5_Nutritional_requirement for health students.pptx

5_Nutritional_requirement for health students.pptx
it contains primary methods of calculating nutritional requirements in different stages

1. Nutritional Requirements 1

2. 2 Nutritional requirements An adequate supply of nutrients is needed to Maintain all the functions of the body and Daily activities at maximum efficiency, thus ensuring healthy living. Health and nutrition are closely linked and to ensure proper development and life quality they must be adequate from early childhood on and most vulnerable groups are Infants, young children, Pregnant women and lactating mothers.

3. Good nutrition must meet the needs of varying ages and activities and always with individual differences. Therefore, the planning of food to meet especial needs begins with: Pregnant women Nursing mothers Infants Adolescents and Adults 3

4. The energy requirements of individuals depend on ♦ Physical activities ♦ Body size and composition ♦ Occupation status ♦ Age may affect requirements in two main ways the infant needs more energy because it is growing During old age, the energy need is less because aged people are engaged with activities that requires less energy. ♦ Climate: Both very cold and very hot climate restrict outdoor activities. 4

5. Predictive equation for energy (calorie) needs Harris Benedict uses Age, Height, and Weight to estimate Resting energy expenditure (REE), the minimum amount of energy needed by the body at rest in fasting state The REE is increased in patent suffering from burns, fever, infections, fractures, trauma e.t.c L owered in malnutrition 5 Estimation of Nutrient Needs

6. Harris Benedict equation In men: REE (kcal/day) = 66.5 + (13.8 X W) + (5.0 X H) – (6.8 X A) In women: REE (kcal/day) = 55.1 + (9.6 X W) + (1.8 X H) – (4.7 X A) Where W = weight in kilograms, H = height in centimeters and A = age in years. 6

7. REE is multiplied by An activity factor and Injury factor To predict total daily energy expenditure Confined to bed = 1.0-1.2 Out of bed = 1.3 Very light = 1.3 Light = 1.5 -1.6 Moderate = 1.6 -1.7 Heavy = 1.9 -2.1 7 Harris Benedict questions

8. Injury Categories Surgery Minor = 1.0-1.1 Major = 1.1-1.2 Infection Mild = 1.0-1.2 Moderate = 1.2-1.4 Severe = 1.4-1.8 Trauma Burn factors 8

9. For pregnant woman, the daily figure must be increased by 150 calories for the first trimester and 350 for the second and third trimester. For the nursing mother the daily figure must be increased by 800 calorie. 11 Daily calorie requirements

10. An unborn child needs a healthy and well-nourished mother to grow properly. Therefore, a mother needs to gain weight during pregnancy to help nourish her growing baby. Women who do not gain enough weight often have babies that weigh too little ( low birth weight). 12 Nutrition during pregnancy and lactation

11. Women’s nutrition during pregnancy and lactation should focus on Vitamin A, Iron and Iodine Extra energy intake/reduction of energy expenditure Therefore the following are essential nutrition actions related to maternal nutrition: 13 during pregnancy and lactation

12. In addition: Iodized salt in her diet At least one liter of water per day Vitamin A rich foods D uring lactation Increased requirements: vitamins A, C, E, all B vitamins, and sodium 14 Nutrition during lactation

13. Nutrition of infants and children. The common feature of infancy, childhood and adolescence is that all these age groups are undergoing rapid growth and development . This in turn poses a heavy demand on their nutritional requirements. Small children and infants do not have a well developed body nutrient store, and are more vulnerable to infection . At risk of nutrient deficiency 15

14. Energy requirements decline thereafter and are based on Weight, Height, And Physical Activity. Total water requirements (from beverages and foods) are also higher in infants and children than for adults. Increased requirements of energy, protein, essential fatty acids, calcium and phosphorus . 16 Nutrition of infants and children.

15. Specific nutrient requirements in old age An elderly person requires less energy than a younger individual due to reductions in muscle mass and physical activity They need fewer calories than younger people, but about the same amount of protein and other nutrients. But need micronutrients like zinc, iron, vitamins, iodine Calcium and antioxidant vitamins 17

16. In order to reduce the risk for age related bone loss and fracture, the requirement for vitamin D is increased Vitamin B9 and B 12 prevent chronic illness risk Increase Vitamin A, C, E need 18 Specific nutrient requirements in old age

17. Nutrient values of food Food sources can be 1 Energy/Starch foods: Cereals, potato- 2 Protein foods : Poultry, meat, egg, soybean- 3 Vit . & Minerals foods: Fresh Vegetables/ Fruits 19

18. Nutritional Value Nutrients in food is to meet the people’s physiological requirement 1 Number 2 Kinds 3 Ratio ( Interaction) 20

19. Nutritional evaluation in foods 1 Food supplement: Ingredients Table Food composition in Table Nutr-ingredients in Table (kinds, amount) 2 Human Physiological Requirement: RDA Energy & Nutrients’ requirement in day/person 3 Compared human requirement with food supplement 4 Designing a reasonable diet for people 5 Preventing metabolic diseases through ration 21

20. Cereals 1 Grain Structure Bran: Cellulose Hemicellulose Endosperm: Starch Less Protein Embryo: Oil Protein Gluten in wheat: 30-40 % CHO 2 >70% Minerals 1.5-3% Protein 7.5-15% Vitamins Oil 2-4% 22

