NUTRITION - UNIT I

INTRODUCTION
NUTRITION - UNIT I

 Nutrition
 History, Concepts, Role of nutrition in maintaining health
 Nutritional problems in India
 National nutrition policy
 Factors affecting food and nutrition: Socioeconomic, cultural, traditional, production, system of
distribution, life style and food habits etc.
 Role of food and its medical value
 Classification of foods
 Food Standards
 Elements of nutrition: Macro and Micro
 Calorie, BMR
INTRODUCTION

 Nutrition is
The provision of the materials necessary in the
form of food to cells and organisms to support
life.
Healthy diet prevents or alleviates - common
health problems.
 History

 Nutrition is a new field of study - about 100

years old.
 Hippocrates had recognised diet on a
component of health as early as 300 BC.
 History

 Past 100 years - The importance of CHOs,

Lipids and Proteins for normal growth and
development were recognised.
 The next nutrition breakthrough was the
discovery of vitamins.
 History

 Vitamin A in 1913, Vitamin C in 1919,

 Vitamin D in 1925, Vitamin K in 1935,

 Vitamin E, B1(Thiamine),B6(Pyridoxine)-1936,
 Vitamin B2 (Riboflavin) in 1935, Vitamin B9
(Folic acid) in 1948.
History

 Nutrition was officially recognized as

an independent field of study in 1928
with the formation of American
Institute of Nutrition.
 History

 It took about half a century more for nutrition

to achieve its current status as one of the most
talked about scientific disciplines.
 History

 Nutrition encompasses not only the study of

vitamins, minerals and other foods, but also
diverse subjects as alcohol, caffeine and
pesticides.
 History

 Besides, nutrition research tries to find out the

impact of food on body by examining the
progress in allied fields, such as physics,
chemistry, biochemistry and immunology.
CONCEPTS

 Nutrition,

 Dietetics,

 Food,

 Diet
CONCEPT - NUTRITION

 Nutrition is defined as the science of food

and its relationship to health.
 It is food at work in the body.
 It includes everything that happens to food.
CONCEPTS - NUTRITION

 It is the study of nutrients and processes by

which they are used by the body.
 It is concerned with the part played by
nutrients in the body growth, development
and maintenance.
CONCEPTS - DIETETICS

 Dietetics are the practical

application of the principles of
nutrition, which includes planning
of meals for the healthy as well as
the sick.
CONCEPTS - DIETETICS

 Good nutrition means

maintenance of nutritional status
that enables us to grow well and
enjoy good health.
CONCEPTS - FOOD

 Food is vital for human existence just as air and

water.
 Food may be defined as anything eaten or
drunk, which meets the needs of tissue
building, regulation and protection of the body
and its energy needs.
CONCEPTS - FOOD

 Food: raw material from which bodies are made.

 Intake of right kinds and amounts can ensure
good nutrition and health - evident in one’s
appearance, well-being and efficiency.
CONCEPTS - DIET

 Diet: Diet refers to whatever

people eat, drink each day.
CONCEPTS - DIET

 It includes the normal diet people

consume and the diet people consume in
groups (hotel diet), but will also be
modified for the sick as part of their
therapy (diet therapy).
ROLE OF NUTRITION IN MAINTAINING
HEALTH

The basic study of nutrition - primary

importance as
 1. It is fundamental for own health.
ROLE OF NUTRITION IN MAINTAINING
HEALTH

2. It is essential for the health and well-being of

patients and clients from the time of eating
till it is utilized for various functions.

