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School of nursing

M.B.S.Hospital, kota

PPT ON NUTRITION,
NUTRITIONAL PROBLEMS &
PROMOTION
Prepared by
MR.O.P. MEGHWAL
MISS ARUNA VAISHNAV
NURSING TUTOR

What Is
Nutrition?
-The study
of how your
body uses
the food
that you
eat.

What is a
A nutrient
is a chemical
Nutrient

substance in food that helps


maintain the body. Some
provide energy. All help build
cells and tissues, regulate
bodily processes such as
breathing. No single food
supplies all the nutrients the
body needs to function.

Vitamins
Minerals
Water
Protein
Carbohydrates

Fats

Sugar
sStarches
Cellulos
e

Nutrients that have


Calories:

Proteins

Carbohydrates

Fats

Definition of a
Calorie:
A unit of measure for energy
in food

Calories per
gram:

Protein
1 Gram = 4
calories
Carbohydrates 1 Gram = 4
calories
Fat
1 Gram = 9 calories

Variables which affect


nutrient needs:
1. Age
2. Gender
3. Activity Level
4. Climate
5. Health
6. State of nutrition

Nutrition through Life Cycle

Pregnant Women
Provide sufficient energy for pregnancy weight gain (developing
baby) Provide all essential nutrients for growth

Lifestyle - Avoid alcohol / smoking due to risk miscarriage / stillbirth

Regular non-strenuous exercise


400ug/day folic acid until week 12

Adequate fibre to prevent constipation 25-35g/day

Increase fluid intake

Increased Energy extra 200 calories/day during last 3mnths

Increased Iron intake form red blood cells, babies iron

store laid down during pregnancy, last for 6mnths after birth

Pregnant Women

, unpasteEssential fatty acid intake important foetal brain

development

Vitamin A high intake not recommended, avoid liver and other


sources

Vitamin C increased need, aids in absorption of iron

Vitamin D increased need to aid calcium absorption, 10ug/day

Adequate Calcium healthy diet should provide sufficient calcium for


mother and baby

Should avoid soft cheesesurised milk, raw eggs, undercooked chicken,


liver products

Good personal / food hygiene important

Special nutritional considerations: teenagers, those with learning


disabilities, ethnic groups

Infants, Babies and Toddlers

Breast-feeding is optimum feeding for first 6mnths

Advantages for baby lower risk of infection, protection against


allergens, provides correct mix and quantity of nutrients, baby
only takes what it needs
Advantages for mother No preparation needed, help with weight
loss after birth, associated with lower risk of certain cancers; eg.
breast, ovarian

Vitamin A, C & D and calcium all important for infants

Nutritional
Deficiency
Diseases

TYPES OF UNDERNUTRITION

UNDERNUTRITION

ACUTE UNDERNUTRITION

Marasmus
kwashiorkor
Marasmic- kwashiorkor
Wasting

CHRONIC UNDERNUTRITION

Stunting
Underweight

Nutritional Diseases
Malnutrition:

Lack of essential nutrients; ie


vitamins, minerals, amino acids

Undernourishment:

(calories).

Lack of food energy

WHO

estimates that half of the worlds


population is malnourished in some form

Can

you be over nourished and malnourished at


the same time?

MALNUTRITION:
INTRODUCTION
Malnutrition essentially means bad nourishment. It concerns
not enough as well as too much food, the wrong types of food, or
the inability to use nutrients properly to maintain health.
The World Health Organization cites malnutrition as the greatest
single threat to the world's public health.
Malnutrition in all its forms is a considerable public health concern
and is associated with increases risk of disease and early death.

MALNUTRITION: : INTRODUCTION

In 2006, more than 36 million people died of hunger or diseases


due to deficiencies in micronutrients; accounted for 58% of the
total mortality in the same year.

Under nutrition contributes to almost 35% of the estimated 7.6


million deaths under-5 deaths; consequently affecting the future
health and socioeconomic development and productive potential
of the society.

The malnourished are unable to live a normal life, are less likely
to fulfill their potential as human beings and cannot contribute
fully to the development of their own countries

MALNUTRITION

The World Health Organization defines malnutrition as "the cellular


imbalance between supply of nutrients & energy and the body's
demand for them to ensure growth, maintenance, and specific
functions.
Malnutrition comprises both;
1.Under nutrition
2.Over nutrition

TYPES OF MALNUTRITION

Under nutrition is depletion of energy (calories)


resulting form insufficient food intake over an extended
period of time.

