BASIC NUTRITION

H HAC 126 (3 credits)

Leonard Atawugeh Kubaloe

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NUTRITION

The provision of energy and nutrients (in

terms of amount, mix and timeliness) to the
cells for them to perform their physiological
function (of growth, reproduction, defense
and repair) for a healthy and disease-free life.

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FOOD

Food is any non toxic solid, semi-solid or liquid

substance, which when ingested provides the
body with one or more nutrients.

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NUTRIENTS

Nutrients are chemical substances found in

food which when ingested and metabolized in
the body give them the property to perform
certain physiological functions.

These functions include:

• Provision of energy,
• Providing the essential materials for building
the body,
• Controlling and regulating body processes.
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NUTRIENTS

Example of nutrients

• Carbohydrates
• Proteins
• Lipids
• Vitamins
• Minerals
• Water

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CLASSIFICATION OF FOOD

Food can be classified based on the

• Major functions it performs in the body

• Major nutrients it contains
• Geographical location etc.

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CLASSIFICATION OF FOOD

Major functions it performs in the body

• Body building foods -protein foods

• Energy giving foods -carbo., fats and
oils
• Protective foods -vits. and mins.

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CLASSIFICATION OF FOOD

Major nutrients it contains

• Carbohydrates -yam, maize

• Proteins -meat, fish
• Fats and oils -palm oil, pork fat
• Vitamins -orange, pineaple
• Minerals -coconut, cashew
• Water -water, all foods

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CLASSIFICATION OF FOOD

Geographical location

The six (6) Ghanaian food groups

• Cereals and grains
• Starchy roots and plantain
• Animals and animal products
• Fats and oils
• Fruits and vegetables
• Beans, nuts and oil seeds
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Nutrients, functions, sources and deficiency
Water

An ionic compound (H2O)

The normal body (70kg) is made up of 60-70 %

of fluid (water)

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Nutrients, functions, sources and deficiency
Water
Functions
• It is essential for digestion and absorption of
food
• Combines with waste material to be excreted
• Helps maintain the temperature of the body
• Helps in transporting nutrients to other parts
of the body

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Nutrients, functions, sources and deficiency
Water
Functions
• It plays an active role in the body’s electrolyte
balance
• Serves as a medium for all body processes
• Lubricates joints and organs
• Quenches thirst

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Nutrients, functions, sources and deficiency
Water
Sources
• Drinking water
• All foods including the so called dried foods

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Nutrients, functions, sources and deficiency
Water
Symptoms of Dehydration
• Frequent headaches
• Higher body temperature
• Tire easily and dizziness
• Depression and forgetfulness
• Lack of concentration
• Pass small quantities of urine which may result
in kidney failure
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General knowledge on water

• Avoid getting thirsty

• Avoid drinking ice-cold water
• Drink a minimum of 30mins before and after
meals.
• Consume fruits with high water content.
• Healthy choices of social drinks include fresh
fruit juices, millet drinks(zomkom), guinea
corn drink(non-alcoholic:pito-brukutu), corn
drink(assana), sobolo(red zinger), ginger drink.

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Nutrients, functions, sources and deficiency
• Carbohydrates
are made most of CHO atoms
Carbohydrates

Monosaccharide Disaccharides
Polysaccharides
glucose maltose starch
fructose sucrose fibre
galactose lactose glycogen
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Nutrients, functions, sources and deficiency
Carbohydrates
Functions in the body
• Provides energy (4kcals/g) for the body
• Spares protein
• Prevents fat metabolism for energy
• Forms components of cells

Carbohydrate makes food bulky and testier.

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Nutrients, functions, sources and deficiency
Carbohydrates
Functions of fibre
• Delays gastric emptying time hence you feel full
• Weight reduction diet by increasing excretion of
fat in the stool
• Prevents constipation
• Helps lower blood cholesterol levels hence
reduce risk of heart diseases
• Soaks up harmful substances from the gut

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Nutrients, functions, sources and deficiency
Carbohydrates
Sources
• Rice
• Yams
• Potatoes
• Plantain
• Banana
• Wholewheat bread

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Nutrients, functions, sources and deficiency
Carbohydrates
Deficiency
• Protein-energy malnutrition (PEM)
• Tiredness and general body aches

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Nutrients, functions, sources and deficiency
• Proteins
are organic substances made up of amino
acids (H,C,O,N)
amino acid

essential AA non-essential AA
(9 ess. aa) (11 non-ess. aa)

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Nutrients, functions, sources and deficiency
• Protein
Essential amino acid Non-essential amino acid
• Histidine • Glutamine
• Valine • Serine
• Leucine • Glutamic acid
• Isoleucine • Tyrosine
• Lysine • Glycine
• Threonine • Cystine
• Methionine • Alanine
• Tryptophan • Aspargine
• phenylalanine • Proline
• Aspartic acid
• Arginine HATS-Damongo
Nutrients, functions, sources and deficiency

Protein
Complete protein Incomplete protein
contains all the are deficient in one
essential amino acids or more essential
plus many of the non- amino acids. Eg of
essential amino acids. food sources, leafy
Eg of food sources, green vegetable,
eggs, milk, meat, fish, grains and legumes
poultry, cheese (peas and beans)

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Nutrients, functions, sources and deficiency
Protein
Functions
• Used for production of enzyme and hormones
• Formation of antibodies (body immune system)
• Provides other nutrients eg. Minerals
• Provision of essential amino acids for making the body
building process
• Controls the body fluid-electrolyte balance
• Controls body’s acid-base balance
• Provides energy (4kcal/g) in the absence of
carbohydrates or fats
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Nutrients, functions, sources and deficiency
Proteins
Sources
• Fish
• Meat
• Beans
• Milk and milk products (cheese)
• egg
• Poultry

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Nutrients, functions, sources and deficiency
Proteins
Deficiency
• Protein energy malnutrition
• Anaemia
• Failure to thrive

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Nutrients, functions, sources and deficiency
Lipids (Fats and oils)
Lipids (9Kcal/g) are generally defined as
substances that are insoluble in water but
soluble in organic solvents.
Made of CHO
In food, lipids occur as triglycerides (95%).
The remaining 5% include steroids
(cholesterol) and phospholipids.

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Nutrients, functions, sources and deficiency
Lipids (Fats and oils)
• Triglycerides are made up of 3 fatty acids
bound to a glycerol.

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Nutrients, functions, sources and deficiency
Lipids (Fats and oils)
Fats are divided into two groups
• Saturated fats
• Unsaturated fats

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Nutrients, functions, sources and deficiency
Lipids (fats and oils)
Saturated fat (animal fat)
• Contains mainly saturated fatty acids and
glycerol.
• Solid at room temperature.
• Food sources include milk, cheese, butter,
eggs, meat, nuts, coconut oil, palm oil and oily
fish such as herring. All animal sources of
protein contain some saturated fat.

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Nutrients, functions, sources and deficiency
Lipids (Fats and oils)
Unsaturated fat (vegetable fat)
• Contains mainly unsaturated fatty acids and
glycerol.
• Liquid at room temperature.
• Food sources include margarine, olive oil,
peanut oils, sunflower and corn oils and most
vegetable oils.

