Nutrition I Year B.SC Nursing Unit - I Short Essay: 1. Explain The History of Nutrition

NUTRITION
I YEAR B.sc NURSING

UNIT – I
INTRODUCTION
Short Essay
1. EXPLAIN THE HISTORY OF NUTRITION.

Although food and nutrition have been studied for centuries, modern nutritional science is
surprisingly young. The first vitamin was isolated and chemically defined in 1926, less
than 100 years ago, ushering in a half century of discovery focused on single nutrient
deficiency diseases. Research on the role of nutrition in complex non-communicable
chronic diseases, such as cardiovascular disease, diabetes, obesity, and cancers, is even
more recent, accelerating over the past two or three decades and especially after 2000. The
first half of the 20th century witnessed the identification and synthesis of many of the
known essential vitamins and minerals and their use to prevent and treat nutritional
deficiency related diseases including scurvy, beriberi, pellagra, rickets, xerophthalmia, and
nutritional anaemias. Casimir Funk in 1913 came up with idea of a “vital amine” in food,
originating from the observation that the hulk of unprocessed rice protected chickens
against a beriberi-like condition. By the mid-20th century all major vitamins had been
isolated and synthesised Their identification in animal and human studies proved the
nutritional basis of serious deficiency diseases and initially led to dietary strategies to
tackle beriberi (vitamin B1), pellagra (vitamin B3), scurvy (vitamin C), pernicious anaemia
(vitamin B12), rickets (vitamin D), and other deficiency conditions. However, the chemical
synthesis of vitamins quickly led to food based strategies being supplanted by treatment
with individual vitamin supplements. This presaged modern day use and marketing of
individual and bundled multivitamins to guard against deficiency, launching an entire
vitamin supplement industry.
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2. Describe the concepts of nutrition
Nutrition is defined as the processes by which an animal or plant takes in and utilises
food substances. Essential nutrients include protein, carbohydrate, fat, vitamins, minerals
and electrolytes.
There are five key factors that make up a healthful diet:
(1) An adequate diet,
(2) A balanced diet,
(3) Calorie control,
(4) Moderation, and
(5) Variety. Nutritional scientists discover the health effects of food and its nutrients by
first making an observation.
3. Mention the role of nutrition in maintaining health.
Most people know good nutrition and physical activity can
help maintain a healthy weight. But the benefits of good nutrition go beyond weight.
Good nutrition can help: Reduce the risk of some diseases, including heart disease,
diabetes, stroke, some cancers, and osteoporosis.
Nutrients have one or more of three basic functions: they provide energy, contribute to
body structure, and/or regulate chemical processes in the body. These
basic functions allow us to detect and respond to environmental surroundings, move,
excrete wastes, respire (breathe), grow, and reproduce.
Nutrition and Physical Activity
 Reduce the risk of chronic diseases, such as diabetes, heart disease, high blood pressure,
stroke, and some cancers and associated disabilities.
 Prevent weight gain and/or promote weight loss.
 Improve overall well-being.
4. Explain the nutritional problems of India.
The major nutritional problems are protein energy mal-nutrition, Vitamin A deficiency,
iron deficiency (anemia) and iodine disorders. Macronutrients Problems in India.
Carbohydrates: Major deficiencies are Diabetic ketoacidosis, hyperosmolar coma,
hypoglycaemia (energy loss, fatigue& constipation)
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Major nutritional problems include: 1) Maternal nutritional anemia; 2) protein
energy malnutrition; 3) vitamin A deficiency; 4) lactation failure; 5) addiction to milk
feeding; and 6) inadequate preparation and use of artificial milk products.
Factors related to under nutrition
1.Malnutrition, disability and death
2. Insufficient access to food
3. Inadequate maternal and child care practices
4. Poor water / sanitation and hygiene
5. Inadequate health services and insufficient access to health services
6. Inadequate and/or inappropriate knowledge and discrimination against women, elderly
and girl child.
7. Inadequate education.
5. Explain the National nutritional policy.
The goal of the National Nutrition Policy is to improve the nutritional status of the
people, especially disadvantaged groups, including mothers, adolescent girls and children;
to prevent and control malnutrition; and to accelerate national development through
raising the standard of living .
Nutrition policy (or nutrition planning) A set of concerted actions, based on a
governmental mandate, intended to ensure good health in the population through informed
access to safe, healthy, and adequate food.
Recommendations
 Focus on 3-6 yr age group children rather than since birth in ICDS because
mal nutritional ready sets in by then.
 Focus on mild to moderate malnutrition and not just on severe malnutrition.
 Establish regional, zonal centers' with nutritionists/ scientists and use the
expertise of bio-technologists and genetic engineers.
 Empower Panchayati raj institutions and form village level nutrition
committees for micro planning and formulating short term goals.
 A compulsory course on nutrition literacy at the UGC level.
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6. What are the factors affecting food and nutrition?
Some of the other factors that influence food choice include: Biological determinants
such as hunger, appetite, and taste. Economic determinants such as cost, income,
availability. Physical determinants such as access, education, skills (e.g. cooking) and
time.
Nutritional status of an individual is generally dependent on two factors,
external factors such as
 food safety,
 cultural,
 social,
 economical factors
internal factors, which include
 age,
 sex,
 nutrition,
 behavior,
 physical activity and
 diseases of the person
7. Describe the role of food and its medicinal value.
Food does much more than simply provide you with fuel. It may promote or worsen
health, depending on what you eat. A nutrient-dense diet of whole foods has been shown
to prevent many chronic diseases and may help treat some conditions, such as type 2
diabetes.
A food is something that provides nutrients. Nutrients are substances that provide: energy
for activity, growth, and all functions of the body such as breathing, digesting food, and
keeping warm; materials for the growth and repair of the body, and for keeping the
immune system healthy.
How is food used as medicine?
Whole foods act as medicine to heal and protect your body and boost your immune
system. But when you fuel your body with processed foods, chemicals, preservatives and
additives, your immune system is lowered, and your digestive system slows down.
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8. Explain the Classification of foods.
Food is any substance normally eaten or drunk by living things. The term food also
includes liquid drinks. Food is the main source of energy and of nutrition for animals, and
is usually of animal or plant origin. There are 4 (four) basic food energy sources: fats,
proteins, carbohydrates and alchol.
The 6 Major Food Groups
 Whole grains and starchy vegetables. ...
 Fruits and non-starchy vegetables. ...
 Dairy and non-dairy alternatives. ...
 Fish, poultry, meat, eggs and alternatives. ...
 Heart-healthy oils. ...
 Elective or Discretionary Calories.
9. Define food standards and explain various food standards.
Definition
food standard A set of criteria that a food must meet if it is to be suitable for human
consumption, such as source, composition, appearance, freshness, permissible additives,
and maximum bacterial content.
Food standards in India
They are formulated along the lines of codex alimentarius.
1. Compulsory standards
2. Voluntary standards Dr. Mrs. Vandana Mahajani
1. Compulsory standards
The prevention of food adulteration act(PFA) 1955 Essential commodities act 1954.
Various orders fall under this :
Fruit Products Order (FPO) regulated by Ministry of food processing Industries
Meat Products Order (MPO) 1973 regulated by the Directorate of Marketing and
Inspection Dr. Mrs. Vandana Mahajani
Milk and Milk Products Order 1992: cover the sale , purchase and distribution of milk
and milk products Solvent extracted oils, flour control order, vegetable products order
1976. the license is granted by the Ministry of Civil Supplies Consumer Affairs and
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Public Distribution . It controls the market price of Vanaspati.(dalda) Standard on
weights and measures 1977. it is compulsory to declare the weight of the Dr. Mrs.
Vandana Mahajani
2. Voluntary standards
AGMARK.
Agriculture produce grading and marketing act 1937.
The Director of Marketing and Inspection grades commodities as 1234 meaning
special, good ,fair and ordinary.
The “Agmark” label is an assurance of quality. It also helps settle disputes between
buyers and sellers. Dr. Mrs. Vandana Mahajani
Bureau of Indian Standards(BIS).
Indian Standards Institute (ISI) is responsible for laying BIS.
These standards are evolved after chemical, biological and physical assessment of the
product to be marketed. Dr. Mrs. Vandana Mahajani
10. Explain with examples, food standardization system in India.
The Food Safety and Standards Authority of India is a statutory body under Food Safety
and Standards Act, 2006. The Food Safety and Standards Act (FSS), 2006 is the
primary law for the regulation of food products. This act also sets up the formulation and
enforcement of food safety standards in India.
The FSSAI appoints food safety authorities on the state level
The FSSAI functions under the administrative control of the Ministry of Health and
Family Welfare.
The main aim of FSSAI is to
1. Lay down science-based standards for articles on food
2. To regulate the manufacture, storage, distribution, import, and sale of food
3. To facilitate the safety of food
The FSS Act is a bucket for all the older laws, rules and regulations for food safety. The
FSS Act took 7 older acts into one umbrella.
1. Prevention of Food Adulteration Act, 1954
2. Fruit Products Order, 1955
3. Meat Food Products Order, 1973
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4. Vegetable Oil Products (Control) Order, 1947
5. Edible Oils Packaging (Regulation) Order 1988
6. Solvent Extracted Oil, De- Oiled Meal and Edible Flour (Control) Order, 1967
7. Milk and Milk Products Order, 1992.
Departments
1. Import Division
2. Eat Right India Movement
3. International Co-operation
4. Regulatory Compliance Division (RCD)
5. Food Safety Management System (FSMS) Division
6. Risk Assessment and R&D division (RARD)
7. Information Education Communication (IEC) Division
8. Regulation and Codex Division
9. Quality Assurance/ lab Division
10.HR Division
11.Standards Division
12.IT Division
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UNIT – II
CARBOHYDRATES
SHORT ESSAY
1.HOW ARE CARBOHYDRATES CLASSIFIED? LIST THE SOURCES AND
FUNCTIONS OF CARBOHYDRATES.
Carbohydrates are biomolecules that consist of carbon, oxygen and hydrogen atoms. The ratio of
hydrogen and oxygen in carbohydrate is 2:1, which is similar to water.
The Nutrition Sources of Carbohydrates
There are both healthy and unhealthy sources of carbohydrates. Healthy sources of carbohydrates
include both food sources-animal and plant products, such as fresh fruits, vegetables, corn,
potatoes, milk and milk products. Unhealthy sources include soda, white bread, artificial sugar,
pastries, and other highly processed foods.
Carbohydrates can be found in different forms, such as sugars, starch, and fibres. Here is a list of
carbohydrates from different sources and different forms.
Types of Carbohydrates
There are two types of carbohydrates:
 Simple carbohydrates.
 Starchy Carbohydrates.
 Fibrous Carbohydrates.
 Complex carbohydrates.
Carbohydrates cannot be produced by the human body. So, they should be taken through diet.
Simple Carbohydrates
Fresh fruits like apples, oranges, banana, pineapple, sweet potatoes, berries are rich sources of
healthy simple carbohydrates. Foods that have artificial sugars and highly processed foods are
unhealthy sources of it. Milk is also a rich source of simple carbohydrates.
Starchy Carbohydrates
Grains are rich sources of carbohydrates. Grains include whole grains, grain bread, etc. Some
foods that are rich in carbohydrates are beans, potatoes, sweet potatoes, and some nuts. Cereals
are also a rich source of carbohydrates.
Fibrous Carbohydrates
Fibrous carbohydrates can be found in fresh vegetables like pumpkin, carrot, tomatoes, beans,
broccoli, cucumbers, squash, etc.
Complex Carbohydrates
Complex carbohydrates are found in beans, peas, whole grains, barley, oats, wild rice, brown
rice, etc.
Complex carbohydrates are good carbohydrates as they contain starch and fibre. Also, these
carbohydrates do not spike sugar levels in the blood thereby helping in minimal sugar level in
blood.
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Functions of Carbohydrates
Following are the important carbohydrates functions:
 These are the main source of energy.
 It is a part of some connecting tissues.
 These also help in maintaining a healthy digestive system.
 The fibre in carbohydrates helps in lowering blood cholesterol.
 It retains protein from being burned so it can be used to build and repair.
2.Explain in detail digestion and absorption of carbohydrates.
All the food you eat goes through your digestive system so it can be broken down and used
by the body. Carbohydrates take a journey starting with the intake at the mouth and ending
with elimination from your colon. There’s a lot that happens between the point of entry and
exit.
1. The mouth
You begin to digest carbohydrates the minute the food hits your mouth. The saliva
secreted from your salivary glands moistens food as it’s chewed.
Saliva releases an enzyme called amylase, which begins the breakdown process of the
sugars in the carbohydrates you’re eating.
2. The stomach
From there, you swallow the food now that it’s chewed into smaller pieces. The
carbohydrates travel through your esophagus to your stomach. At this stage, the food is
referred to as chyme. Your stomach makes acid to kill bacteria in the chyme before it makes
its next step in the digestion journey.
3. The small intestine, pancreas, and liver
The chyme then goes from the stomach into the first part of the small intestine, called the
duodenum. This causes the pancreas to release pancreatic amylase. This enzyme breaks
down the chyme into dextrin and maltose.
From there, the wall of the small intestine begins to make lactase, sucrase, and maltase.
These enzymes break down the sugars even further into monosaccharides or single
sugars.
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These sugars are the ones that are finally absorbed into the small intestine. Once they’re
absorbed, they’re processed even more by the liver and stored as glycogen. Other glucose
is moved through the body by the bloodstream.
The hormone insulin is released from the pancreas and allows the glucose to be used as
energy.
4. Colon
Anything that’s left over after these digestive processes goes to the colon. It’s then
broken down by intestinal bacteria. Fiber is contained in many carbohydrates and cannot
be digested by the body. It reaches the colon and is then eliminated with your stools.
Carbohydrate Absorption
A restricted alimentary limb also affects carbohydrate absorption, but not to any detrimental
degree. Because as much as 40% of the body's amylase is produced by the parotid and
submandibular glands, carbohydrate digestion begins in the mouth. Therefore, more than enough
absorption of carbohydrates is maintained, even with the restricted alimentary limb. In fact, if
carbohydrate intake is excessive, weight loss will be inadequate. This is the reason for advising
patients to eat a limited-carbohydrate diet. Increasing the alimentary limb length also increases
the absorption of carbohydrates.
3.Write note on excessive intake of carbohydrates and what happens in deficiency.
Excess carbohydrate intake places a large metabolic load on the body. When the body
constantly has high levels of blood sugars (the end point of food sugar and starch) to deal with
over time, this leads to weight gain, poor metabolic health and an increased risk of heart disease.
The body can store extra carbohydrates in your muscles and liver for use when you're not
getting enough carbohydrates in your diet. A carbohydrate-deficient diet may cause
headaches, fatigue, weakness, difficulty concentrating, nausea, constipation, bad breath and
vitamin and mineral deficiencies.
4.What is the calorific value of carbohydrate? List the key differences between
Kwashiorkor and Marasmus.
Carbohydrates provide 4 calories per gram, protein provides 4 calories per gram, and fat
provides 9 calories per gram.
Kwashiorkor Marasmus
Causes
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Deficiency of proteins. Deficiency of both proteins and calories.
Age factors
Between the age of 6 months and 3 years of Between the age of 6 months and 1 year of
age. age.
Oedema
Present. Absent.
Subcutaneous fat
Present. Absent.
Weight loss
There is some weight loss. There is severe weight loss.
Symptoms
The thinning of muscles and limbs. The thinning of limbs.
Fatty liver cells
There is an enlargement in the fatty liver There is no enlargement in the fatty liver
cells. cells.
Appetite
Voracious feeder. Poor appetite.
The texture of the skin
Flaky paint appearance on the skin. Dry and wrinkled skin.
Requirement of Nutrition
Adequate amounts of proteins,

Adequate amounts of proteins.
carbohydrates and fats.
5.What is the daily requirement of carbohydrates? Explain the metabolism of

carbohydrates.
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The primary role of carbohydrate is to provide energy to all cells in the body and dietary fiber.
Adults should consume 45–65% of their total calories from carbohydrates, except for younger
children who need a somewhat higher proportion of fat in their diets. A maximum intake of 25%
of added sugars is suggested.
Carbohydrate metabolism is the whole of the biochemical processes responsible for the
metabolic formation, breakdown, and interconversion of carbohydrates in living organisms.
Carbohydrates are central to many essential metabolic pathways.
Metabolic pathways.
 Glycolysis
Glycolysis is the process of breaking down a glucose molecule into
two pyruvate molecules, while storing energy released during this process
as ATP and NADH. Nearly all organisms that break down glucose utilize glycolysis.
 Gluconeogenesis
Gluconeogenesis (GNG) is a metabolic pathway that results in the generation of glucose
from certain non-carbohydrate carbon substrates. It is a ubiquitous process, present in
plants, animals, fungi, bacteria, and other microorganisms. In humans, substrates for
gluconeogenesis may come from any non-carbohydrate sources that can be converted to
pyruvate or intermediates of glycolysis
 Glycogenolysis
Glycogenolysis refers to the breakdown of glycogen. In the liver, muscles, and the
kidney, this process occurs to provide glucose when necessary. A single glucose
molecule is cleaved from a branch of glycogen, and is transformed into glucose-1-
phosphate during this process. This molecule can then be converted to glucose-6-
phosphate, an intermediate in the glycolysis pathway.
 Glycogenesis
Glycogenesis refers to the process of synthesizing glycogen. In humans, glucose can be
converted to glycogen via this process. Glycogen is a highly branched structure,
consisting of the core protein Glycogenin, surrounded by branches of glucose units,
linked together.
SHORT ANSWERS
1. Write the clinical features of Marasmus
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Marasmus occurs more often in young children and babies. It leads to dehydration and weight
loss. Starvation is a form of this disorder. The symptoms of marasmus include:
 weight loss
 dehydration
 chronic diarrhea
 stomach shrinkage
2. Write the clinical features of Kwashiorkor
kwashiorkor occurs in people who have a severe protein deficiency. Children who develop
kwashiorkor are often older than children who develop marasmus. Having a diet that’s mainly
carbohydrates can lead to this condition.
The symptoms of kwashiorkor include:
 edema, or puffy or swollen appearance due to fluid retention
 bulging of the abdomen
 an inability to grow or gain weight
3. Sources of carbohydrate
The Nutrition Sources of Carbohydrates
There are both healthy and unhealthy sources of carbohydrates. Healthy sources of
carbohydrates include both food sources-animal and plant products, such as fresh
fruits, vegetables, corn, potatoes, milk and milk products. Unhealthy sources include
soda, white bread, artificial sugar, pastries, and other highly processed foods.
Carbohydrates can be found in different forms, such as sugars, starch, and fibres. Here is
a list of carbohydrates from different sources and different forms.
UNIT – III
LIPIDS
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SHORT ESSAY
1. DESCRIBE LIPIDS UNDER THE FOLLOWING HEADINGS, CLASSIFICATION,

FUNCTION AND FOOD SOURCES OF FATS.
Lipids are molecules that contain hydrocarbons and make up the building blocks of the structure
and function of living cells. Examples of lipids include fats, oils, waxes, certain vitamins (such
as A, D, E and K), hormones and most of the cell membrane that is not made up of protein
Classification
1.Very low-density lipoproteins (VLDL),
2.Hhigh-density lipoproteins (HDL).
 Fatty acids (saturated and unsaturated)
 Glycerides (glycerol-containing lipids)
 Nonglyceride lipids (sphingolipids, steroids, waxes)
 Complex lipids (lipoproteins, glycolipids)
The Functions of Fats in the Body

 Storing Energy. ...
 Insulating and Protecting. ...
 Regulating and Signaling. ...
 Aiding Absorption and Increasing Bioavailability. ...
 Contributing to the Smell, Taste, and Satiety of Foods. ...
 Providing Essential Fatty Acids. ...
 Attributions:
Saturated fat – primary sources include:
 Red meat (beef, lamb, pork)
 Chicken skin.
 Whole-fat dairy products (milk, cream, cheese)
 Butter.
 Ice cream.
 Lard.
 Tropical oils such as coconut and palm oil.
2.Define lipids and explain the classification of lipids.

Definition
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Lipids are molecules that contain hydrocarbons and make up the building blocks of the structure
and function of living cells. Examples of lipids include fats, oils, waxes
Classification of Lipids
Lipids can be classified into two main classes:
 Nonsaponifiable lipids
 Saponifiable lipids
Nonsaponifiable Lipids
A nonsaponifiable lipid cannot be disintegrated into smaller molecules through hydrolysis.
Nonsaponifiable lipids include cholesterol, prostaglandins, etc
Saponifiable Lipids
A saponifiable lipid comprises one or more ester groups, enabling it to undergo hydrolysis in the
presence of a base, acid, or enzymes, including waxes, triglycerides, sphingolipids and
phospholipids.
Further, these categories can be divided into non-polar and polar lipids.
Nonpolar lipids, namely triglycerides, are utilized as fuel and to store energy.
3. Explain in detail the functions of lipids.