In extreme cases under-nutrition is called Starvation.


While Famine is severe food shortage of a whole
community.

Specific

Deficiency is the pathological state resulting


form a deficiency of an individual nutrient such as
vitamin A deficiency, iodine deficiency.

Over nutrition:

TYPES OF MALNUTRITION

Many tend to think malnutrition only in terms of hunger, however, overeating is also a
contributing factor.
Over

nutrition is the pathological state resulting from the consumption of excessive


quantity of food over an extended period of time.
Overweight

and obesity are very common conditions in developed society and are becoming
more common in developing societies and those in transition.

NUTRITIONAL DEFICIENCY DISEASES


On global scale the five principal nutritional deficiency diseases are:
1 Kwashiorkor
2 Marasmus
3 Xerophthalmia
4 Nutritional anemia
5 Endemic goiter

Diseases of Malnourishment

Marasmus: progressive emaciation due to lack of


protein & calories preventing growth.

Kwashiorkor: lack of protein in diet, leading to


failure of neural development.

Cause of 49% of the 10.4 million deaths occurring in


children younger than 5 years in developing countries.

the sickness the older child gets when the next baby
is born
Characterized by bloated belly

Chronic hunger: enough food to stay alive, but


not be productive

MALNUTRITION IN CHILDREN: PROTEINENERGY MALNUTRITION

In children, proteinenergy malnutrition is defined by measurements that fall


below 2 standard deviations under the normal weight for age (underweight), height
for age (stunting) and weight for height (wasting).

Protein energy malnutrition usually manifests early, in children between 6 months and
2 years of age and is associated with early weaning, delayed introduction of
complementary foods, a low-protein diet and severe or frequent infections.

PROTEIN-ENERGY MALNUTRITION

KWASHIORKOR

KWASHIORKOR

Child
w/Marasmus

Child
w/Kwashiorkor

MANIFESTATIONS OF
MALNUTRITION

MANIFESTATIONS OF UNERNUTRITION
Under nutrition results in the loss of body weight. The loss of
weight is a manifestation of energy depletion.
Malnutrition from any cause retards normal growth. Malnourished
children grow up with worse health and lower educational
achievements.
Decrease in immunity increases the susceptibility to infections such
as T.B, which add to the morbidity and mortality.
Malnutrition is also associated with lowered vitality of the people
leading to lowered productivity and reduced life expectancy.

Cancrum oris

Cause: under/malnutrition

Problem: secondary infection;


mucous membranes become
inflamed and develop ulcers, often
in the mouth

Anemia
Cause: iron deficiency, decrease in the
number of RBCs
Problem: fatigue, irritability, shortness of
breath, constant headache

Beriberi
Cause: lack of vitamin B1 (thiamine)
Problem: heart and nervous system
damage, muscle wasting, brain
damage

Cretinism & Goiter


Cretinism

Goiter

Causes: lack of iodine


during pregnancy

Causes: lack of iodine

Problem: physical &


mental retardation,
stunted growth

Problem: deafness,
fatigue, weight gain,
enlarged thyroid

Pellagra
Cause: lack of niacin
Problem: dermatitis, weakness,
intestinal distress, neurologic
manifestations, organ failure

Osteoporosis
Cause: lack of calcium and/or
vitamin D (prevents absorption of
calcium)
Problem: weak bones, fractures,
decrease bone density

Rickets
Cause: lack of vitamin D
Problem: softening and
weakening of bones from release
of calcium from bones

Scurvy
Cause: lack of vitamin C
Problem: irritability, swelling and
hemorrhage especially over long
bones, death from hemorrhage and
cardiac failure

Xerophthalmia
Cause: vitamin A deficiency
Problem: blindness

Zinc deficiency
Cause: diet deficient in zinc
Problem: poor wound healing,
bone deformities, dwarfism,
hyperpigmentation, fetal
abnormalities, immune system
failure

Promotion of nutrition

Aim for Fitness

1. Aim for a healthy


weight

2. Be physically active each


day

Build a Healthy
Base
3. Let the pyramid guide
your choices
4. Choose a variety of
grains daily, especially
whole grains
5. Choose a variety of fruits
and vegetables daily.
6. Keep food safe to eat.

