. no salt was added.
C. it was cooked in a microwave.
41. Fruits and vegetables are usually
considered as good sources of
A. protein.
B. vitamins & minerals.
C. unsaturated fats.
42. Degenerative diseases are most closely

associated with
A. diets deficient in protein.
B. affluent lifestyles.
C. heredity.
43. The “bottom line” in determining the

quality of a recipe is
A. nutritional value.
B. taste testing.
C. cost.
44. Eggs, milk, and meat are usually
classified as good sources of
A. carbohydrates.
B. protein.
C. fat.
45. The human body and the food that

fuels it came together as a consequence of
A. chance, time, and circumstance
B. the activity of an intelligent designer
C. neither of the above

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" Reference of Gym movers towards nutrition product

SURVEY PROJECT REPORT

Veer bahadur singh purvanchal University, Jaunpur

BACHOLER OF BUSINESS ADMINISTRATION

Submitted by: Under the Supervision of:

Technical Education & Research Institute

This is to certify that Nagesh Paswan, pursuing BBA 4thSemester from

I recommend that this project report may be sent for evaluation.

Dr. Neetu Singh Miss Neetu Singh

I, Nagesh Paswan, hereby declare that this research project report

 Introduction of the topic 1-30

 Literature review 31-34

●Research Methodology 39-43

●Data analysis & Interpretation 44-60

●Finding & Recommendation 61-63

●Conclusion & Limitation 64-66

learn in the class room and its practical orientation in organization.

the Literature Review.

research, methods of data collection, sampling and sample design.

list of books, authors, web sites use etc.

It is my pleasure to be indebted to various people, who directly or indirectly contributed in the

opportunity to undergo summer training at Business Standard.

Introduction of the topic

Overview of the global fitness products and services market

Companies mentioned in the global fitness products and services market

Customer Experience Maps

The following regional segments are covered comprehensively:

Below is a snapshot of these quadrants

1. Customer Experience Map

2. Insights and Tools

Carbohydrates can be classified as monosaccharide (e.g. glucose, fructose, galactose),

Fats and oils

Regulations for future practices

Role of Liquid Dietary Supplements

Nutritional, Herbal, and Homeopathic Supplements

Diabetes mellitus and sarcopenia

Calcium: Properties and Determination

Pancreatin is also used for pancreatic exocrine insufficiency following pancreatectomy,

Nutrition Problems and Their Solutions

1/2 cup heavy whipping cream

Put all ingredients into a blender. Mix well.

1 cup whole milk

Put all ingredients into a blender. Mix well.

Makes one serving; 550 calories per serving.

2 cups whole milk

Makes four 1/2 cup servings; 250 calories per serving.

Great Grape Slush

2 grape juice bars

Put all ingredients into a blender. Mix well.

Makes one serving; 490 calories per serving.

(To prevent illness, avoid the use of uncooked eggs.)

Non-fat powdered milk or undiluted evaporated milk

Creamed soups, yogurt.

Vegetable oils, mayonnaise, butter, margarine or sour cream

Peanut butter (creamy or crunchy)

Nut "dust" (Grind any type of nuts in a blender or food processor.)

Add to puddings, gravy, mashed potatoes, casseroles, salad or yogurt cereals.

Miscellaneous foods (Limit to one serving per day.)

Sugar, jelly, jam, preserves.

• To analyses factors that influence the purchase decision of consumers

• To mprove cardiorespiratory and muscular fitness. Decrease levels of body fat.

• To increase the knowledge of sales to person influence consumer to buy product.

Methodology for Selection and Interpretation of Health-Related Fitness Measures