BALANCED DIET & TREATMENT & PREVENTION OF DEFICIENCY DISORDERS

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1. VIGNAN PHARMACY COLLEGE (Approved by AICTE & PCI Affiliated to JNTU KAKINADA) VADLAMUDI, GUNTUR DIST, ANDHRA PRADESH, INDIA, PIN: 522 213 Submitted By :- MANNAM SANTHOSH KUMAR 16AB1T0013 Submitted to: Satheesh S.Gottipati B.Pharm ., MS ( USA ) , R.Ph .,CIP( USA ) BALANCED DIET & TREATMENT & PREVENTION OF DEFICIENCY DISORDERS

2. Definition: A balanced diet is defined as the diet that contains the required amount of calories, vitamins and minerals that are essential to keep a person healthy. A balanced diet is mixture of Carbohydrates (50%), Fats (32%) Proteins (12%) vitamins (3%) Minerals sufficient water

3. Carbohydrates: These are chief source of energy (60 – 70% total energy) Deficiency Disorders Acidosis Ketosis Hypoglycemia Fatigue & decreased energy levels Unhealthy weight loss Loss of sodium

4. Proteins: These are the fundamental basis of cell structure & function. Maintains osmotic pressure & have role in clotting of blood, muscle contraction. Deficiency Disorders: Kwashiorkor Marasmus Mental retardation

5. Dietary vitamins and minerals Calcium deficiency disorder Osteoporosis Rickets Tetany Iodine deficiency disorder Goiter Iron deficiency disorder Iron deficiency anemia Vitamin Deficiency Disorders Vitamin B 1 (thiamine ) Disorders Vitamin B 2 (riboflavin ) Disorders Vitamin B 3 (niacin ) Disorders Vitamin B 5 (pantothenic acid ) Disorders Vitamin B 6 (pyridoxine ) Disorders Vitamin B 7 (biotin ) Disorders Vitamin B 9 (folic acid ) Disorders Vitamin B 12 (cyanocobalamin ) Disorders

6. Protein Deficiency Disorders Kwashiorkor: Also called wet-protein energy malnutrition. Form of PEM characterized by protein deficiency . Refers to an insufficient protein consumption but with sufficient calorie intake. Usually appear in the age of 12 months whenbreast feeding is discontinued .

7. Signs and symptoms : Change in skin pigment. Diarrhea. Decreased muscle mass. Swelling(edema). Fatigue. Hair changes Lethargy. Increased & more severe infection due to damaged immune system. Failure to gain weight & grow.

8. MANAGEMENT: The children affected with kwashiorkor should be fed with dietary protein gradually . Kwashiorkor can be corrected by eating more protein and more calories overall, especially if treatment is started early. You may first be given more calories in the form of carbohydrates, sugars, and fats. Once these calories provide energy, you will be given foods with proteins. Foods must be introduced and calories should be increased slowly because you have been without proper nutrition for a long period. Your body may need to adjust to the increased intake.

9. MARASMUS : Severe protein calorie malnutrition characterized by energy deficiency and emaciation Causes stunted growth and wasting of muscles and tissue Develop between the age of 6 months & 1 years in children who weaned from breast feeding/who suffer from weakening conditions like chronic diarrhea .

10. Symptoms Severe growth retardation. Loss of subcutaneous fat. Severe muscle wasting. Child looks thin and limbs Wrinkled skin. Bony prominence. Frequent watery diarrhea & acid stools. Temperature is abnormal. Edema absent.

11. VITAMIN DEFICIENCY DISORDERS

12. Vitamin A deficiency disorder Functions of vitamin A Vitamins plays several roles in the body for Vision Gene transcription Immune function Embryonic development and reproduction Bone metabolism Hematopoiesis Skin and cellular health Antioxidant activity

13. Deficiency Disorders Night blindness, Xerophthalmia, Keartomalacia Complete blindness Impaired immune function Birth defects

14. Management Deficiency of vitamin a can be achieved by eating vitamin A rich foods and external supplementation of vitamin A Preparations . Foods rich in vitamin A Vitamin A is found naturally in many foods: Liver (beef, pork, chicken, turkey, fish ) Cheddar cheese (256 µg) Carrot (835 µg) Spinach (469 µg ) Sweet potato (709 µg) Butter (684 µg) Egg (140 µg) Apricot (96 µg) Papaya (55 µg) Mango (38 µg) Pea (38 µg) Milk (28 µg)

15. Vitamin D deficiency disorder : Function of vitamin D Maintain the normal calcium and phosphorus levels in the body to build strong bones, teeth and nails. Supporting the cell functions and other neuromuscular functions in the body. Controls the supply of calcium between the bones and the blood and supports bone mineralization (hardening of bones) and bone remodeling by osteoblasts and osteoclasts. Preventing of rickets in children, and osteoporosis or osteomalacia in adults. Vitamin D as a powerful antioxidant and anti-carcinogen, it helps in combination depression, prostate cancer, breast cancer, high blood pressure, cardiovascular diseases, phagocytosis activity and boosts anti-tumor activity . Vitamin D helps in maintaining a health immune system in the body.