Choose
7.
Choose a diet that is low in
Sensibly

saturated fat and cholesterol and


moderate in total fat
8. Choose beverages and
foods to moderate your
intake of sugars
9. Choose and prepare food with
less salt
10. If you drink alcoholic
beverages do so in
moderation

Source of Energy

Polyunsaturated Fatty Acids

Monounsaturated Fatty Acids

Saturated Fatty Acids

Trans Fatty Acids

Vitamins
Essential

organic substances, they yield no energy, but facilitate energy-yielding


chemical reactions

Essential

Obtained

You

nutrients in maintenance of normal health

from food because the body cant make them

need only small amounts (micronutrients) because the body uses them without
breaking them down, unlike what happens to carbohydrates and other
macronutrients

Vitamins

13 compounds have been classified as vitamins


Vitamins A, D, E, and K, the four fat-soluble vitamins, tend to
accumulate in the body
Vitamin C and the eight B vitamins (biotin, folate, niacin,
pantothenic acid, riboflavin, thiamin, vitamin B6, and vitamin B12)
dissolve in water, so excess amounts are excreted (water-soluble
vitamins

Vitamins

Vitamin A = Retinol, retinaldehyde,


retonoic acid (performed) and
carotenoids (provitamin A)

Vitamin C = Ascorbic Acid


Vitamin D = Calciferol

Vitamin B1 = Thiamin
Vitamin B2 = Riboflavin
Vitamin B6 = Pyridoxine,
pyridoxal, pyridoxamine
Vitamin B12 = Cobalamin

Vitamin E = Tocopherol,
tocotrienol
Vitamin K = Phylloquinone

Vitamin A
Food
Function

Sources Performed (Liver, fish oils, fortified milk and eggs)


Promote Vision and Growth, prevent drying of skin and eyes

Proformed (Dark leafy green, yellow orange


vegetables & fruits

Deficiency

Those

Cause night blindness, skin changes and nutritional anaemia

at risk Urban poor, breast fed infants (mothers poor diet) elderly,
schoolchildren (poor veg. intake)

Vitamin D
Function

Calcium absorption, regulate bone metabolism, healthy


immune system

Food

Sources Herring, eel, salmon, tuna, milk, some fortified cereals,


pork sausage, egg yolk (sunlight)

Deficiency

Those

Rickets in children, Osteomalacia in adults

at risk Elderly (stay indoors) People living in Northern Climate,


People with fat malabsorption

Vitamin E
Function Antioxidant, protects cells from attacks by free
radicals, role
in iron metabolism
Food Sources Vegetable oils, nuts, seeds, green leafy
vegetables
and a variety of fish
Deficiency Nerve degeneration
Those at risk Premature infants, smokers, people with fat
malabsorption

Vitamin K
Function

Food

Role in coagulation process (blood-clotting)

Sources Liver, green leafy vegetables, broccoli, peas and


green beans

Deficiency

Those

Bleeding disorders, fractures

at risk People taking antibiotics for long periods

Vitamin C
Function

Food

Aids in calcium / iron absorption, immune functions

Sources Citrus fruits, potatoes, green peppers, cauliflower,


broccoli, strawberries

Deficiency

Those

Scurvy, fatigue, bleeding gums and joints

at risk Infants, elderly, alcoholics, smokers

B Vitamins

Minerals
The

Trace

major minerals present in the body include sodium, potassium,


chloride, calcium, magnesium, phosphorus, and sulfur.

minerals are present (and required) in very small amounts in the


body. The most important trace minerals are iron, zinc, copper, chromium,
fluoride, iodine, selenium and manganese.

Minerals

Water
Adults
Functions

are 60-70% water

- Maintain the health and integrity of every cell in the body.

Help eliminate by-products of the bodys metabolism, excess


electrolytes (sodium & potassium). Regulate body temperature through
sweating.
Dehydration

occurs when the water content of the body is too low.


This is easily fixed by increasing fluid intake. Symptoms of dehydration
include headaches, lethargy, mood changes and slow responses, dry
nasal passages, dry or cracked lips, dark-coloured urine, weakness,
tiredness, confusion and hallucinations.
Recommended

intake depends on age, hot environment etc. Averages


between 6-10 cups/day

THANK YOU