Nutrition slides for ug paediatric practical’s

Nutrition for paediatric practical’s

1. nutrition
Dr.K. Z. Parveen
Department of Paediatrics
Father Muller Medical College Hospital

2. nutrition
•Identify
•Calorie, protein content
•Any limiting amino acid
•If its rich in any vitamin
•Use

3. rice (original pics)
WHITE RICE
Parboiled rice is better : Rice is soaked, steamed, dried with the husk. So, Thiamine n other vitamins
driven from husk into grain in parboiled rice. It also increases shelf life & ability to resist insects.
PAR BOILED RICE

4. rice
Limiting amino acid in cereals– Lysine
Cereals don’t have vit A & C, except maize
IDLI – “complete food” – rice +dal (what is lacking in one is made up for by the other)
Rice – Fe 0.7mg/100gm , puffed rice 6.6
Cereals – rice, ragi, wheat, maize
Q: why is caloric value of 100 mg uncooked rice more than cooked rice?
A: 1 cup of uncooked parboiled rice, increases in volume to 3 times, so calorie value of 100gm
of cooked rice is lesser.
Cooked Uncooked
Calories 100gms 120 340
Proteins 100gm 2 6

5. ragi
(looks like mustard seed but red in colour)
•Rich in Calcium : 344 mg in 100gm
•Iron : 3.9mg in 100gm
•Calories : 330 kCal, Protein : 7gm
•One of initial complimentary foods used in India
•How to prepare :- soak overnight, wash, grind to
paste, cook with water and sugar to porridge
consistency
•Ragi mudde = ragi balls , ragi rotti

6. pulses - bengal gram
BLACK CHANA
Limiting amino acid – Methionine
Pulses lack vitamin A & C
Energy - 370kcal, protein 20gm in 100gm
Source of protein in veg diets, PEM
Biological value of pulse protein : 74
Absorption of protein in pulses is lesser than egg.
*** (extra) RAJMA / RED KIDNEY BEANS – calcium 260mg/100gm

7. black gram
URAD DAL
•Calories : 340kcal
•Proteins: 24gm in 100gm
•Limiting amino acid – Methionine
•Used along with rice to make idli,
Dosa, idli

8. horse gram
•Horse gram ( black, flat dal)
•Energy – 350kcal
•Proteins 20gm
•Limiting amino acid – Methionine
•Just like green gram, horsegram
can also be used for cooking after
germination. (soak overnight in
water, strained and kept in muslin
Cloth x 24 hrs)

9. green gram
•Energy – 340kcal, Proteins 24 gm
•Limiting amino acid – Methionine
•Can also be germinated & used
•Germination ↑ digestibility (due to↑
amylase) &
↑Vitamins, ↓ bulk on cooking & ↓
phytate levels

10. amylase rich food
•Green gram, jowar, wheat, bajra used 2 make amylase rich food(ARF) -
soak in water x12hrs,drain, wrap in muslin cloth , allow to germinate,
dry in sunlight x8hrs, remove sprouts, roast on low flame, grind to
powder.
Stored in airtight container- powder is added 2 rice, dal to reduce
viscosity & increase calorie density
•Pulses deficient in vit A & C, but the germinated legumes have
vitamin C !!!!

11. • concentrated source of energy
•1 tsp = 5g = 20 kCal (1gm =4 kCal)
•Add to milk/ juice to increase calorie intake
•Excessive intake not desirable as it can cause caries&
fluctuations in blood sugar
sugar

12. jaggery
•Concentrated source of energy
•1 tsp -20 kCal
•Rich in Iron – Why? Cooked in iron vessels
•Used instead of sugar in preparing sweets
eg payasam, for kids & pregnant women

13. GHEE / OIL
•1 tsp – 45 kcal
•1gm – 9cal
•Increase palatability
•Used to increase calorie intake by adding to rice/ chapathi
•CALORIE definition: amount of energy required to raise
the temperature of 1gm of water by 1 degree celsius

