Nutritional Problems PDF

 NUTRITION - The word Nutrition is the science of foods, the study of nutrients and other substances therein, their action, interaction and balance in relationship to disease.  Malnutrition – defined as a pathological state resulting from a relative or absolute deficiency or excess of one...

 NUTRITION - The word Nutrition is the science of foods, the study of nutrients and other substances therein, their action, interaction and balance in relationship to disease.  Malnutrition – defined as a pathological state resulting from a relative or absolute deficiency or excess of one or more essential nutrients Undernutrition - condition that results when insufficient food is consumed over an extended period of time Overnutrition – pathological state resulting from the consumption of excessive quantity of food over an extended time Imbalance – pathological state resulting from disproportion among essential nutrients with or without the absolute deficiency of any nutrient Specific deficiency – pathological state resulting from a relative or absolute lack of specific  CARBOHYDRATES ENERGY YIELDING FOOD FATS BASED ON BODY BUILDING PROTEINS FUNCTIONS FOOD CLASSIFICATION OF FOOD VITAMINS PROTECTIVE FOOD MINERALS MACRONUTRIENTS BASED ON NUTRIENTS MICRONUTRIENTS  Clinical Examination Anthropometry Biochemical evaluation Assessment of dietary intake Vital statistics – morbidity and mortality Ecological factors  NUTRITIONAL PROBLEMS PROTEIN ENERGY MICRONUTRIENT CHRONIC EATING MALNUTRITION DEFICIENCY DISEASES DISORDERS (PEM) NUTRITION PROBLEMS IN INDIA WHO IS AT RISK??  PREGNANT WOMEN  LACTATING WOMEN  INFANTS.  PRESCHOOL CHILDREN  ADOLESCENT GIRLS  ELDERLY Vijayaraghavan  Protein–energy malnutrition (or protein–calorie malnutrition) refers to a form of malnutrition where there is inadequate protein and calorie intake It is considered as the primary nutritional problem in India PEM is due to the “food gap” between the intake and requirement Causes childhood morbidity and mortality  KWASHIORKOR PEM MARASMUS MARASMIC - KWASHIORKOR  CAUSES AND RISK CONTRIBUTORY FACTORS FACTORS  Inadequate intake of food  Poor envt. Hygiene  Diarrhea  Large family size  Respiratory infections  Poor maternal health  Measles  Failure of lactation  Intestinal worms  Premature termination  Infants and pre of breast feeding schoolers  Delayed supplementary feeding  Use of over diluted cow’s milk Kwashiorkor is the most common and widespread nutritional disorder in developing countries. It is a form of malnutrition caused by not getting enough protein in the diet.  Marasmus is a severe form of malnutrition that consists of the chronic wasting away of fat, muscle, and other tissues in the body. Malnutrition occurs when the body does not get enough protein and calories. This lack of nutrition can range from a shortage of certain vitamins to complete starvation. Marasmus is one of the most serious forms of protein-energy A malnutrition disease, primarily of children, resulting from the deficiency of both calories and protein. The condition is characterized by severe tissue wasting, dehydration, loss of subcutaneous fat, lethargy, and growth retardation  KWASHIORKOR MARASMUS  Acute Severe prolonged illness/infections, starvation, measles, AGE, chronic/recurring trauma, sepsis are infections some causes Calories and protein are principal nutrients  Protein is principal nutrient 6 months to 2 years  18 months to 3 years Chronic, slow onset Severe weight loss  Rapid, acute onset Low mortality unless  Some weight loss related to underlying  High mortality disease condition  KWASHIORKOR MARASMUS  Edema, pot belly, swollen No edema legs  Weight loss upto 40%  Mild to moderate growth  Severe growth failure retardation  Weight masked by edema  Severe emaciation  