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Nutrients, functions, sources and deficiency
Lipids (fats and oils)
Cholesterol and Phospholipids

• Cholesterol is a steroid found in high

concentraions in the brain, liver and egg yolks,
whole milk, cheese, butter and meats but not
found in plants.

• Phospholipids (lecithin) found in egg yolks.

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Nutrients, functions, sources and deficiency
Lipids (Fats and oils)
Functions
• Provides energy (9kcal/g) for the body
• Serve as energy store in the adipose tissue
• Serve as heat insulator under the skin
• Form components of cells
• Formation of steroid hormones (sex
hormones-estrogen, progesterone and
testosterone)
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Nutrients, functions, sources and deficiency
Lipids (Fats and oils)
Deficiency
• Wasting
• Skin problems
• Hypothermia (feeling excessive cold in the
body, hands and feet)

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 Nutrients

MACRO-NUTRIENTS MICRO-NUTRIENTS
• Proteins • Vitamins
• Carbohydrates • Minerals
• Fats and oils
macronutrients because micronutrients because
the body need them in the body need them in
larger quantities such as smaller quantities such
grams and some times as milligrams and
kilograms. micrograms.

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Micronutrients

Micronutrients are small non-energy yielding

elements and compounds. They are very
essential needed for body’s processes (such as
the regulation and control functions in cell
metabolism and building certain body
structures).

The bioavailability of micronutrients depends

on the presence of phytates, oxalates, tannins
and dietary fiber.
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Vitamins

are organic compounds required by the body in

small amounts for metabolism, to protect health,
for proper growth (esp. in children), formation of
hormones, blood cells, nervous-system chemicals,
and genetic material.
They generally act as catalysts, combining with
proteins to create metabolically active enzymes
that in turn produce hundreds of important
chemical reactions throughout the body. Without
vitamins, many of these reactions would slow
down or cease.
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Vitamins

Vitamins
(13 well-identified)

Fat soluble Water soluble

Vitamin-A, D, E, and K.
They are generally
consumed along with fat-
containing foods and they
can be stored in the body’s
fat.
8B vitamins and vitamin C.
These vitamins cannot be
stored and must be
consumed frequently,
preferably every day

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 Vitamins

Vitamin A (retinol)
Functions Food sources Deficiency
•Vision •Animal tissue •Night blindness
•Formation and •Yellow, green and •Depressed growth
maintenance of orange pigmented •Susceptibility to
epithelial cell/mucosal fruits and vegetables infection
cells (eye, GIT, •Palm oil •Xerophthalmia
respiratory, genito •Margarine •keratomalacia
urinary tracts, skin, •Egg yolk
tooth buds) •butter
•Antioxidant
•Resistance to
infections

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 Vitamins

Vitamin D (cholecalciferol)
Functions Food sources Deficiency
•Calcium absorption •Fish liver oils •Rickets
from intestine •Liver •Osteomalacia
•Helps move calcium •Egg yolk •Bone pain
from bone to the •Milk •Hypercalcemia
blood and maintain •Margarine •osteoporosis
blood calcium level •Early morning
•Helps in teeth and sunshine
bone formation
•Helps in calcium
phosphate
metabolism

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 Vitamins

Vitamin E (tocopherol)-anti sterility vitamin

Functions Food sources Deficiency
•Antioxidant •Fish liver oils •Haemolytic anaemia
•Reduction in •Vegetable oils •Oxidative attack and
susceptibility to •Milk damage of cells
coronary heart attacks •Eggs •Spontaneous
•Fish abortion in women
•Leafy vegetables •sterility
•liver

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 Vitamins

Vitamin k(menadione)-anti haemorrhagic vitamin

Functions Food sources Deficiency
•Required for •Green leafy •Defective blood
synthesis of a number vegetables (cabbage) clotting
of clotting factors •Egg yolk
•Bone development •Cheese
•Liver
•Fish liver oils
*also synthesized by
bacteria in large
intestine

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 Vitamins

Vitamin B1 (thiamin)
Functions Food sources Deficiency
•Carbohydrate •Pork •Beriberi
metabolism •Liver •Anorexia
•Normal functioning •Kidney •Constipation
of the central nervous •Yeast •General weakness
system •Legumes and fatigue
•Maintenance of •Nuts •Poor neuronal
normal muscle tone •Whole cereals function
•Beef (lean) •Poor musculoskeletal
function

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 Vitamins

Vitamin B2 (riboflavin)
Functions Food sources Deficiency
•Macronutrient •Yeast •Angular stomatitis
metabolism for energy •Milk •Vascularization
•Normal growth •Meat •Vulvitis
•Maintenance of •Green leafy •Scrotal dermatitis
tissues vegetables
•Fish
•Poultry
•Whole meal cereals
•Liver
•Kidney
•Eggs
•Legumes

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 Vitamins

Vitamin B3 (niacin)
Functions Food sources Deficiency
•Macronutrient •Meat •Pellagra
metabolism for •Fish •Disease of the 4D’s
energy •Liver (Diarrhoea, Dermatitis,
•Helps to maintain •Whole grain cereals Dementia and Death)
healthy skin •Legumes
•Peanuts

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 Vitamins

Vitamin B6 (pyridoxine)
Functions Food sources Deficiency
•Amino acid and •Offal •Anaemia
protein synthesis •Egg •Weakness of body
(production of •Legumes •Insomnia
antibodies, rbc and •Fish •Growth failure
nerve transmitters) •Poultry •Impaired motor
•Controls formation of •Wholegrain cereals function
niacin from •Tomatoes
tryptophan •Intestinal bacteria
•Nervous function

NB. TB drug causes vitamin B6 deficiency

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 Vitamins

Pantothenic acid
Functions Food sources Deficiency
•Macronutrient •Milk Neuromuscular
metabolism •Egg yolk dysfunction and
•Liver fatigue
•Kidney
•yeast
•Whole grain cereals
•Green vegetables
•Intestinal bacteria

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 Vitamins

Biotin
Functions Food sources Deficiency
•Carbohydrate and fat •Egg yolk Rare, but
metabolism •Yeast consumption of raw
•Liver eggs can lead to
•Kidney deficiency
•Some vegetables •Mental and muscle
dysfunction, fatigue
and nausea

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 Vitamins

Folic acid
Functions Food sources Deficiency
•Blood formation •Green leafy •Megaloblastic
•DNA synthesis vegetables anaemia
•Growth/foetal •Liver •Growth failure
development •Kidney
•Egg yolk
•Yeast
•Legumes

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 Vitamins

Vitamin B12 (cyanocobalamin)

Functions Food sources Deficiency
•Blood formation •Liver •Pernicious anaemia
•Fat metabolism •Meat •Megaloblastic
•Egg anaemia
•Cheese •Nerve damage and
•Milk paralysis

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 Vitamins

Vitamin C (ascorbic acid)

Functions Food sources Deficiency
•Helps in iron •Citrus fruits •scurvy
absorption •Fresh tubers
•Helps in collagen •Vegetables
formation
•Wound healing
•Helps build
resistance of body to
infections

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Minerals

Minerals are minute amounts of metallic

elements that are vital for the healthy growth
of teeth and bones. They also help in enzyme
action, muscle contraction, nerve reaction,
and blood clotting.

