1. Nutritional requirment for PC II Medical student.pptx

Nutrition

1. Nutritional Requirement for PC II medical students By Meseret Tamrat Aprol ,2024

2. objective At the end of the course , students will be able to Describe the recommend energy and other nutrients requirements

3. Nutritional Requirement A requirements of nutrients is the minimum requirement of the nutrients that needs to be consumed to prevent symptoms of deficiency to maintain satisfactory level of the nutrient in the body.

4. Nutritional Requirement Humans need a wide range of nutrients to lead a healthy and active life. Components of the diet must be chosen based on all the nutrients to meet the human requirements in proper proportions for the different physiological activities.

5. ...requirement The amount of each nutrient needed for an individual depends upon Age and sex Physiological status Physical activity

6. Dietary Reference Intake (DRI) standards are a set of scientifically developed reference values for nutrients. Quantitative estimates of nutrient intakes required to prevent deficiencies and maintain optimal health and growth. DRI values provide the scientific basis for nutrition and other professionals, governments, and non-governmental organizations to carry out activities .

7. DRI…… The DRI standards can be divided into two main categories: Recommendations for nutrient intake  – How much of each nutrient should be consumed how much is excessive Recommendations for energy intake   How many calories are required how much energy should proportionately come from carbohydrate, fat, and protein

8. Development of nutrients Standards Nutrient standards are established in 1993 by experts  FNB and AMS . These standards are based on the  scientific evidences on the distribution of nutrient requirements  and population's diet.  Establishment of Standard  considered on the biological effects intake and bioavailability of nutrients other dietary factors 

9. Why it is important to know about estimation of nutritional requirement Individuals can use the DRIs help to assess and plan their diets. It established with an ample safety margin and should be used as guidance for optimal intakes. to assess and plan the average intake over time Health professionals . Registered dietitcians and other nutrition professionals to provide dietary counselling and education to plan menus for institutions

10. Why DRI ? Development of dietary guidelines . U.S. Dietary Guidelines for Americans MyPlate and Canada’s Food Guide EFBG Nutrition labeling . help to inform Nutrition Facts labels on foods Supplement Facts on supplement labels Assistance programs . School meals,Child and Adult Care, and Administration on Aging programs Nutrition monitoring research . For comparison of survey

11. DRI…… DRI :- Standard to guide safe and adequate intake of essential nutrients for healthy individuals . Designed to promote optimal nutrition and health Specific for different life cycle Adequate for moderately and active people

12. Dietary Rreference Intakes (DRI). DRI encompass four Types of nutrient recommendations for healthy individuals Recommended dietary Allowances (RDA) Estimated Average Requirement(EAR) Adequate Intake (AI) Tolerable upper intake Level (UL)

13. Recommended Dietary Allowances (RDA) RDA seted by American Medical Association in 1941 and 1943 revised. It estimated The average daily amount of nutrient intake that is sufficient to meet the nutritional requirement of nearly all (97-98%) of healthy individuals in age and gender group . So there is 2-3% of the population that will not receive the sufficient amount of the nutrient if they take the recommended daily allowance RDA =2 SD above EAR and below 2SD RDA = EAR ± 2 SD

14. Estimated Average Requirement (EAR ) The average daily amount of nutrient intake estimated to meet the nutritional requirement of half of the healthy population in life cycle and gender group. the mean level of nutrient requirement

15. Adequate Intake (AI) Covers the nutritional requirement of all individuals in a group to ensure nutritional adequacy the level sufficient to prevent deficiencies  when requirement curve is not available It is used instead of EAR and RDA when evidence is insufficient .

16. Tolerable upper intake Level (UL) The highest average daily nutrient intake level that has no adverse health effects or toxicity in almost all individuals. can prevent any toxic effects

17. Target population Each of the nutrient recommendation categories in the DRI system is used for specific purposes among individuals or populations. EAR is used for evaluating the nutrient intake of populations. The new RDA can be used for individuals.

18. Recommendations for energy intake  Estimated energy requirement (EER) an estimate of how many calories a person needs to consume, on average, each day to stay healthy based on: - Age & sex Weight & height Physical activity

19. Acceptable Macro nutrient Distribution Ranges (AMDR) Range of adequate intake of a macronutrient associated with reduced risk of chronic disease while producing adequate amounts of essential nutrients.

20. Acceptable Macro- nutrient Distribution Ranges(AMDR)

21. How determine the nutritional requirement for individual? An 8 years old male child called Tollosa , consumed the following food Yesterday CHO = 300g/d(300*4)=1200 Total Fat = 40 g/d(40*9)=360 Protein = 12 g/d(12*4)=48 Recommended KCAl for tollossa =1742 how much Kcal found in ( Tollossa’s ) yesterday's diet ? Compare Kcal of each nutrients with the standard and decide whether the child in deficiency or excess state?