Role of lipids in the body
Lipids have several roles in the body, these include acting as chemical messengers, storage and
provision of energy and so forth.
Chemical messengers
All multicellular organisms use chemical messengers to send information between organelles
and to other cells. torage and provision of energy Storage lipids are triacylglycerols. These are
inert and made up of three fatty acids and a glycerol.
Maintenance of temperature
Layers of subcutaneous fat under the skin also help in insulation and protection from cold.
Maintenance of body temperature is mainly done by brown fat as opposed to white fat
Membrane lipid layer formation
Membrane lipids are made of polyunsaturated fatty acids. Polyunsaturated fatty acids are
important as constituents of the phospholipids, where they appear to confer several important
properties to the membranes. One of the most important properties are fluidity and flexibility of
the membrane.
Cholesterol formation
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Much of the cholesterol is located in cell membranes. It also occurs in blood in free form as
plasma lipoproteins.
Prostaglandin formation and role in inflammation
The essential fatty acids, linoleic and linolenic acids are precursors of many different types of
eicosanoids, including the hydroxyeicosatetraenes, prostanoids (prostaglandins, thromboxanes
and prostacyclins), leukotrienes (and lipoxins) and resolvins etc. these play an important role in
pain, fever, inflammation and blood clotting.
4. What are the sources of lipids? What is the calorific value and daily requirement of
lipids?
 Monounsaturated fat. This type of fat is found in plant oils. Common sources are nuts
(almonds, cashews, pecans, peanuts, and walnuts) and nut products, avocados, extra
virgin olive oil, sesame oil, high oleic safflower oil, sunflower oil, and canola oil.
 Polyunsaturated fat. This type of fat is found mainly in plant-based foods, oils, and fish.
Common sources are nuts (walnuts, hazel nuts, pecans, almonds, and peanuts), soybean
oil, corn oil, safflower oil, flaxseed oil, canola oil, and fish (trout, herring, and salmon).
 Saturated fat. This fat is found in animal products, dairy products, palm and coconut
oils, and cocoa butter. Limit these products to less than 10 percent of your overall dietary
fat consumption.
 Trans fatty acids
. Stick margarines, fast foods, commercial baked goods, and some snack foods contain
trans fats. Limit your consumption of these products to keep trans fats to less than 1
percent of your fat consumption.
 Omega-3 fatty acids(linolenic acid). Good sources of these are canola oil, flaxseed oil,
soybean oil, olive oil, nuts, seeds, whole grains, legumes, and green leafy vegetables.
 DHA and EPA. Good sources of these are cod liver oil and fish such as tuna, herring,
mackerel, salmon, and trout.
 Omega-6 fatty acids (linoleic acid). Eggs, poultry, most vegetable oils, wheat germ oil,
whole grains, baked goods, and cereals contain these
fatty acids
Calorific value and daily requirement of lipids
Lipids are a concentrated source of energy and provide almost twice the amount of energy than
that supplied by proteins and carbohydrates. Children aged between 4-18 years require ~6500 to
14000 kJ per day.
5. Explain in detail digestion and absorption of fats.
The process of fat digestion involves a series of steps that begin the moment food enters your
mouth. Here’s a look at the process from beginning to end:
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DIGESTION
1. Mouth
The digestion process begins when you start chewing your food. Your teeth break the
food into smaller pieces, and your saliva moistens the food so that it’s easier for it to
move through your esophagus and into your stomach. Your saliva also contains enzymes
that begin breaking down the fat in your food.
2. Esophagus
When you swallow, a series of muscle contractions called peristalsis moves the food
through your esophagus and into your stomach.
3. Stomach
Your stomach lining produces acids and enzymes that break down your food further so
that the foods can pass to the small intestine.
4. Small intestine
The majority of fat digestion happens once it reaches the small intestine. This is also
where the majority of nutrients are absorbed. Your pancreas produces enzymes that break
down fats, carbohydrates, and proteins
ABSORTION
After the fat has been digested, fatty acids are passed through the lymph system and then
throughout the body via your bloodstream to be used or stored for energy, cell repair, and
growth. Your lymph system also absorbs fatty acids to help fight infection. Adipose, which is fat
tissue, takes triglyceride from the chylomicrons. Each chylomicron gets smaller, eventually
leaving a remnant that’s rich in cholesterol and taken in by the liver.
6.. Write note on excessive intake and deficiency of fats.
Dietary fat deficiency is rare in healthy people who eat a balanced, nutritious diet. However,
some conditions can put you at risk for fat deficiency, such as:
eating disorders
large bowel resection (colectomy)
 inflammatory bowel disease
 cystic fibrosis
 pancreatic insufficiency
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 an extremely low fat diet
excessive intake of fats causes

 Cardiovascular disease.
 Heart attack. Ischemic stroke.
 Congestive heart failure.
 Arrhythmia.
 Heart valve problems.
 Obesity.
III.SHORT ANSWERS
1. What is calorific values of Lipids?
The calorific values of lipids and carbohydrates respectively, are 9.3 kcals/g and 4.5
kcals/g.
2) What are Refined Oils?
Definition: An oil has been refined by using chemicals that are harmful to us. In short it
means to 'purify'.
AVOID
 Canola oil
 Vegetable oil
 Soybean
 Safflower
 Corn oils
 Margarine (or any other ‘buttery’ spread)
2. What is Emulsification?
Emulsification is the formation of emulsions from two immiscible liquid phases is
probably the most versatile property of surface-active agents for practical applications
and, as a result, has been extensively studied.
3. What are the effects of over consumption of Lipids?
 Cardiovascular disease.
 Heart attack. Ischemic stroke.
 Congestive heart failure.
 Arrhythmia.
 Heart valve problems.
 Obesity.
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4. What is the deficiency of lipids called as?
Wolman's disease, also known as acid lipase deficiency, is a severe lipid storage disorder
that is usually fatal by age 1.
5. What are the differences between essential and non essential fatty acids?
The body is capable of synthesizing most of the fatty acids it needs from food.
These fatty acids are known as nonessential fatty acids. However, there are some fatty
acids that the body cannot synthesize and these are called essential fatty acids.
UNIT – IV
PROTIENS
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II.SHORT ESSAY
1. How are proteins classified? What are the sources of proteins? What is the calorific
value of protein?
Proteins can be classified into groups according to sequence or structural similarity.
These groups often contain well characterised proteins whose function is known. Thus,
when a novel protein is identified, its functional properties can be proposed based on the
group to which it is predicted to belong.
Sources of proteins
Some food sources of dietary protein include:
 lean meats – beef, lamb, veal, pork, kangaroo
 poultry – chicken, turkey, duck, emu, goose, bush birds
 fish and seafood – fish, prawns, crab, lobster, mussels, oysters, scallops, clams
 eggs
 dairy products – milk, yoghurt (especially Greek yoghurt), cheese (especially cottage
cheese)
 nuts (including nut pastes) and seeds – almonds, pine nuts, walnuts, macadamias,
hazelnuts, cashews, pumpkin seeds, sesame seeds, sunflower seeds
 legumes and beans – all beans, lentils, chickpeas, split peas, tofu.
calorific value of protein
Carbohydrates provide 4 calories per gram, protein provides 4 calories per gram, and fat
provides 9 calories per gram.
2. What is PEM? Write note on excessive intake and deficiency symptoms of protein.
According to World Health Organization, protein energy malnutrition (PEM) refers to
“an imbalance between the supply of protein and energy and the body's demand for them
to ensure optimal growth and function”.
Risks of eating too much protein
Weight gain. High-protein diets may tout weight loss, but this type of weight loss may only be
short-term. ...
 Bad breath. ...
 Constipation. ...
 Diarrhea. ...
 Dehydration. ...
 Kidney damage. ...
 Increased cancer risk. ...
 Heart disease.
This article lists 8 symptoms of low protein intake or deficiency.
20
 What Is Protein Deficiency? Share on Pinterest. ...
 Edema. ...
 Fatty Liver. ...
 Skin, Hair and Nail Problems. ...
 Loss of Muscle Mass. ...
 Greater Risk of Bone Fractures. ...
 Stunted Growth in Children. ...
 Increased Severity of Infections.
3. Explain in detail digestion, absorption, and metabolism of proteins.

Digestion
Protein digestion begins when you first start chewing. There are two enzymes in your
saliva called amylase and lipase. They mostly break down carbohydrates and fats. Once
a protein source reaches your stomach, hydrochloric acid and enzymes called proteases
break it down into smaller chains of amino acids
Protein digestion in the mouth
Unless you are eating it raw, the first step in digesting an egg (or any other solid food) is
chewing. The teeth begin the mechanical breakdown of large egg pieces into smaller
pieces that can be swallowed. The salivary glands secrete saliva to aid swallowing and
the passage of the partially mashed egg through the esophagus.
Protein digestion in stomach
The mashed egg pieces enter the stomach from the esophagus. As illustrated in the image
below, both mechanical and chemical digestion take place in the stomach. The stomach
releases gastric juices containing hydrochloric acid and the enzyme, pepsin, which
initiate the chemical digestion of protein. Muscular contractions, called peristalsis, also
aid in digestion. The powerful stomach contractions churn the partially digested protein
into a more uniform mixture, which is called chyme.
Protein digestion and absorption in the small intestine
The two major pancreatic enzymes that digest proteins in the small intestine
are chymotrypsin and trypsin. Trypsin activates other protein-digesting enzymes
called proteases, and together, these enzymes break proteins down to tripeptides,
dipeptides, and individual amino acids. The cells that line the small intestine release
additional enzymes that also contribute to the enzymatic digestion of polypeptides.
21
Tripeptides, dipeptides, and single amino acids enter the enterocytes of the small intestine
using active transport systems, which require ATP. Once inside, the tripeptides and
dipeptides are all broken down to single amino acids, which are absorbed into the
bloodstream.
4. List the functions of proteins. What is the daily requirement of protein for an
adult?
1. Protein is required for the growth and maintenance of tissues. Your body’s protein
needs are dependent upon your health and activity level.
 Causes Biochemical Reactions
Enzymes are proteins that aid the thousands of biochemical reactions that take
place within and outside of your cells
 Acts as a Messenger
Some proteins are hormones, which are chemical messengers that aid
communication between your cells, tissues and organs
 Provides Structure
Some proteins are fibrous and provide cells and tissues with stiffness and rigidity.
These proteins include keratin, collagen and elastin, which help form the
connective framework of certain structures in your body Keratin is a structural
protein that is found in your skin, hair and nails.
 Maintains Proper pH
Protein plays a vital role in regulating the concentrations of acids and bases in
your blood and other bodily fluids The balance between acids and bases is
measured using the pH scale. It ranges from 0 to 14, with 0 being the most acidic,
7 neutral and 14 the most alkaline.
 Balances Fluids
Proteins regulate body processes to maintain fluid balance. Albumin and globulin
are proteins in your blood that help maintain your body’s fluid balance by
attracting and retaining water
 Transports and Stores Nutrients
22
 proteins carry substances throughout your bloodstream — into cells, out of cells
or within cells. The substances transported by these proteins include nutrients like
vitamins or minerals, blood sugar, cholesterol and oxygen
 Provides Energy
Proteins can supply your body with energy. Protein contains four calories per
gram, the same amount of energy that carbs provide. Fats supply the most energy,
at nine calories per gram.
Requirement of protein for adult
The current recommended dietary allowance (RDA) for protein is 0.8 grams per kilogram
(g/kg) of body weight a day for adults over 18, or about 2.3 ounces for a 180-pound adult.
5. Explain PEM.
Protein–energy malnutrition (PEM), sometimes called protein-energy
undernutrition (PEU), is a form of malnutrition that is defined as a range of conditions
arising from coincident lack of dietary protein and/or energy (calories) in varying
proportions. The condition has mild, moderate, and severe degrees.
Types include:
Kwashiorkor (protein malnutrition predominant)
Marasmus (deficiency in calorie intake)
Marasmic kwashiorkor (marked protein deficiency and marked calorie insufficiency
signs present, sometimes referred to as the most severe form of malnutrition)
a. Clinical signs and symptoms of protein-energy malnutrition (PEM) include the
following:
b. Poor weight gain
c. Slowing of linear growth
d. Behavioral changes - Irritability, apathy, decreased social responsiveness, anxiety,
and attention deficits
Management
Mild or moderate PEM are best judged by anthropometry; regular weighing, for
monitoring growth, may be a useful control strategy. Because infections play such an
important role in PEM, three practical approaches-immunization, deworming of children,
and oral rehydration therapy for diarrhea
23
III.SHORT ANWERS
1. What are amino acids?
Amino acids are organic compounds that contain amino and carboxyl functional groups,
along with a side chain specific to each amino acid. The key elements of an amino acid
are carbon, hydrogen, oxygen, and nitrogen, although other elements are found in the side
chains of certain amino acids.
2. What are essential amino acids?
An essential amino acid, or indispensable amino acid, is an amino acid that cannot be
synthesized from scratch by the organism fast enough to supply its demand, and must
therefore come from the diet. Of the 21 amino acids common to all life forms, the nine
amino
acidshumanscannotsynthesizeare phenylalanine, valine, threonine, tryptophan, methionin
e, leucine, isoleucine, lysine, and histidine.
3. What are non-essential amino acids?
NONESSENTIAL AMINO ACIDS. Nonessential means that our bodies produce
an amino acid, even if we do not get it from the food we eat. Nonessential amino
acids include: alanine, arginine, asparagine, aspartic acid, cysteine, glutamic acid,
glutamine, glycine, proline, serine, and tyrosine
4. Mention the biological value of proteins?
Biological value (BV) is a measure of the proportion of absorbed protein from a food
which becomes incorporated into the proteins of the organism's body. It captures how
readily the digested protein can be used in protein synthesis in the cells of the
organism. Proteins are the major source of nitrogen in food
5. What are complete proteins/first class proteins?
A food is considered a complete protein when it contains the nine essential amino acids
that our body cannot produce on its own.
6. What are incomplete proteins/class II proteins?

Plant foods are considered incomplete proteins because they are low or lacking in one or
more of the amino acids we need to build cells. Incomplete proteins found in plant foods
can be mixed together to make a complete protein.
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7. Give examples of complete proteins
Here are some complete protein examples:
 Fish.
1. Poultry.
2. Eggs.
3. Beef.
4. Pork.
5. Dairy.
6. Whole sources of soy
8. Give examples of incomplete proteins
 Legumes (beans, peas, lentils).
 Nuts.
 Seeds.
 Whole grains.
 Vegetables.
9. What is Kwashiorker?
Kwashiorkor is a condition resulting from inadequate protein intake.
Early symptoms include fatigue, irritability, and lethargy. As protein deprivation
continues, one sees growth failure, loss of muscle mass, generalized swelling (edema),
and decreased immunity. A large, protuberant belly is common.
10. Define Marasmas.
Marasmus is a form of severe malnutrition. It can occur in anyone who has severe
malnutrition, but it usually occurs in children. It typically occurs in developing
countries. Marasmus can be life-threatening, but you can get treatment for it.
25
UNIT – V
ENERGY
SHORT ANSWERS
1. What is Calorific Value?

Calorific value is the amount of energy released or produced when 1 kg of fuel burns or
any other substance is burnt in the presence of oxygen and the products of combustion
are cooled to STP. Its SI unit is kJ/kg.
2. Define Basal Metabolic Rate.
Basal metabolic rate is the rate of energy expenditure per unit time by endothermic
animals at rest. It is reported in energy units per unit time ranging from watt to ml
O₂/min or joule per hour per kg body mass J/. Proper measurement requires a strict set of
criteria be met.
3. What is specific Dynamic Action of food?
Specific dynamic action (SDA), also known as thermic effect of food (TEF) or dietary
induced thermogenesis (DIT), is the amount of energy expenditure above the basal
metabolic rate due to the cost of processing food for use and storage.[1] Heat production
by brown adipose tissue which is activated after consumption of a meal is an additional
component of dietary induced thermogenesis
4. What is Obesity?
A disorder involving excessive body fat that increases the risk of health problems.Obesity
often results from taking in more calories than are burned by exercise and normal daily
activities.Obesity occurs when a person's body mass index is 25 or greater. The excessive
body fat increases the risk of serious health problems.
5. What is Energy requirement of different categories of people?
Energy requirement is the amount of food energy needed to
balance energy expenditure in order to maintain body size, body composition and a level
of necessary and desirable physical activity consistent with long-term good health.
26
For men of reference body size, the average allowance is 2,900 kcal/day; for women, it is
2,200 kcal. With light-to-moderate activity, the coefficient of variation in energy
requirements of adults is approximately 20%
6. How is Energy produced in our body? Explain
The human body uses three types of molecules to yield the necessary energy to drive
ATP synthesis: fats, proteins, and carbohydrates. Mitochondria are the main site for ATP
synthesis in mammals, although some ATP is also synthesized in the cytoplasm.
7. Explain various methods to assess obesity.
 Body Mass Index (BMI)

 Waist Circumference
 Waist-to-Hip Ratio
 Skinfold Thickness
 Bioelectric Impedance (BIA)
8. What are the factors which affect BMR?
Here are ten factors that affect BMR and metabolism:
 Muscle mass. The amount of muscle tissue on your body. ...
 Age. As you get older, your metabolic rate generally slows. ...
 Body size. ...
 Gender. ...
 Genetics. ...
 Physical activity. ...
 Hormonal factors. ...
 Environmental factors.
9. Difference between actual calorific value and physiological value
physiologic value of food. The energy released by complete combustion of one
gram of food is gross calorific value. The actual amount of energy liberated in the body
from carbohydrates, proteins and fats is called physiologic value of food.
10. Define Energy
In physics, energy is the quantitative property that must be transferred to an object in
order to perform work on, or to heat, the object. Energy is a conserved quantity; the law
27
of conservation of energy states that energy can be converted in form, but not created or
destroyed
11. Define Calorie
The calorie is a unit of energy defined as the amount of heat needed to raise the
temperature of a quantity of water by one degree.
12. What is the measurement of Energy
The official measurement unit for energy is the Joule (J). Among the most common
units measuring energy mention should be made of the kilowatt/hour (kWh), used
especially for electric energy (in fact it is used to calculate electricity bills).
13. Define Actual Calorific Values of food.
The calorific value of food indicates the total amount of energy, a human body could
generate during its metabolism which is expressed in Kilojoules per 100 grams or 100 ml.
The calorific value of food is generally expressed in kilocalories i.e. kcal.
14. Define Physiological Calorific Value of food.
Term for the physiological value of a food, depending on the quantity and ratio of its
ingredients. However, this also depends on the type of preparation and the combination
of individual foods. he usable energy is called the physiological calorific value. This
value corresponds to its energy content when "burned" in the body; the assessment of this
combustion is called quantitative nutritional value. This is expressed in kilojoules,
15. What is the significance of BMR.
BMR is the number of calories your body uses to maintain vital functions, such as
breathing, heart rate, and brain function. Thermic effect of food (TEF). This is the
number of calories burned while digesting a meal, which is usually about 10% of calorie
intake. Thermic effect of exercise (TEE).
28
UNIT – VI
VITAMINS
I.LONG ESSAYS ESSAYS
1. DEFINE VITAMINS, CLASSIFY VITAMINS; EXPLAIN THE DIETARY

SOURCES DAILY REQUIREMENTS OF VITAMIN A
A vitamin is an organic molecule (or a set of molecules closely related chemically,
i.e. vitamers) that is an essential micronutrient which an organism needs in small
quantities for the proper functioning of its metabolism. Essential nutrients cannot
be synthesized in the organism, either at all or not in sufficient quantities, and
therefore must be obtained through the diet. Vitamin C can be synthesized by some
species but not by others; it is not a vitamin in the first instance but is in the second.
CLASSIFICATION OF VITAMINS
Vitamins are classified as either water-soluble or fat-soluble. In humans there are 13
vitamins: 4 fat-soluble (A, D, E, and K) and 9 water-soluble (8 B vitamins and
vitamin C). Water-soluble vitamins dissolve easily in water and, in general, are
readily excreted from the body, to the degree that urinary output is a strong predictor
of vitamin consumption.[24] Because they are not as readily stored, more consistent
intake is important. Fat-soluble vitamins are absorbed through the intestinal tract with
the help of lipids (fats). Vitamins A and D can accumulate in the body, which can
result in dangerous hypervitaminosis. Fat-soluble vitamin deficiency due to
malabsorption is of particular significance in cystic fibrosis.
Sources
For the most part, vitamins are obtained from the diet, but some are acquired by other
means: for example, microorganisms in the gut flora produce vitamin K and biotin;
and one form of vitamin D is synthesized in skin cells when they are exposed to a
certain wavelength of ultraviolet light present in sunlight. Humans can produce some
vitamins from precursors they consume: for example, vitamin A is synthesized
from beta carotene; and niacin is synthesized from the amino acid tryptophan.The
29
Food Fortification Initiative lists countries which have mandatory fortification
programs for vitamins folic acid, niacin, vitamin A and vitamins B1, B2 and B1
How much vitamin A do needed?
The amount of vitamin A you need depends on your age and sex. Average daily recommended
amounts are listed below in micrograms (mcg) of retinol activity equivalents (RAE).
Life Stage Recommended Amount

Birth to 6 months 400 mcg RAE
Infants 7–12 months 500 mcg RAE
Children 1–3 years 300 mcg RAE
Teen boys 14–18 years 900 mcg RAE
Teen girls 14–18 years 700 mcg RAE
Adult men 900 mcg RAE
Adult women 700 mcg RAE
Pregnant teens 750 mcg RAE
Pregnant women 770 mcg RAE
Breastfeeding teens 1,200 mcg RAE
Breastfeeding women 1,300 mcg RAE
2. DEFINE VITAMINS. CLASSIFY VITAMINS; EXPLAIN THE DIETARY

SOURCES DAILY REQUIREMENTS, ABSORPTION, FUNCTIONS,
DEFICIENCY OF VITAMIN D
be synthesized in the organism, either at all or not in sufficient quantities, and
therefore must be obtained through the diet. Vitamin C can be synthesized by some
species but not by others; it is not a vitamin in the first instance but is in the second.
Classification of vitamins
vitamins: 4 fat-soluble (A, D, E, and K) and 9 water-soluble (8 B vitamins and
30
vitamin C). Water-soluble vitamins dissolve easily in water and, in general, are
readily excreted from the body, to the degree that urinary output is a strong predictor
of vitamin consumption.] Because they are not as readily stored, more consistent
intake is important.[25] Fat-soluble vitamins are absorbed through the intestinal
tract with the help of lipids (fats). Vitamins A and D can accumulate in the body,
which can result in dangerous hypervitaminosis. Fat-soluble vitamin deficiency due
to malabsorption is of particular significance in cystic fibrosis.
Good sources of vitamin D
 Oily fish – such as salmon, sardines, herring and mackerel.
 Red meat.
 Lliver.
 Egg yolks.
 Fortified foods – such as some fat spreads and breakfast cereals.
How much vitamin D do needed?
The amount of vitamin D you need each day depends on your age. Average daily
recommended amounts are listed below in micrograms (mcg) and International
Units (IU):

Birth to 12 months 10 mcg (400 IU)
Children 1–13 years 15 mcg (600 IU)
Teens 14–18 years 15 mcg (600 IU)
Adults 19–70 years 15 mcg (600 IU)
Adults 71 years and older 20 mcg (800 IU)
Pregnant and breastfeeding teens and women 15 mcg (600 IU)

