Nutritional problems

Nutrition Problems - History of nutrition, Types, Major and Minor Nutrition Problems

1. NUTRITIONAL PROBLEMS SUBMITTED TO; MRS.GRACE MSC(N), ASSOCIATE PROFESSOR CSI JACON SUBMITTED BY; MS.LOGESWARI MSC(N) I YEAR, CSI JACON.

2. NUTRITIONAL PROBLEMS Nutrition is the selection of foods and preparation of foods, and their ingestion to be assimilated by the body. By practicing a healthy diet, many of the know health issues can be avoided The diet of an organism is what it eats, which is largely determined by the perceived palatability of foods .

3. DEFINITION ; A Nutritional deficiency occurs when the body doesn’t absorb or get from food the necessary amount of a nutrient. Deficiencies can lead to a variety of health problems. These can include digestion problems, skin disorders, shunted or defective bone growth and even dementia.

4. HISTORY OF NUTRITION ; 400 B.C – Hippocrates the ‘Father of medicine’ said to the students, ‘Let thy food be thy medicine and thy medicine be thy food’. He also said A wish man should consider that health is the greatest of human blessings. One story describes the treatment of eye disease, now known to be due to a vitamin A deficiency, by squeezing the juice of liver onto the eye. Vitamin A is stored in large amounts on the liver. 1747 Dr. James Lind, a physician is the British Navy, performed the first scientific experiment in nutrition.

5. HISTORY OF NUTRITION; Early 1800s It was discovered that foods are composed primarily of four elements; Carbon, nitrogen, hydrogen and oxygen, and methods were developed for determining the amounts of these elements. 1930s William Rose discovered the essential amino acids, the building blocks of protein. 1940s The water soluble B and C vitamins were identified. 1950s to the present – The roles of essential nutrients as per of bodily processes have been brought to light. For example, more became know about the role of vitamins and minerals as components of enzymes and hormones that work within the body

6. CAUSES OF NUTRITIONAL PROBLEMS; Population growth Agriculture and food production Prevalence of parasitic and infectious disease Religious and cultural food fads General illiteracy and ignorance illiteracy Economic barriers

7. NUTRITIONAL PROBLEMS IN INDIA ; In our India, the people are affected with malnutrition and this is found to be one of the greatest health problems facing our communities today. It is recorded that 60-70% of young children today have nutritional deficiency. The specific nutritional health problems; Protein energy malnutrition Vitamin A deficiency Iron deficiency anaemia Iodine deficiency anaemia

8. TYPES OF NUTRIONAL PROBLEMS TYPES OF NUTRITION PROBLEMS MAJOR NUTRITION PROBLEMS MINOR NUTRITION PROBLEMS

9. MAJOR PROBLEMS ; Is defined as a pathological state resulting from an absolute or relative deficiency of one or more essential nutrient. Protein energy malnutrition Low birth weight Micronutrient deficient Vitamin A deficient Nutritional anaemia Iodine deficiency disorders(Endemic goiter) Endemic fluorosis Lathyrism

10. MINOR DISORDERS; Obesity , swallowing problems Decreased appetite, nausea, constipation , Heartburn, sore mouth or throat

11. PROTEIN ENERGY MALNUTRITION (Protein – calorie malnutrition) 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 . Conditions/ Diseases; Kwashiorkor Marasmus Marasmic - Kwashiorkor

12. CAUSES Inadequate intake of food Diarrhoea Respiratory infections Measles Poor hygiene Large family size Poor maternal health Failure of lactation Premature termination of breast feeding Use of over diluted cow’s milk Delayed supplementary feeding

13. KWASHIORKOR ; It is the most common and widespread disorder in developing countries. It is form of malnutrition caused by not getting enough protein in the diet.

14. MARASMUS; It 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.

15. MARASMIC KWASHIORKOR ; A malnutrition disease, primarily of children, resulting from the deficiency of both calories and protein. The condition is characterizing by severe tissue wasting, dehydration, loss of subcutaneous fat, lethargy, and growth retardation.