The scope of the study involves:

ROLE OF NUTRITION IN MAINTAINING
HEALTH

The scope of the study involves:

 Nutrition helps growth and

development

 Prevents malnutrition

 Resists infection

 Prevents diseases
ROLE OF NUTRITION IN MAINTAINING
HEALTH

• Proper nutrition supports wellness

• Wellness is more than the absence of

disease

• Physical, emotional, and spiritual

health

• Active process
ROLE OF NUTRITION IN MAINTAINING
HEALTH
NUTRITIONAL PROBLEMS IN
INDIA

A survey in south India has revealed that

about
1% children aged 1-5 years showed signs
of kwashiorkor, 2% marasmus and
3%-5% vitamin A deficiency.
NUTRITIONAL PROBLEMS IN
INDIA

 Community studies have shown that

Many mothers give only breast milk to
children up to 2years.
Thus, no additional food is added to the
child’s diet.
NUTRITIONAL PROBLEMS IN
INDIA

 Papaya, vitamin ‘A’ rich, considered which

produces more heat - cause miscarriage -
avoided by pregnant women.
NUTRITIONAL PROBLEMS IN
INDIA

 Belief - if a pregnant woman eats more, the

baby will be big and delivery difficult, so
expectant mothers are not fed adequately
both in quality and quantity.
 Nutritional Problems in India
NUTRITIONAL
Problem PROBLEMSFeatures
IN
INDIA
Low Birth Weight Less than 2.5kg
Still birth Birth of dead baby
Protein deficiency between 1
Kwashiorkor
and 4 years
20% adolescent girls and 90%
Anaemia
pregnant women
 Nutritional Problems in India
NUTRITIONAL
Problem PROBLEMSFeatures
IN
INDIA
Stunted growth Height and weight not ideal
Vitamin A deficiency after 50
Night blindness
years
Vitamin A and Vitamin D
Cataract
deficiency
Goitre Iodine deficiency in females
 Nutritional Problems in India
NUTRITIONAL
Problem PROBLEMS IN
Features
Under weight INDIA
50% adults
Overweight 15% Mumbai school children are
obese
About 10% of the total population and
Diabetes
about 1/5 above age 50 suffer
 Nutritional Problems in India
NUTRITIONAL
Problem PROBLEMS Features
IN
INDIA
Male and female suffer more
Hypertension
in urban areas

Cardiac problems More in males

Cancer More in females

Nutritional Problems in India

 The hunger and malnutrition survey report 2011

covered
 7,300 households in 112 districts across 9 states
and more than 1 lakh children and 74,000
mothers.
 Nutritional Problems in India

The key findings of the survey

 42% children under 5 are underweight; 59% are stunted.
 66% of mothers did not attend school. Rates of child
underweight and stunting are higher among mothers with low
levels of education.
Nutritional Problems in India

 By 2 years, 42% children are underweight and 58%

stunted in the 100 focus districts.
 Prevalence of child underweight has decreased from
53% in 2004 to 42% in 2011.
 Nutritional Problems in India
 Birth weight:
Under 2.5kg at birth and continue to stay underweight 50%
Over 2.5 kg at birth, but underweight now 34%
Under 2.5kg at birth and stunted now 62%
Over 2.5kg at birth, but stunted now 50%
 Nutritional Problems in India

 Prevalence of malnutrition is significantly higher among children

from low-income families particularly Muslims, Scheduled Castes
and Scheduled Tribes although rates of malnutrition are significant
among middle and high income families.
Nutritional Problems in India

 We cannot hope for a healthy future for India with

such a large number of malnourished children.
 The government cannot solely depend on Integrated
Child Development Services (ICDS) to solve the
issue.
Nutritional Problems in India

 The government is launching a strengthened and

restructured ICDS, to start a multisectoral
program for 200 high burden districts and initiate
a nationwide communication campaign against
malnutrition.
Cause of Nutritional Problem

 Poor Nutrition,
 Under Nutrition (Malnutrition),
 Overnutrition.
Cause of Nutritional Problem

 The World Bank estimates that India is ranked

2nd in the world of the number of children
suffering from malnutrition.
Cause of Nutritional Problem

 Undernutrition is found mostly in rural

areas 10% of villages and districts
accounting for 27-28% of all
underweight children.
Cause of Nutritional Problem