Functions of Vitamin D
Vitamin D is both a nutrient we eat and a hormone our bodies make. It is a fat-soluble vitamin
that has long been known to help the body absorb and retain calcium and phosphorus; both are
critical for building bone. Also, laboratory studies show that vitamin D can reduce cancer cell
growth, help control infections and reduce inflammation. Many of the body’s organs and tissues
have receptors for vitamin D, which suggest important roles beyond bone health, and scientists
are actively investigating other possible functions.
Defeciency of vitamin D
31
 People who are obese tend to have lower blood vitamin D levels. Vitamin D accumulates
in excess fat tissues but is not easily available for use by the body when needed. Higher
doses of vitamin D supplementation may be needed to achieve a desirable blood level.
Conversely, blood levels of vitamin D rise when obese people lose weight.
 People who have undergone gastric bypass surgery, which typically removes the upper
part of the small intestine where vitamin D is absorbed.
Conditions resulting from prolonged vitamin D deficiency:
 Rickets: A condition in infants and children of soft bones and skeletal deformities caused
by failure of bone tissue to harden.
 Osteomalacia: A condition in adults of weak and softened bones that can be reversed with
supplementation. This is different than osteoporosis, in which the bones are porous and
brittle and the condition is irreversible.
Toxicity
Vitamin D toxicity most often occurs from taking supplements. The low amounts of
the vitamin found in food are unlikely to reach a toxic level, and a high amount of sun
exposure does not lead to toxicity because excess heat on the skin prevents D3 from
forming. It is advised to not take daily vitamin D supplements containing more than
4,000 IU unless monitored under the supervision of your doctor.
3. DEFINE VITAMINS. MENTION FAT SOLUBLE VITAMIN. EXPLAIN
VITAMIN K IN DETAIL.
Definition of vitamins
A vitamin is an organic molecule that is an essential micronutrient which an organism
needs in small quantities for the proper functioning of its metabolism. Essential
nutrients cannot be synthesized in the organism, either at all or not in sufficient
quantities, and therefore must be obtained through the diet.
Fat-soluble vitamins
Fat-soluble vitamins are stored in the body's cells and are not excreted as easily as water-
soluble vitamins. They do not need to be consumed as often as water-soluble vitamins,
although adequate amounts are needed. If you take too much of a fat-soluble vitamin, it
could become toxic. Your body is especially sensitive to too much vitamin A from animal
sources (retinol) and too much vitamin D. A balanced diet usually provides enough fat-
soluble vitamins.
Fat-soluble vitamins
32
Nutrient Function Sources
Vitamin A (and Needed for vision, healthy Vitamin A from animal sources (retinol):
its precursor*, skin and mucous fortified milk, cheese, cream, butter,
beta-carotene) membranes, bone and fortified margarine, eggs, liver
*A precursor is tooth growth, immune Beta-carotene (from plant sources):
converted by the system health Leafy, dark green vegetables; dark
body to the orange fruits (apricots, cantaloupe) and
vitamin. vegetables (carrots, winter squash, sweet
potatoes, pumpkin)
Vitamin D Needed for proper Egg yolks, liver, fatty fish, fortified milk,
absorption of calcium; fortified margarine. When exposed to
stored in bones sunlight, the skin can make vitamin D.
Vitamin E Antioxidant; protects cell Polyunsaturated plant oils (soybean,

walls corn, cottonseed, safflower); leafy green
vegetables; wheat germ; whole-grain
products; liver; egg yolks; nuts and seeds
Vitamin K Needed for proper blood Leafy green vegetables such as kale,
clotting collard greens, and spinach; green
vegetables such as broccoli, brussels
sprouts, and asparagus; also produced
in intestinal tract by bacteria
Vitamin k
Vitamin K refers to a group of fat-soluble vitamins that play a role in blood clotting,
bone metabolism, and regulating blood calcium levels.
The body needs vitamin K to produce prothrombin, a protein and clotting factor that
is important in blood clotting and bone metabolism. People who use blood-thinning
medications, such as warfarin, or Coumadin, should not start consuming additional
vitamin K without first asking a doctor.
Deficiency is rare, but, in severe cases, it can increaseTrusted Source clotting time,
leading to hemorrhage and excessive bleeding.
33
Vitamin K1, or phylloquinone, comes from plants. It is the main typeTrusted
Source of dietary vitamin K. A lesser source is vitamin K2, or menaquinone, which
occurs in some animal-based and fermented foods.
USES
 Phylloquinone, also known as vitamin K1, is found in plants. When people eat
it, bacteria in the large intestine convert it to its storage form, vitamin K2. It is
absorbed in the small intestine and stored in fatty tissue and the liver.
 Without vitamin K, the body cannot produce prothrombin, a clotting factor
that is necessary for blood clotting and bone metabolism.
 Most Americans are not at riskTrusted Source of a vitamin-K deficiency. It is
most likely to affect newborns and those with a malapsorption problem, due,
for example, to short-bowel syndrome, cystic fibrosis, celiac disease, or
ulcerative colitis.
 Newborns normally receive a vitamin K injection to protect them from
bleeding in the skull, which could be fatal.
 The recommended adequate intake for vitamin K depends on age and gender.
Women aged 19 years and over should consume 90 microgramsTrusted
Source (mcg) a day, and men should have 120 mcg.
4. EXPLAIN THE DIETARY SOURCES, FUNCTIONS, DEFICIENCY

MANIFESTATIONS AND DAILY REQUIREMENTS OF VITAMIN C.
Vitamin C, also known as ascorbic acid, has several important functions.
These include:
 Helping to protect cells and keeping them healthy

 Maintaining healthy skin, blood vessels, bones and cartilage
 Hlping with wound healing
Lack of vitamin C can lead to scurvy.

Good sources of vitamin C
34
Vitamin C is found in a wide variety of fruit and vegetables.
Good sources include:
 Citrus fruit, such as oranges and orange juice

 Seppers
 Strawberries
 Blackcurrants
 Broccoli
 Brussels sprouts
 Potatoes
How common is vitamin C deficiency?

 Scurvy due to vitamin C deficiency is rare in the UK.
 There are certain groups of people who are more at risk of vitamin C deficiency. They
include:
 People dependent on drugs and/or alcohol who may not have a healthy, balanced diet.
 People who go on very restrictive diets.
 People living on a low income who tend not to buy foods with a high vitamin C content.
 People with a medical condition that affects the body's ability to digest and absorb food,
such as Crohn's disease and ulcerative colitis.
 Older people who may eat a less varied diet.
 Smokers. Smoking affects the absorption of vitamin C from foods and also vitamin C is
used up in the body more quickly in those who smoke.
 Pregnant and breastfeeding women because they need higher amounts of vitamin C.
What are the symptoms of vitamin C
The first symptoms of vitamin C deficiency tend to be:
 Tiredness and weakness.
 Muscle and joint pains.
 Easy bruising.
 Spots that look like tiny, red-blue bruises on your skin.
Other symptoms can include:
 Dry skin.
35
 Splitting hair.
 Swelling and discoloration of your gums.
 Sudden and unexpected bleeding from your gums.
 Nosebleeds.
 Poor healing of wounds.
 Problems fighting infections.
 Bleeding into joints, causing severe joint pains.
 Changes in your bones.
 Tooth loss.
 Weight loss.
How much vitamin C do needed?
The amount of vitamin C you need each day depends on your age. Average daily recommended amounts
for different ages are listed below in milligrams (mg).

Birth to 6 months 40 mg
Infants 7–12 months 50 mg
Children 1–3 years 15 mg
Teens 14–18 years (boys) 75 mg
Teens 14–18 years (girls) 65 mg
Adults (men) 90 mg
Adults (women) 75 mg
Pregnant teens 80 mg
Pregnant women 85 mg
Breastfeeding teens 115 mg
Breastfeeding women 120 mg
If you smoke, add 35 mg to the above values to calculate your total daily recommended
amount.
5. DESCRIBE THE DIETARY SOURCES, DEFICIENCY MANIFESTATIONS

AND DAILY REQUIREMENTS OF THIAMINE.
Sources of Thiamin
36
Food
 Food sources of thiamin include whole grains, meat, and fish. Breads, cereals, and infant
formulas in the United States and many other countries are fortified with thiamin.The
most common sources of thiamin in the U.S. diet are cereals and bread. Pork is another
major source of the vitamin. Dairy products and most fruits contain little thiamin. About
half of the thiamin in the U.S. diet comes from foods that naturally contain thiamin; the
remainder comes from foods to which thiamin has been added.
 Heating foods containing thiamin can reduce their thiamin content. For example, bread
has 20%–30% less thiamin than its raw ingredients, and pasteurization reduces thiamin
content (which is very small to begin with) in milk by up to 20% . Because thiamin
dissolves in water, a significant amount of the vitamin is lost when cooking water is
thrown out. Processing also alters thiamin levels in foods; for example, unless white rice
is enriched with thiamin, it has one tenth the amount of thiamin in unenriched brown rice
Recommended Intakes
Intake recommendations for thiamin and other nutrients are provided in the Dietary Reference
Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of
the National Academies (formerly National Academy of Sciences). DRI is the general term for a
set of reference values used for planning and assessing nutrient intakes of healthy people. These
values, which vary by age and sex, include:
 Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to

meet the nutrient requirements of nearly all (97%–98%) healthy individuals; often used to
plan nutritionally adequate diets for individuals.
 Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy;
established when evidence is insufficient to develop an RDA.
 Estimated Average Requirement (EAR): Average daily level of intake estimated to meet
the requirements of 50% of healthy individuals; usually used to assess the nutrient intakes
of groups of people and to plan nutritionally adequate diets for them; can also be used to
assess the nutrient intakes of individuals.
 Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse
health effects.
 Table 1 lists the current RDAs for thiamin. For infants from birth to 12 months, the FNB
established an AI for thiamin that is equivalent to the mean intake of thiamin in healthy,
breastfed infants.
37
Table 1: Recommended Dietary Allowances (RDAs) for Thiamin
Age Male Female Pregnancy Lactation
Birth to 6 months* 0.2 mg 0.2 mg
7–12 months* 0.3 mg 0.3 mg
1–3 years 0.5 mg 0.5 mg
4–8 years 0.6 mg 0.6 mg
9–13 years 0.9 mg 0.9 mg
14–18 years 1.2 mg 1.0 mg 1.4 mg 1.4 mg
19-50 years 1.2 mg 1.1 mg 1.4 mg 1.4 mg
51+ years 1.2 mg 1.1 mg
6. DESCRIBE THE DIETARY SOURCES, DEFICIENCY MANIFESTATIONS

AND DAILY REQUIREMENTS OF RIBOFLAVIN.
also called vitamin B2) is important for the growth, development, and function of
the cells in your body. It also helps turn the food you eat into the energy you need.
How much riboflavin do I need?
The amount of riboflavin you need depends on your age and sex. Average daily
recommended amounts are listed below in milligrams (mg).
Recommended
Life Stage Amount
Birth to 6 months 0.3 mg
Infants 7–12 months 0.4 mg
Children 1–3 years 0.5 mg
Teen boys 14–18 years 1.3 mg
Teen girls 14–18 years 1.0 mg
Men 1.3 mg
38
Recommended
Life Stage Amount
Women 1.1 mg
Pregnant teens and women 1.4 mg
Breastfeeding teens and women 1.6 mg

What foods provide riboflavin?
 Riboflavin is found naturally in some foods and is added to many fortified foods. You
can get recommended amounts of riboflavin by eating a variety of foods, including the
following:
 Eggs, organ meats (such as kidneys and liver), lean meats, and low-fat milk
 Green vegetables (such as asparagus, broccoli, and spinach)
 Fortified cereals, bread, and grain products
What kinds of riboflavin dietary supplements are available?
Riboflavin is found in multivitamin/multimineral supplements, in B-complex dietary
supplements, and in supplements containing only riboflavin. Some supplements have
much more than the recommended amounts of riboflavin, but your body
can’t absorb more than about 27 mg at a time.
Am I getting enough riboflavin?
Most people in the United States get enough riboflavin from the foods they eat and
deficiencies are very rare. However, certain groups of people are more likely than
others to have trouble getting enough riboflavin:
 Athletes who are vegetarians (especially strict vegetarians who avoid dairy
foods and eggs)
 Pregnant women and breastfeeding women and their babies
 People who are vegan
 People who do not eat dairy foods
 People with a genetic disorder called riboflavin transporter deficiency.
This disorder prevents the body from properly absorbing and using riboflavin,
causing riboflavin deficiency
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7. WHAT ARE THE SOURCES AND FUNCTIONS OF VITAMIN K?
Sources of vitamin K
Several foods are rich in vitamin K-1, and vitamin K-2 is much less common.
Bacteria in the gut can convert some K-1 into K-2.
Fermented foods are a good source of vitamin K-2.
Also, because it is fat-soluble, organ meats and high-fat dairy products contain fairly
substantial quantities of vitamin K-2. Conversely, lean meats, such as poultry, are not
good sources of K-2.
Dietary sources of vitamin K-1 include:
 Dark leafy green vegetables, such as spinach, kale, and collards
 Lettuce
 Turnips
 Broccoli
 Carrots
 Vegetable oils
 Blueberries
 Grapes
Dietary sources of vitamin K-2 include:
 Natto, a traditional Japanese dish of fermented soybeans
 Sauerkraut
 Dairy products, especially hard cheeses
 Liver and other organ meats
 Beef
 Pork
 Egg yolks
 Chicken
 Fatty fish, such as salmon
Functions
 The body needs both types of vitamin K to produce prothrombin, a protein that plays
crucial roles in blood clotting, bone metabolism, and heart health. Vitamin K also helps
facilitate energy production in the mitochondria of cells.
40
 Vitamin K-1 is primarily involved in blood coagulation. K-2 may have a more diverse
range of functions in the body.
 In a long-term study involving 36,629 participants, researchers observed an association
 between high intakes of vitamin K-2 and a reduced risk of developing peripheral arterial
disease (PAD), particularly in people with high blood pressure. However, the authors
concluded that K-1 had no effect on PAD risk.
 Vitamin K has antioxidant properties. It protects cellular membranes from damage due to
excess free radicals, in a process known as peroxidation. Blood thinning medication, such
as warfarin, can lower the antioxidative potential of vitamin K.
8. WHAT ARE WATER SOLUBLE VITAMINS? WRITE A NOTE ON
FUNCTIONS AND DEFICIENCY OF THIAMINE.
Water soluble vitamins
Thiamin
Thiamin functions in the body in the form of thiamin pyrophosphate (TPP), the
coenzyme for the transfer of active aldehyde in carbohydrate metabolism and
decarboxylation of α-keto acids such as pyruvate. The requirement for thiamin is
directly correlated with carbohydrate intake and increases as the metabolic rate
increases due to pregnancy, lactation, or increased physical exercise. The 1980 RDA
of 0.5 mg/1,000 kcal was set to maintain normal levels of TPP-dependent erythrocyte
transketolase activity and urinary excretion. For those whose total caloric intake is
less than 2,000 kcal, at least 1.0 mg/day is recommended.
Riboflavin
In its coenzyme forms (flavin mononucleotide and flavin adenine dinucleotide),
riboflavin functions in oxidation-reduction reactions in energy production, in the
respiratory chain, and in many other metabolic pathways. Richest food sources of
riboflavin include liver, milk, dark-green leafy vegetables, and enriched breads and
cereals.
Niacin
In nutrition literature, the term niacin is used generically to encompass the active
forms of this vitamin, nicotinic acid and nicotinamide; however, estimates of niacin
requirements take into account preformed niacin as well as that obtained as equivalent
(NE) in the body from tryptophan metabolism. For this purpose, it is estimated that
when 60 mg of tryptophan are consumed by an adult, enough is oxidized to produce 1
mg of niacin (NRC, 1980).
Vitamin B6
Vitamin B6 is the generic term used for pyridoxine, pyridoxal, and pyridoxamine, the
coenzyme forms of which are pyridoxal phosphate and pyridoxamine phosphate.
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Vitamin B6-dependent enzymes are needed in a wide range of reactions, most of
which involve amino acid metabolism. The 1980 RDAs were based on a ratio of 0.02
mg of vitamin B6 per gram of protein consumed. The allowance for adult females was
therefore set at 2.0 mg/day, assuming a protein intake of 100 g/day; for adult males, it
was set at 2.2 mg/day, assuming a protein intake of 110 g/day. A lower allowance
presumably would be appropriate for those with lower protein intakes.
Vitamin B12
Vitamin B12 substances are physiologically active cobalamins. The coenzyme (5'-
deoxyadenosyl) and methyl forms of this vitamin are essential for the recyling of the
active folate coenzyme, for the methylation of homocysteine to form methionine, and
for metabolism of propionate. Vitamin B12 is also essential in the metabolism of fatty
acids and aliphatic amino acids through its role in the isomerization of
methylmalonyl-CoA to succinyl-CoA.
Folacin (Folic Acid or Folate)
Folacin intakes have been studied very little, because values for this vitamin in food
composition tables are imputed. In addition, present analytical methods for this
vitamin are not very reliable. There is also some concern that the 1980 RDA for
folacin is unrealistically high (DHHS-USDA, 1986).
THIAMINE DEFICIENCY
Thiamin deficiency (causing beriberi) is most common among people subsisting on
white rice or highly refined carbohydrates in developing countries and among
alcoholics. Symptoms include diffuse polyneuropathy, high-output heart failure, and
Wernicke-Korsakoff syndrome. Thiamin is given to help diagnose and treat the
deficiency.
Early symptoms of thiamin deficiency are nonspecific: fatigue, irritability, poor
memory, sleep disturbances, precordial pain, anorexia, and abdominal discomfort.
Different forms of beriberi cause different symptoms.
 Dry beriberi refers to peripheral neurologic deficits due to thiamin
deficiency. These deficits are bilateral and roughly symmetric, occurring in a
stocking-glove distribution. They affect predominantly the lower extremities,
beginning with paresthesias in the toes, burning in the feet (particularly severe
at night), muscle cramps in the calves, pains in the legs, and plantar
dysesthesias. Calf muscle tenderness, difficulty rising from a squatting
position, and decreased vibratory sensation in the toes are early signs. Muscle
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wasting occurs. Continued deficiency worsens polyneuropathy, which can
eventually affect the arms.
 Wernicke-Korsakoff syndrome, which combines Wernicke
encephalopathy and Korsakoff psychosis, occurs in some alcoholics who do
not consume foods fortified with thiamin. Wernicke encephalopathy consists
of psychomotor slowing or apathy, nystagmus, ataxia, ophthalmoplegia,
impaired consciousness, and, if untreated, coma and death. It probably results
from severe acute deficiency superimposed on chronic deficiency. Korsakoff
psychosis consists of mental confusion, dysphonia, and confabulation with
impaired memory of recent events. It probably results from chronic deficiency
and may develop after repeated episodes of Wernicke encephalopathy.
 Cardiovascular (wet) beriberi is myocardial disease due to thiamin
deficiency. The first effects are vasodilation, tachycardia, a wide pulse
pressure, sweating, warm skin, and lactic acidosis. Later, heart
failure develops, causing orthopnea and pulmonary and peripheral edema.
Vasodilation can continue, sometimes resulting in shock.
 Infantile beriberi occurs in infants (usually by age 3 to 4 weeks) who are
breastfed by thiamin-deficient mothers. Heart failure (which may occur
suddenly), aphonia, and absent deep tendon reflexes are characteristic.
 Because thiamin is necessary for glucose metabolism, glucose infusions may
precipitate or worsen symptoms of deficiency in thiamin-deficient people.
9. WHAT ARE FAT SOLUBLE VITAMINS? WRITE A NOTE ON VITAMIN A.
Vitamins can be classified based on their solubility.
Most are water-soluble, meaning they dissolve in water. In contrast, the fat-soluble vitamins are
similar to oil and do not dissolve in water.
Fat-soluble vitamins are most abundant in high-fat foods and are much better absorbed into your
bloodstream when you eat them with fat.
There are four fat-soluble vitamins in the human diet:
 Vitamin A
 Vitamin D
 Vitamin E
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 Vitamin K
This article provides a comprehensive overview of the fat-soluble vitamins, their health benefits,
functions and main dietary sources.
Role and Function of Vitamin A
Vitamin A supports many critical aspects of body function, including:
 Vision maintenance: Vitamin A is essential for maintaining the light-sensing cells in the

eyes and for the formation of tear fluid (2Trusted Source).
 Immune function: Vitamin A deficiency impairs immune function, increasing
susceptibility to infections (3Trusted Source, 4Trusted Source).
 Body growth: Vitamin A is necessary for cell growth. Deficiency may slow or prevent
growth in children (5Trusted Source).
 Hair growth: It is also vital for hair growth. Deficiency leads to alopecia, or hair loss
(6Trusted Source).
 Reproductive function: Vitamin A maintains fertility and is vital for fetal development
 Dietary Sources
 Vitamin A is only found in animal-sourced foods. The main natural food sources are
liver, fish liver oil and butter.
 Recommended Intake
 The table below shows the recommended daily allowance (RDA) for vitamin A. The
RDA is the estimated amount of vitamin A that the vast majority (about 97.5%) of people
need to meet their daily requirements.
 This table also shows the tolerable upper intake limit (UL), which is the highest level of
daily intake considered safe for 97.5% of healthy people (11Trusted Source)
RDA (IU / mcg) UL (IU / mcg)
Infants 0–6 months 1,333 / 400 2,000 / 600
7–12 months 1,667 / 500 2,000 / 600
Children 1–3 years 1,000 / 300 2,000 / 600
4–8 years 1,333 / 400 3,000 / 900
9–13 years 2,000 / 600 5,667 / 1700
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Women 14–18 years 2,333 / 700 9,333 / 2800
19–70 years 2,333 / 700 10,000 / 3000
Men 14–18 years 3,000 / 900 9,333 / 2800
19–70 years 3,000 / 900 10,000 / 3000
Vitamin A Deficiency
 Dry eyes: Severe deficiency may cause xerophthalmia, a condition characterized by dry

eyes caused by reduced tear fluid formation (2Trusted Source).
 Blindness: Serious vitamin A deficiency may lead to total blindness. In fact, it is among

the most common preventable causes of blindness in the world (14Trusted Source).
 Hair loss: If you are vitamin A deficient, you may start to lose your hair (15Trusted
Source).
 Skin problems: Deficiency leads to a skin condition known as hyperkeratosis or goose

flesh (16Trusted Source).
 Poor immune function: Poor vitamin A status or deficiency makes people prone to

infections (3Trusted Source).
SHORT ESSAYS
1. Explain functions of Vitamin A
 Helping your body's natural defence against illness and infection (the immune
system) work properly
 Helping vision in dim light
 Keeping skin and the lining of some parts of the body, such as the nose, healthy
 Vitamin A helps form and maintain healthy teeth, skeletal and soft tissue, mucus
membranes, and skin. It is also known as retinol because it produces the pigments
in the retina of the eye.
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 Vitamin A promotes good eyesight, especially in low light. It also has a role in
healthy pregnancy and breastfeeding.
Vitamin A plays a role in a variety of functions throughout the body, such as:
 Vision.
 Gene transcription.
 Immune function.
 Embryonic development and reproduction.
 Bone metabolism.
 Haematopoiesis.
 Skin and cellular health.
 Teeth.
2. Explain deficiency and hypervitaminosis of Vitamin A
 Hypervitaminosis A, or vitamin A toxicity, occurs when you have too much
vitamin A in your body. This condition may be acute or chronic. Acute
toxicity occurs after consuming large amounts of vitamin A over a short
period of time, typically within a few hours or days.
 Chronic toxicity occurs when large amounts of vitamin A build up in your
body over a long period of time. Symptoms include changes to vision, bone
pain, and skin changes.
 Chronic toxicity can lead to liver damage and increased pressure on your
brain. Hypervitaminosis A can be diagnosed using blood tests to check your
vitamin A levels. Most people improve simply by decreasing their intake of
vitamin A.
 Excess amounts of vitamin A are stored in your liver, and it accumulates over time. Most
people develop vitamin A toxicity by taking high-dose dietary supplements, possibly due
to megavitamin therapy.
 A megavitamin therapy involves consuming very large doses of certain vitamins in an
attempt to prevent or treat diseases.
 It may also be caused by long-term use of certain acne treatments that contain high doses
of vitamin A, such as isotretinoin (Sotret, Absorica).
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 Acute vitamin A toxicity is usually the result of accidental ingestion when it occurs in
children.
3. Explain functions of Vitamin D
 Vitamin D which acts both as a nutrient and a hormone is a quintessential element

