CHAP – 3 - PUBLIC NUTRITION & HEALTH

Q. Nutrition related problems in our country.

 1/3rd infants born in India are LBW (weight less than 2.5 kg) which may

lead to child mortality.

 Pre-scholars from Low Socio- economic background have growth

retardation.

 Number of children suffer from various deficiency diseases examples

Night blindness, Rickets, Anemia

All these lead to less mental & cognitive development which in turns

causes Low quality of life hence low economic growth of country.

Q. Write the causes of life style diseases/problemswith our nutrition

Altered Sedentary Introduction Heart problems

dietary life style of convenient food obesity

pattern because in the market diabetes

(fast food & missing (Frozen Snacks

meals, snacking) Maggie)

Less Faster Less

Walk means of outdoor

transport Activities
Q. Factors related to under nutrition

Immediate causes UnderlyingCauses BasicCauses

 1.Faulty  1.Less availability  1.Less availability of

dietary in of food resources because of

take due to poverty poverty, large

population

Dieting  2.Faulty childcare  2.Social systems low

amongst practices status of women

adolescent ignorance
 2.Disease  3.Inadequate health  3.Religious factors eg in

Ring worm services in rural Jainism food restrictions

infection areas

causes less

absorption
 4.Discrimination of  4.Environmental

girl child degradation more of

pesticides, fertilizers are

entering in food chains.

 5.Inadequate

education

No knowledge

about balanced diet.

All these factors cause Malnutrition, Disability, Death

Q. What is community?

Specific group of people who share common characters eg common language,

common lifestyle.

Q. Various nutritional problems in India.

PEM Micronutrient deficiency

 Cause due to  Deficiency of micronutrients is

inadequate intake also called hidden hunger

of food
 Leads to  If diet is deficient in protein

deficiency of and

macro-nutrients energy deficiencies of

(energy, protein) micronutrients also appear eg.

iron, Vit A, Zinc.

 Children are at

greater risk IDA IDD VAD

 It can occur to

adults who suffer Iron Iodine Vit A

from TB, AIDS deficiency deficiency Deficiency

 It can be assessed Anemia disorder.

by height weight.,

chest

circumference
 Deficiency of

energy, protein is

called Marasmus
 Protein deficiency

is called

Kwashiorkor

IDA  Most common nutritional disorder in both developed & developing

countries

 Most vulnerable groups are women (18 – 36 years), adolescent girls,

pregnant women, school going children.

 It results in low hemoglobin level in blood.

 Symptom is breathlessness on slight exertion.

 Also, Fatigue, pale eyes – tongue, less attention span, memory is also

affected, flat nails, dizziness, shortness of breath, dry skin.

VDA  Vit A is important for good eye sight, soft skin, growth
leads to
 deficiency causes night blindness  complete blindness

 Less resistance to infections

Causes – Fat mal-absorption & liver disorders

VAD

Increase loss of Increased

Vit A Infections

Cycle between VAD & Infection.

IDD  Iodine is required for normal growth and development.

 IDD occurs due to deficiency of iodine in soil.

 It affects foetus in the womb of mother as well as adults because of

insufficient iodine intake.

  Due to less iodine, thyroid gland synthesis less thyroid hormone.

 Goiter is most common feature of IDD and it leads to poor mental

development in children.

 IDD during pregnancy causes mental retardation of foetus called

cretinism.

Q. What strategies are made by Govt to tackle the nutritional problems?

- NNP (National Nutrition Policy in 1993) under Department of Women

& Child Development.

It involves 3 aspects of development

ICDS Fortification Production of low-cost

Integrated Child (Iodized salt) nutritious food by including

development Milk with Vit D Oats – protein, fiber

Pasta with Folic Acid Fresh fruits

Cereals with Iron lentils-Iron, Protein, Potassium

Beans – fiber (controls blood

sugar)

peanuts

Sweet potato, -carotene, fiber

Control of micro-

nutrient deficiency

diseases of Vit A,

Iodine, Iron
II. Long term strategies include

Ensuring food Improved dietary Removal of poverty by

security intake Employment Generating

Increased The Balanced Schemes

availability of food Diet&availability of DWCRA

Decreased fortified food Public Distribution System

adulteration Health & Family Welfare

Program

OTHER TWO STRATEGIES

Diet food-based strategies Medicinal Approach

1. Preventive measures taken to 6. Strategy used for Vit A, iron,

stop deficiencies Folic Acid.

2. Increasing nutrient rich food 7. It is short term strategy

availability 8. It includes supplementation

3. It is having long term benefits programs.

4. It is not having risk of toxicity 9. Expensive method

which happens in medicinal 10. Coverage is a problem.

approach

5. Other approach is home

gardening & health education

 Comparison between various approaches

Nutrient  For  Timely given  Coverage is not

Supplementation Specific much

Target Costly method

group

Fortification  For all Wide coverage  Requires

Cost effective research

 Participation of

food industry

 It spreads less

awareness in

public about the

nutrition

 No long - term

dietary changes

happen in

consumer.

For all  Cost effective  Less change in

(Availability of food method eating behavior

throughout the year)  Wide coverage  Economic

 Provide many development

micronutrients should be there

in a one go  Require change

 Improves food in agricultural

security policies
Q. Various nutrition program operating in our country

1. ICDS Program for early childhood care & development

2. Nutrient Deficiency Control Program

National Prophylaxis National Anemia National Iodine

program Control Prog. Deficiency Prog.

(VAD) (Control of Anemia) (Control of IDD)

3. Food supplementation program – Mid day meal program

4. Food Security Prog. PDS (Public Distribution Scheme)

Annapurna Scheme

5. Self- employment & Wage employment scheme.

Q. What is health care?

Fundamental right of all citizens to be safe.

It includes both medical care & services to promote community health.

In India it is provided at three levels through PHC (Primary Health Centre)

Primary Secondary Tertiary

Contact with District Hospitals & Medical colleges,

individual, family Community- health specialized hospitals

through PHCs (Public centers like AIIMS

health centers)

Q. Scope of Public Nutritionist

She is also called community nutritionist

Because she is well trained in promoting health knowledge in community.

She can work in following areas: -

1. Become a part of nutritional health prog. undertaken by hospitals.

2. As a part of ICDs at different levels.

3. As a consultant in Govt. Level Policies.

4. As a part of national &b international organizations, Eg. UNICEF,

WHO, FAO, USAID.

5. Become a part of organizations who runs large scale feeding program

for – adolescents, pregnant, Lactating mothers.

6. Nutritionist in schools.