14. egg
•Energy : 60kcal, Protein : 6gm, Fe- 2mg/100gm
•Best protein, containing all essential amino acids in adequate amounts
•Essential amino acids – MaTT VIL PHLy – Methionine, tryptophan, threonine, Valine, Isoleucine,
Leucine, Phenylalanine, Lysine
•Egg is called ”Reference protein” – others r compared to it, fully digested as compared to other
protein products, high biological value(as all of d protein is digested )
•Yellow- fat – introduced to infants @ 8 months
•White - protein – introduced to infants @ 9 months
•Rich in proteins, vitamins & fats; deficient in carbohydrate & vitamin C
•USE - Convalescing pt, to gain weight
•Avoided – allergy to egg

15. milk
Milk type (in 100ml) Energy Protein Calcium
Cow’s milk 67kcal 3.2g 120mg
Buffalo milk 117kcal 4.3g 210mg
Goat’s milk 72kcal 3.3 170mg
Milk type (in 100ml) Energy Protein // carbohydrates fats,
osmolality, ca: phosphorous
ratio
Cow’s milk 67 3.2
Breast milk 65 1.1

16. milk
•It’s a good source of protein, Ca & vitamins
•It’s deficient in Iron and Vitamin K & D
•Iron absorption is reduced by high phosphate content in cow’s milk
•Goat s milk deficient in folic acid and vitamin B12. Goat milk can
predispose to folate deficiency and brucellosis.
•Buffalo milk high fat content, so it is high in calories.
•Camel milk beneficial to children with cow’s milk allergy.

17. BREASTMILK VS COW’S MILK
Property Breastmilk cow’s milk
Lactose 7g(Lactose made of galactose, which
is required to make myelin(made of
galactocerebroside) so myelination is
better in kids who have breastmilk
4.5g
Protein 1.1gm 3gm (more than breastmilk,
but less digestible)
Casein : Whey 40:60 (whey proteins are: β casein,
Lactalbumin & Lactoferrin),
lactoferrin is bacteriostatic
80: 20 (whey proteins are:
casein,β lactoglobulin) {
casein is an allergen}
Fats 3.8gm (mostly unsaturated fats,
essential fatty acids)
3.7gm (mostly unsaturated
fats
Growth regulating
& mediating factrs
More less

18. BREASTMILK VS COW’S MILK
Property Breastmilk cow’s milk
Iron &Zinc Lesser , but bioavailability
better than cow’s milk due
to presence of carrier
protein Lactoferrin
More
Sodium
Potassium
Chloride
Lesser More
Increases solute load on
kidneys
Immunoglobulin IgA(constitute15-20% of
whey proteins)
IgG lesser
Calcium : Phosphorous ratio 2:1 <2
Osmolality 260mOsm/kg 260mOsm/kg

19. fruits
guava
•It’s rich in vitamin C
•Energy – 50kCal
•Protein : 0.9mg
•High fibre content 5.2g
•LEMON : Rich in vitamin C
Calcium – 70g/ 100g

20. apple
•Energy: 59 kCal
•Protein : 0.2
•Fibre rich
•It’s a negative calorie food ( amount of
energy required to digest > nutritive
content)
•So, can b consumed in any quantity
(without butter, sugar/ dips)
•Apple seeds contain cyanide, so 100
apple seeds will cause cyanide poisoning

21. orange/ musambi
• all yellow/ orange fruits are rich in vit A
•Rich source of vit C& vit A
• Ca 26mg/100g
•Energy : 48 (orange), 43 (musambi)
•Protein 0.6

22. papaya
•USES:
1.To treat Constipation
2.Dengue
•It’s a rich source of Vit A
•Energy : 32kCal
•It’s a negative calorie food ( amount of energy
required to digest > nutritive content)
•So, can b consumed in any quantity
(without butter, sugar/ dips)
Papaya seeds should not be eaten by pregnant
women as it is abortificient