16. COMPARISON OF CLINICAL FEATURES KWASHIORKOR; 1. Acute illness/infections, prolonge d starvation 2. Protein is principal nutrient 3.18 months to 3 years 4. Rapid acute onset 5. Some weight loss 6. High mortality 7.Mild and moderate growth retardation 8.Edema ,pot belly,swellon legs 9.Low subcutaneous fat   MARASMUS; 1.Severe prolonged 2.calories and protein are principal nutrient 3.6 months to 2 years 4.chronic slow onset 5.severe weight loss 6.low mortality unless 7.Severe growth failure 8.No 9.Severe loss of subcutaneous fat

17. ASSESSMENT OF PEM; Gomez classification; Weight for age(%) = weight of child x wt of normal child of same age Between 90 – 110% Normal nutritional status Between 75 – 89% Mild malnutrition (1 st degree) Between 60 – 74% Moderate malnutrition(2 nd degree) Under 60% Severe malnutrition (3 rd degree)

18. PREVENTION; Oral rehydration therapy helps to prevent dehydration caused by diarrhoea Exclusive breast feeding for 6 months there after supplementary foods may be introduced along with breast feeds. Immunization for infants and children Early diagnosis and treatment Promotion and correction of feeding practices Nutritional supplements Family planning and spacing of birth Nutritional rehabilitation

19. LOW BIRTH WEIGHT An LBW newborn is any newborn with a birth weight of loss than 2.5kg (including 2.499) regardless of gestational age. RISK FACTORS; Maternal malnutrition Anaemia CASUSES; Illness/infections Short maternal stature, Very young age Close birth intervals , IUGR Hard physical labour during pregnancy, smoking.

20. PREVENTION Identification of mother at risk – malnutrition heavy work load,infections,diseases and high BP Increasing food intake of mother, supplementary feeding, distribution of iron and folic acid tablets. Avoidance of smoking Improving health and nutrition of young girls Controlling infections- UTI,rubella,syphilis,malaria.

21. MICRONUTRIENT DEFICIENCY; VITAMIN A DEFICIENCY; Is a lack of vitamin A in blood and tissues. It is common in poorer countries but rarely seen in more developed countries. Nyctalopia (night blindness) is one of the first signs of VAD. XEROPHTHALMIA; i.e., dry eyes refers to all the ocular manifestations of vitamin A deficient in man .It is the most widespread and serious nutritional disorders leading to blindness.

22. CLINICAL MANIFESTATION; Corneal inflammation Dry eyes which could also lead to xerophthalmia . The child or adult may experience susceptibility towards respiratory infections and urinary infections Reduced vision in the night or dim light Corneal ulcers, Softening of cornea Keratomalacia, Bitot spot

23. 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.

24. NUTRITIONAL ANEMIA Nutritional anaemia is a condition where the haemoglobin 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.

25. CAUSES; Inadequate diet, Insufficient intake of iron, Iron malabsorption Excessive menstrual bleeding, GI bleeding Hook worm infestation, Malaria. Close birth intervals Infants and children's Pre menopausal women Pregnancy

26. NUTRITIONAL ANEMIA CLINICAL MANIFESTATION; Lethargy, Anorexia, Malaise, Insomnia Impaired concentration, Pruritus Shortness of breath, weakness

27. PREVENTION; Estimation of Hb to assess degree of anaemia Blood transfusion in severs cases of anaemia (lessthan8g/dl) Iron and folic acid supplements, Food fortification with iron Changing dietary patterns Nutritional education and awareness

28. IODINE DEFICIENCY DISORDERS IDD leads a much wider spectrum of disorders commencing with the intrauterine life and extending through childhood to adult life with serious health and social implication. DISORDERS; Goiter, Hypothyroidism Neuromuscular weakness Speech defects, hearing defect, Mental retardation,

29. IODINE DEFICIENCY DISORDERS PREVENTION; Iodized salt, Iodine monitoring Public awareness and education COMPLICATION; Thyroxicosis , Iodine goiter, Iodinism Lymphocytic thyroiditis

30. ENDEMIC FLUROSIS ; In many parts of the world where drinking water contains excessive amount of fluorine(3-5mg/dl) endemic flurosis has been observed.