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Minerals

Mineral

Major elements Trace elements

calcium, chlorine, chromium, copper,
magnesium, fluoride, iodine, iron,
phosphorus, selenium, and zinc
potassium, sodium,
and sulfur

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 Minerals

Calcium
Functions Food sources Deficiency
•Bone and tooth •Milk and milk •Stunted growth
formation products •Bone malformation
•Blood clotting •Cheese •Osteoporosis
•Strengthening of •Dark green leafy •Rickets
bones vegetables •Osteomalacia
•Muscle contraction •Fish consumed with •Teeth fall off easily
•Metabolic function bones
•Growth •Whole cereals

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 Minerals

Sodium
Functions Food sources Deficiency
•Regulate acid-base •Table salt Rare but may occur
balance •Sea foods with heavy sweating
•Transmission of nerve •Baked products in hot climates
impulses •Monosodium
•Normal muscle glutamate
contraction •Processed foods
•Body fluid balance containing table salt

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 Minerals

Potassium
Functions Food sources Deficiency
•Constituent of body •Fruits especially Rare but may occur
cells banana with prolonged
•Ensures water(fluid) •Coconut water diarrhoea, vomiting
balance in the body •Vegetables including use of diuretic drugs,
•Nerve impulse potatoes, spinach severe burns and
transmission •Legumes surgery leading to
•Acid-base balance •Mental apathy
•Insulin release •Muscular
•Carbohydrate Weakness which can
metabolism result in heart failure

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 Minerals

Iron
Functions Food sources Deficiency
•Component of •Liver •anaemia
haemoglobin •Dark green leafy
•Component of vegetables
myoglobin in red •Meat including organ
muscles meat/shellfish
•Cocoa powder

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 Minerals

Iodine
Functions Food sources Deficiency
•Component of •Seafoods including: •Goitre
thyroxine which help seaweeds, fish etc. •Cretinism
in metabolism •Table salt (iodised) •Reduced productivity
•Vegetables grown on
iodine-rich soils

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NUTRITIONAL DEFICIENCIES:
CAUSES, SIGNS & SYPTOMS AND MANAGEMENT
• Scurvy
• Goiter
• Beriberi
• Pellagra
• Anemia
• Xerophthalmia
• rickets

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SCURVY
It is characterized by
• progressive bodily weakness,
• spongy and inflamed gums,
• loose teeth,
• swollen and tender joints,
• Dark purplish spots on skin, especially legs,
• Bleeding from all mucous membranes,
• Sunken eyes,
• Opening of healed scars and separation of knitted
bone fractures

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SCURVY

Scurvy can be prevented by a diet that include

certain citrus fruits such as oranges or lemons.
Other good sources of vitamin C are fruits
such as guava, pawpaw, tomatoes or
strawberries.

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GOITRE

Goiter, disease of the thyroid gland, characterized by

an enlargement of the gland, visible externally as a
swelling on the front of the neck.
It is associated with hypothyroidism or
hyperthyroidism, a condition caused by insufficient
or excess production of thyroid hormone
respectively.
Because the body needs iodine to produce thyroid
hormone, inadequate amounts of iodine in the diet
may result in simple goiters.

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GOITRE

Simple goiters may be classified as either

endemic or nontoxic.

Endemic goiters are caused by a deficiency of

iodine in the diet and usually occur in
populations living in areas with iodine-
depleted soil.

Reading assignment: Types of goitre

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GOITRE

Goitre can be prevented by eating food containing

adequate amount of iodine (in the form of
iodide). Eg iodised salt in diet (food fortification).
Most simple goiters do not produce symptoms.
The administration of thyroid hormone (artificial)
will lead to a reduction in size of simple goiters in
most cases. Surgical removal of a simple goiter is
usually unnecessary unless the goiter is very large
and is impinging on vital bodily functions

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BERIBERI

The origin of the word is from a Sinhalese

phrase meaning “I cannot, I cannot”.

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BERIBERI

Beriberi is a diet-deficiency disease caused by

lack of vitamin B1. Chronic deficiency is known
to cause two distinct forms of beriberi.
• Dry beriberi
• Wet beriberi
Common among:
• Individuals who consume only polish rice
• Alcohol dependents
• Starved patients
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BERIBERI

• Dry beriberi
When associated with low calorie intake and
inactivity, the disease tends to affect the
nervous system. This form, termed dry
beriberi, is characterized by neuritis in the
lower extremities, often with muscle atrophy,
poor coordination, and eventually paralysis.
• Initial symptoms are heaviness and stiffness of
the legs, followed by weakness, numbness
and sensations of pins and needles pricks
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BERIBERI

• Wet beriberi
The second form of beriberi, known as wet beriberi, is usually
associated with extremely high activity levels and a high
carbohydrate intake. Symptoms of wet beriberi include
sweating, warm skin, and elevated heart rate; heart failure
and death may follow.
• Wet beriberi also causes oedema. Initially of the legs but later
extend to involve the whole body with ascites and pleural
effusion
• Infantile beriberi affects breastfed babies at approx. 3mths of
age. No sign of thiamin def in mother but stores must be
virtually nil. Infant becomes anorexic, develops oedema and
some degree of aphonia. Death ensues without treatment
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BERIBERI

Beriberi is especially prevalent in those parts of the

world where the diet consists mainly of polished rice
(which contains little or no thiamine because the husk,
which contains most of the thiamine has been
removed).

Recovery is complete in about 50 percent of cases when

adequate amounts of vitamin B1 are restored to the
diet. In most cases treatment is with thiamine
hydrochloride, either in tablet form or injection.
Infantile beriberi is treated by giving thiamine to the
mother which is passed on to the infant via breastmilk.
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PELLAGRA
Pellagra is a vitamin deficiency disease caused by
dietary lack of niacin (vitamin B3) and protein,
especially proteins containing the essential amino
acid tryptophan. Because tryptophan can be
converted into niacin, foods with tryptophan but
without niacin, such as milk, prevent pellagra.
However, if dietary tryptophan is diverted into
protein production, niacin deficiency may still result.

Tryptophan is an essential amino acid found in meat,

poultry, fish, and eggs. So, if your diet contains these
foods, your need for niacin from other sources will
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PELLAGRA

Signs and Symptoms

• high sensitivity to sunlight
• Aggression
• smooth, beefy red glossitis
• red skin lesions
• insomnia
• Weakness
• Mental confusion
• the four D’s
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PELLAGRA

Pellagra can be common in people who obtain

most of their food energy from maize, since
untreated corn is a poor source of niacin (vitamin
B3). Corn is also a poor source of tryptophan.

Untreated, the disease can kill within four or five

years. Pellagra can be treated with niacin (usually
as niacinamide). The frequency and amount of
niacinamide administered depends on the degree
to which the condition has progressed.