Low subcutaneous fat  Severe loss of subcut fat  Muscle atrophy  Severe muscle atrophy  Round face (moon face)  Wrinkled face (old man’s  Dry, flaky peeling skin face)  Thin dry easily plucked  Rare skin changes hair  Common hair changes  Enlarged liver  Mildly enlarged liver  Xerophthalmia  Anemia, diarrhea,  Anemia, diarrhea, infection infection Gomez Classification Weight for age (%) = Weight of child 100 Wt. of normal child of same age Between 90 – 110% Normal Nutritional Status Between 75 – 89% Mild malnutrition (1st degree) Between 60 – 74% Moderate Malnutrition (2nd degree) Under 60% Severe Malnutrition (3rd degree)  Infant – Weight (Kg) = Age in months + 9 2 Pre schooler – Weight (Kg) = 2 x (Age in years) + 5  Oral rehydration therapy helps to prevent dehydration caused by diarrhea Exclusive breast feeding for 6 months there after supplementary foods may be introduced along with breast feeds Immunization for infants and children Nutritional supplements Early diagnosis and treatment Promotion and correction of feeding practices Family planning and spacing of birth Periodic surveillance Nutritional rehabilitation  An LBW newborn is any newborn with a birth weight of less than 2.5kg (including 2.499kg) regardless of gestational age.  RISK FACTORS CAUSES o Maternal malnutrition o Illness/infections o Anemia o Short maternal stature o Very young age o High parity o Close birth intervals o IUGR o Hard physical labor during pregnancy o Smoking  LOW BIRTH WEIGHT PRE TERM SGA BABIES BABIES SPONTANEOUS PROVIDER PRE TERM INITIATED PRE BIRTH TERM BIRTH  Identification of mothers at risk – malnutrition, heavy work load, infections, disease and high BP Increasing food intake of mother, supplementary feeding, distribution of iron and folic acid tablets Avoidance if smoking Improved sanitation methods Improving health and nutrition of young girls Early detection and treatment of medical disorders – DM HTN Controlling infections – UTI, rubella, syphillis, malaria  VITAMIN A VITAMIN B COMPLEXES VITAMINS VITAMIN C VITAMIN D MICRONUTRIENTS VITAMIN K CALCIUM PHOSPHORUS MAJOR MINERALS SODIUM POTASSIUM MAGNESIUM MINERALS IRON IODINE TRACE ELEMENTS FLUORINE ZINC.  Xerophthalmia i.e., dry eyes refers to all the ocular manifestations of vitamin A deficiency in man It is the most widespread and serious nutritional disorder leading to blindness  RISK FACTORS CLINICAL FEATURES  Poor SE status  Corneal ulcers  Faulty feeding  Softening of cornea practices  Keratomalacia  Weaning  Bitot spot  PEM  Infections  1-3 years  PREVENTION AND CONTROL  Administering large doses of vitamin A orally on a periodic basis  Regular and adequate intake of vitamin A  Fortification of certain food with vitamin A – sugar, salt, tea and skimmed milk  Nutritional anemia is a condition where the hemoglobin content of blood is lower than normal as a result of a deficiency of one or more essential nutrients, regardless of the cause of such deficiency.  RISK FACTORS CAUSES  Infants and children  Inadequate diet  Pregnant women  Insufficient intake of  Pre menopausal iron women  Iron malabsorption  Adolescent girls  Pregnancy  Older adults  Excessive menstrual  Alcoholism bleeding  Chronic/ critically ill  Hook worm infestation  Excessive exercise  Malaria  Close birth intervals  GI bleed  PREGNANC Y Increases risk of maternal and fetal morbidity and mortality Abortions, premature births, PPH, low birth weight are associated with anemia during pregnancy  Anemia can be aggravated by INFECTION parasitic infections like malaria, intestinal parasites Iron deficiency may repair cellular response and immune functions WORK CAPACIT Y More severe the anemia, greater the reduction in work performance  Estimation of Hb to assess degree of anemia  Blood transfusion in severe cases of anemia (