31. ENDEMIC FLUOROSIS SKELETAL FLUROSIS; Associated with life time daily intake of 3-6mg/L or more. Heavy deposition of fluoride in skeleton Crippling occurs leading to disability. DENTAL FLUROSIS; It occurs when excess fluoride is ingested during the years of tooth calcification first 7 years of life Characterized by molting of dental enamel which has been reported above 1.5mg/L intake.

32. PREVENTION Changing the water sources Chemical defluorination Preventing use of fluoridated toothpaste Fluoride supplements not prescribed for children consuming fluoridated water.

33. LATHYRISM; It is paralyzing disease of human and animals. In the humans it is referred to as neurolathyrism because it affects the nervous system and in animals asosteolathyrism because the pathological changes occurs in the bones resulting in skeletal deformities .

34. LATHYRISM Causes; Poverty Malnutrition Food adulteration Prevention; Vitamin C prophylaxis Removal of toxic steeping method Education Socio economic changes

35. MINOR DISORDERS; Obesity, Swallowing problems Decreased appetite, Nausea, Constipation, Heartburn, Sore mouth or throat Dryness in the mouth Diarrhoea

36. OBESITY Obesity is an epidemic diseases, which consists of body weight that is in excess of that appropriate for a persons height and age standardized to account for differences,leadind to an increased risk to health related problems . Causes; Smoking Unhealthy diet Pregnancy Age Certain medical problems and medications Family lifestyle

37. CLINICAL MANIFESTATION Amenorrhea Hypotension Bradycardia or tachycardia Swollen joints Abdominal distension Fatigue Rapid mood swings Dry hair and skin

38. ANOREXIA NERVOSA It is an eating disorders characterized by immoderate food restriction, inappropriate eating habits or rituals, obsession with having a thin figure, and an irrational fear of weight gain, as well as a distorted body self perception.

39. BULIMIA NERVOSA It is an characterized by binge eating and purging or consuming a large amount of food in a short amount of time followed by an attempt to rid oneself of the food consumed(purging),typically by vomiting taking a laxative, diuretic ,because of an extensive concern for body weight.

40. SWALLOWING PROBLEMS;(Dysphagia ) Weakness in the muscles of mouth might make it difficult for one to chew and manage solid foods. Example include; large bites of food,inaduquate chewing, dry mouth, pills or food that’s too hot.

41. HEARTBURN Heartburn can occur for many reasons, including overeating, eating certain foods, taking medicines, or as a result of surgery.

42. DIARRHOEA; Diarrhoea is an increase in either the number of stools, the amount of liquid in the stools, or both. Medicines, a reactions to certain foods, stress ,and ordinary colds or flu can cause dehydration. Prolonged diarrhoea can cause dehydration,weakness,fatigue,and weight loss

43. CONSTIPATION ; Constipation occurs when bowel movements become difficult or infrequent, usually more than 48 hrs apart. Constipation can be caused by medicines and by not drinking or eating enough liquids or food and inactivity .

44. PREVENTION Group therapy Cognitive behavioural Interpersonal Psycho education Medication; Antidepressants Nutritional educations Hospitalization; Nutritional rehabilitation Correct electrolyte abnormalities

45. NUTRITIONAL PROGRAMS; Vitamin A prophylaxis program Prophylaxis against nutritional anaemia IDD control program Balwadi nutritional program Integrated child developmental scheme Mid – day meal program and scheme .

46. CONCLUSION ; A well balanced diet is required for the normal growth and development of an individual. Healthful eating means a lifestyle of making choices and decisins,planning,knowing how to make quick and wise choices when you haven’t planned. By practicing a healthy diet, many of the known health issues can be avoided.

47. THANK YOU