21. Beans & Their Products Carbohydrate (30-40%), protein Rich Ca , Vit.B 1 & B 2 Also contain Iron Other Beans -20% protein, 50 -60% CHO oligosaccharides 23

22. 4 Vegetables & Fruits Property : H 2 O High protein, Energy Low Dietary Fibers Vit . C、 B 2 Flavor , Pigment Ca P Fe K Na Mg Cu 24

23. Nutritive value of raw mango (per 100g) Principle Nutrient value % of RDA Energy 70 kcal 3.5 Carbohydrates 17 g 13 Dietary fiber 1.8 g 4.5 Fat 0.27 g 1 Protein 0.51 g 1 Vitamin A 765 IU 25.5 Vitamin C 27.7mg 46 Calcium 10 mg 1 Iron 0.13 mg 1.5 Magnesium 9 mg 2 Potassium 156 mg 3 Nutritive value of fruits and vegetables 25

24. Nutritive value of banana per 100 g Principle Nutrient Value % of RDA Energy 90 kcal 4.5 Carbohydrates 22.84 g 18 Fat 0.33 g 1 Dietary fiber 2.6 g 7 Protein 1.09 g 2 Vitamin A 64 IU 2 Vitamin C 8.7 mg 15 Calcium 5 mg 0.5 Iron 0.26 mg 2 Magnesium 27 mg 7 Potassium 358 mg 8 (Source: USDA National Nutrient Database) Nutritive value of fruits and vegetables 26

25. 5 Meat, Fish and Poultry Protein, iron and high zinc content Vitamin B1, B2, B3, B12 27

26. 6 Milk & Its Products Carbohydrates Fat Protein and fat Calcium Vit A, B1, B2, B12 Vitamin D Low in iron 28

27. NUTRITIONAL DEFICIENCY DISEASES On global scale the five principal nutritional deficiency diseases are: Kwashiorkor Marasmus Xerophthalmia Nutritional anemia Endemic goiter 29

28. PROTEIN-ENERGY MALNUTRITION Protein– energy malnutrition usually manifests early, in children between 6 months and 2 years of age E arly weaning, delayed introduction of complementary foods, a low-protein diet and severe or fr equent infections. Types of PEM based on duration: 1 . Chronic Malnutrition stunting (height for age) Underweight & stunting (weight for age) obesity 2. Acute malnutrition wasting (MUAC or weight for height) 30

29. Causes of malnutrition Malnutrition is multifactorial Its cause can be classified in to three Immediate causes Decreased food intake Disease Underlying causes Food insecurity Inadequate access to health care, sanitation Basic causes Poverty, politics 31

30. Types of acute malnutrition 1. Severe acute malnutrition (SAM) All children with oedema; Weight-for-height below 70% or WFH Z score below -3 Severe wasting MUAC below 11 cm for children It has three clinical forms Marasmus kwashiorkor Marasmic - kwashiorkor 2.Moderate acute malnutrition (MAM) Weight-for-height between 70-79% Moderate wasting WFH Z score between -2 and -3 No edema 32

31. Kwashiorkor Is one of the serious forms of PEM. It is seen most frequently in children one to three years of age. It is found in children who have a diet that is usually insufficient in energy and protein. There is edema together with failure to thrive, anorexia, diarrhea and a generalized unhappiness or apathy. 33

32. Signs and symptoms Failure of growth Edema and the presence of some subcutaneous fat make the weight loss less striking than in marasmus . Edema in face, limb and body The characteristic dermatitis called ' flacky -paint dermatosis ‘ The hair is sparse, soft and thin with color change. Watery diarrhea, enlarged liver Apathy is a characteristic feature and the child appears constantly unhappy.   34

33. Cont… KWASHIORKOR 35

34. Marasmus More prevalent than kwashiorkor. In marasmus the main deficiency is one of food in general, and therefore also of energy. It may occur at any age, most commonly up to about three and a half years, but in contrast to kwashiorkor it is more common during the first year of life. 36

35. Clinical features Clinical pictures of Marasmus Growth retardation Wasting of Subcutaneous fat and muscles (flabby muscles) old man face (wizened (wrinkled)monkey) sunken eye balls increased appetite Irritable always and has mild skin and hair change 37

36. MARASMUS 3. Marasmic kwashiorkor Children with features of both nutritional marasmus and kwashiorkor are diagnosed as having marasmic kwashiorkor. 38

37. Community based management of Acute malnutrition (CMAM) Has four areas Community Mobilization 2. Outpatient supplementary feeding protocols for those with moderate acute malnutrition and no serious medical complications ; 3. Outpatient therapeutic protocols for those with severe acute malnutrition and no serious medical complications ; and 4. Inpatient therapeutic protocols for those with acute malnutrition also suffering from serious medical complications. 39

38. Treatment Include: Diet. Treatment is often based on dried skimmed milk (DSM) powder. Formula Milk: F75 and F100 Ready to use therapeutic foods (RUTF) Treatment of hypothermia. Medication like antibiotics and deworming Micronutrients: Vitamin A, folic acid, iron, Follow up 40

39. Read on Vitamin A deficiency Iodine deficiency disorder Iron deficiency anemia Vitamin D deficiency disorders 41