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PELLAGRA

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ANEMIA

Anemia, medical condition caused by an

abnormally low number of red blood cells. Red
blood cells, also called erythrocytes, contain
hemoglobin, a red, iron-rich protein that carries
oxygen in the blood to the body’s tissues.
People with anemia develop symptoms caused by
the poor delivery of oxygen to their body tissues
(hypoxia). These symptoms include pale skin,
shortness of breath, rapid heartbeat, low vitality,
dizziness, and if left untreated, stroke or heart
failure
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ANEMIA

Causes of anemia (into category)

• Excessive blood loss

• Excessive blood cell destruction

• Deficient red blood cell production (ineffective

hematopoiesis)

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ANEMIA

• Deficient red blood cell production (ineffective

hematopoiesis)

Red blood cell production becomes impaired if the

body has inadequate amounts of certain nutrients,
including iron, vitamin B12, and folic acid, as well as
the hormone erythropoietin, which is produced by
the kidneys.
Chronic illnesses, such as cancer, kidney disease,
diabetes mellitus, and inflammatory bowel disease,
may also lead to decreased red blood cell production.
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ANEMIA

• Excessive blood cell destruction

Red blood cells normally live for about 120 days

before the immune system removes them from
the body. The body compensates by producing
new red blood cells. But if the destruction of red
blood cells exceeds the body’s ability to produce
new red blood cells, anemia results.

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ANEMIA

Abnormal destruction of red blood cells may

be caused by an enlarged spleen, an organ
that removes worn red blood cells from the
body. The larger the spleen grows, the more
red blood cells it traps and destroys.

In some cases red blood cells are destroyed by

a malfunction of the immune system in which
antibodies attach to red blood cells, marking
them for destruction.
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ANEMIA

• Excessive blood loss

Excessive bleeding can cause dangerously low
blood pressure as well as insufficient oxygen
delivery to body tissues. Large amounts of
blood loss may occur suddenly due to injury or
surgery.

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ANEMIA

There are more than 100 types of anemia. The

most common type is

• Iron-deficiency anemia.
• Pernicious anemia
• Aplastic anaemia
• Sickle cell anemia

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ANEMIA

• Iron-deficiency anemia.
When the body’s need for iron increases—
such as during periods of rapid growth in
childhood, during pregnancy, or when there is
chronic bleeding—an iron deficiency may
develop. Low iron levels impair the body’s
ability to produce hemoglobin, a primary
component of red blood cells.

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ANEMIA

• Pernicious anemia
a chronic ailment that mostly affects people over 40, as a
result of vitamin B12 deficiency.
This vitamin is normally found in meats and vegetables
and is essential for the maturation of red blood cells.
People with pernicious anemia are unable to produce
intrinsic factor, a substance that allows the small intestine
to absorb vitamin B12. This inability may be caused by a
genetic disorder, Crohn’s disease (an immune system
disorder that causes chronic inflammation of the
digestive tract), or surgery that removes the part of the
stomach that normally produces intrinsic factor.
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ANEMIA

• Aplastic anemia
this occurs when bone marrow, the tissue that
produces new red blood cells, becomes
diseased or injured. Bone marrow damage
may result from a viral infection, cancer,
radiation, or exposure to toxic chemicals,
including arsenic, benzene, and some
antibiotics and cancer medications.

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ANEMIA

• Sickle-cell anemia
is an inherited disorder that affects mostly people
of African ancestry. People with sickle-cell anemia
have an abnormal form of hemoglobin that
distorts red blood cells. These distorted cells are
called sickled cells because of their resemblance to
the sickle, a type of crescent-shaped cutting blade
used in agriculture. The sickled shape makes it
difficult for these cells to pass through tiny blood
vessels, preventing oxygen in the blood from
reaching organs and tissues.
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HATS-Damongo
ANEMIA

All the types of anemia can be broad classified as

• Microcytic anemia
• Normocytic anemia
• macrocytic anemia

Assignment (to be submitted on 21st june, 2011)

Briefly elaborate on the above broad classifications

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ANEMIA

Physicians treat anemia associated with illnesses as a

serious disease by treating the underlying disorder. In some
cases, when symptoms persist or worsen, additional
medications that boost red blood cells may be necessary to
avoid life-threatening conditions and improve quality of life.
For instance, doctors prescribe iron pills to treat iron-
deficiency anemia and injections of vitamin B 12 to treat
pernicious anemia. Synthetically manufactured
erythropoietin stimulates the production and growth of red
blood cells in people with kidney disease or cancer. Blood
transfusions may be used in cases of massive blood loss.
Removal of the spleen may prevent blood cells from being
removed from the circulation of the blood or destroyed too
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XEROPHTHALMIA

A lack of vitamin A in the diet, almost always associated

with malnutrition, is the chief cause of xerophthalmia
(extreme dryness of the conjunctiva) and the more
advanced condition known as keratomalacia
(deterioration and ulceration of the cornea).

Xerophthalmia results from inadequate function of the

lacrimal gland which produce tears. When xerophthalmia
is due to vitamin A deficiency, the condition begins with
night blindness and conjunctival xerosis (dryness of the
eye membranes) and progresses to corneal
xerosis(dryness of the cornea), and, in the late stages, to
keratomalacia (softening of the cornea).
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XEROPHTHALMIA

• The treatment depends on the cause. Artificial tears,

which lubricate the eye, are the principal symptomatic
treatment for dry eye.
• For people with severe cases of dry eye, temporary or
permanent closure of the tear drain (small openings at
the inner corner of the eyelids where tears drain from
the eye) may be helpful. Also known as conjunctivitis
arida.

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RICKET

Rickets is a nutritional disorder characterized by

skeletal deformities. Rickets is caused by a decreased
concentration of the mineral hydroxyapatite in bones
and cartilage due to low levels of calcium and
phosphorus in the blood. Vitamin D is essential for
the maintenance of normal calcium and phosphorus
levels. Classic rickets, a deficiency disease of children
characterized by improper development or
hardening of bones, is due to lack of sufficient
vitamin D in the diet, or to insufficient ultraviolet
radiation from direct sunlight, a lack that prevents
conversion of the element 7-dehydrocholesterol in
the skin to vitamin D. HATS-Damongo
RICKET

The type of skeletal deformities depends largely on

the child's age when the vitamin-D deficiency occurs.
A child who has not yet learned to walk develops
vertebral curvatures; a walking child develops leg
curvatures.

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RICKET

Signs and Symptoms of rickets include:

– Bone pain or tenderness
– Dental problems
– Muscle weakness
– Increased tendency for fractures
– Skeletal deformity
– Cranial, spinal and pelvic deformities
– Growth disturbance

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RICKET

Treatment involves increasing dietary intake of

calcium, phosphates and vitamin D. Exposure
to ultraviolet in sunshine, cod liver oil are all
sources of vitamin D.
A sufficient amount of ultraviolet in sunlight
each day and adequate supplies of calcium
and phosphorus in the diet can prevent rickets

HATS-Damongo
MALNUTRITION

Malnutrition simply means poor or abnormal

(mal- meaning faulty) feeding (nutrition).
Intake of nutrients below/in excess of the
recommended daily requirements (allowances)
can lead to under nutrition and the vise versa
can lead to over-nutrition.
The major causes of malnutrition
 Poor dietary intake
 Over feeding
 malabsorption
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MALNUTRITION

Malnutrition may be due to

• Protein-Energy malnutrition (PEM)

• Vitamin (micronutrient) deficiencies
• Both PEM and Vitamin deficiency (multi-
nutrient deficiency).