highly significant for a host of bodily functions thanks to its wide range of
therapeutic efficacies.
 Calcium, being the building block of bones is absorbed by the body due to the
presence of Vitamin D which is extremely beneficial in the natural growth and
remodelling of bones. It reduces the risk of fracture, strengthen the bones,
maintain overall body balance and provides the body with a strong and perfect
skeletal structure.
 Researches also show the importance of vitamin D in getting strong muscles. A
by-product of Vitamin D helps in the contraction and relaxation of muscles. Thus,
providing strength and supporting the skeletal frame of the body.
 Vitamin D is also essential for the dental health. It prevents tooth decay and loss,
strengthen the gums and reduces risk of any oral infection.
 Vitamin D, being a fat-soluble vitamin plays a vital role in regulating the renal
functions and protecting the kidney from any infections. It plays a major role in
cellular growth, repair and metabolism. A sensible exposure to sunlight is very
effective in wound healing and repair.
 Vitamin D also plays a key role in reducing obesity and maintaining proper
weight. The abundance of vitamin D in the body restores the function of the
appetite hormone leptin, which gives you a feeling of fullness and reduces the
tendency of snacking all the time, thus aiding in weight loss.
4. Mention deficiency and hypervitaminosis of Vitamin D
o A number of regions have published guidelines defining vitamin deficiencies and
advising specific intakes for healthy people, with different recommendations for
women, men, infants, the elderly, and during pregnancy and breast feeding
including Japan, the European Union, the United States, and Canada. These
documents have been updated as research is published. In the US, Recommended
Dietary Allowances (RDAs) were first set in 1941 by the Food and Nutrition
Board of the National Academy of Sciences. There were periodic updates,
culminating in the Dietary Reference Intakes.Updated in 2016, the US Food and
Drug Administration published a set of tables that define Estimated Average
47
Requirements (EARs) and (RDAs). RDAs are higher to cover people with higher
than average needs. Together, these are part of Dietary Reference Intakes. For a
few vitamins, there is not sufficient information to set EARs and RDAs. For
these, an Adequate Intake is shown, based on an assumption that what healthy
people consume is sufficient. Countries do not always agree on the amounts of
vitamins needed to safeguard against deficiency. For example, for vitamin C, the
RDAs for women for Japan, the European Union (called Population Reference
Intakes) and the US are 100, 95 and 75 mg/day, respectively. India sets its
recommendation at 40 mg/day.
 Vitamin deficiency is the condition of a long-term lack of a vitamin. When caused by not
enough vitamin intake it is classified as a primary deficiency, whereas when due to an
underlying disorder such as malabsorption it is called a secondary deficiency. An
underlying disorder may be metabolic – as in a genetic defect for
converting tryptophan to niacin – or from lifestyle choices that increase vitamin needs,
such as smoking or drinking alcohol. Governments guidelines on vitamin deficiencies
advise certain intakes for healthy people, with specific values for women, men, babies,
the elderly, and during pregnancy or breastfeeding. Many countries have mandated
vitamin food fortification programs to prevent commonly occurring vitamin deficiencies.
 Conversely hypervitaminosis refers to symptoms caused by vitamin intakes in excess of
needs, especially for fat-soluble vitamins that can accumulate in body tissues.
 The history of the discovery of vitamin deficiencies progressed over centuries from
observations that certain conditions – for example, scurvy – could be prevented or treated
with certain foods having high content of a necessary vitamin, to the identification and
description of specific molecules essential for life and health. During the 20th century,
several scientists were awarded the Nobel Prize in Physiology or Medicine or the Nobel
Prize in Chemistry for their roles in the discovery of vitamins.
5. Write a short essay on Vitamin E
 Vitamin E is a group of eight fat soluble compounds that include four tocopherols and
four tocotrienols. Vitamin E deficiency, which is rare and usually due to an underlying
problem with digesting dietary fat rather than from a diet low in vitamin E, can cause
nerve problems. Both the tocopherols and tocotrienols occur in α (alpha), β (beta), γ
(gamma) and δ (delta) forms, as determined by the number and position of methyl groups
on the chromanol ring. All eight of these vitamers feature a chromane double ring, with
48
a hydroxyl group that can donate a hydrogen atom to reduce free radicals, and
a hydrophobic side chain which allows for penetration into biological membranes.
 Vitamin E may have various roles as a vitamin. Many biological functions have been
postulated, including a role as a fat-soluble antioxidant. In this role, vitamin E acts as a
radical scavenger, delivering a hydrogen (H) atom to free radicals. As it is fat-soluble,
vitamin E is incorporated into cell membranes, which are therefore protected from
oxidative damage.
 Vitamin E affects gene expression and is an enzyme activity regulator, such as for protein kinase
C (PKC) – which plays a role in smooth muscle growth – with vitamin E participating in deactivation
of PKC to inhibit smooth muscle growth.
Deficiency
Vitamin E deficiency is rare in humans, occurring as a consequence of abnormalities in dietary
fat absorption or metabolism rather than from a diet low in vitamin E. One example of a genetic
abnormality in metabolism is mutations of genes coding for alpha-tocopherol transfer protein (α-
TTP). Humans with this genetic defect exhibit a progressive neurodegenerative disorder known
as ataxia with vitamin E deficiency (AVED) despite consuming normal amounts of vitamin E.
Large amounts of alpha-tocopherol as a dietary supplement are needed to compensate for the
lack of α-TTP. Vitamin E deficiency due to either malabsorption or metabolic anomaly can
cause nerve problems due to poor conduction of electrical impulses along nerves due to changes
in nerve membrane structure and function. In addition to ataxia, vitamin E deficiency can
cause peripheral neuropathy, myopathies, retinopathy and impairment of immune responses.
6.Write a short essay on Vitamin K

Vitamin K refers to a group of fat-soluble vitamins that play a role in blood clotting, bone
metabolism, and regulating blood calcium levels.The body needs vitamin K to produce
prothrombin, a protein and clotting factor that is important in blood clotting and bone
metabolism. People who use blood-thinning medications, such as warfarin, or Coumadin,
should not start consuming additional vitamin K without first asking a doctor. Deficiency is
rare, but, in severe cases, it can increase clotting time, leading to hemorrhage and excessive
bleeding.Vitamin K1, or phylloquinone, comes from plants. It is the main type of dietary
vitamin K. A lesser source is vitamin K2, or menaquinone, which occurs in some animal-
based and fermented foods.
USES
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 Phylloquinone, also known as vitamin K1, is found in plants. When people eat it, bacteria
in the large intestine convert it to its storage form, vitamin K2. It is absorbed in the small
intestine and stored in fatty tissue and the liver.
 Without vitamin K, the body cannot produce prothrombin, a clotting factor that is
necessary for blood clotting and bone metabolism.
 Most Americans are not at risk of a vitamin-K deficiency. It is most likely to affect
newborns and those with a malapsorption problem, due, for example, to short-bowel
syndrome, cystic fibrosis, celiac disease, or ulcerative colitis.
 Newborns normally receive a vitamin K injection to protect them from bleeding in the
skull, which could be fatal.
 The recommended adequate intake for vitamin K depends on age and gender. Women
aged 19 years and over should consume 90 micrograms (mcg) a day, and men should
have 120 mcg.
SOURCES
 10 sprigs of parsley contains 90 micrograms (mcg)
 A 3-ounce serving of natto contains 850 mcg
 A half-cup serving of frozen and boiled collard greens contains 530 mcg
 One cup of raw spinach contains 145 mcg
 1 tablespoon of soybean oil contains 25 mcg
 A half-cup serving of grapes contains 11 mcg
 A hard-boiled egg contains 4 mcg
7.Define Vitamins. Classify vitamins

vitamins: 4 fat-soluble (A, D, E, and K) and 9 water-soluble (8 B vitamins and vitamin
C). Water-soluble vitamins dissolve easily in water and, in general, are readily excreted
from the body, to the degree that urinary output is a strong predictor of vitamin
consumption.Because they are not as readily stored, more consistent intake is
important.Fat-soluble vitamins are absorbed through the intestinal tract with the help
of lipids (fats). Vitamins A and D can accumulate in the body, which can result in
dangerous hypervitaminosis. Fat-soluble vitamin deficiency due to malabsorption is of
particular significance in cystic fibrosis.
50
be synthesized in the organism, either at all or not in sufficient quantities, and therefore
must be obtained through the diet. Vitamin C can be synthesized by some species but not
by others; it is not a vitamin in the first instance but is in the second. The
term vitamin does not include the three other groups of essential
nutrients: minerals, essential fatty acids, and essential amino acids. Most vitamins are not
single molecules, but groups of related molecules called vitamers. For example, there are
eight vitamers of vitamin E: four tocopherols and four tocotrienols. Some sources list
fourteen vitamins, by including choline,[3] but major health organizations list
thirteen: vitamin A (as all-trans-retinol, all-trans-retinyl-esters, as well as all-trans-beta-
carotene and other provitamin A carotenoids), vitamin B1 (thiamine), vitamin
B2 (riboflavin), vitamin B3 (niacin), vitamin B5 (pantothenic acid), vitamin
B6 (pyridoxine), vitamin B7 (biotin), vitamin B9 (folic acid or folate), vitamin
B12 (cobalamins), vitamin C (ascorbic acid), vitamin D (calciferols), vitamin
E (tocopherols and tocotrienols),and vitamin K (phylloquinone and menaquinones).[4][5][6]
6. What are fat soluble vitamins
The fat-soluble vitamins, A, D, E, and K, are stored in the body for long periods of time
and generally pose a greater risk for toxicity than water-soluble vitamins when consumed
in excess. Eating a normal, well-balanced diet will not lead to toxicity in otherwise
healthy individuals. However, taking vitamin supplements that contain megadoses of
vitamins A, D, E and K may lead to toxicity.
Vitamin A
Vitamin A, also called retinol, has many functions in the body. In addition to helping the
eyes adjust to light changes, vitamin A plays an important role in bone growth, tooth
development, reproduction, cell division, gene expression, and regulation of the immune
system.
Vitamin D
Vitamin D plays a critical role in the body’s use of calcium and phosphorous. It works by
increasing the amount of calcium absorbed from the small intestine, helping to form and
maintain bones. Vitamin D benefits the body by playing a role in immunity and
controlling cell growth and may protect against osteoporosis, high blood pressure, cancer,
and other diseases.
Vitamin E
Vitamin E benefits the body by acting as an antioxidant, and protecting vitamins A and
C, red blood cells, and essential fatty acids from destruction. Research from decades ago
51
suggested that taking antioxidant supplements, vitamin E in particular, might help
prevent heart disease and cancer. However, newer findings indicate that people who take
antioxidant and vitamin E supplements are not better protected against heart disease and
cancer than non-supplement users. Many studies show a link between regularly eating an
antioxidant rich diet full of fruits and vegetables, and a lower risk for heart disease,
cancer, Alzheimer’s Disease, and several other diseases.
Vitamin k
Vitamin K is naturally produced by the bacteria in the intestines, and plays an essential
role in normal blood clotting, promoting bone health, and helping to produce proteins for
blood, bones, and kidneys.
Food Sources for Vitamin K
Good food sources of vitamin K are green, leafy-vegetables such as turnip greens,
spinach, cauliflower, cabbage and broccoli, and certain vegetables oils including soybean
oil, cottonseed oil, canola oil and olive oil. Animal foods, in general, contain limited
amounts of vitamin K.
9.What is the role of Vitamin A in vision?
 Vitamin A plays a crucial role in vision by maintaining a clear cornea,
which is the outside covering of your eye.
 This vitamin is also a component of rhodopsin, a protein in your eyes
that allows you to see in low light conditions. Vitamin A deficiency is
rare in developed countries, but if unaddressed can lead to a serious
condition called xerophthalmia.
 Xerophthalmia is a progressive eye disease which begins with night
blindness.
 If vitamin A deficiency continues, your tear ducts and eyes can dry out.
Eventually, your cornea softens, resulting in irreversible blindness
Vitamin A may also help protect against other eye afflictions. Some
studies suggest that diets high in vitamin A may be associated with a
reduced risk of cataracts and age-related macular degeneration
52
(AMD).For general eye health, vitamin-A-rich foods are recommended
over supplements.
 Sweet potatoes are an excellent source, as are leafy green vegetables,
pumpkins and bell peppers
10.What are functions of Vitamin C
Functions
 A natural antioxidant, vitamin C plays a key role in scavenging free radicals from the
body and thereby takes part in reducing damage from inflammation and oxidation and
hence is a key component for fighting a multitude of pathological conditions and
infections.
 Vitamin C is an absolute requirement when it comes to wound healing and collagen
synthesis. Vitamin C and its supplements have marked effect on reducing the risks of
cancer, cardiac and respiratory diseases. Vitamin C rich foods also play a key role in the
production of collagen, a protein found in bones, tissues and blood vessels.
 Historical studies suggest the vitamin C is extremely effective in preventing and treating
scurvy – a disease caused due to lack of vitamin C. It is also extremely beneficial for
treating tuberculosis, HIV infection, gum disease, bronchitis, asthma, liver damage,
inflammation of the urinary bladder and prostate gland, infertility, restless leg syndrome,
metal poisoning, gout, tetanus infection, nerve pain and swine flu.
 Several studies also suggest the usefulness of vitamin C in treating Alzheimer’s disease,
dementia, depression, autism, attention deficit-hyperactivity disorder (ADHD),
schizophrenia, chronic fatigue syndrome, psychoses and Parkinson’s disease.
 Additionally, scientific researches have concluded the significance of vitamin C in
promoting cardiovascular health. It is used for lowering high blood pressure, high
cholesterol, preventing blood coagulation in the veins and arteries, preventing hardening
of arteries and normalising the irregular heartbeat. Regular intake of vitamin C also
reduces the risk of heart attack and strokes.
 Vitamin C is also found beneficial in healing burn wounds, treating cataract, glaucoma,
age-related macular degeneration, vision defects, constipation, gastritis, stomach ulcer,
dysentery, Lyme’s disease, arthritis, back pain, joint inflammation, osteoporosis,
heatstroke, hay fever and dental problem.
11.List the deficiencies of Vitamin C
o Rough, Bumpy Skin. ...
o Corkscrew-Shaped Body Hair. ...
o Bright Red Hair Follicles. ...
o Spoon-Shaped Fingernails With Red Spots or Lines. ...
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o Dry, Damaged Skin. ...
o Easy Bruising. ...
o Slowly Healing Wounds. ...
Painful, Swollen Joints.
o Weak Bones
o Bleeding Gums and Tooth Loss
o Poor Immunity
o Persistent Iron Deficiency Anemia
o Fatigue and Poor Mood
o Unexplained Weight Gain
o Chronic Inflammation and Oxidative Stress
12.Mention the B complex Vitamins and sources
Consuming adequate amounts of the eight B complex vitamins puts you on the path to a
healthy diet. Some top sources of B vitamins include meat (especially liver), seafood,
poultry, eggs, dairy products, legumes, leafy greens, seeds and fortified foods, such as
breakfast cereal and nutritional yeast.
Vitamin B complex is composed of eight B vitamins:
 B-1 (thiamine)
 B-2 (riboflavin)
 B-3 (niacin)
 B-5 (pantothenic acid)
 B-6 (pyridoxine)
 B-7 (biotin)
 B-9 (folic acid)
 B-12 (cobalamin)
SOURCES
 Milk.
 Cheese.
 Eggs.
 Liver and kidney.
 Meat, such as chicken and red meat.
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 Fish, such as tuna, mackerel, and salmon.
 Shellfish, such as oysters and clams.
 Dark green vegetables, such as spinach and kale.
 Vegetables, such as beets, avocados, and potatoes
 Whole grains and cereals
 Beans, such as kidney beans, black beans, and chickpeas
 Nuts and seeds
 Fruits, such as citrus, banana, and watermelon
 Soy products, such as soy milk and tempeh
 Blackstrap molasses
 Wheat germ
 Yeast and nutritional yeast
13.Mention deficiency disorders of B complex vitamins

Most people get enough B vitamins by eating a balanced diet. However, it’s still possible
to be deficient.
The following symptoms may be a sign that you’re not getting enough B vitamins:
 skin rashes
 cracks around the mouth
 scaly skin on the lips
 swollen tongue
 fatigue
 weakness
 anemia
 confusion
 irritability or depression
 nausea
 abdominal cramps
55
 diarrhea
 constipation
 numbness or tingling in the feet and hands
If you’re experiencing any of these symptoms and aren’t sure why, make an appointment
to see your doctor.
Although it’s possible that you’re experiencing a vitamin B deficiency, these symptoms
also overlap with many other underlying conditions. Your doctor can make a diagnosis
and advise you on any next steps.
Can being deficient increase your risk of certain conditions?
If you’re deficient in B vitamins you may experience a range of symptoms depending on
which B vitamins you’re lacking.
If left untreated, deficiency could increase your risk of developing:
 Anemia
 Digestive issues
 Skin conditions
 Infections
 peripheral neuropathy
Vitamin B-12 deficiency, in particular, may increase your risk of neuropsychiatric
disorders.Researchers are also investigating its role
in hyperhomocysteinemia and atherosclerosis.
Babies born to women who were deficient in folic acid during pregnancy are more
likely to have birth defects.
14.Mention sources, requirements and deficiency of vitamin C
Good sources of vitamin C
 Citrus fruit, such as oranges and orange juice.
 Peppers.
 Strawberries.
 Blackcurrants.
 Broccoli.
 Brussels sprouts.
 Potatoes.
Requirements
56
Age Male Female
9–13 years 45 mg 45 mg
14–18 years 75 mg 65 mg
19+ years 90 mg 75 mg
Smokers Individuals who smoke require 35 mg/day more vitamin C than nonsmokers.
Defeciencies
 Rough, Bumpy Skin. ...
 Corkscrew-Shaped Body Hair. ...
 Bright Red Hair Follicles. ...
 Spoon-Shaped Fingernails With Red Spots or Lines. ...
 Dry, Damaged Skin. ...
 Easy Bruising. ...
 Slowly Healing Wounds. ...
 Painful, Swollen Joints.
 Weak Bones
15.What is vitamin K. Sources, uses and requirements
Vitamin K refers to a group of fat-soluble vitamins that play a role in blood clotting, bone
metabolism, and regulating blood calcium levels.The body needs vitamin K to produce
prothrombin, a protein and clotting factor that is important in blood clotting and bone
metabolism
Uses
 Phylloquinone, also known as vitamin K1, is found in plants. When people eat it,
bacteria in the large intestine convert it to its storage form, vitamin K2. It is
absorbed in the small intestine and stored in fatty tissue and the liver.
 Without vitamin K, the body cannot produce prothrombin, a clotting factor that is
necessary for blood clotting and bone metabolism.
 Most Americans are not at riskTrusted Source of a vitamin-K deficiency. It is
most likely to affect newborns and those with a malapsorption problem, due, for
57
example, to short-bowel syndrome, cystic fibrosis, celiac disease, or ulcerative
colitis.
 Newborns normally receive a vitamin K injection to protect them from bleeding
in the skull, which could be fatal.
 The recommended adequate intake for vitamin K depends on age and gender.
Women aged 19 years and over should consume 90 microgramsTrusted
Source (mcg) a day, and men should have 120 mcg.
Recommendations
Adult men 19 years and older 120 mcg
Adult women 19 years and older 90 mcg
Pregnant or breastfeeding teens 75 mcg
Pregnant or breastfeeding women 90 cg
16.Explain vitamin A. deficiency & effects.