23. mango
•All yellow/ orange fruits are rich in vitamin A
•Mango is rich in vit A
•Energy: 75 k Cal
•Iron 1.3 gm
•It contains carotene, an antioxidant.
•Antioxidants scavenge free radicals,
protect against coronary artery diseases
stroke, cancer, DM, Asthma

24. watermelon
•It is rich in Iron – 7.9g/ 100g
•It’s low K
•Energy : 16kCal
•It contains phytochemical
Lycopene , has
Antimutagenic property

25. banana
•Energy: 100kcal
•Protein : 1.2gm, 1gm fibre
USES:-
1.Rich in fibres – treat constipation
2.K content high
3.Weaning food – gain weight
4.In convalescent phase

26. grapes
•Energy : 58k Cal
•Proteins : 0.6
•Fibre 2.8gm
•Foods to avoid in those with renal
calculi – tomato, grapes, nuts,
anything containing oxalates

27. custard apple
•Seethaphal
•Energy : 94 kCal
•Protein 2gm
•Rich in vitamin C

28. tomato
•Energy : 20 kCal
•Ca – 48mg/ 100g
•It contains phytochemical Lycopene , has
Antimutagenic property
•Lowers risk of prostate cancer
•Super antioxidant food
•Foods to avoid in those with renal
calculi – tomato, grapes, nuts,
anything containing oxalates

29. vegetables
carrot
•It’s a tuber
•Energy : 50k Cal
•Fibre 1.2gm, iron 1mg
•Carrots are rich in Vitamin A
•They have high calcium content of 80mg/100g
•It contains carotene, an antioxidant.
•Antioxidants scavenge free radicals, protect against coronary artery
diseases, stroke, cancer, DM, Asthma

30. radish
•TUBER
•Energy : 17 kCal
•It’s a negative calorie food ( amount of energy
required to digest > nutritive content)
•So, can b consumed in any quantity
(without butter, sugar/ dips)

31. brinjal
•Also called Eggplant / Aubergines
•Energy : 25 kCal
•Protein 1.4
•Rich in potassium

32. capsicum
•Also called bell peppers –green, yellow & red
•It’s a good source of Vit A, C, E,
potassium, folic acid & fibre
•Energy : 24 kCal
•Red capsicum has 11 times more beta
carotene & 1.5 times more vitamin C
than green capsicum

33. garlic
•Energy : 145k Cal
•Protein 6.3gm
•It contains phytochemicals (allium)
giving it antimutagenic properties –
prevents cancers
•Rich source of Selenium

34. onion•Energy : 60 kCal (small)
•Protein 1.8 gm
•It contains phytochemicals (allium) giving
it antimutagenic properties – prevents cancers
•It’s a negative calorie food ( amount of energy
required to digest > nutritive content)
•So, can b consumed in any quantity
(without butter, sugar/ dips)
Flavonoid in onion reduces risk of coronary
artery disease, prevents cataract, antihistamine
properties

35. cabbage
•Rich in fibres
•Fe 0.8mg, Ca 39mg
•K
•It’s a negative calorie food ( amount of
Energy required to digest > nutritive content)
•So, can b consumed in any quantity
(without butter, sugar/ dips)
•Thiocyanates, isothiocyanates present in
cabbage, cauliflower block iodine uptake &
Cause goitre
Cauliflower green
rich in Fe 40mg,
turmeric 67.8mg

36. interpretation of chest x ray
1.Identification & date
2.Site of x ray – chest/ abdomen/ head
3.Type of x ray - Plain / contrast
4.Projection - AP/PA/Lateral view
5.Position- Erect/ Supine
6.Mark the side - R/L
7.Rotation
8.Inspiratory / Expiratory film
9.Penetration - under(white) /over penetration (dark)
10.Cardia
11.Hilum, Mediastinum
12. Lungs, Pleura, Diaphragm
13.Soft tissues and thoracic skeleton

37. thank you