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MALNUTRITION

The degree of malnutrition is assessed using

body index (measurements of the body) or
anthropometric data

• Body mass index (BMI)

• Age for height
• Age for weight
• Mid-upper arm circumference (MUAC)

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MALNUTRITION

• BMI = weight (kg)

(height)² (m²)

BMI > 21 -normal

18.5 – 20 -marginal
17 – 18.5 -mild malnutrition
16 – 17 -moderate malnutrition
BMI < 16 -severe malnutrition

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MALNUTRITION

Protein Energy Malnutrition

Kwashiorkor Marasmus

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MALNUTRITION

• KWASHIORKOR
occurs when a child is weaned later than
normal and receives starchy foods low in
protein, leading to reduced plasma protein.
SS:Growth stops and there is loss of weight,
oedema in the lower extremities, ascites
(distended abdomen) and discoloration of the
hair and depigmented skin.

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HATS-Damongo
MALNUTRITION

• MARASMUS
occurs when a child is weaned earlier than
normal and receives foods low in nutrients
and energy. A child with marasmus is very
underweight, with no body fat and wasted
muscles (dry skin, loose skin folds hanging
over the glutei)

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HATS-Damongo
Treatment of malnutrition

General the disease can be treated by adding

food energy and protein to the diet including
recommended and appropriate administration of
vitamins and minerals. It is essential to treat not
only the symptoms but also the complications of
the disorder like infections, dehydration and
circulation disorders, which are frequently lethal
and lead to high mortality if ignored.

HATS-Damongo
MALNUTRITION treatment

General the disease can be treated by adding

food energy and protein to the diet including
recommended and appropriate administration
of vitamins and minerals.
It is essential to treat not only the symptoms
but also the complications of the disorder like
infections, dehydration and circulation
disorders, which are frequently lethal and lead
to high mortality if ignored.

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 MALNUTRITION

Every year some 12 million children die before

they reach their 5th birthday.

Seven out of every 10 of these deaths are due to

diarrhoea, pneumonia, measles, malaria or
malnutrition.

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 MALNUTRITION

The WHO/UNICEF strategy of Integrated

Management of Childhood Illness (IMCI) aims
at improving treatment and reducing mortality
in these conditions.

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 MALNUTRITION

GUIDELINES FOR THE INPATIENT TREATMENT

OF SEVERELY MALNOURISHED CHILDREN

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General principles for routine care

• Treat/prevent hypoglycaemia
• Treat/prevent hypothermia
• Treat/prevent dehydration
• Correct electrolyte imbalance
• Treat/prevent infection
• Correct micronutrient deficiencies
• Start cautious feeding
• Achieve catch-up growth
• Provide sensory stimulation and emotional support
• Prepare for follow-up after recovery
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These steps are accomplished in two phases:

• An initial STABILISATION PHASE where the acute

medical conditions are managed

• And a longer REHABILITATION PHASE

Treatment procedures are similar for marasmus

and kwashiorkor.
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HATS-Damongo
MALNUTRITION treatment

CONDITIONS COMMONLY ASSOCIATED WITH

SEVERE MALNUTRITION

• Vitamin A deficiency
• Dermatosis
• Parasitic worms
• Continuing diarrhoea
• Tuberculosis

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MALNUTRITION treatment

Failure to respond to treatment is indicated by

• High mortality
– >20% -unacceptable
– 11-20% -poor
– 5-10% -moderate
– <5% -good

• Low weight gain during the rehabilitation

phase

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MALNUTRITION treatment

Possible causes of poor weight gain are

– Inadequate feeding
– Specific nutrient deficiencies
– Untreated infection
– HIV/AIDS
– Psychological problems

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FACTORS INFLUENCING FOOD CONSUMPTION

THESE INCLUDE:

– Food availability
– Food habits
– Food taboos
– Food storage
– Health status

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FOOD AVAILABILITY

Food security is the access by all people (in the

world, country, district, household) at all times to
enough food for an active, healthy life.

• Availability
• Accessibility
• Affordability

Food must be available, accessible and then

affordable
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ACCESS

• Physical access: this is dependant on food availability

which is determined by food production and supply.
Factors affecting physical access are land, labour (that is
factors of food production) technology and research and
extension.
• Economic access: this is the ability of households to
obtain available food. It has to do with purchasing power.
income
Economic access demand
price
supply
One’s income determines what can be acquired-what the
money can buy is also determined by price HATS-Damongo
• Social access: this is food acquisition behavior thus the
desire to obtain available food.

FOOD TABOOS AND FOOD HABITS

Habit may be simply defined as a pattern or a particular way
of doing things, a behaviour or an attitude developed and
adopted over a long period of time. It may be inborn,
learned and/or adopted consciously or unconsciously.

Taboo is said to be something that is not allowed by a

particular religion or culture
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• Food taboo refers to some particular type of food that
is forbidden by a group of people for culture, religious
and other reasons.
• Food habits can be said to be someone or people’s
perception of food, attitude towards the food and
pattern of choice and consumption of the food. This
will determine what someone may regard, accept,
handle, choose, prepare and consume as food.

What an individual or group will accept as food may be

rejected or forbidden by another, ‘one man’s meat is
another man’s poison’.
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 Factors influencing food habits/taboos include culture,
ethnicity, traditions, family background, religion,
occupation, health, food availability, education.

• FOOD STORAGE
Food storage has got to do with preserving food to be used
later. This involves maintaining the quality and quantity of
the food stored. The nutritional quality of food stored is
likely to be affected due to method of storage, duration of
storage and chemicals used. Inadequate food stored results
into inadequate food consumption during the lean season.

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BASAL METABOLISM

Metabolism
catabolism
anabolism
Basal metabolism is the energy needed by an
organism when it is in complete physical and
mental rest.
The energy is needed for the beating of the
heart, liver, kidney, body temperature etc.

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BASAL METABOLISM

Basal metabolism can be measured when the

person is at rest; not sleeping and in a
comfortable position and condition in a
normal environment (room) temperature,
usually 12-18 hours after the last meal.

• Basal metabolic rate is the energy produced

expressed per unit of surface area of body per
hour. BMR can be expressed as:
kcal/m²/hour
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ENERGY REQUIREMENT (ER)

ER is the amount of energy an individual need

for basal metabolism and physical activity. The
energy requirement is influenced by:
– Physical activity
– Sex
– Age
– Body size and composition

An imbalance in energy requirement may lead to

underweight or overweight.
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NUTRITION THROUGHOUT THE LIFE CYCLE (NTTLC)

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 NTTLC (PREGNANCY)

Pregnancy starts when a male’s sperm

fertilizes a female’s ovum, and the fertilized
ovum (zygote) implants in the lining of the
uterus.

It then develops into a conceptus after a

number of cell divisions. After two weeks the
conceptus is now referred to as embryo and
after eight weeks the developing offspring is
known as a fetus.
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NTTLC (PREGNANCY)
Because pregnancy changes a woman’s normal
hormone patterns, one of the first signs of
pregnancy is a missed menstrual period.
Other symptoms include breast tenderness and
swelling, fatigue, nausea or sensitivity to smells,
increased frequency of urination, mood swings,
and weight gain, vomiting etc .
Some women also experience cravings for unusual
substances such as ice, clay, or cornstarch; this
condition, called pica, can indicate a dietary
deficiency in iron or other nutrients.
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NTTLC (PREGNANCY)

By the 12th week of pregnancy many of these

symptoms have subsided, but others appear.
For example, a woman’s breasts usually
increase in size, and her nipples darken. The
most obvious symptom is weight gain.