Vitamin A deficiency can result from inadequate intake, fat malabsorption, or liver
disorders. Deficiency impairs immunity and hematopoiesis and causes rashes and typical
ocular effects (eg, xerophthalmia, night blindness).
Primary vitamin A deficiency is usually caused by
 Prolonged dietary deprivation
It is endemic in areas such as southern and eastern Asia, where rice, devoid of beta-
carotene, is the staple food. Xerophthalmia due to primary deficiency is a common cause
of blindness among young children in developing countries.
Secondary vitamin A deficiency may be due to
 Decreased bioavailability of provitamin A carotenoids
 Interference with absorption, storage, or transport of vitamin A
Interference with absorption or storage is likely in celiac disease, cystic
fibrosis, pancreatic insufficiency, duodenal bypass, chronic diarrhea, bile duct
obstruction, giardiasis, and cirrhosis. Vitamin A deficiency is common in
58
prolonged protein-energy undernutrition not only because the diet is deficient but also
because vitamin A storage and transport is defective.
Signs and symptoms of vitamin A deficiency
 Impaired dark adaptation of the eyes, which can lead to night blindness, is an
early symptom of vitamin A deficiency.
 Xerophthalmia (which is nearly pathognomonic) results from keratinization of the
eyes. It involves drying (xerosis) and thickening of the conjunctivae and corneas.
 Superficial foamy patches composed of epithelial debris and secretions on the
exposed bulbar conjunctiva (Bitot spots) develop. In advanced deficiency, the
cornea becomes hazy and can develop erosions, which can lead to its destruction
(keratomalacia).
 Keratinization of the skin and of the mucous membranes in the respiratory,
gastrointestinal, and urinary tracts can occur. Drying, scaling, and follicular
thickening of the skin and respiratory infections can result.
Immunity is generally impaired.
The younger the patient, the more severe are the effects of vitamin A deficiency. Growth
retardation and infections are common among children. Mortality rate can exceed 50% in
children with severe vitamin A deficiency.
17.Mention Sources, requirements, deficiency disorders of thiamine
Sources
Sources of Thiamin
Food
Food sources of thiamin include whole grains, meat, and fish. Breads, cereals, and infant
formulas in the United States and many other countries are fortified with thiamin .The
most common sources of thiamin in the U.S. diet are cereals and bread. Pork is another
major source of the vitamin. Dairy products and most fruits contain little thiamin . About
half of the thiamin in the U.S. diet comes from foods that naturally contain thiamin; the
remainder comes from foods to which thiamin has been added.
Heating foods containing thiamin can reduce their thiamin content. For example, bread
has 20%–30% less thiamin than its raw ingredients, and pasteurization reduces thiamin
content (which is very small to begin with) in milk by up to 20%. Because thiamin
59
dissolves in water, a significant amount of the vitamin is lost when cooking water is
thrown out . Processing also alters thiamin levels in foods; for example, unless white rice
is enriched with thiamin, it has one tenth the amount of thiamin in unenriched brown rice
Requuirements
health effects.
Thiamin Deficiency
 In addition to insufficient intakes of thiamin from the diet, the causes of thiamin
deficiency include lower absorption or higher excretion rates than normal due, for
example, to certain conditions (such as alcohol dependence or HIV/AIDS) or use of some
medications.
 In its early stage, thiamin deficiency can cause weight loss and anorexia, confusion,
short-term memory loss, and other mental signs and symptoms; muscle weakness; and
cardiovascular symptoms (such as an enlarged heart).
 The most common effect of thiamin deficiency is beriberi, which is characterized mainly
by peripheral neuropathy and wasting. People with this condition have impaired sensory,
motor, and reflex functions. In rare cases, beriberi causes congestive heart failure that
leads to edema in the lower limbs and, occasionally, death
 A more common manifestation of thiamin deficiency in the United States is Wernicke-
Korsakoff syndrome . This disorder is about 8–10 times more common in people with
chronic alcoholism than in the general population, but it can also develop in patients who
have severe gastrointestinal disorders, rapidly progressing hematologic malignancies,
drug use disorders, or AIDS.
18.Mention sources, requirements, deficiency disorders of Riboflavin

Recommendations
60
Intake recommendations for riboflavin and other nutrients are provided in the Dietary Reference
Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of
the National Academies . DRI is the general term for a set of reference values used for planning
and assessing nutrient intakes of healthy people. These values, which vary by age and sex,
include:

health effects.
Sources of Riboflavin
Food
Foods that are particularly rich in riboflavin include eggs, organ meats (kidneys and liver), lean
meats, and milk. Green vegetables also contain riboflavin. Grains and cereals are fortified with
riboflavin in the United States and many other countries .The largest dietary contributors of total
riboflavin intake in U.S. men and women are milk and milk drinks, bread and bread products,
mixed foods whose main ingredient is meat, ready-to-eat cereals, and mixed foods whose main
ingredient is grain. The riboflavin in most foods is in the form of FAD, although the main form
in eggs and milk is free riboflavin .
About 95% of riboflavin in the form of FAD or FMN from food is bioavailable up to a maximum
of about 27 mg of riboflavin per meal or dose.The bioavailability of free riboflavin is similar to
that of FAD and FMN . Because riboflavin is soluble in water, about twice as much riboflavin
content is lost in cooking water when foods are boiled as when they are prepared in other ways,
such as by steaming or microwaving
Riboflavin Deficiency
Riboflavin deficiency is extremely rare in the United States. In addition to inadequate
intake, causes of riboflavin deficiency can include endocrine abnormalities (such as
thyroid hormone insufficiency) and some diseases.The signs and symptoms of
61
riboflavin deficiency (also known as ariboflavinosis) include skin disorders,
hyperemia (excess blood) and edema of the mouth and throat, angular stomatitis
(lesions at the corners of the mouth), cheilosis (swollen, cracked lips), hair loss,
reproductive problems, sore throat, itchy and red eyes, and degeneration of the liver
and nervous system. People with riboflavin deficiency typically have deficiencies of
other nutrients, so some of these signs and symptoms might reflect these other
deficiencies. Severe riboflavin deficiency can impair the metabolism of other
nutrients, especially other B vitamins, through diminished levels of flavin coenzymes
Anemia and cataracts can develop if riboflavin deficiency is severe and prolonged
19.Mention sources, requirements, deficiency disorders of Vitamin B3
 Liver. Liver is one of the best natural sources of niacin. ...
o Chicken Breast. Chicken, especially the breast meat, is a good source of
both niacin and lean protein. ...
o Tuna. ...
o Turkey. ...
o Salmon. ...
o Anchovies. ...
o Pork. ...
o Ground Beef.
 Chicken breast: 59% of
the RDI
 Light tuna, canned in oil: 53% of

the RDI
 Beef: 33% of the RDI
 Smoked salmon: 32% of
the RDI
 Peanuts: 19% of the RDI
 Lentils: 10% of the RDI
REQUIREMENTS
62
Infants
 0–6 months: 2 mg/day*
 7–12 months: 4 mg/day*
*These figures represent the Adequate Intake (AI), which is similar to RDI but based
on weaker scientific evidence.
Children
 1–3 years: 6 mg/day
Adolescents and adults
 Men 14 years and older: 16 mg/day
 Women 14 years and older: 14 mg/day
 Pregnant women: 18 mg/day
 Breastfeeding women: 17 mg/day
According to the Office of Dietary Supplements (ODS)Trusted Source, a person who
lacks vitamin B-3 may experience:
 A pigmented rash on skin that is exposed to the sun
 Rough appearance to the skin
 Bright red tongue
 Fatigue or apathy
 Vomiting, constipation, and diarrhea
 Circulatory problems
 Depression
 Headache
 Memory loss
 In severe cases, hallucinations
A severe lack of vitamin B-3 can result in pellagra. The condition can be fatal.
Factors that can lead to low levels of B-3 include:
 Having a diet low in tryptophans or a condition that reduces the body’s ability to convert
tryptophan to niacin, such as Hartnup disease or carcinoid syndrome
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 undernutrition, for example, due to alcohol use disorder, anorexia, and inflammatory
bowel disease
 A low intake of vitamin B-2, B-6, or iron, as this can reduce the amount of tryptophan
that converts to niacin
Sources
Foods that contain high amounts of folate include:
 Leafy, green vegetables, such as broccoli and spinach.
 Brussels sprouts.
 Peas.
 Citrus.
 Fruits, such as bananas and melons.
 Tomato juice.
 Eggs.
 Beans.
REQUIREMNTS
RDA: The Recommended Dietary Allowance for folate is listed as micrograms
(mcg) of dietary folate equivalents (DFE). Men and women ages 19 years and older
should aim for 400 mcg DFE. Pregnant and lactating women require 600 mcg DFE
and 500 mcg DFE, respectively.
The symptoms of folate deficiency are often subtle. They include:
 fatigue
 gray hair
 mouth sores
 tongue swelling
 growth problems
The symptoms of anemia that occur due to folate deficiency include:
 persistent fatigue
 Weakness
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 Lethargy
 Pale skin
 Shortness of breath
 Irritability
 Crohn’s disease
 Celiac disease
 Certain types of cancers
 Severe kidney problems that require dialysis

Sources
What foods provide vitamin B12?
Vitamin B12 is found naturally in a wide variety of animal foods and is added to
some fortified foods. Plant foods have no vitamin B12 unless they are fortified. You can get
recommended amounts of vitamin B12 by eating a variety of foods including the following:
 Beef liver and clams, which are the best sources of vitamin B12.
 Fish, meat, poultry, eggs, milk, and other dairy products, which also contain vitamin B12.
 Some breakfast cereals, nutritional yeasts and other food products that are fortified with
vitamin B12. To find out if vitamin B12 has been added to a food product, check the
product labels.
Requirements
The amount of vitamin B12 you need each day depends on your age. Average daily
recommended amounts for different ages are listed below in micrograms (mcg):

Birth to 6 months 0.4 mcg
Infants 7–12 months 0.5 mcg
Children 1–3 years 0.9 mcg
Teens 14–18 years 2.4 mcg
65
Adults 2.4 mcg
Pregnant teens and women 2.6 mcg
Breastfeeding teens and women 2.8 mcg
Deficiency symptoms
Vitamin B-12 deficiency occurs when the body does not receive enough vitamin B-12.
It can result in irreversible and potentially severe damage, especially to the nervous system and
brain.
Even slightly lower-than-normal levels of vitamin B-12 can trigger deficiency symptoms, such
as depression, confusion, memory problems, and fatigue. However, these symptoms alone are
not specific enough to diagnose vitamin B-12 deficiency.
Other symptoms of vitamin B-12 deficiency include constipation, loss of appetite, and weight
loss.
Once symptoms escalate, they can include neurological changes, such as numbness and tingling
in the hands and feet. Some people may have difficulty maintaining balance.
Infants who lack vitamin B-12 may demonstrate unusual movements, such as face tremors, as
well as reflex problems, feeding difficulties, irritation, and eventual growth problems if the
deficiency is left untreated.
Vitamin B-12 deficiency carries a serious risk of permanent nerve and brain damage. Some
people with insufficient vitamin B-12 have a higher risk of developing psychosis, mania,
and dementia.
Insufficient vitamin B-12 can also lead to anemia. The most common symptoms of anemia are
fatigue, shortness of breath, and an irregular heartbeat. People with anemia might also
experience:
 A sore mouth or tongue
 Weight loss
 Pale or yellowing skin
 Diarrhea
 Menstrual problems
III.SHORT ANSWERS
66
1. DEFINE PRO-VITAMINS.
A provitamin is a substance that may be converted within the body to a vitamin. The
term previtamin is a synonym. The term "provitamin" is used when it is desirable to label
a substance with little or no vitamin activity, but which can be converted to an active
form by normal metabolic processes.
2. WHAT ARE CAROTENES
The term carotene (also carotin, from the Latin carota, "carrot" is used for many
related unsaturated hydrocarbon substances having the formula C40Hx, The two
primary isomers of carotene, α-carotene and β-carotene, differ in the position of a double
bond (and thus a hydrogen) in the cyclic group at one end (the right end in the diagram at
right). β-Carotene is the more common form and can be found in yellow, orange,
and green leafy fruits and vegetables. As a rule of thumb, the greater the intensity of the
orange colour of the fruit or vegetable, the more β-carotene it contains. Carotene protects
plant cells against the destructive effects of ultraviolet light. β-Carotene is an antioxidant.
3. DEFINE NIGHT BLINDNESS
Night blindness (nyctalopia) is the inability to see well at night or in poor light such as
in a restaurant or movie theater. It is often associated with an inability to quickly adapt
from a well-illuminated to a poorly illuminated environment.
4. DEFINE EXOPHTHALMIA
Xerophthalmia is a progressive eye disease caused by vitamin A deficiency. Lack of
vitamin A can dry out your tear ducts and eyes. Xerophthalmia can develop into night
blindness or more serious damage to your cornea, the outer layer of your eye.
5. WHAT IS THE CAUSE OF RICKETS
The most common cause of rickets is a lack of vitamin D or calcium in a child's diet.
Both are essential for children to develop strong and healthy bones. Sources of vitamin D
are: sunlight – your skin produces vitamin D when it's exposed to the sun, and we get
most of our vitamin D this way.
6. MENTION THE CAUSE OF OSTEOMALACIA
Vitamin D deficiency is the most common cause of osteomalacia worldwide. Certain
surgeries. Normally, the stomach breaks down food to release calcium and other minerals
that are absorbed in the intestine.
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7. VITAMIN E HAS SELENIUM SPARING ACTION. GIVE REASON.
The importance of maintaining adequate levels of Se, vitamin C
and vitamin E is underscored by studies indicating that low antioxidant status may be
associated with increased risk of developing various diseases. Se has been shown
to spare both AA and AT.
8. WHAT IS CAUSED BY TONICITY OF VITAMIN A
The tonicity of a solution is related to its effect on the volume of a cell. Solutions that do not
change the volume of a cell are said to be isotonic. A hypotonic solution causes a cell to swell,
whereas a hypertonic solution causes a cell to shrink.
9. WHAT IS SOURCES OF VITAMIN D
o Salmon. Salmon is a popular fatty fish and great source of vitamin D.
o Herring and sardines. Herring is a fish eaten around the world.
o Cod liver oil. Cod liver oil is a popular supplement.
o Canned tuna. Many people enjoy canned tuna because of its flavor and easy
storage methods. ...
o Egg yolks. ...
o Mushrooms. ..
10. DEFINE BERI – BERI

A disease in which the body doesn't have enough vitamin B1 (thiamin). Beriberi is usually
caused by poor diet or alcoholism. Symptoms include loss of appetite, weakness, pain in the
limbs, shortness of breath and swollen feet or legs.
11. WHAT IS CHEILOSIS

Cheilosis is a condition where the corners of the mouth become inflamed, which can
lead to cracking and pain at the corners of the mouth. The cracks can split and bleed; they
can also make it difficult to yawn, chew, or talk. It can happen to people of any age
group. It is also called cheilitis, angular cheilitis, angular cheilosis, and perleche.
12. DEFINE PELLAGRA
A deficiency disease caused by a lack of nicotinic acid or its precursor tryptophan in the
diet. It is characterized by dermatitis, diarrhoea, and mental disturbance, and is often
linked to over-dependence on maize as a staple food.
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13. DEFINE PERNICIOUS ANEMIA
 Pernicious anemia is defined as a type of vitamin B12 deficiency that results
from impaired uptake of vitamin B-12 due to the lack of a substance known as
intrinsic factor (IF) produced by the stomach lining.
 Pernicious anemia is a condition caused by too little vitamin B12 in the body. It
is one form of vitamin B12 deficiency anemia.
14. WHAT IS VITAMIN B12
Vitamin B₁₂, also known as cobalamin, is a water-soluble vitamin involved in the
metabolism of every cell of the human body. It is one of eight B vitamins. It is a cofactor
in DNA synthesis, and in both fatty acid and amino acid metabolism.
15. DEFINE MEGALOBLASTIC ANEMIA
Megaloblastic anemia is a condition in which the bone marrow produces unusually
large, structurally abnormal, immature red blood cells (megaloblasts). Bone marrow, the
soft spongy material found inside certain bones, produces the main blood cells of the
body -red cells, white cells, and platelets.
16. DEFINE SCURVY
A disease caused by a deficiency of vitamin C, characterized by swollen bleeding gums
and the opening of previously healed wounds, which particularly affected poorly
nourished sailors until the end of the 18th century.
17. DEFINE WERNICKE’S ENCEPHALOPATHY

Wernicke encephalopathy (WE) is an acute neurological condition characterized by a clinical
triad of ophthalmoparesis with nystagmus, ataxia, and confusion. This is a life-threatening
illness caused by thiamine deficiency, which primarily affects the peripheral and central
nervous systems.
69
UNIT – VII
MINERALS
SHORT ESSAY
1.DISCUSS THE ROLE OF MINERALS IN THE BODY.

Minerals are needed for the proper composition of body fluids, including blood,
and for the proper composition of tissues, bone, teeth, muscles and nerves. Minerals also
play a significant role in maintaining healthy nerve function, the regulation of muscle
tone, and supporting a healthy cardiovascular system.
Calcium
70
Calcium is the top macromineral when it comes to your bones. This mineral helps build
strong bones, so you can do everything from standing up straight to scoring that winning
goal. It also helps build strong, healthy teeth, for chomping on tasty food.
Iron
The body needs iron to transport oxygen from your lungs to the rest of your body. Your
entire body needs oxygen to stay healthy and alive. Iron helps because it's important in
the formation of hemoglobin (say: HEE-muh-glo-bun), which is the part of your red
blood cells that carries oxygen throughout the body.
Potassium
Potassium (say: puh-TAH-see-um) keeps your muscles and nervous system working
properly.
Zinc
Zinc helps your immune system, which is your body's system for fighting off illnesses
and infections. It also helps with cell growth and helps heal wounds, such as cuts.
2.Explain the absorption, storage and excretion of calcium. Add a note on factors
affecting calcium absorption.
Calcium Absorption
Calcium absorption occurs by an active, carrier-dependent process and a passive,
paracellular process. The active process is vitamin D-dependent, but the passive
process is not. When calcium intakes are low, 25(OH)D is converted to 1,25(OH)2D,
which upregulates transcription of calcium transport proteins in the gut. However, this
homeostatic regulation mechanism is unable to correct for chronically low calcium
intakes. If vitamin D stores are too low, conversion to 1,25(OH)2D is reduced.
Storage
Calcium is stored in cells in a structure called the reticulum, a series of interconnected
tubules and tiny sacs distributed throughout the cells. Too much calcium can cause cell
injury or even death. ... Small changes in sodium concentration can produce large
changes in calcium stores.
Excretion.
Calcium leaves the body mainly in urine and feces, but also in other body tissues and
fluids, such as sweat. Calcium excretion in the urine is a function of the balance
71
between the calcium load filtered by the kidneys and the efficiency of reabsorption
from the renal tubules.
3.Explain the digestion, absorption, transport, storage and exertion of Iron.
Digestion and Absorption
The absorption of most dietary iron occurs in the duodenum and proximal jejunum and
depends heavily on the physical state of the iron atom. At physiological pH, iron exists
in the oxidized, ferric (Fe3+) state. To be absorbed, iron must be in the ferrous (Fe2+)
state or bound by a protein such as heme.
Iron Transport & Storage
Transferrin is the major iron transport protein (transports iron through blood). Fe3+ is
the form of iron that binds to transferrin, so the Fe2+ transported through ferroportin
must be oxidized to Fe3+. There are 2 copper-containing proteins that catalyze this
oxidation of Fe2+: hephaestin and ceruloplasmin. Hephaestin is found in the membrane
of enterocytes, while ceruloplasmin is the major copper transport protein in blood.
Hephaestin is the primary protein that performs this function in a coupled manner (need
to occur together) with transport through ferroportin. This means that the Fe2+ needs to
be oxidized to be transported through ferroportin. Evidence suggests that ceruloplasmin
is involved in oxidizing Fe2+ when iron status is low1. Once oxidized, Fe3+ binds to
transferrin and is transported to a tissue cell that contains a transferrin receptor.
Transferrin binds to the transferrin receptor and is endocytosed,.
Excretion
In contrast to iron uptake and recycling, there is no physiologic regulatory mechanism
for excreting iron. People lose a small but steady amount by gastrointestinal blood loss,
sweating and by shedding cells of the skin and the mucosal lining of the
gastrointestinal tract.
4.What is daily requirement and functions of calcium
Age Male Female
14–18 years 1,300 mg 1,300 mg
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19–50 years 1,000 mg 1,000 mg
51–70 years 1,000 mg 1,200 mg
71+ years 1,200 mg 1,200 mg
Functions of calcium
 Building strong bones and teeth.
 Clotting blood.
 Sending and receiving nerve signals.
 Squeezing and relaxing muscles.
 Releasing hormones and other chemicals.
 Keeping a normal heartbeat.
1. Mention the functions of Iron
a. Read on to find out the role of iron in the human body.
b. Iron helps oxygenate the blood. ...
The key function of iron is to facilitate oxygen transport by haemoglobin, the oxygen-
carrying pigment of the erythrocytes (red blood cells)1.
c. Iron helps convert blood sugar to energy. ...
Our bodies need iron to convert blood sugar to energy. It helps boost haemoglobin
production and thus increases the transport of oxygen to help alleviate fatigue and
tiredness. Also, the creation of enzymes (which play a vital role in the production of new
cells, amino acids, hormones and neurotransmitters) also depends on iron.
d. Iron boosts the immune system. ...
Iron is vital for the proliferation of all cells including those of the immune system.
Having an adequate amount of iron in your system will help your immune system to
function helping you to support and maintain good health.
e. Iron aids cognitive function. ...
Iron deficiency can contribute to impaired cognitive function.
f. Iron supports healthy skin, hair and nails.
Iron supports enzyme systems that are involved in the synthesis of collagen and
elastin. It helps the hair to become vibrant and shiny and it also helps prevent the
nails from becoming brittle and dry by keeping them strong and moist. Our bodies
don’t produce iron by themselves and also lose it through a number of ways
73
including menstruation, urination, defecation, sweat and the exfoliation of dead
skin cells. Iron deficiency is the most common nutritional deficiency in the world.
5.Mention the functions of copper
Copper is an essential trace mineral necessary for survival. It is found in all body
tissues and plays a role in making red blood cells and maintaining nerve cells and the
immune system. It also helps the body form collagen and absorb iron, and plays a role
in energy production
Functions.
 Copper works with iron to help the body form red blood cells.
 It also helps keep the blood vessels, nerves, immune system, and bones healthy.
 Copper also aids in iron absorption.
 Helping strengthen bones, joints and increasing bone mineral density, to lower
the risk of debilitating illnesses like osteoporosis and arthritis
 Regulating blood pressure, blood sugar and cholesterol levels, by ensuring
proper glucose, lipid metabolism and decreasing the chances of acquiring
chronic conditions of hypertension, diabetes
 Preserving smooth relay of signals between nerves, to ensure optimal brain
functions and responses across all organs in the body
 Controlling fundamental biological processes of new blood vessel formation or
angiogenesis, gene expression in cells, tissues, neurological development,
neurohormone production and pigment compounds i.e. melanin secretion
 Contributing to adequate white blood cells within the system, to support
immunity, keep seasonal illnesses and infectious diseases due to bacteria,
viruses at bay
6.Mention the function and deficiency of Phosphorus
Functions
 The main function of phosphorus is in the formation of bones and teeth.
 It plays an important role in how the body uses carbohydrates and fats.
 It is also needed for the body to make protein for the growth, maintenance, and
repair of cells and tissues.
Deficiency of phosphorus
74
Symptoms of phosphorus deficiency include loss of appetite, anxiety, bone pain,
fragile bones, stiff joints, fatigue, irregular breathing, irritability, numbness, weakness,
and weight change. In children, decreased growth and poor bone and tooth
development may occur.
A reduced concentration of phosphate in the blood serum is a disorder known as
hypophosphatemia. Phosphorus deficiency may cause bone diseases such as rickets in
children and osteomalacia in adults. An improper balance of phosphorus and calcium
may cause osteoporosis.
7.Mention the functions of Zinc
 Zinc is found in cells throughout the body.
 It is needed for the body's defensive (immune) system to properly work.
 It plays a role in cell division, cell growth, wound healing, and the breakdown
of carbohydrates.
 Zinc is also needed for the senses of smell and taste.
 It helps the immune system fight off invading bacteria and viruses.
 The body also needs zinc to make proteins and DNA, the genetic material in all
cells. During pregnancy, infancy, and childhood, the body needs zinc to grow
and develop properly
2. What are sources and deficiency of Minerals?
An increased need for the mineral, lack of the mineral in the diet, or difficulty
absorbing the mineral from food are some of the more common reasons. Mineral
deficiencies can lead to a variety of health problems, such as weak bones, fatigue, or a
decreased immune system.
Minerals include calcium and iron amongst many others and are found in:
 Meat.
 Cereals.
 Fish.
 Milk and dairy foods.
 Fruit and vegetables.
 Nuts.
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UNIT – VIII
WATER & ELECTROLYTES
SHORT ANSWERS
1. How is water distributed in the body
Water passes from the intestinal lumen into plasma mainly by passive transport,
regulated by osmotic gradients. Water molecules are then transported via blood
circulation to be distributed all over the body, to the interstitial fluids and to cells.
2. What is over hydration and water intoxication?
A condition that occurs from drinking too much water, upsetting electrolyte balances.
Drinking too much water can decrease sodium in the blood to dangerously low levels,
causing mild to life-threatening problems. People who participate in endurance activities,
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such as a marathon or triathlon, are at risk. Confusion, nausea and vomiting are
symptoms. Severe cases can cause seizures, coma and death.Treatments are fluid
restriction, IV fluids high in sodium and medication.
3. Define dehydration.
Dehydration is a condition that results when the body loses more water than it takes in.
This imbalance disrupts the usual levels of salts and sugars present in the blood, which
can interfere with the way the body functions.
4. Explain ORT/ORS
Oral rehydration salts (ORS) are a mixture of electrolytes (salts), and carbohydrates (in
the form of sugar), which are dissolved in water. They are used to replace salts and water
that the body loses when you have dehydration caused by gastroenteritis, diarrhoea, or
vomiting.
5. What is the daily requirement of Water?
Total daily fluid requirements have been shown to range from as little as 2 liters per
day to 16 liters per day pending on the work load and the level of heat stress (21). It has
long been known that persons under thermal and physiologic stress need to pay special
attention to fluid and salt intake
6. What is Electrolyte imbalance?
Electrolyte imbalances can be caused by a deficiency or an overabundance of minerals in
the body. For example, hyperkalemia and hypercalcemia are indicative of excess amounts
of potassium and calcium, respectively, which can disrupt the overall balance and
functioning of the nerves, cardiovascular system, and muscles.
7. What is Normal ranges of plasma electrolyte.?
All of the ions in plasma contribute to the osmotic balance that controls the movement of water
between cells and their environment. Electrolytes in living systems include sodium, potassium,
chloride, bicarbonate, calcium, phosphate, magnesium, copper, zinc, iron, manganese,
molybdenum, copper, and chromium.
Normal range: Male: 135-146 mmol/L. Female: 132-148 mmol/L.
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UNIT – IX
COOKERY RULES & PRESERVATION OF NUTRIENTS