22. EER…. Carb= 1200, fat 360 and protein 48 = 1608 ,inadequate energy b/c the recommended= 1742

23. Estimated Energy Requirements (EER), Recommended Dietary Allowances (RDA), and Adequate Intakes (AI) for Water, Energy, and the Energy Nutrients

24. Recommended Dietary Allowances (RDA) and Adequate Intakes (AI) for Vitamins

25. EAR and RDA relative to individual requirements for a given nutrient

26. Requirment of nutrients

27. Dietary guidelines and goals Dietary guidelines : give advice on specific areas of the diet to make dietary improvements. “choose whole-grain foods” “no more than 10% of energy from saturated fat” “eat five servings a day of fruit and vegetables’’ Different guideline for developed and developing countries

28. Dietary guidelines for developing countries Eat a variety of foods Eat vegetables and fruits every day Eat more fish Eat beans or meat regularly Use wholegrain products Use only iodized salt, but use less salt Eat at least three meals a day Avoid drinking alcohol Consume clean and safe water and food Achieve and maintain a healthy body weight

29. ...guide line Caloric intake:      – Fat should be < 30% of total calories;     – Saturated fat should be < 10% of total calories;     – Polyunsaturated fat consumption should be >300 mg/day;     – Carbohydrates (especially complex type) should constitute 1/2 of calories in diet Sodium intake should be < 3 g/day. 

30. Infancy, Childhood and Adolescence requirement in life cycle The common denominator for the estimation of the nutritional requirement is rapid growth and development Infancy: have higher demand for nutrients Rapid growth More vulnerable to infection

31. --requirement in life cycle Adolescents requires higher needs for nutrients a very rapid growth during their puberty. During the pubertal growth spurt, they increase both weight and height rapidly. The growth velocity is very high during Infancy, Childhood and Adolescence of the human life span including the intrauterine life.

32. Weight gain( lb/year) Age in years Height gain( inches /year) Age in years Growth Rate Pre- pubetal dip Pubetal growth spurt

33. Nutrients requirement During Pregnancy and lactation a healthy and well-nourished mother can give a birth normal infants with appropriate weight A mother needs to gain weight during pregnancy to nourish her growing baby. LBW baby more likely to have physical and mental Problems Infection Malnutrition

34. …pregnancy Women should gain weight at least 11kg Eats at least one extra meals /d during pregnancy and two extra meal during lactation Prevent anemia – consume diversified and iron rich foods

35. Elderly Elderly people need special attention as they are more vulnerable to nutritional problems impaired physiological and anatomical capacity with regard to procurement, preparation, ingestion, digestion and absorption of food and nutrients.

36. Ethiopia Food-based dietary guidelines (EFBDG) FBG are established as basis for food and nutrition ,health and agricultural policies and nutrition education programs To promote healthy eating habits and lifestyles. To provide advice to the general public on foods, food groups and dietary patterns provide clues on the required nutrients, promote overall health and prevent chronic diseases . FBDGs contains easily understood messages for the general public Supported by an image or diagram .

37. Transition to healthier diets can only by FBG Because it consider Socio-economic, culture, ecological and environmental conditions

38. Ethiopia Food-based dietary guidelines (EFBDG) Key messages for Public

39. Key message 1: Diversify your diet by selecting from at least 4 food groups in every meal and 6 food groups every day

40. Key message 2: Every day, eat 80–120 grams of legumes such as beans, chickpeas, peas or lentils

41. Commonly consumed legumes depicted in grams

42. Key message 3: Eat 100–200 grams of various fruits and vegetables of different colours every day

43. Key message 4: Diversify your diet with 10–20 grams of nuts and oilseeds such as groundnuts, and sunflower or sesame seeds

44. Key message 5: Add animal-source foods such as eggs and meat (60 grams) and dairy foods (300–400 grams) to your meals every day

45. Key message 6: Drink 8–10 large glasses of clean water daily

46. Key message 7: Be physically active for at least 30 minutes a day

47. Key message 8: Take up to 15–20 grams of fats and oils per day

48. Key message 9: Limit intake of sugar, sweets and soft drinks to below 30 grams per day

49. Key message 10: Limit salt intake to below 5 grams per day

50. Key message 11: Limit alcoholic drinks – both factory-processed and homemade – to no more than 2 glasses per week

51. THANK YOU