16. Deficiency Disorders osteomalacia (softening of the bones) in elders rickets in children . Avoiding the exposure to sun may result in low blood calcidiol (25-hydroxy-vitamin D) and that may causes vitamin D deficiency disorder .

17. Management Dietary supplementation of vitamin D 2 (mushrooms) and vitamin D 3 (fish liver oils, egg and beef liver. Sources of vitamin D The man source of vitamin D s exposure of an individual is to sun’s UVB rays. Apart from this, vitamin D is found in various types of fish such as herring, mackerel, salmon, and sardines. It is also available in other food sources such as egg yolk, orange juice, cereals, green leafy vegetables, fish liver oils, yogurt, cheese, etc. fortified foods are other common sources of vitamin D.

18. Vitamin E deficiency disorder Functions Prevents the oxidative damage of the cell membranes Prevents unnecessary growth of the smooth muscle. Responsible for the repair of wounds Vitamin E plays a role in neurological functions. It inhibits platelet aggregation. Vitamin E also protects lipids and prevents the oxidation of polyunsaturated fatty acids (PUFAs).

19. Deficiency Disorders Spinocerebellar ataxia Myopathies Peripheral neuropathy Ataxia Skeletal myopathy Retinopathy Impairment of the immune response Erythrocyte hemolysis Male infertility

20. Treatment Individuals who cannot absorb fat may require a vitamin E supplement because some dietary fat is needed for the absorption of vitamin E from the gastrointestinal tract. Dietary sources Vitamin is found mostly abundantly in wheat germ oil, sunflower oil, safflower oil, nuts and nut oils, like almond and hazelnuts palm oil. It is also found in high value green, leafy vegetables like spinach, turnip, broccoli, avocados, asparagus, kiwifruit (green) pumpkin, sweet potato, mangoes, tomatoes, rockfish, and papaya.

21. Vitamin K deficiency disorder The functions of vitamin K are concerned with blood clotting process It brings about post-translational modification of certain blood clotting factors The clotting factors II, VII, IX and X are synthesized as inactive precursors in the liver Vitamin K act as a coenzyme for the carboxylation of glutamic acid residues present in the protein and this reaction is catalyzed by a carboxylase (microsomal ) Warfarin is a synthetic analogue that can inhibit vitamin K action

22. Deficiency Disorders Petechae Hematomas Stomach pains Cartilage calcification R isk of massive uncontrolled bleeding Oozing of blood at surgical or puncture sites D eposition of insoluble calcium salts in the walls of arteries I n infants, it can cause some birth defects such as underdeveloped face, nose, bones, and fingers.

23. Dietary sources of vitamin K Vitamin K is found in green, leafy vegetables and in oils, such as soybean, cottonseed, canola, and olive oils. It can also be synthesized from colonies bacteria. Diet is the main source of vitamin K. Management Dietary supplementation of vitamin K

24. Deficiency disorders of vitamin B complex The vitamin B complex is essential to Support and increase the rate of metabolism Maintain healthy skin, hair and muscle tone Enhance immune and nervous system functions Promote cell growth and division, including that of the red blood cells that help prevent anemia Reduce the risk of pancreatic cancer Reduce the symptoms of attention deficit hyperactivity disorder

25. S.No VITAMIN NAME DEFECIENCY DISORDER 1 Vitamin B Thiamine Beriberi 2 Vitamin B 2 Riboflavin Ariboflavinosis 3 Vitamin B 3 Niacin Pellagra 4 Vitamin B 5 Pantothenic acid Acne and Paresthesia 5 Vitamin B 6 Pyridoxine Microcytic anemia, Depression, Dermatitis, High Blood Pressure 6 Vitamin B 7 Biotin Impaired growth and Neurological disorders in infants. 7 Vitamin B 9 Folic acid Macrocytic anemia and Elevated levels of homocysteine. 8 Vitamin B 12 Cobalamin Deficiency results in a macrocytic anemia, Elevated homocysteine, Peripheral neuropathy, Memory loss and other Cognitive deficits.

26. Dietary sources of vitamin B complex B-complex vitamins are found in completely unprocessed foods. Processed carbohydrates such as sugar and white flour tent to have lower B vitamin than their unprocessed counterparts. For this reason, thiamine, riboflavin, niacin, and folic acid is added to white flour after processing. B vitamins are richly present in tuna and turkey meat in fish liver. Good sources for vitamins include whole grains, potatoes, bananas, lentils, chilli peppers, tempeh, beans, nutritional yeast, brewer’s yeast, and molasses.