 Children of scheduled tribes have

the poorest nutritional status and
the highest wasting.
 Causes of
Malnutrition
in India
5. Illiteracy and
ignorance bout
balanced diet

4. Religious
1. Population
and cultural
food facts growth

3. Parasitic and
2.
infectious
diseases Agriculture
NATIONAL NUTRITION POLICY

 India’s nutritional policy was formulated in the year 1993 by

an act of the parliament
 With the following goals:

1. Reduction of incidence of low birth weight

2. Elimination of nutrition blindness

 NATIONAL NUTRITION POLICY

 NNP goals:

3. Reduction of anaemia to 20% in pregnant women.

4. Universal iodination of common salt to lower-iodine

deficiency disorders to less than 1%.

5. Establish special care to geriatric nutrition.

 NATIONAL NUTRITION POLICY

 NNP goals:

6. Increase annual food grain production to 250 metric tons.

7. Steps to create household food security through poverty

alleviation.
 NATIONAL NUTRITION POLICY

 NNP goals:

8. Decrease incidence of moderate and severe malnutrition in

children.

9. Promotion of appropriate diets and healthy lifestyle.

 NATIONAL NUTRITION POLICY

 NNP goals:

Short - term intervention

Long - term interventions.
 NATIONAL NUTRITION POLICY - Short - term
intervention
 Expanding the nutrition intervention net (ICDS)
 Empowering mothers with nutrition and health education
 Teaching adolescent girls to avoid anaemia
 Ensuring better nutritional coverage for expectant women.
 Controlling micronutrient deficiencies and fortifying essential foods
with nutrients
 NATIONAL NUTRITION POLICY - Long Term
Interventions or Development Policy Instruments

 Food security
 Improvement of dietary pattern
 Increasing purchase power of the population
 Streamlining and expanding Public Distribution System (PDS)
 NATIONAL NUTRITION POLICY - Long Term
Interventions or Development Policy Instruments
 Strengthening health and family welfare programs
 Nutrition and public education
 Education and literacy
 Nutrition and surveillance
 Information and communication
 Ensure community participation
 NATIONAL NUTRITION POLICY

 A nutritional plan of action was formulated in 1995

To implement the short and long term policy instruments with

sectorial commitment by the following nutrition related

ministries.
 NATIONAL NUTRITION POLICY - Nutrition
Related Ministries

 Agriculture

 Food production
 Civil supplies
 Public distribution
 Education and literacy
 NATIONAL NUTRITION POLICY - Nutrition
Related Ministries

 Health and family welfare

 Preventive care
 Information and broad casting
 Awareness

 Forestry and environment protection

 NATIONAL NUTRITION POLICY - Nutrition
Related Ministries

 Labor

 Rural, urban and tribal development

 Transport communications
 Formation of high-level committees/councils for identifying
factors affecting food and nutrition.
 4. Child Rearing
3. Religious/Traditional Practices - Faulty
2. Cultural, Taboos And Child Feeding Practices
Superstitions

5. Production,
1. Socioeconomic - 6. System of Distribution
Large Families, Dietary Determinants /
Inadequacy Factors of
Malnutrition
7. Life style,
11. Maternal 8. Food Habits
Malnutrition,
Low Birth Weight

10. High Female

9. Frequent Infections
Illiteracy
 Factors Affecting Nutritional Status

High Risk Lactating

Groups Pregnant women
are
women

Preschool
Infants
children
ROLE OF FOOD AND ITS MEDICAL VALUE
1. PROVIDE ENERGY

2. BODYBUILDING

3. REGULATES BODILY ACTIVITIES

4. PROVIDE RESISTANCE TO DISEASES

5. SOCIAL FUNCTIONS OF FUNCTION

6. PSYCHOLOGICAL FUNCTIONS OF FOOD

7. NUTRITIONAL STATUS

8. ELIMINATION OF DEFICIENCY DISEASES

 2. Chemical
1. Origin Composition
CLASSIFICATIO
N OF FOODS

3. Function 4. Nutrition Value

BASED ON ITS ORIGIN

1. ●
Foods of animal origin

2. ●
Foods of vegetable origin
BASED ON CHEMICAL COMPOSITION

2. Fats,
1. Proteins
CHO

3. Minerals 4. Vitamins
 BASED ON ITS FUNCTION

3. Protective foods
1. Body building foods – 2. Energy giving foods
–
Amino acids, Proteins – Carbohydrates (wheat, rice)
Vitamins and Minerals
 Based on Nutrition Value