Most physicians now recommend a gain of

about 9 to 12 kg by the end of pregnancy.

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NTTLC (PREGNANCY)

• The mother nourishes her offspring in utero

via a placenta.

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 FIRST TRIMESTER OF PREGNANCY
• Growth begins in the first trimester with a
rapid increase in cell number (hyperplasia)
and size (hypertrophy).

• By the end of the first trimester-most organs

are formed. The placenta is also formed and
attaches the embryo to the uterine wall and
exchanges nutrients, gases and waste
between maternal blood and blood of
embryo.
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 FIRST TRIMESTER OF PREGNANCY

• At any stage of development an insult (injury)

to the embryo or fetus caused by nutritional
deficiencies, medications or illegal drugs,
radiation, trauma or other factors can alter or
arrest the specific phase of growth and
development in progress.
• The most critical time for intrauterine
development is the first trimester especially
week two through eight

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SECOND TRIMESTER OF PREGNANCY

• In the second trimester arms, hands, fingers, legs,

feet and toes are fully formed. The fetus has ears
and is beginning to form tooth sockets in its
jawbone.
• During this phase of development, organs
continue to grow and mature, and a physician
can detect a heart beat. Most bones will be
distinctly evident throughout the body. Skeletal
muscles become active and it may suck its thumb
and kick strongly enough to be felt by the
mother.
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 SECOND TRIMESTER OF PREGNANCY

• At this stage the placenta produces estrogen

and progesterone to maintain the uterine
wall. Placenta estrogen and progesterone in
combination with another hormone called
placental lactogen, stimulate breast
development and prepare mammary glands
for milk secretion. This continues to the third
trimester.

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 SECOND TRIMESTER OF PREGNANCY

• Other hormones such as aldosterone ensures

renal reabsorption of sodium and parathyroid
hormone help maintain high concentration of
maternal blood calcium.

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THIRD TRIMESTER OF PREGNANCY

By the beginning of the third trimester, a fetus

weighs approximately 2 to 3 pounds. In this trimester
fetal development continues that include the central
nervous system, ears, eyes, teeth, external genitalia
etc. mineral and fat stores normally accumulates
during the last month of gestation. At the 9 months,
the fetus should weight about 7 to 8 pounds (about
3.5kg). There is an especially large soft spot on the
top of the head (fontanelle) where the bones of the
skull are growing together. It takes about 12 to 18
months after birth for that soft spot to close.

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NTTLC

• Preterm: an infant born before 37 weeks of gestation;

also referred to as premature.

• Low birthweight (LBW): any infant weighing less than

2.5kg (5.5 pounds) at birth; the most commonly
results from preterm birth.

• Small for gestation age (SGA): any infant whose

birthweight is less than the expected weight
corresponding to the duration of gestation.
A full-term newborn weighing less than 2.5 kg is SGA.
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NUTRIENT NEEDS OF PREGNANT WOMAN
Energy needs during the first trimester of
pregnancy are the same as during the non
pregnant state. But during the second and
third trimesters, the pregnant woman requires
an extra energy intake of approximately 300
kcal/day(2 cup of 2%milk and a slice of bread).
Many vitamins and minerals needs are
increased by 20% to more than 100% during
pregnancy.

HATS-Damongo
NUTRIENT NEEDS OF PREGNANT WOMAN
If a woman is active during pregnancy, the
energy she expends is added to any extra
energy needed for pregnancy to balance her
total energy use. Due to the benefits of
physical activity, pregnant women are
encourage to continue with most activities
during pregnancy except weightlifting, contact
sports like hockey etc.

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210
200
190
180
170
160
150
140
130
120
110
100

phosphorus
magnesium
riboflacin
thiamin
*energy

calcium
protein

iodide
vit. B12
niacin

folate
vit. B6
vit. A

zinc
vit. D
vit. E
vit. C

iron
• *second and third trimester only.
• Nutrients needs of pregnant women expressed as percentage of the RDA for
adult non pregnant women.

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 RECOMMENDED WEIGHT GAIN

For women with a normal weight to height ratio, the

prenatal diet should allow for approximately 2 to 4
pounds of weight gain during the first trimester and
then a subsequent weight gain of ¾ to 1 pound per
week during the second and third trimester. The total
weight gain goal is about 25 to 35 pounds. The total
weight gain is as a result of the increase in
• Maternal fat stores
• Uterus and breast
• Blood
• Fetus, placenta, amniotic fluid
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 BREAST FEEDING

• Breast feeding is the process of feeding the

infant (newborn) directly with human milk.

• When breast milk is given continuously to a child

for 6 months without any other food or liquid, it
is termed as EXCLUSIVE BREAST FEEDING.
• All women are physically capable of nursing
(breastfeeding) their children. Breast size is no
indication of success in breastfeeding and
generally increases during pregnancy.
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 BREAST FEEDING

• During pregnancy, cells in the breast aggregate to

form milk producing cells called lobules. After
birth, increased maternal production of the
hormone prolactin enhances milk production.
Suckling by the infant stimulates release of
prolactin, which in turn stimulates milk synthesis.
The longer the infant suckles, the more milk is
produced. Thus milk production is closely parallel
to infant demand-allowing for successful feeding
of more than one infant. Demand is the driving
force for milk production.
HATS-Damongo
THE LET-DOWN
REFLEX

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 BREAST FEEDING

• The monosaccharide galactose is synthesized

in the breast, while glucose enters from the
maternal circulation. Together these
monosaccharides form the dissaccharide
lactose, the primary carbohydrate in human
milk.

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 BREAST FEEDING

• Colostrum: the first fluid made by the human

breast is colostrum. This thick, yellowish fluid
may leak from the breast during late pregnancy.
Colostrum contains antibodies and immune-
system cells, some of which pass unaltered
through the immature GI tract of the infant into
the bloodstream. These immune factors and
cells protect the infant from some
gastrointestinal disease and other infectious
disorders, compensating for its own immature
immune system.
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 TYPES OF BREAST MILK

• Colostrum (yellowish)
• Fore (true) milk (blue-wish in colour)
• Hind milk (whiter)

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 COMPOSITION OF BREAST MILK

• Immune components-antibodies and

antinfective properties.
• Water (80-90%)
• Contain all the food nutrients in their right
proportion
• Lysosomes
• Protein called bifidus factor to kill all GIT
pathogens and prevent diarrhoea
• Immunoglobulin A
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 FACTORS THAT AFFECT BREAST MILK
PRODUCTION
• Suckling of the baby
• Crying of the baby (increase milk prodcution0
• Prolactin reflex
• Oxytocin reflex
• Emotional state of the mother eg worries
• Health status of the mother.
• Pain eg. Nursing mothers experience lower
abdominal pains upon starting breastfeeding.

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 BENEFITS OF BREASTFEEDING

TO THE BABY
• Breast milk contains essential nutrients like
fats, protein and carbo. which the baby need
for growth and development for the first 6
months.
• Breast milk is always at the right temperature
to suit baby’s health
• It contains antibodies and anti-infectives
which provides baby’s resistance to diseases.