I. LONG ESSAY
1. Explain the various methods of cooking and its effect on nutrients.
Dry Heat Cooking
Dry heat cooking works without the presence of any moisture, broth, or water. Instead, it
relies on the circulation of hot air or contact with fat to transfer heat to foods.
 Broiling
Broiling works by transferring extremely high heat onto food, usually directed from a
radiant located above the food which cooks on one side at a time. Browning can occur
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very quickly with this method, sealing juices and flavor inside and leaving a crisp
exterior.
 Grilling
Grilling is similar to broiling, in that it uses radiant heat to cook foods quickly. Most
commonly, grilling equipment will feature an open grate with a heat source located
beneath the food. Flipping is required to cook foods on both sides and grill marks from
the hot grate or rack are desirable.
Roasting
Roasting is performed inside an oven and uses indirect heat that cooks from all sides for
even browning. This method of cooking works more slowly, coaxing flavors out of meats
and vegetables. Roasting can be performed at very low temperatures between 200
degrees and 350 degrees Fahrenheit for tougher cuts of meat, or higher temperatures up
to 450 degrees Fahrenheit for more tender cuts.
 Baking
roasting both use indirect heat to surround foods and cook from all sides. The term
roasting is used when cooking meats or vegetables, and baking is used when making
bread, rolls, and cakes. Technically, these cooking methods are the same, but baking is
usually performed at lower temperatures than roasting.
 Sauteing
Sauteing is performed over a burner in a hot, shallow pan and uses a small amount of oil
or fat to coat food for even browning. This method cooks foods very quickly so it's best
to keep the food moving by tossing or flipping. Saute is a French word that translates to
"jump". To achieve great results with sauteing, make sure the oiled pan is hot before
adding any food, don't overcrowd the pan with too many items, and stir or toss
frequently.
Moist Heat Cooking
As the name indicates, moist heat cooking relies on the presence of liquid or steam to
cook foods. This method can be used to make healthy dishes without any added fat or oil.
It's also a great way to tenderize the tough fibers in certain cuts of meat, like beef chuck
or brisket. When cooking fibrous vegetables and legumes, moist heat cooking softens the
food until it reaches the perfect tenderness. Unlike dry heat cooking methods, moist heat
cooking will not produce a browned crust.
 Poaching
Poaching is a gentle method of cooking in which foods are submerged in hot liquid
between 140 degrees and 180 degrees Fahrenheit. The low heat works especially well for
delicate items, and moisture and flavor are preserved without the need for fat or oil.
 Simmering
Simmering is also a gentle method of cooking foods but uses higher temperatures than
poaching, usually between 180 degrees and 205 degrees Fahrenheit. This temperature
range lies below the boiling point and produces tiny bubbles. To achieve a simmer, first
bring water to the boiling point and then lower the temperature.
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 Boiling
This cooking technique involves submerging food in water that has been heated to the
boiling point of 212 degrees Fahrenheit. The boiling water produces large bubbles, which
keep foods in motion while they cook. The expression slow boil means that the water has
just started to produce large, slow-moving bubbles but is not quite heated to the boiling
temperature. A full boil occurs at the boiling point and results in fast-moving, rolling
bubbles. Steam is also released from the water as it boils.
 Steaming
In steaming, water is boiled continuously to produce a steady amount of steam. The
steam surrounds foods and cooks evenly while retaining moisture. Steaming can be
performed in a few different ways. For high volume kitchens, a commercial steamer or
combi oven is the most efficient. Other methods of steaming include using a pot and
steamer basket, using a microwave, or wrapping foods in foil so they can steam in the
oven.
Combination Cooking
Combination cooking utilizes both dry and moist cooking methods. Foods are cooked in
liquids at low heat for an extended period of time, resulting in a fork tender product. This
technique works with the toughest cuts of meat, gradually breaking down fibers until they
melt into the liquid.
 Braising
During braising, foods are first seared in a hot oiled pan then transferred to a larger pot to
cook in hot liquid. The foods are only partially submerged in simmering water, broth, or
stock. Using low heat, the foods soften over an extended cook time and the liquid
becomes reduced with intensified flavors. Braising is a great method for producing fork
tender meats that fall off the bone.
 Stewing
The key difference between stewing and braising is that foods are completely submerged
in hot liquid while stewing instead of being partially submerged. Smaller cuts of meat are
used in a stew, but the method of slow cooking at low heat is the same. As the stew
cooks, fibrous vegetables break down and fat and collagen from the meats melt away.
The result is a thick, flavorful gravy filled with tender bites of meat and soft vegetables.
2. WRITE A NOTE ON HOUSEHOLD METHODS OF PRESERVATION

OF FOODS.WHAT ARE THE GOLDEN RULES TO PREVENT VITAMIN
LOSS?
1. Refrigeration:
Microorganisms though not readily destroyed by severe cold are less active at low temperatures.
Refrigeration is widely used at homes and in commercial plants as a means of maintaining the
low temperature for the storage of perishable foods.
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2. Heating: Food is also preserved through the application of heat. The heat is applied at very
high temperatures. The food stuff heated in containers or by others means to a temperature below
the boiling point of water for definite period is known as pasteurization.

3. Canning:
Canning is the procedure of placing food stuffs in scalable containers, which involves the steps
closing [sealing] heating and cooling. Large amounts of food are canned which include a wide
variety of fruits, vegetables and fleshy foods.

4. Pickles and Jam:
This is the age old method of preserving foods. By the use of preservatives like salts, vinegar, the
goods were preserved in ancient time which continues to the present day. Salt is considered as a
valuable preservative and used in pickling. Salt helps to remove the moisture. Sugar is also used
as preservative in a few varieties of pickles. Jams are usually fruits preserved in the form of pulp
by the addition of sugar, fruit pulp and chemical preservatives like Sodium benzoate, potassium
metabisulphate, citric acid, etc.

5. Drying:
Drying is also an ancient method of food preservation. Drying is a natural method of food
preservation. Drying is the process by which the moisture content of foodstuff is removed.
Drying has a very good advantage, i.e. due to removal of water microorganisms would not grow
as moisture is important for the growth of microorganisms. Many fruits and vegetables are
preserved by this method too.

6. Chemical Preservatives:
Certain chemicals are used as preservatives, which retard the growth of Microorganisms by
increasing or decreasing the pH of food for their survival. The common chemical preservatives
used are potassium meta-bisulphate, sodium, benzoate, citric acid, vinegar, etc.
Freezing:
Freezing certain foods can be a good method of food preservations. Though the freezing
procedure does not destroy microorganisms, it stops their growth. Fruits, vegetables, meat, fish,
poultry can be preserved by this method.
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HOW TO PREVENT VITAMIN LOSS?
Take advantage of as many vitamins as possible by following these tips:

 Keep skins on when possible.
 Avoid continuous reheating of food.
 Use a minimal amount of cooking liquid.
 Choose steaming over boiling.
 When you do boil, retain the cooking liquid for a future use (like soups and stocks)
 Use the microwave.
3. DESCRIBE PERSONAL HYGIENE OF FOOD HANDLERS. EXPLAIN THE
SIGNS OF GOOD MEAT HYGIENE AND HYGIENE OF SLAUGHTER HOUSES.
Hygienic habits when handling food
 Correctly wash food with plenty of water, especially fruits and vegetables, where it is
recommended to wash them with specific products when they are to be consumed raw to
ensure that bacteria and chemicals used in the growing process are eliminated.
 Do not leave food at room temperature for more than two hours.
 Prepare food shortly before eating or freezing.
 Reheat the plates to high temperature to eliminate possible bacteria.
 Eat the fish always cooked or after freezing.
 Eat the minced meat on the same day you buy it.
 Freeze food by portion to avoid freezing and thawing food several times.
 Wash knives and cutting boards thoroughly.
 Do not mix raw food with cooked food in the refrigerator.
 Do not thaw food at room temperature, it is best to thaw it overnight or the day before in
the refrigerator or use the microwave to thaw food.
Poor food handling practices
In order to guarantee the safety and hygiene of food handling, certain practices must be avoided:
 Smoking.
 Chewing gum.
 Eating at the workplace.
 Coughing, sneezing, or blowing into food.
 Touching your hair or scratching.
 Wear cloths hanging at the waist.
 Try food with your finger.
 Introduce dirty spoons of a different food.
 Clean only with water the utensils used to taste the food.
 Leave the cloths on the work tables.
 Leave utensils inside the recipients.
 Dry hands on apron or pants.
 Wear bracelets or rings.
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GENERAL PRINCIPLES OF MEAT HYGIENE
1. Meat must be safe and suitable for human consumption and all interested parties including
government, industry and consumers have a role in achieving this outcome. However, it is the
responsibility of the establishment operator to produce meat that is safe and suitable in
accordance with regulatory meat hygiene requirements. There should be a legal obligation on
relevant parties to provide any information and assistance as may be required by the competent
authority.
2. The competent authority should set and enforce regulatory meat hygiene requirements, and
have final responsibility for verifying that regulatory meat hygiene requirements are met.
3. Meat hygiene programmes should have as their primary goal the protection of public health
and should be based on a scientific evaluation of meat-borne risks to human health and take into
account all relevant food safety hazards, as identified by research, monitoring and other relevant
activities.
4. The principles of food safety risk analysis should be incorporated wherever possible and
appropriate in the design and implementation of meat hygiene programmes.
5. Meat hygiene requirements should control hazards to the greatest extent practicable
throughout the entire food chain. Information available from primary production should be taken
into account so as to tailor meat hygiene requirements to the spectrum and prevalence of hazards
in the animal population from which the meat is sourced.
6. The establishment operator should apply HACCP Prerequisite Programmes (PRPs), and to the
greatest extent practicable, the PRPs should also be applied in the design and implementation of
hygiene measures throughout the entire food chain.
7. The range of activities involved in meat hygiene should be carried out by personnel with the
appropriate training, knowledge, skills and ability as and where defined by the competent
authority. 8. The competent authority should verify that the establishment operator has adequate
systems in place to trace and withdraw meat from the food chain. Communication with
consumers and other interested parties should be considered and undertaken where appropriate.
HYGIENE OF SLAUGHTER ANIMALS
Both primary producers and the competent authority should work together to implement
riskbased meat hygiene programmes at the level of primary production that document the general
health status of slaughter animals, and implement practices that maintain or improve that status,
e.g. zoonoses control programmes. QA programmes at the level of primary production should be
encouraged and may include application of HACCP principles as appropriate to the
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circumstances. Such programmes should be taken into account by the competent authority in the
overall design and implementation of risk-based meat hygiene programmes. So as to facilitate
the application of risk-based meat hygiene programmes:
a) Primary producers should record relevant information to the extent possible on the health
status of animals as it relates to the production of meat that is safe and suitable for human
consumption. This information should be made available to the abattoir as required.
b) Systems should be in place for return from the abattoir to the primary producer, of
information on the safety and suitability of slaughter animals and meat, in order to improve the
hygiene on the farm and, where producer-led QA-programmes are applied, to be incorporated
into these programmes to improve their effectiveness.
c) The competent authority should systematically analyse monitoring and surveillance
information from primary production so that meat hygiene requirements may be modified if
necessary.
4. A. WHAT ARE FOOD ADDITIVES? ENUMERATE THE CLASSIFICATION OF

FOOD ADDITIVES
What are food additives?

Substances that are added to food to maintain or improve the safety, freshness, taste, texture,
or appearance of food are known as food additives. Some food additives have been in use for
centuries for preservation – such as salt (in meats such as bacon or dried fish), sugar (in
marmalade), or sulfur dioxide (in wine).
Many different food additives have been developed over time to meet the needs of food
production, as making food on a large scale is very different from making them on a small
scale at home. Additives are needed to ensure processed food remains safe and in good
condition throughout its journey from factories or industrial kitchens, during transportation to
warehouses and shops, and finally to consumers.
The use of food additives is only justified when their use has a technological need, does not
mislead consumers, and serves a well-defined technological function, such as to preserve the
nutritional quality of the food or enhance the stability of the food.
TYPES OF FOOD ADDITIVES
The different types of food additive and their uses include:
 Anti-caking agents – stop ingredients from becoming lumpy.
 Antioxidants – prevent foods from oxidising, or going rancid.
 Artificial sweeteners – increase the sweetness.
 Emulsifiers – stop fats from clotting together.
 Food acids – maintain the right acid level.
 Colours – enhance or add colour.
 Humectants – keep foods moist.
 Flavours – add flavour.
 Flavour enhancers – increase the power of a flavour.
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 Foaming agents – maintain uniform aeration of gases in foods.
 Mineral salts – enhance texture and flavour.
 Preservatives – stop microbes from multiplying and spoiling the food.
 Thickeners and vegetable gums – enhance texture and consistency.
 Stabilisers and firming agents – maintain even food dispersion.
 Flour treatment – improves baking quality.
 Glazing agent – improves appearance and can protect food.
 Gelling agents – alter the texture of foods through gel formation.
 Propellants – help propel food from a container.
 Raising agents – increase the volume of food through the use of gases.
 Bulking agents – increase the volume of food without major changes to its available
energy.
B. WRITE A NOTE ON FOOD ADULTERATION.

Adulteration is a legal term meaning that a food product fails to meet the legal standards. One
form of adulteration is an addition of another substance to a food item in order to increase the
quantity of the food item in raw form or prepared form, which results in the loss of actual
quality of food item. These substances may be either available food items or non-food items.
Among meat and meat products some of the items used to adulterate are water or ice,
carcasses, or carcasses of animals other than the animal meant to be consumed.[1]
Federal Meat Inspection Act and the Poultry Products

Inspection Act
Poisonous or deleterious substances
Generally, if a food contains a poisonous or deleterious substance that may render it injurious
to health, it is considered to be adulterated. For example, apple cider contaminated with E.
coli O157:H7 and Brie cheese contaminated with Listeria monocytogenes are adulterated.
There are two exceptions to this general rule. First, if the poisonous substance is inherent or
naturally occurring and its quantity in the food does not ordinarily render it injurious to health,
the food will not be considered adulterated.
Filth and foreign matter of adulteration
Filth and extraneous material include any objectionable substances in foods, such as foreign
matter (for example, glass, metal, plastic, wood, stones, sand, cigarette butts), undesirable parts
of the raw plant material (such as stems, pits in pitted olives, pieces of shell in canned oysters),
and filth (namely, mold, rot, insect and rodent parts, excreta, decomposition).
Economic-adulteration
A food is adulterated if it omits a valuable constituent or substitutes another substance, in
whole or in part, for a valuable constituent (for instance, olive oil diluted with tea tree oil);
conceals damage or inferiority in any manner (such as fresh fruit with food coloring on its
surface to conceal defects); or any substance has been added to it or packed with it to increase
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its bulk or weight, reduce its quality or strength, or make it appear bigger or of greater value
than it is (for example, scallops to which water has been added to make them heavier).
Microbiological contamination and adulteration of food
The fact that a food is contaminated with pathogens (harmful microorganisms such
as bacteria, viruses, or protozoa) may, or may not, render it adulterated. Generally, for ready-
to-eat foods, the presence of pathogens will render the food adulterated. For example, the
presence of Salmonella on fresh fruits or vegetables or in ready-to-eat meat or poultry products
(such as luncheon meats) will render those products adulterated.
5. DEFINE COOKING; EXPLAIN THE PRINCIPLES OF COOKING
DEFINITION
Cooking is defined as the transfer of energy from a heat source to food. ... This energy alters
food's molecular structure. Changing the taste, aroma and appearance of food. The method you
select gives the finished product a specific texture, appearance, aroma and flavor.
PRINCIPLES OF COOKING AND METHODS OF COOKING

Some foods like fruits, vegetables and nuts are eaten raw. It is good that they are consumed
raw as in the uncooked condition they retain most of their nutritive value. However most foods
are cooked before being consumed.

The process of subjecting foods to the action of heat is termed as cooking.
Objectives of cooking.
i. Improves the taste and food quality.
ii. Cooking food to the required temperature for a required length of time can
destroy all harmful microorganisms in food.
iii. Cooking improves digestibility.
iv. Cooking increases variety.
Methods of cooking
Moist heat methods
 Boiling
Boiling is cooking foods by just immersing them in water at 100 o C and maintaining the
water at that temperature till the food is tender. It does not require special skill and
equipment. It is time consuming.
 Simmering
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When foods are cooked in a pan with a well fitted lid at a temperature just below the
boiling point 82 o -99 o C , it is known as simmering. It is a useful method when foods
have to be cooked for a long time to make it tender. (eg) vegetables.
 Poaching
This involves cooking in the minimum amount of liquid at a temperature of 80 o -85 o C.
Foods generally poached are eggs and fish
 Stewing
This is a gentle method of cooking in a pan with a tight fitting lid, using small quantities
of liquid to cover only half the food. The liquid is brought to a boiling point and then the
heat applied is reduced to maintain the cooking at simmering temperature ie., 98 o C.
Apples can be cooked by this method.
 Steaming
This method requires the food to be cooked in steam. This is generated from vigorously
boiling water or liquid in a pan so that the food is completely surrounded by steam and
not in contact with the water or liquid. Here the food gets cooked at 1000C.
 Pressure cooking
In pressure cooking escaping steam is trapped and kept under pressure so that the
temperature of the boiling water and steam can be raised above 100 o C thus reducing
cooking time. Foods cooked in pressure cooker are rice, dhal, vegetables and meat.
 Dry heat methods
In this either air or fat is used as the medium of cooking.
Air as medium of cooking
 Grilling
Grilling consists of placing the food below or above or in between a red-hot surface. This
results in the browning of the food.
 Pan broiling or roasting
When food is cooked uncovered on heated metal or a frying pan, the method is known as
pan-broiling, (e.g) chapathis.
 Baking
Here food gets cooked by hot air inside the oven. Foods baked are generally brown and
crisp on the top and soft and porous in the centre, (eg) cakes and breads. The temperature
that is normally maintained in the oven is between 120 o C-260 o C.
 Fat as medium of cooking
Sauteing
This method involves cooking in just enough of oil to cover the base of the pan. Foods
cooked by sauteing are generally vegetables used as side dishes in a menu.
 Shallow fat frying
Here food is cooked on a tava with little oil (eg) chapathi, cutlets, etc.
 Deep fat frying
Food is totally immersed in hot oil and cooked. The temperature maintained is 180 o -
220 o C (eg.) Samosa, Bajji, etc. The taste of the food is improved along with texture.
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OTHER COOKING METHODS
Braising
Braising is a combined method of roasting and stewing in a pan with a tight fitting lid. Meat is
cooked by this method.
Microwave cooking
1. Door release button
2. See-through oven window
3. Door safety lock system
4. External air vents
5. Control panel
6. Identification plate
7. Glass tray
8. Roller ring
Electromagnetic waves from a power source called magnetron are absorbed by the food and
food becomes hot at once. Microwave cooking enhances the flavour of food because it cooks
quickly with little or no water and thus preserves the natural colour of vegetables and fruits.
SOLAR COOKING
1. Plain mirror 2. Cooking container
3. Glass sheet 4. Cover
5. Insulation material glass 6. Outer box
7. Handle 8. Mirror support
9. Hinged adjuster and guide

Solar cooker works on solar energy. Solar cooker consists of well insulated box, the inside of
which is painted dull black and is covered by one or more transparent covers, the purpose of
which is to trap the heat inside the solar cooker. The temperature maintained is around 140 o C.
Cost of the cooker and the maintenance cost is low. It takes longer time and special vessels
need to be used.
6. DISCUSS THE VARIOUS METHODS OF COOKING WITH EXAMPLES.
Dry Heat Cooking

 Broiling
exterior.
 Grilling
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Roasting
 Baking
 Sauteing
frequently.
Moist Heat Cooking
 Poaching
 Simmering
 Boiling
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 Steaming
oven.
Combination Cooking
 Braising
 Stewing
8. WHAT IS EFFECT OF COOKING ON FOOD? EXPLAIN WITH EXAMPLES.
Effect of processing on nutritive value of foods