3. Milk,
2. Pulses
1. Cereals Milk 4. Fruits & 5. Fats &
&
& Millets Products Vegetables Sugars
Legumes
& Meat
 FOOD STANDARDS

 Definition: Food standards are a set of criteria that a food must

meet and it should be suitable for human consumption, such as
source, composition, appearance, freshness, permissible additives,
and maximum bacterial content.
 FOOD LAWS IN INDIA

 Prevention of Food Adulteration Act, 1954

 Fruit Products Order,1955
 Meat Food Products Order ,1973
 Vegetable Oil Products (Control) Order, 1947
 FOOD LAWS IN INDIA

 Edible Oils Packaging (Regulation) Order 1988

 Solvent Extracted Oil, De- Oiled Meal and Edible Flour
(Control) Order, 1967,
 Milk and Milk Products Order, 1992.
 The Food Safety and Standards Authority of India (FSSAI),
2006.
 PREVENTION OF FOOD ADULTERATION
ACT, 1954

PFA Act covers food standards, general procedures for

sampling, analysis of food, powers of authorized officers,
nature of penalties and other parameters related to food.
 PREVENTION OF FOOD ADULTERATION
ACT, 1954

It deals with parameters relating to food additives,

preservative, colouring matters, packing & labelling of
foods, prohibition & regulations of sales etc.
 FRUIT PRODUCTS ORDER,1955

Objective: To manufacture fruit & vegetable products

maintaining sanitary and hygienic conditions in the
premises and quality standards laid down in the Order.
 FRUIT PRODUCTS ORDER,1955

Minimum requirements for hygienic production and

quality standards:
Location and surroundings of the factory
Sanitary and hygienic conditions of premises
Personnel hygiene, Portability of water
 FRUIT PRODUCTS ORDER,1955

Machinery & equipment with installed capacity

Quality control facility & technical staff
Product standards
Limits for preservatives & other additives
 MEAT Food Products Order ,1973

 Fastest growing animal protein in India.

 Indian consumers prefer to buy fresh meat from the wet market,
rather than processed or frozen meats.
 Meat & meat products are highly perishable in nature and can
transmit diseases from animals to human-beings.
 Vegetable Oil Products (Control) Order, 1947

 Regulated by this order through the directorate of Vanaspati,

vegetable oils & fats, department of food, public distribution,
ministry of consumer affairs, and food & public distribution.
 EDIBLE OILS PACKAGING
(REGULATION) ORDER 1988

Ensure availability of safe and quality edible oils in

packed form at pre-determined prices to the
consumers.
 SOLVENT EXTRACTED OIL, DE-
OILED MEAL AND EDIBLE FLOUR
(CONTROL) ORDER, 1967,

Quality control order to ensure that the quality

reached to the consumers for consumption
 MILK AND MILK PRODUCTS ORDER,
1992.

The objective of the order is

To maintain and increase the supply of liquid milk of desired
quality in the interest of the general public and
Also for regulating the production, processing and
distribution of milk and milk products.
 THE FOOD SAFETY AND STANDARDS
AUTHORITY OF INDIA (FSSAI), 2006.

Regulating body related to food safety and laying down of

standards of food in INDIA.
FSSAI creates science based standards for articles of food.
 THE FOOD SAFETY AND STANDARDS
AUTHORITY OF INDIA (FSSAI), 2006.