HATS-Damongo
 BENEFITS OF BREASTFEEDING

TO THE MOTHER
• It contracts the womb and help stop bleeding
after delivery.
• It lowers the risk of ovarian and breast cancer
• It establishes bonding between mother and
baby
• It is cheap and easily available

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 BENEFITS OF BREASTFEEDING

TO THE NATION
• Helps prevent childhood diseases since children
will not be infected and transmit them to other
children
• Decrease health cost or budget cost on the
government
• Produce intelligent and learned people
• Increase productivity
• Healthy and emotionally stable families and
better education.
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 BENEFITS OF BREASTFEEDING

BREAST
• B - best for baby
• R - reduces allergies
• E - economical
• A - antibodies and anti-infective for
immuniy
• S - stool not offensive
• T - temperature normal

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 BENEFITS OF BREASTFEEDING

FEEDING
• F - fresh and does not go sour
• E - economically bonding
• E - easy once established
• D - digested in two-three hours
• I -immediately available
• N -nutritionally balanced
• G -GIT infections greatly reduced

HATS-Damongo
 PROBLEMS OF BREAST FEEDING

• Sore nipple
• Engorgement of breast
• Mastitis or breast abscess

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 WHY NOT COW MILK

• It is for cows not humans

• It causes gastrointestinal bleeding
• Its renal solute load is too heavy for the infant’s
renal system to handle
• It affects iron status, not only because of the
gastrointestinal bleeding and blood loss but also
because it is low in iron and its high calcium and
phosphorus levels inhibit iron absorption.
• The constituent and proportion of nutrient in cow
milk does not meet the varying requirement of the
infant
HATS-Damongo
 INFANT (BIRTH TO 1 YEAR)

• During the first year of life, the infant grows rapidly, from
this average birth weight to a 1 year old child ready to
walk and weighing about 9kg.
• Thus energy requirements during this first year of
tremendous growth are high. Full-term infants have the
ability to digest and absorb protein, a moderate amount
of fat, and simple carbohydrate. They have some
difficulty with starch, since amylase, the starch splitting
enzyme is not being produced at first. However, as starch
is introduced, this enzyme begins to function. The renal
system functions well but more water relative to size is
needed than in an adult to manage urinary excretion.

HATS-Damongo
 INFANT (BIRTH TO 1 YEAR)
Their first baby teeth do not erupt until about the fourth
month, so initial food must be liquid or semi liquid. They
have limited nutritional stores from gestation, especially
in iron. Thus they need supplements of vitamins and
minerals, first in concentrated drops and later in semi
solid food additions to their first food (breast milk). The
ideal food for the human infant is human milk. It has
specific characteristics that match the infant’s nutritional
requirements during the first year of life.

Psychosocial development
establishment of trust versus distrust

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 TODDLER (1-3 YEARS)

• After the rapid growth of the first year the growth rate
of children slows. The legs become longer, and the child
begins losing baby fat. Important muscle development
begins which account for half the total gain during this
period. As the child begins to walk and stand erect,
more muscle is needed to strengthen the body. ( big
muscles in the back, the buttocks and thighs). Skeletal
growth slows, but there is more deposit of mineral
rather than lengthening of the bones. The increased
mineralization strengthen the bones to support the
increasing weight. By 3 years of age the remainder of
the deciduous teeth have erupted.
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 TODDLER (1-3 YEARS)

Psychosocial development
The core development problem they struggle with
is the conflict of autonomy versus shame

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 PRESCHOOLER (3-6 YEARS)

• Children play is hard play (running, jumping, and

testing new physical resources). At other times the
child will sit for increasing periods of time engrossed in
passive types of activities. Mental capacities are
developing and there is more thinking and exploring of
the environment.
• Energy needs increases to about 1800 kcal/day as well
as other nutrients. Protein requirement also continue
to increase as the child grows older. They continue to
need calcium and iron for storage. Since vitamin A and
C may be lacking in the diet, a variety of fruits and
vegetables should be provided.
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 PRESCHOOLER (3-6 YEARS)

• Psychosocial development
Each age group builds on the previous one.
The core psychosocial development problem
preschool children struggle with is essentially
that of

Initiative versus Guilt

They begin to develop the super ego-conscience

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 SCHOOL-AGED CHILD (6-12 YEARS)

The school age period had been called the latent

time of growth. The rate of growth slows and body
changes occur gradually. However, resources are
being laid down for the rapid adolescent growth
ahead. Some times this had been called the lull
before the storm. Girls usually outdistance boys in
the latter part of this period.

Psychosocial development
tension between industry versus inferiority

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 ADOLESCENT

During the adolescent period, with the onset

of puberty, the final growth spurt of childhood
occurs.

Struggle with identity versus role diffusion

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 ADOLESCENT

FEMALES
The amount of subcutaneous fat deposit
increases, particularly in the abdominal area.
The hip breadth increases, and the bony pelvis
widens in preparation for reproduction. This is
often a source of anxiety to many figure
conscious young girls.

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 ADOLESCENT

MALES
In boys physical growth is manifested more by
an increased muscle mass and long bone
growth. Males growth spurt is slower than
that of the girl, but he soon passes her in
weight and height.

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 NUTRITION IN ADOLESCENCE

• The adolescent growth spurt account for app.

25% of adult height and 50% of adult weight.
• In addition, adolescents are developing
reproductive capacity at this time
• Nutrients needs are greater during
adolescence than any other period after birth
• Failure to consume adequate diet can disrupt
normal growth and development.

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 NUTRIENT REQUIREMENTS
• Energy needs for individual adolescents vary
according to:
– Sex
– Age
– Body size
– Pubertal development
– Physical activity
• A sedentary teenager may gain excess weight by
consuming fewer than the recommended amount
of calories or vice versa
• An active adolescent may require a higher caloric
intake to maintain adequate weight gain
HATS-Damongo
 NUTRIENT REQUIREMENTS

The need for vitamins and minerals rises

during adolescence.
A greater energy demand means the following
will be necessary for the release of energy
from carbohydrates
– More thiamine (B1)
– More riboflavin (B2)
– More Niacin

HATS-Damongo
 NUTRIENT REQUIREMENTS

Increased tissue synthesis means a greater

demand for the substances that are needed
for DNA and RNA metabolism
– Folic acid
– Cynocobalamin (B12)
Rapid rate of skeletal growth means a need for
– Vitamin D
– Calcium
– phosphorous

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An increase in the following substances are
needed to maintain structural and functional
properties of the new cells attained during
growth
– Vitamin A
– Vitamin C
– Vitamin E

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The need for minerals increases substantially
during the growth spurt of adolescence
– Calcium for increased skeletal mass
– Iron for expansion of blood volume
– Zinc for the generation of skeletal and muscle
tissue

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Most likely to be inadequate during
adolescence are;
– Iron
– Calcium
– Vitamin A
ADOLESCENT EATING PRACTICES
– Eating away from home
– Skipping meals
– Snacking

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• Adolescence is characterized by a heightened
awareness of physical appearance

• Dissatisfaction with body weight or body image

is widespread in adolescence

• Males are concerned with physical development

• Females are concerned with body weight

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 EATING DISORDERS

ANOREXIA NERVOSA
(extreme fear of becoming
overweight)

• Relentless pursuit of thinness

• Weight deficits
• Distorted body image
• amenorrhea

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 EATING DISORDERS

BULIMIA
(bouts of overeating followed by under eating, use of
laxatives, or self-induced vomiting. It is associated with
depression and anxiety about putting on weight)

• Frequent binging
• Purging
• Vigorous exercise
• Strict dieting
• Laxatives
• diuretics
HATS-Damongo
Complication of Anorexia Nervosa and Bulimia

• Cardiovascular abnormalities

• Electrolyte disturbances

• Malnutrition

• Reduced body mass may contribute to bone

deficit

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 assignment
• Briefly describe the nutritional requirement of
an adult and the elderly.