All the foods we eat, with exception of fruit and vegetable salads, are subjected to some sort of
cooking or processing. When we talk of nutritional value, we should consider the actual nutrients
that reach our table.
THE COMMON COOKING METHODS ARE:
Steaming, pressure cooking, boiling, roasting, frying, baking, grilling, etc.
Some ways wherein nutrients are lost in cooking are:
 If vegetables are cooked in water containing salt & the cooking water discarded . This
results in loss of minerals like sodium, potassium and calcium.
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 Cutting vegetables into small pieces and exposing them to air may result in loss of
Vitamin C.
 Water soluble vitamins are lost during excessive washing as in repeated washing of
legumes, rice, etc. Washing may remove as much as 40 % thiamine & nicotinic acid.
 Cooking for long periods results in vitamin loss. If fat is repeatedly used in frying, it may
contain toxins due to peroxidation and rancidity.
 Excessive heating of milk with lactose & other foods with Jaggery may affect protein
quality as it may lead to browning.
Cereals
This category includes primarily - rice, wheat, corn and millets.
Rich In
Deficient In
Carbohydrates esp.
Lysine ( amino acid )
Dietary fiber
Vitamin A
Protein, Calcium (some of them)
Vitamin C
Iron ( some of them )
Fat ( only~2- 5per 100 g)
B-Complex Vitamins esp. whole grains
Pulse ( Legumes )
This includes the legumes like green gram, whole gram, bengal gram, black gram, lentil, field
bean, cow pea, rajma etc.
Rich In
Deficient In
Proteins
Vitamin A
Vitamin B-Complex
Vitamin C
Rich in amino acid lysine
Amino Acid Methionine
Total fat ( visible + invisible )
Tryptophan(esp. red gram)
Nuts & Oilseeds
Rich In
Deficient In
Protein
Methionine (sesame seeds are an exception )
Fat (oil)
Carbohydrates
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Vitamin B-Complex
(groundnuts are esp. rich in Vitamin B -1 & nicotinic acid )
Lysine
Fats & Oils
Rich In
Deficient In
Vitamin A ( red palm oil has a high content of beta-carotene )
Carbohydrates
Fat
Proteins
Vitamin C
Vitamin D
Fruits
Rich In
Deficient In
Vitamin C
Proteins
Vitamin A ( like yellow fruits as mango & papaya )
Fat
Carbohydrates ( like fruits like banana) Iron ( esp. dry fruits ) Pectin's
Vitamin D
Vegetables - Green Leafy Vegetables
This includes amaranth , fenugreek , drumstick , mint , etc.
Rich In
Calcium
Iron
Beta-carotene
Vitamin C
Riboflavin
Folic Acid
Roots & Tubers
This includes tapioca , potato , sweet potato , carrots , yam , colocacia , etc.
Rich In
Carbohydrate esp. starch
Carotene ( esp. carrots & yellow varieties of yam )
Calcium ( esp. tapioca & yams )
Other Vegetables - This includes vegetables like eggplant, lady finger , french beans , guar
beans , various gourds , tomatoes , etc.
Rich In
Vitamin C ( esp. tomatoes )
Dietary fiber
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Animal Foods
Milk , Milk Products & Eggs This group includes liquid milk , milk powder , curd , butter milk
etc.
Rich In
Deficient In
Good quality protein
Vitamin C
Calcium
Iron
Riboflavin
Lactose
Flesh Foods
Rich In
Protein
Vitamin B-Complex
Vitamin A (esp. liver)
Calcium (esp. fish)
W-3 (polyunsaturated)
Fatty acids (esp. fish)
Spices & Condiments
Rich In
Flavoring agents
Beta-carotene (like green chillies)
Vitamin C (like green chillies)
Tannin (esp. turmeric)
Pharmacologically active substances like choline, biogenic amines, etc.
8. DEFINE FOOD HYGIENE AND DISCUSS VARIOUS METHODS OF FOOD

STORAGE.
 Food Hygiene, otherwise known as Food Safety can be defined as handling, preparing and
storing food or drink in a way that best reduces the risk of consumers becoming sick from
the food-borne disease. The principles of food safety aim to prevent food from becoming
contaminated and causing food poisoning.
 Food safety is used as a scientific method/discipline describing handling, preparation, and
storage of food in ways that prevent food-borne illness. The occurrence of two or more
cases of a similar illnesses resulting from the ingestion of a common food is known as a
food-borne disease outbreak.
Chilling
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 Although refrigeration is a basic storage method nowadays, it was once a luxury.
Storing food at a low temperature is the simplest, and often safest, way to store
many types of food, as the food you plan to chill usually requires minimal
preparation – or it’s already done for you.
 Fridges preserve the quality and safety of food because the cold slows bacterial
growth and minimises spoilage. Depending on the type of food, it can last between
a few days and a few weeks in the fridge before the texture and taste deteriorate.
 Freezing
If stored properly, frozen food can last for months. In fact, because bacteria cannot
grow when frozen, food you keep in the freezer can remain safe to eat for almost
indefinite periods of time. However, it will eventually deteriorate in quality and
become unappetising, so you should use most frozen food within a few months or
a year.
 To safely freeze food, you should:
Set the freezer to a temperature between -18°C and -22°C.
Place food in air-tight containers or freezer bags before freezing. Proper
wrapping is especially important for meat, otherwise it may get freezer burn and
become inedible
Sugaring
Preserving food in a high-sugar environment stops bacterial growth by reducing
the food’s water content. It works particularly well for fruit: you can make jam and
marmalade that lasts for a long time, and you can use canning to store it (see the
section below).
salting
Similar to sugaring, salt draws water out of food and stops bacterial growth. In
high concentrations, it can even destroy bacteria cells, although by this point the
food is likely unappetising.
Canning
Keeping food canned significantly extends its lifespan – but only if done correctly.
The canning process preserves food by removing oxygen through an airtight seal
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and containing food in an acidic, sugary, or salty environment, where bacteria
cannot thrive.
Vaccum packing
Similar to canning, vacuum packing deprives bacteria of oxygen by creating an
airtight atmosphere. While food may not last for as long as canned goods,
vacuuming still extends its storage life for much longer than keeping food in the
fridge or in a cupboard.
9.DEFINE FOOD ADULTERATION, TYPES OF ADULTERANTS AND

LEGISLATURE MEASURES TO CONTROL IT.
Adulteration of food commonly defined as “the addition or subtraction of any substance to or

from food, so that the natural composition and quality of food substance is affected".
Adulteration is either intentional by either removing substances to food or altering the existing
natural properties of food knowingly. Unintentional adulteration is usually attributed to
ignorance’s, carelessness or lack of facilities for maintaining food quality. Incidental
contamination during the period of growth, harvesting, storage, processing, transport and
distribution of foods are also considered.
“Adulterant” means any material which is or could be employed for making the food unsafe or
sub-standard or mis-branded or containing extraneous matter.
Food is declared adulterated if:
 A substance is added which depreciates or injuriously affects it.
 Cheaper or inferior substances are substituted wholly or in part.
 Any valuable or necessary constituent has been wholly or in part abstracted.
 It is an imitation.
 It is colored or otherwise treated, to improve its appearance or if it contains any added
substance injurious to health.
 For whatever reasons its quality is below the Standard
Adulterated food is dangerous because it may be toxic and can affect health and it could deprive
nutrients essential for proper growth and development.
TYPES OF FOOD ADULTRANTS
 Poisonous or Deleterious Substances
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Generally, if a food contains a poisonous or deleterious substance that may render it
injurious to health, it is adulterated. For example, apple cider contaminated with E.coli
O157:H7 and Brie cheese contaminated with Listeria monocytogenes are adulterated.
If a food contains a poisonous substance in excess of a tolerance, regulatory limit, or
action level, mixing it with "clean" food to reduce the level of contamination is not
allowed. The deliberate mixing of adulterated food with good food renders the finished
product adulterated
 Filth and Foreign Matter
Filth and extraneous material include any objectionable substances in foods, such as
foreign matter (for example, glass, metal, plastic, wood, stones, sand, cigarette butts),
undesirable parts of the raw plant material (such as stems, pits in pitted olives, pieces of
shell in canned oysters), and filth (namely, mold, rot, insect and rodent parts, excreta,
decomposition.
 Economic Adulteration
A food is adulterated if it omits a valuable constituent or substitutes another substance, in
whole or in part, for a valuable constituent (for instance, olive oil diluted with tea tree
oil); conceals damage or inferiority in any manner (such as fresh fruit with food coloring
on its surface to conceal defects); or any substance has been added to it or packed with it
to increase its bulk or weight, reduce its quality or strength, or make it appear bigger or of
greater value than it is (for example, scallops to which water has been added to make
them heavier).
 Microbiological Contamination and Adulteration
The fact that a food is contaminated with pathogens (harmful microorganisms such as
bacteria, viruses, or protozoa) may, or may not, render it adulterated. Generally, for ready
-to-eat foods, the presence of pathogens will render the food adulterated. For example,
the presence of Salmonella on fresh fruits or vegetables or in ready-to-eat meat or poultry
products (such as luncheon meats) will render those products adulterated.
 Ready -to- eat meat and poultry products contaminated with pathogens, such as
Salmonella or Listeria monocytogenes, are adulterated. For raw meat or poultry products,
the presence of pathogens will not always render a product adulterated (because raw meat
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and poultry products are intended to be cooked and proper cooking should kill
pathogens).
II.SHORT ESSAY
1. WHAT ARE PURPOSES OF COOKING?
 Cooking gives a variety to the menu, as one item could be cooked in various
ways.
 Cooking pleases the eye and is receptive to the palate and helps to stimulate the
digestive juices, thereby creating an appetite
 Cooking kills the germs present in the raw food items.
 Cooking preserve food for a longer time.
 Cooking makes food easier to eat. It makes food more appetizing and palatable.
It makes food easier to digest.
 Cooking destroys many harmful micro-organisms or germs in the food.
Aims and objectives of cooking
1. The aim or intention of cooking is to see that the food cooked undergoes a physical and at
times chemical changes and that the end result is edible and acceptable.
2. Cooking preserve food for a longer time.
 Cooking kills the germs present in the raw food items.
 Cooking pleases the eye and is receptive to the palate and helps to stimulate the
digestive juices, thereby creating an appetite
 Cooking gives a variety to the menu, as one item could be cooked in various ways.
 Cooking retains, nutritive and flavouring ingredients.
 Enhance the flavor
. Easily to masticate the food items.
 It helps to digest the food.
3. The effect of cooking upon the three chief constituents of food : proteins, carbohydrates
and fats.
2. WHAT ARE DIFFERENT METHODS OF COOKING
Dry Heat Cooking
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 Broiling
exterior.
 Grilling
Roasting
 Baking
 Sauteing
frequently.
Moist Heat Cooking
 Poaching
 Simmering
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 Boiling
 Steaming
oven.
Combination Cooking
 Braising
 Stewing
3. WHAT IS SAFE FOOD HANDLING
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The food supply in the United States is among the safest in the world. However, when
certain disease-causing bacteria or pathogens contaminate food, they can cause foodborne
illness, often called “food poisoning.”
Know the Symptoms
Consuming dangerous foodborne bacteria will usually cause illness within 1 to 3 days of
eating the contaminated food. However, sickness can also occur within 20 minutes or up
to 6 weeks later. Symptoms of foodborne illness can include: vomiting, diarrhea, and
abdominal pain – and flu-like symptoms, such as fever, headache, and body ache.
Handle Foods Safely
Although most healthy people will recover from a foodborne illness within a short period
of time, some can develop chronic, severe, or even life-threatening health problems. In
addition, some people are at a higher risk for developing foodborne illness, including
pregnant women, young children, older adults, and people with weakened immune
systems (such as transplant patients and individuals with HIV/AIDS, cancer, or diabetes).
To keep your family safer from food poisoning, follow these four simple steps: clean,
separate, cook, and chill.
Wash hands and surfaces often

 Wash your hands with warm water and soap for at least 20 seconds before and after
handling food and after using the bathroom, changing diapers, and handling pets.
 Wash your cutting boards, dishes, utensils, and counter tops with hot soapy water after
preparing each food item.
 Consider using paper towels to clean up kitchen surfaces. If you use cloth towels, launder
them often in the hot cycle.
 Rinse fresh fruits and vegetables under running tap water, including those with skins and
rinds that are not eaten. Scrub firm produce with a clean produce brush.
 With canned goods, remember to clean lids before opening.
SEPARATE
Separate raw meats from other foods
 Separate raw meat, poultry, seafood, and eggs from other foods in your grocery shopping
cart, grocery bags, and refrigerator.
 Use one cutting board for fresh produce and a separate one for raw meat, poultry, and
seafood.
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 Never place cooked food on a plate that previously held raw meat, poultry, seafood, or
eggs unless the plate has been washed in hot, soapy water.
 Don’t reuse marinades used on raw foods unless you bring them to a boil first.
COOK
Cook to the right temperature
 Color and texture are unreliable indicators of safety. Using a food thermometer is the
only way to ensure the safety of meat, poultry, seafood, and egg products for all cooking
methods. These foods must be cooked to a safe minimum internal temperature to destroy
any harmful bacteria.
 Cook eggs until the yolk and white are firm. Only use recipes in which eggs are cooked
or heated thoroughly.
 When cooking in a microwave oven, cover food, stir, and rotate for even cooking. If there
is no turntable, rotate the dish by hand once or twice during cooking. Always allow
standing time, which completes the cooking, before checking the internal temperature
with a food thermometer.
 Bring sauces, soups and gravy to a boil when reheating.
CHILL
Refrigerate foods promptly
 Use an appliance thermometer to be sure the temperature is consistently 40° F or below
and the freezer temperature is 0° F or below.
 Refrigerate or freeze meat, poultry, eggs, seafood, and other perishables within 2 hours of
cooking or purchasing. Refrigerate within 1 hour if the temperature outside is above 90°
F.
 Never thaw food at room temperature, such as on the counter top. There are three safe
ways to defrost food: in the refrigerator, in cold water, and in the microwave. Food
thawed in cold water or in the microwave should be cooked immediately.
 Always marinate food in the refrigerator.
 Divide large amounts of leftovers into shallow containers for quicker cooling in the
refrigerator.
4. EXPLAIN FOOD HYGIENE AND SANITATION
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Food sanitation is the practice of following certain rules and procedures to prevent the
contamination of food, keeping it safe to eat. Many jurisdictions around the world have
specific food sanitation laws, along with lists of regulations created by public health
agencies. The practice of food sanitation is recommended at every step of the supply
chain within the food industry, from workers in crop fields to waiters at restaurants. The
term "food sanitation" typically refers to rules and procedures within the food industry,
whether during production, packaging, transporting or serving. At the consumer level,
such as in a home kitchen, practices designed to ensure that food is uncontaminated and
safe to eat are often referred to using the term "food hygiene."
FOOD SAFETY ISSUES
From the moment that food is produced or harvested to the time that it is eaten, it is vulnerable to
contamination from bacteria and other substances that could be harmful. The key to food sanitation is
keeping food safe and clean, with all of its handlers complying with the necessary rules and
recommendations.
Food sanitation included making sure canned goods are properly stored.
Within the commercial food industry, food sanitation can get complex. A single mistake along the supply
chain could make many people sick from eating contaminated food. For example, if a deli worker failed
to wash his or her hands after using the restroom and then prepared a dozen boxed salads, many
customers could get sick from fecal bacteria on the leaves of the salad greens. If a case of meat at a
packaging plant was not stored at the proper temperature, it could be sold, transported and then served in
a restaurant, possibly making the restaurant's customers sick, even if the restaurant followed all of the
proper food sanitation guidelines.
COMMON PROBLEMS
Food sanitation is a concern for restaurants with buffets where customers have direct access to
food.
Outbreaks of foodborne illness because of poor food sanitation are a recurrent problem in many regions
of the world. Failure to process foods properly has led to sickness from foods such as peanut butter,
spinach, hamburger meat and many other basic staples, and outbreaks have been traced to restaurants,
roadside food stands and many other locations where food is sold or served. Even institutions such as
churches and community bake sales are not exempt from food safety issues,
5. EXPLAIN FOOD PRESERVATION
Food preservation, any of a number of methods by which food is kept from spoilage
after harvest or slaughter. Such practices date to prehistoric times. Among the oldest
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methods of preservation are drying, refrigeration, and fermentation. Modern methods
include canning, pasteurization, freezing, irradiation, and the addition of chemicals.
Advances in packaging materials have played an important role in modern food
preservation.
Food spoilage may be defined as any change that renders food unfit for
human consumption. These changes may be caused by various factors, including
contamination by microorganisms, infestation by insects, or degradation by endogenous
enzymes (those present naturally in the food). In addition, physical and chemical
changes, such as the tearing of plant or animal tissues or the oxidation of
certain constituents of food, may promote food spoilage. Foods obtained from plant or
animal sources begin to spoil soon after harvest or slaughter. The enzymes contained in
the cells of plant and animal tissues may be released as a result of any mechanical
damage inflicted during postharvest handling. These enzymes begin to break
down the cellular material. The chemical reactions catalyzed by the enzymes result in the
degradation of food quality, such as the development of off-flavours, the deterioration of
texture, and the loss of nutrients. The typical microorganisms that cause food spoilage are
bacteria (e.g., Lactobacillus), yeasts (e.g., Saccharomyces), and molds (e.g., Rhizopus).
6. MENTION VARIOUS FOOD STORAGE METHODS.

Chilling
 Although refrigeration is a basic storage method nowadays, it was once a luxury.
Storing food at a low temperature is the simplest, and often safest, way to store
many types of food, as the food you plan to chill usually requires minimal
preparation – or it’s already done for you.
 Fridges preserve the quality and safety of food because the cold slows bacterial
growth and minimises spoilage. Depending on the type of food, it can last between
a few days and a few weeks in the fridge before the texture and taste deteriorate.
 Freezing
If stored properly, frozen food can last for months. In fact, because bacteria cannot
grow when frozen, food you keep in the freezer can remain safe to eat for almost
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indefinite periods of time. However, it will eventually deteriorate in quality and
become unappetising, so you should use most frozen food within a few months or
a year.
 To safely freeze food, you should:
Set the freezer to a temperature between -18°C and -22°C.
Place food in air-tight containers or freezer bags before freezing. Proper
wrapping is especially important for meat, otherwise it may get freezer burn and
become inedible
Sugaring
Preserving food in a high-sugar environment stops bacterial growth by reducing
the food’s water content. It works particularly well for fruit: you can make jam and
marmalade that lasts for a long time, and you can use canning to store it (see the
section below).
salting
Similar to sugaring, salt draws water out of food and stops bacterial growth. In
high concentrations, it can even destroy bacteria cells, although by this point the
food is likely unappetising.
Canning
Keeping food canned significantly extends its lifespan – but only if done correctly.
The canning process preserves food by removing oxygen through an airtight seal
and containing food in an acidic, sugary, or salty environment, where bacteria
cannot thrive.
Vaccum packing
Similar to canning, vacuum packing deprives bacteria of oxygen by creating an
airtight atmosphere. While food may not last for as long as canned goods,
vacuuming still extends its storage life for much longer than keeping food in the
fridge or in a cupboard.
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7. WHAT ARE DIFFERENT HOUSEHOLD METHODS USED FOR
PRESERVATION OF FOOD.
Among the oldest methods of preservation are drying, refrigeration, and fermentation.
Modern methods include canning, pasteurization, freezing, irradiation, and the addition of
chemicals. Advances in packaging materials have played an important role in modern food
preservation.
1. Refrigeration:
Microorganisms though not readily destroyed by severe cold are less active at low temperatures.
Refrigeration is widely used at homes and in commercial plants as a means of maintaining the
low temperature for the storage of perishable foods.
2. Heating: Food is also preserved through the application of heat. The heat is applied at very
high temperatures. The food stuff heated in containers or by others means to a temperature below
the boiling point of water for definite period is known as pasteurization.

3. Canning:
Canning is the procedure of placing food stuffs in scalable containers, which involves the steps
closing [sealing] heating and cooling. Large amounts of food are canned which include a wide
variety of fruits, vegetables and fleshy foods.

4. Pickles and Jam:
This is the age old method of preserving foods. By the use of preservatives like salts, vinegar, the
goods were preserved in ancient time which continues to the present day. Salt is considered as a
valuable preservative and used in pickling. Salt helps to remove the moisture. Sugar is also used
as preservative in a few varieties of pickles. Jams are usually fruits preserved in the form of pulp
by the addition of sugar, fruit pulp and chemical preservatives like Sodium benzoate, potassium
metabisulphate, citric acid, etc.

5. Drying:
Drying is also an ancient method of food preservation. Drying is a natural method of food
preservation. Drying is the process by which the moisture content of foodstuff is removed.
Drying has a very good advantage, i.e. due to removal of water microorganisms would not grow
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as moisture is important for the growth of microorganisms. Many fruits and vegetables are
preserved by this method too.

6. Chemical Preservatives:
Certain chemicals are used as preservatives, which retard the growth of Microorganisms by
increasing or decreasing the pH of food for their survival. The common chemical preservatives
used are potassium meta-bisulphate, sodium, benzoate, citric acid, vinegar, etc.
Freezing:
Freezing certain foods can be a good method of food preservations. Though the freezing
procedure does not destroy microorganisms, it stops their growth. Fruits, vegetables, meat, fish,
poultry can be preserved by this method.
8. WHAT ARE THE DIFFERENT FOOD BORNE DISEASES.

 Norovirus
 If you’ve ever eaten out at a restaurant only to come down with a case of the stomach flu,
you’ve had the norovirus. The most common known pathogen, the Norwalk virus (aka
norovirus) is responsible for 5.4 million cases of food poisoning each year. Chalk up its
prevalence to how easily it can be transmitted. People infected with the virus can spread it
directly to other people or cross-contaminate food or drinks they prepare for others.
 Salmonella
Salmonella is a bacteria that is estimated to cause 1.2 million illnesses and close to 450
deaths each year. Salmonella can contaminate almost any food, including meats, poultry,
eggs, unpasteurized milk or juice, cheese and contaminated raw fruits, vegetables, spices
and nuts. Additionally, drippings from raw meat or poultry can contaminate kitchen
surfaces and have been correlated to transmission of salmonella. It is killed by cooking
and pasteurization.
 Clostridium perfringens
 Causing an estimated 1 million illnesses a year, clostridium perfringens (C. perfringens)
ranks among the most common causes of food poisoning in the United States. C.
perfringens bacteria thrive in what is called the “Danger Zone,” a term referring to
temperatures between 40 and 140 degrees. Although cooking kills the C. perfringens cells
responsible for food poisoning, illness can occur when meat is not cooked to a high
enough temperature and then is held at the ideal temperature for the growth of the
bacteria – between 109 and 117 degrees.
 E. coli
 While it seems that cases of E. coli are more prevalent in the news, only about 176,000
cases of the illness crop up every year.Most strains of the Escherichia coli bacteria are
harmless and are important for a healthy intestinal tract, but some strains can cause
severe infections. The most notorious E coli – 0157:H7 – produces a toxin called Shiga
toxin-producing E. coli (STEC) that can lead to severe complications including bloody
diarrhea, kidney failure and even death.
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 Listeria
Though less common than other pathogens listed above, listeriosis is one of the most
lethal – it is estimated to cause more than 250 deaths and close to 1,600 illnesses every
year.Listeriosis is caused by eating food contaminated with listeria, the name for a bacteria
found in soil, water and even some animals, including cattle and poultry.
9. WHAT ARE VARIOUS METHODS TO CONTROL FOOD ADULTERATION?