FSSAI regulates their manufacture, storage, distribution,

sale and import to ensure availability of safe and
wholesome food for human consumption.
 DUTIES AND FUNCTIONS OF FSSAI

Framing of Rules, Regulations, Standards and Guidelines

in relation to articles of food.
Procedure and the enforcement of quality control on any
article of imported into India.
 DUTIES AND FUNCTIONS OF FSSAI

Guidelines for accreditation of certification bodies engaged

in certification of Food Safety Management System for food
businesses.
Providing scientific advice and technical support to the
Central Government and State Governments on food safety
 DUTIES AND FUNCTIONS OF FSSAI

Training programmes for various stakeholders in food safety

and standards.
Contribute to the development of international technical
standards for food, sanitary and Phyto- sanitary standards
 DUTIES AND FUNCTIONS OF FSSAI

Guidelines for accreditation of Laboratories and their

notification.
Promote general awareness about Food Safety and Food
Standards.
 DUTIES AND FUNCTIONS OF FSSAI

Collect and collate data regarding

 Food consumption,
 Incidence and prevalence of biological risk,
 Contaminants in food, Residues of various contaminants,
 Identification of emerging risks and Introduction of rapid alert system
 Creating information dissemination network across the country about food
safety & issues of concern.
 ELEMENTS OF NUTRITION: MACRO
AND MICRO

 Food is composed of a wide distribution of nutrients,

 Have very specific metabolic effects on the human body.
 Two categories: macronutrients, micronutrients.
 MACRONUTRIENTS

 It constitute the majority of an individual’s diet.

 It essential nutrients that are needed for growth and energy -
carbohydrates, proteins, fats, and water.
 MACRONUTRIENTS

 Carbohydrates, proteins, and fats are interchangeable as sources

of energy.
 Fats yielding 9 calories per gram,
 Protein and carbohydrates each yielding 4 calories per gram.
 Carbohydrates

 Composed of carbon, hydrogen, and oxygen, and “constitute the

main source of energy for all body functions, particularly brain
functions, and are necessary for the metabolism of other
nutrients” (Mosby 260).
 Carbohydrates

 It is the easiest form of food to convert into energy.

 Ingested carbohydrates are turned into glucose, which circulates
in the bloodstream being readily available, and into glycogen
which is stored in the liver and muscle cells, for later use.
 Protein

 Large combinations of amino acids containing the elements

carbon, hydrogen, nitrogen, and oxygen,
 It the major source of building materials for muscles, blood,
skin, hair, nails, and internal organs.
 Protein

 It is used by the body to build, repair, and maintain muscle

tissue.
 The ingested protein is broken down into peptides and amino
acids which are vital for proper growth, development, and
maintenance of health.
 Fat

 Composed of carbon, hydrogen, and oxygen (these elements are

connected together differently than in carbohydrates).
 Fat

3 primary functions are:

 They are the major source of stored energy for the body,
 They serve to cushion and protect the major organs,
 They act as an insulator, preserving body heat, and protecting
against excessive cold.
 Water

 Water is a key essential to a healthy body.

 The body is roughly 60% water.
 An average person needs about 8 cups of water per day
depending on their activity levels.
 Water

 Typically, the thirst mechanism is not a good sign to indicate

when the body needs water.
 This mechanism is activated when dehydration has already
occurred.
 Water

 Dehydration can lead to heat illnesses - heat exhaustion and heat

stroke because of the inability to sweat.
 Italso can cause electrolyte imbalance and malfunction of the
body systems.
 This can lead to decreases in energy and performance.
 MICRONUTRIENTS

 Micronutrients are vitamins and trace minerals.