The psychosocial development

(generativity versus stagnation)

(ego integrity versus despair)

 THERAPEUTIC DIETS

Therapeutic diets are diets that have been

modified to suite a particular disease
condition or administered during a therapy
(treatment)

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 GASTRIC DIET

• STOMACH

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 GASTRIC DIET

The stomach is usually a highly acidic

environment due to gastric acid production
and secretion which produces a luminal pH
range usually between 1 and 4 depending on
the species, food intake, time of the day, drug
use etc. the stomach can produce and secrete
about 2 to 3 litres of gastric acid per day.

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 GASTRIC DIET
Ulcer - shallow sore produced by the destruction of
skin or mucous membrane.

Peptic ulcers are ulcers of the stomach (gastric) or

small intestine (duodenal) or esophagus
(esophageal ulcer). In addition to the pain caused
by the ulcer itself, peptic ulcers give rise to such
complications as hemorrhage from the erosion of a
major blood vessel; perforation of the wall of the
stomach or intestine, obstruction of the
gastrointestinal tract because of spasm or swelling
in the area of the ulcer.
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 GASTRIC DIET

The direct cause of peptic ulcers is the

destruction of the gastric or intestinal mucosal
lining by hydrochloric acid or the bacterium
Helicobacter pylori or by some drugs such as
Aspirin and other nonsteroidal anti-
inflammatories (NSAIDs)

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 GASTRIC DIET

• Avoid the consumption of irritating foods eg.

Pepper
• Avoid the consumption of acidic foods
• Avoid smoking and alcohol
• Avoid starvation
• Eat adequately and drink good water
• Abstain from certain drugs eg Aspirin, NSAIDs

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DIABETES

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 DIABETES

Diabetes Mellitus, disease in which the

pancreas produces insufficient amounts of
insulin, or in which the body’s cells fail to
respond appropriately to insulin.

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 DIABETES
Insulin is a hormone produced by the pancreas
that helps the body’s cells absorb glucose (sugar)
so it can be used as a source of energy. In people
with diabetes, glucose levels build up in the blood
and urine, causing excessive urination, thirst,
hunger, and problems with fat and protein
metabolism.
Diabetes mellitus differs from the less common
diabetes insipidus, which is caused by lack of the
hormone vasopressin, which controls the amount
of urine secreted.
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 DIABETES

TYPES OF DIABETES

• Type 1 diabetes mellitus

• Type 2 diabetes mellitus

NB. Gestational diabetes

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 DIABETES

• Type 1 diabetes, formerly called insulin-

dependent diabetes mellitus (IDDM) and
juvenile-onset diabetes, the body does not
produce insulin or produces it only in very
small quantities. Symptoms usually appear
suddenly, typically in individuals under 20
years of age.

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 DIABETES

• Type 1 diabetes is an autoimmune disease,

that is, a condition in which the body’s
disease-fighting immune system goes awry
and attacks healthy tissues. In the case of Type
1 diabetes, the immune system mistakenly
attacks and destroys insulin-producing cells,
known as beta cells, in the pancreas.

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 DIABETES
• In Type 2 diabetes, formerly known as non-
insulin-dependent diabetes mellitus (NIDDM)
and adult-onset diabetes, the body’s delicate
balance between insulin production and the
ability of cells to use insulin goes awry.

Assignment
• Identify the sign and symptom of diabetes
• Briefly describe at least five of the
complications of diabetes.
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 DIET THERAPY FOR DIABETES

• Consume food with low glycemic index

• Reduce carbohydrate intake
• Eat a lot of vegetables and fruits
• Exercise regularly
• Avoid intake of refine sugar
• Observe good personal hygiene
• Consume complex carbohydrate small at a
time

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 OBESITY

• Obesity is a condition in which the natural

energy reserve, stored in the fatty tissue of
humans and other mammals, is increased to a
point where it is associated with certain health
conditions or increased mortality.

Excessive body weight has been shown to

predispose to various diseases, particularly
cardiovascular diseases, diabetes mellitus type
2, sleep apnea, and osteoarthritis
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 OBESITY

• BMI = < 18.5 is underweight

• BMI = 18.5 – 24.9 normal weight
• BMI = 25.0-29.9 overweight
• BMI = 30.0 – 39.9 obese
• BMI = > 40 is severely (or morbidly) obese

Causes of obesity
• Over eating

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 OBESITY
Factors that have been suggested to contribute to
the development of obesity include
• Genetic factors and some genetic disorders
• Underlying illness (eg hypothyroidism)
• Eating disorders (eg binge eating disorder)
• Certain medication (some fertility medication)
• Sedentary lifestyle
• A high glycemic diet (diet that consists of meals
that give high postprandial blood sugar)
• Insufficient sleep
• Smoking cessation
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 DIET THERAPY FOR OBESITY

• Reduce fat intake

• Eat fibre foods
• Reduce carbohydrate intake but consume
normal complex carbohydrates
• Do a lot of exercise starting with mild and
gradually a vigorous one
• Eat more fruits and vegetable
• Drink good and plenty water

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 HYPERTENSION

Hypertension (high blood pressure) is a

medical condition in which the blood pressure
is chronically elevated.
Hypertension has been associated with a
higher risk of heart attack or stroke.
Sodium is the environmental factor that has
received the greatest attention.

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 DIET THERAPY FOR HYPERTENSION

• Physicians recommend that people with

hypertension undergo diet and lifestyle
changes, such as losing weight and quitting
smoking, in order to prevent a rise in blood
pressure.
• Some patients can lower their blood pressure
by limiting salt in their diet. Increasing physical
activity and reducing alcohol consumption
may also lower blood pressure.

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• In addition, fruits, vegetables and nuts have
the added benefit of increasing dietary
potassium, which offsets the effect of sodium
and acts on the kidney to decrease blood
pressure.
• Diuretics are antihypertensives that promote
excess salt and water excretion, reducing the
amount of fluid in the bloodstream and
relieving pressure on blood vessel walls.

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 ESSENTIAL NUTRITION ACTIONS

• Demonstrate impact on child and maternal

morbidity and mortality
• Feasible and affordable
• Actions can be changed through cost-effective
primary health care programs
• Relevant in a wide range of communities
• Can be integrated into on-going health
delivery services.

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 ENAs
• Immediate and exclusive breastfeeding for the
first six month.

• Appropriate complementary feeding starting at

six months and breastfeeding to 24 month and
beyond.

• Adequate intake of vitamin A by young children

and mother within eight weeks after birth

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 ENAs

• Regular use of iodized salt by all family

members

• Adequate micronutrient intake (particular

iron) during pregnancy and lactation

• Prevention and treatment of helminthes

among pregnant women and children.

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 6 CRITICAL CONTACTS

• Antenatal
• Delivery
• Postnatal
• Sick child
• Well child
• Immunization

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TO BE CONTINUED . . . .

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