 Body requires them in very small amounts.
 Vitamins are organic substances that we ingest with our foods,
and that help to trigger other reactions in the body.
 MICRONUTRIENTS

 Needed only in small amounts,

 Deficiency leads to critical health problems.
 Most of the diseases and conditions are due to deficiency of
micronutrients.
 WHO - Elimination of micronutrient deficiency, labour efficiency
will increase multifold.
 LIST OF MICRONUTRIENTS

MICRONUTRIENTS: VITAMINS
 Vitamin A, Vitamin B,
 Vitamin C, Vitamin D,
 Vitamin E, Vitamin K and
 Carotenoids.
 LIST OF MICRONUTRIENTS

Minerals are - Boron, Calcium, Chloride, Chromium,

Cobalt, Copper, Fluoride, Iodine, Iron, Magnesium,
Manganese, Molybdenum, Phosphorous, Potassium,
Selenium, Sodium and Zinc.
 LIST OF MICRONUTRIENTS

ORGANIC ACIDS
 Acetic acid, Citric acid,
 Lactic acid, Malic acid,
 Choline and Taurine.
 CALORIE

 A calorie is a unit of energy.

 In nutrition and everyday language, calories refer to energy
consumption through eating and drinking and energy usage
through physical activity.
 For example, an apple may have 80 calories, while a mile walk
may use up about 100 calories.
 CALORIE

 Symbols: kcal, Cal or C

 The international unit of energy is Joule (J)

 Fat 1 gram = 9 kcal/g 
Protein 1 gram = 4 kcal/g 
 Carbohydrates 1 gram = 4 kcal/g 
THE BASAL METABOLIC RATE

 The basal metabolic rate is the energy

expenditure necessary to maintain basic
physiologic conditions.
 BASIC PHYSIOLOGIC CONDITIONS

 The activity of the heart

 Respiration

 Conduction of nerve impulses

 Ion transport across membranes
 Reabsorption in the kidney
 Metabolic activity.
 About 60% of the energy - supports the ongoing metabolic work
of the body cells, the basic metabolism.
 This is the work that goes on all the time, without conscious
awareness.
A person whose energy expenditure amounts to 2,000 cal/day
spends as much as 1200 – 1400 calories to support usual
metabolism.
 Basal metabolic energy required to support the basic processes
of life - circulation, respiration, temperature maintenance, etc. It
excludes digestion and voluntary activities.
 BMR constitutes the largest proportion (2/3) of a person’s daily
expenditure.
 Definition

 The BMR is defined as the energy expenditure of a subject at

complete physical and mental rest, awake (and not during sleep)
having normal body temperature and in the post-absorption state
(12 hours after the last meal) and 8 – 12 hours after any
significant physical activity.
 Measurement Basal metabolism

 1. Calorimeter directly by measuring the heat dissipated under

the basic conditions.
 2. Indirectly by measuring oxygen consumption.
 Factors affecting BMR

 The metabolic rate differs among different individuals. It

depends on:
 1. Variable factors
 2. Invariable factors
 1. Nutritional
state

2. Body size
6. Drugs or surface
area
Variable
factors
5. affecting BMR
Environmenta 3. Body
l temperature composition
or climate

4. Endocrinal
or hormonal
state
 Lean Body Mass is a component of body composition,
calculated by subtracting body fat weight from total body
weight: total body weight is lean plus fat.
 In equations: LBM = BW − BF Lean Body Mass equals Body
Weight minus Body Fat
 LBM + BF = BW. Lean Body Mass plus Body Fat equals Body
Weight.
 Eg A man with 165 cm height should have 65 kg as per normal
BMI
 Suppose consider he is 85 kg. then the lean body mass = 85 - 20
= 65 kg
HIGHER THE
PERCENTAGE
OF adipose tissue

Lower the BMR

per kilogram body
weight.
 Invariable factors affecting BMR

Gender or Sex Age

• Women
• Sex hormone
 Normal Value

 BMR values are expressed as ‘kcal or KJ/m2’ of body surface per

hour.
 In adults, BMR for healthy males is 40 kcal (168kJ) per hour
and
 Healthy females is 37 kcal (155kJ) per hour.
 Clinical Applications

 BMR estimation is used to diagnose thyroid disorders

 BMR is used in calculating food and drugs.