 Choose better
Make sure the food you buy has an FSSAI-validated label; which means, there is
FSSAI license number, detailed list of ingredients with the amount and the clear
mention of expiration date. This is the first barrier - the first line of defence in
ensuring the food is aptly chosen by the consumer, considering the health
benefits. Avoid choosing products in loose packaging.
 Drink safe water
Use water after properly purifying it. A combination of purification methods like
water purifier, heating, etc. can be used to ensure quality. Often we miss out on
water quality which is one of the major sources of food contamination.
Be aware
The recent adulteration analysis at home eBook released by FSSAI - DART
(Detect Adulteration with Rapid Test) - a must have for all food businesses,
companies and majorly, homes to check for adulteration by using locally available
chemicals. It might be an all-comprehensive solution as to methods used for
estimation.
 Don't let the manufacturers
We Just because the ingredients seem healthier option, doesn't mean they are.
Always look up for the 'claims' made by the food businesses using alternate,
'healthier' choices. For example, several artificial sweeteners use ingredients
which do more harm to the body than natural sugars 'assume' to do.
 Dig deepe
Often we claim that the product was prepared steaming hot right in front of us.
We forget that the ingredients that are used, like frying oil, might be reused that
can be harmful to the health. Food colouring mixed while preparing food served
to you can be equally harmful. Observe while the local food vendors or the
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vendors in your cafeteria make something. If it doesn't seem right, healthy, stale
or adulterated, then it should be avoided.
10. EXPLAIN PFA – 1954 ACT.
The Act seeks to prevent the adulteration of any article used as food of drinks for human
consumption excluding drugs and water. The Act gives the power to the Central Government to
set up at Central Committee for Food Standards and Central Food Laboratory for testing and
analysing food items.
(1) This Act may be called the Prevention of Food Adulteration Act, 1954.
(2) It extends to the whole of India
(3) It shall come into force on such date as the Central Government may, by notification in the
Official Gazette, appoint.
(37 OF 1954) [29th September, 1954 An Act to make provision for the prevention of
adulteration of food
Objectives
The main objectives of the PFA Act and Rules are to protect the consumer against ill-health
caused by adulteration; to restrict and control the use of food additives and to confirm the
nutritional standards of the food. These laws are applicable for both kinds of foods whether
manufactured indigenously or imported.
UNIT – X
BALANCED DIET
I.LONG ESSAY
1. DEFINE BALANCED DIET. WHAT ARE THE FACTORS YOU WOULD
CONSIDER WHILE PLANNING A DIET?
Balanced diet
 A healthy diet is a diet that helps maintain or improve overall health. A
healthy diet provides the body with essential nutrition: fluid, macronutrients,
micronutrients, and adequate food energy.
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 Many factors influence the acceptability of a meal. Customers select what
appeals most to them from a menu card based on individual likes and dislikes,
budget, the popularity of items, etc.
However, while planning meals the following factors need to be considered:
Nutritional Adequacy
The most important consideration in menu planning is to ensure that the meal fulfills
the nutrient needs of the individual consuming the meal. For example, if the meal is
planned for industrial workers, it must meet the RDAs for that age group. Foods from
all basic food groups should be included in each meal so that the meal is balanced and
nutritionally adequate. Nutrient needs may be modified for hospital diets (therapeutic
diets).
Economic Considerations
The spending power of the clientele has to be kept in mind and meals have to be
planned within the budget. Low-cost nutritious substitutes should be included in the
menu to keep the costs low. The food cost should be maintained if the organization
has to run profitably.
Food Service
Menus should be planned concerning the type of food service, whether it is a
cafeteria, seated service, buffet, etc.
Equipment and Work Space

The menu should be planned, keeping the available equipment and workspace in
mind. Deep freezers, refrigerators, grinders, dough kneaders, deep fat fryers, boilers,
etc. should be adequate.
Leftover Food
An effective manager should consider as to how leftovers could be rotated to obtain
maximum profit. Adequate storage space and hygienic standards should be ensured to
minimize the risk of contamination and spoilage of food.
Food Habits
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Food habits of the customer is another important criteria which need to be considered
as food served has to be acceptable to the customer. Special attention should be paid
when a particular type of community is catered to. Religious considerations should be
known to the meal planner.
Availability
Some fruits and vegetables are seasonal. During the season the cost is reasonable and
quality is better. Today, practically all fruits and vegetables are available throughout
the year because of advanced preservation technology. However, seasonal fruits and
vegetables should be given preference. Regional availability influences menu
planning. For example, fish and seafood are fresh and cheaper in coastal areas.
Meal Frequency and Pattern
The meal timings and number of meals consumed in a day, whether meals are packed
or served at the table, also influences the selection of food items on the menu. The
age, activity level, physiological state, work schedule, and economic factors need to
be known before planning meals for institutional catering.
Variety
This is one of the most important considerations while planning meals. A variety of
foods from different food groups should be included.
The term variety means:
 Variety in food ingredients
 Variety in recipe
 Method of cooking
 Colour, texture, and flavour
 Variety in presentation and garnish.
2. WHAT IS BALANCED DIET? HOW DO YOU PLAN A BALANCED DIET
FOR A PREGNANT WOMAN?
Balanced Diet
 A balanced diet is a diet that contains differing kinds of foods in certain
quantities and proportions so that the requirement for calories, proteins,
minerals, vitamins and alternative nutrients is adequate and a small provision
is reserved for additional nutrients to endure the short length of leanness.
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 At no other time in life is nutrition as important as before, during, and
following pregnancy. On the other hand, women can still eat foods that come
in a box or a bag, eat out several times a week, or order pizza to go as long as
they also follow a few simple eating-for-two dietary guidelines.
A Pregnant Woman Should Include in Their Daily Diet at Least:

 Five servings of fresh fruits and vegetables (including at least one serving of a dark
orange vegetable, two servings of dark green leafy vegetables, and one serving of citrus
fruit)
 Six servings of enriched, whole-grain breads and cereals. Three servings of nonfat or
low-fat milk or milk products
 Two to three servings of extra-lean meats, chicken without the skin, fish, or cooked dried
beans and peas
 Eight glasses of water
 The guidelines for eating well for a healthy pregnancy are simple and easy to follow.
When, where, and how much they eat is flexible, and often is governed by necessity. A
pregnant woman in their first trimester might choose a snack for breakfast and a large
evening meal if they suffer from morning sickness, but select a larger breakfast and a
light evening meal in the last trimester when heartburn is more of a problem. Avoid or
limit caffeine (such as coffee, tea, and colas) and avoid alcohol and tobacco. Since no
safe limit has been established for alcohol, abstinence is a woman's best bet.
At no other time in life is nutrition as important as before, during, and following

pregnancy. On the other hand, women can still eat foods that come in a box or a bag,
eat out several times a week, or order pizza to go as long as they also follow a few
simple eating-for-two dietary guidelines.
 Five servings of fresh fruits and vegetables (including at least one serving of a dark
orange vegetable, two servings of dark green leafy vegetables, and one serving of
citrus fruit)
 Six servings of enriched, whole-grain breads and cereals. Three servings of nonfat or
 Two to three servings of extra-lean meats, chicken without the skin, fish, or cooked
dried beans and peas
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 Eight glasses of water
 The guidelines for eating well for a healthy pregnancy are simple and easy to follow.
When, where, and how much they eat is flexible, and often is governed by necessity.
 A pregnant woman in their first trimester might choose a snack for breakfast and a
large evening meal if they suffer from morning sickness, but select a
larger breakfast and a light evening meal in the last trimester when heartburn is more
of a problem. Avoid or limit caffeine (such as coffee, tea, and colas) and avoid
alcohol and tobacco. Since no safe limit has been established for alcohol, abstinence
is a woman's best bet.
 At no other time in life is nutrition as important as before, during, and following

orange vegetable, two servings of dark green leafy vegetables, and one serving of citrus
fruit)
 Two to three servings of extra-lean meats, chicken without the skin, fish, or cooked dried
beans and peas
The guidelines for eating well for a healthy pregnancy are simple and easy to follow. When,
where, and how much they eat is flexible, and often is governed by necessity. A pregnant woman
in their first trimester might choose a snack for breakfast and a large evening meal if they suffer
from morning sickness, but select a larger breakfast and a light evening meal in the last trimester
when heartburn is more of a problem. Avoid or limit caffeine (such as coffee, tea, and colas) and
avoid alcohol and tobacco. Since no safe limit has been established for alcohol, abstinence is a
woman's best bet.
Folic Acid: It's a Must

Nutrition experts agree that the best place for the mother-to-be to get all the essential
nutrients, including ample amounts of vitamins and minerals, is from their diet. The
trick is getting enough. For example, the MRC Vitamin Study at the Medical College
of St. Bartholomew's Hospital in London found that women taking folic
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acid supplements around conception had significantly lower risks for giving birth to
babies with neural tube defects (NTD), a type of birth defect where the embryonic
neural tube that forms the future brain and spinal column fails to close properly.
Luckily, in 1996 the U.S. Food and Drug Administration (FDA) issued a regulation
requiring that all enriched grain products, including breads and pasta, be
supplemented with folic acid. Every woman during the childbearing years should
make sure they get at least 400 micrograms of folic acid from food or supplements
3. WHAT IS THERAPEUTIC DIET? WHAT ARE THE MODIFICATIONS IN
DIET? PLAN A MENU FOR A DIABETIC PERSON.
Therapeutic diet
A therapeutic diet, or healing diet protocol, is a meal plan that controls the intake of
certain foods or nutrients/compounds in foods. It is often followed as part of the
treatment of a medical condition, and is most times done temporarily to heal and/or to
prevent health conditions. The most common therapeutic diet protocols used today
follow a similar approach as their foundation: to start with whole, unprocessed foods
as the base. From there, the inclusions and exclusions vary from diet to diet, but
always with this as their core principle while also staying away from pre-packaged
foods that have long ingredient lists. The key component to remember is that no
matter which therapeutic diet is being followed, it should always be monitored by a
healthcare professional who can ensure that the nutritional needs are still being met
through the course of the diet protocol.
DIETARY MODIFICATION
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Dietary modifications are changes made during food preparation, processing, and
consumption to increase the bioavailability of micronutrients—and
reduce micronutrient deficiencies—in food at the commercial or
individual/household level (Beck and Heath 2013). One example of dietary
modification is the simultaneous consumption of iron-rich foods with ascorbic acid
(vitamin C) (Gibson 2014), which increases the amount of iron absorbed by the body.
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Decreasing the amount of coffee and tea consumed with meals containing iron-rich
foods is another example of dietary modification, because coffee and tea inhibit iron
absorption.
Other strategies to increase bioavailability include
(1) using germinated cereal flours containing amylase to increase the energy and
nutrient density of cereal-based porridges; and
(2) using processes like germination, fermentation, and soaking to reduce the phytate
content, which can interfere with iron and zinc absorption. These practices improve
the intake and absorption of micronutrients, thus reducing anemia.
MEASUREMENT AND DATA SOURCES
 Data on the commercial or individual/household-level dietary modification are
not easily available. Currently, tools or indices to assess dietary modification
practices are not developed.
 Still, the consumption of specific foods that enhance or inhibit the absorption
of micronutrients can be measured.
 Population-based surveys that measure household, or individual-level food
consumption, may list specific foods and processing practices that enhance or
inhibit the absorption of micronutrients.
 National Micronutrient Surveys, the Optifood tool (FANTA 2016), and other
population-based surveys with dietary intake modules, collect information
about coffee and tea consumption, which can decrease iron absorption when
consumed with meals containing iron-rich foods.
 Other dietary modification practices—using germinated cereal flours in
cereal-based porridges or germination, fermentation, and soaking practices in
cooking to reduce the phytate content—may be available from individual
research studies (Hotz and Gibson 2001; Hotz, Gibson, and Temple 2001;
Hotz and Gibson 2005). It’s important to note that these dietary modification
practices may vary by geographic location within a country, or by cultural or
ethnic groups.
4. WHAT ARE WEANING FOODS? EXPLAIN THE PRINCIPLES OF WEANING
FOODS. WHAT ARE THEADVANTAGES OF BREAST FEEDING?
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Weaning foods
 Weaning is the process by which babies who were fully reliant on milk
are introduced to solid foods.
 It starts with the first mouthful of food and ends with the last feed of
breastmilk or formula milk .
 When and how solid foods are introduced is vital to establishing
healthy eating habits and limiting fussy eating.
 This article provides successful weaning tips, including foods to
choose and avoid, proper timing and potential concerns.
Appropriate first foods include:
 Soft, cooked vegetables: Broccoli, carrot, potato, sweet potato, butternut
squash, pumpkin, peas — pureed, mashed or served as finger food
 Soft fruit: Banana, mango, blueberries, raspberries, avocado, cooked pear or apple,
plums, peaches — pureed, mashed or served as finger food
 Cereals: Oatmeal, rice, quinoa, millet — cooked, mashed or pureed to a suitable texture
and mixed with a small amount of breastmilk or formula milk
 Start with a few spoonfuls or a couple of bites once a day for about a week to gauge
whether your baby wants more or less.
 New foods can be introduced every day or so, and you can also combine foods. For
example, try mixing infant rice cereal with pear — or banana with avocado.
Principles of weaning food

For parents, the principles of weaning are to be flexible, offer variety, keep
calm and show tolerance. Weaning is usually begun between three and six
months old. Premature introduction of solids is inadvisable, as is delaying
beyond six months.
 A wide range of home-prepared and/or manufactured baby foods
broadens the experience of taste and smell at a receptive age. Foods
during weaning should be given without added salt or added sugar.
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 A low-fat diet is not appropriate for babies. Skimmed or semi-
skimmed milk are not suitable.
 Fibre need not be excluded but should be given only in small amounts.
Current Department of Health guidelines are that breast or complete
formula milk should preferably be continued throughout the first year
of life. Follow-on milk or whole cow's milk may be given from six
months onwards Follow-on milk is preferable to cow's milk because it
is a more reliable source of iron and vitamin D.
 The need for fluid increases with the intake of solids. Watch the sugar
content in fruit juices and give well diluted. Children's vitamin drops
should be given from six months up to two years, and preferably up to
five years.
Benefits for life, breastfeeding may result in:
 Lower risk of breast cancer.
 Lower risk of ovarian cancer.
 Lower risk of rheumatoid arthritis and lupus.
 Less endometriosis.
 Less osteoporosis with age.
 Less diabetes.
 Less hypertension decreases blood pressure.
 Less cardiovascular disease.
5. WHAT IS MENU PLANNING? DISCUSS IN DETAIL THE STEPS INVOLVED IN

PLANNING A MENU.
Menu planning is the process to make the list of food items going to serve in any
type of meal whether it is breakfast, lunch, brunch or dinner. Menu planning is the
most important aspect of planning and organization in the food industry. It is an
advance plan of a dietary pattern over a given period of time.
6 Steps to Meal Planning Success
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Being prepared for healthy home cooking is the key to your success. Stock up on healthy shelf-
stable items for your pantry, plan out your grocery list and enjoy heart-healthy and flavorful
meals.
Step 1: Take Stock
Check your pantry and fridge for staples you have on hand and like as well as items that need to
be used. Make a grocery list of remaining items you need!
Step 2: Map Your Meals
Map out your meals - outline meals to use for the week and use it as your guide. It can be helpful
to have a theme for each day (Meatless Monday, Taco Tuesday, Leftovers Wednesday, Crockpot
Thursday, etc.).
Step 3: Focus on Fresh
Incorporate fresh fruits and a variety of veggies! Look for new recipes and vary your favorite
fruits and vegetables throughout the week to hit all of your food groups throughout each day! As
the seasons change, be on the lookout for seasonal items at their peak!
Step 4: Pack in Protein
Tired of chicken? Mix up your protein sources—beans or tofu for a meatless meal, chicken the
next day, and round out the week with beef and fish to create variety in your meals!
Step 5: Love Your Leftovers
Make a plan for leftovers! Grilled chicken breast can be sliced and top a salad, leftover meat and
vegetables can become the base for a soup or rice bowl. Leftovers can be great for busy days!
Step 6: Plan Ahead
Consider devoting a couple of hours on a weekend or evening to cook and prepare ingredients
for meals for the week. This can include healthy snacks like grapes or celery sticks.
6. DEFINE THERAPEUTIC DIETS. EXPLAIN THERAPEUTIC DIET FOR

CARDIOVASCULAR DISEASE.
THERAPEUTIC DIET
 A therapeutic diet is a meal plan that controls the intake of certain foods or
nutrients. It is part of the treatment of a medical condition and are normally
prescribed by a physician and planned by a dietician. A therapeutic diet is usually
a modification of a regular diet.
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 In nutrition, diet is the sum of food consumed by a person or other organism. The
word diet often implies the use of specific intake of nutrition for health or weight-
management reasons. Although humans are omnivores, each culture and each
person holds some food preferences or some food taboos.
 Diet is an important risk factor in coronary heart disease. Food-related risk
factors include obesity, high blood pressure, uncontrolled diabetes and a diet high
in saturated fats. A low-saturated fat, high-fibre, high plant food diet can
substantially reduce the risk of developing heart disease.
Therapeutic diet for caedio vascular disease
Hypertension – Also known as high blood pressure, hypertension is a serious condition
that leads to coronary heart disease, heart failure, stroke, kidney failure, and more.
Hypercholesterolemia – High cholesterol is a harmful condition, affecting the heart and
blood vessels, and managing this condition is important for long-term heart health.
Hyperlipidemia – This condition involves elevated levels of lipids (fats) in the blood,
which is related to high cholesterol and high triglycerides.
Hypertriglyceridemia – Triglycerides are a specific type of fat found in your blood, and
elevated levels of triglycerides are associated with a range of metabolic and
cardiovascular conditions.
Dietary Management of Cardiovascular Disease
 While there is a range of genetic and other factors influencing cardiovascular
diseases, the strongest factors for these conditions are generally dietary and
lifestyle behaviors. Anne Till Consulting dietitians and nutritionists are highly
trained professionals who use medical nutrition therapy and targeted lifestyle
interventions to treat, manage, and slow the progression and worsening of
conditions associated with cardiovascular diseases.
 Because each of these conditions has specific dietary and lifestyle modifications
associated with successful management, the expertise of the dietitians and
nutritionists at Anne Till Consulting is most valuable for individuals seeking to
use medical nutrition therapy (MNT) and lifestyle changes to help manage their
risk for cardiovascular disease and enhance their overall wellness.
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 Targeting specific metabolic abnormalities, the dietitians/nutritionists at Anne Till
Consulting are highly experienced at assessing each client’s medical condition
and matching individual needs with the most suitable nutrition and lifestyle-based
interventions.
 Their approach relies on scientific evidence, personal medical data, and the most
up-to-date, best-practice methods to adopt a diet and lifestyle change specifically
for each client.
 Equipped with appropriate knowledge, a personalized plan, and ongoing
monitoring and support, managing your “numbers” and reducing your risk for
cardiovascular disease is well within reach.
7 WRITE A DETAILED ACCOUNT OF NUTRITIVE VALUES OF ALL FOOD
GROUPS.
What are the five food groups?
 Fruit and vegetables
 Starchy food
 Dairy
 Protein
 Fat
FOOD GROUP FUN
Eating a balanced diet is important for our health. Enjoy food from each of the five food
groups and you’ll be getting a fantastic mix of the best nutrients and vitamins.
1 Carbohydrates
Carbohydrates give you energy, calcium and B vitamins. These could be servings of
pasta, rice, oats, potatoes and sweet potatoes or noodles, yam, couscous, bread, barley
and rye. Breakfast cereals are also a carbohydrate and many contain extra iron too.
o One slice of bread, one roll or half a pizza
o Six tablespoons of breakfast cereal or porridge
o Four wholewheat crisp breads
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o Six tablespoons of pasta, rice, millet or couscous
o Two small new potatoes
o Two tablespoons mashed sweet potato.
2 .Protein
Think of proteins as building blocks for the body – they help it grow and repair itself.
Protein is found in meat, fish and eggs, while nuts, beans, lentils, peas, dahl, Quorn and
soya are great vegetable proteins. These foods also provide us with iron and other
vitamins and minerals.
o Two slices of cold ham, turkey and chicken
o One medium chicken breast
o Two sausages
o Three bacon rashers
o One beefburger
o One fillet of fish or fish steak
o One small can of tuna, salmon, mackerel, sardines
o Four fish fingers
o One cup of cooked lentils or beans
o Half a large can of beans, chickpeas or lentils
o A 100g portion of tofu or Quorn.
3 Dairy products
Packed with calcium, protein and vitamins such as vitamins A, D and B12, dairy products
keep our bones and teeth healthy. Our bodies easily absorb the calcium from these foods,
such as milk, yoghurt, fromage frais and cheese.
o One glass of milk
o One pot of yoghurt or fromage frais
o One matchbox-sized piece of cheese or two triangles
o Half a tin of low-fat custard.
4 Fruit and vegetables
Fruit and veg – fresh, frozen, tinned, dried and juices – are brilliant for our diets. They’re
full of health-giving vitamins, antioxidants and fibre – that keep us feeling full and our
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digestive systems healthy – plus they’re low in calories. By eating a wide variety of fruit
and veg, you’ll be getting a range of the important nutrients they contain.
o One apple, orange, pear or banana or similar-sized fruit
o Two smaller fruits such as plums, satsumas or kiwi fruit
o A handful of small fruits such as grapes, cherries or berries
o Half to one tablespoon of dried fruits such as raisins, prunes or apricots
o A slice of large fruit such as a piece of melon or a slice of pineapple
o Three heaped tablespoons of raw, cooked, frozen or canned vegetables
5 Fats and sugars
It’s important not to have too many foods from this group as they give us a lot of energy
from calories but not much nutrition. Try to keep foods such as butter, margarine,
cooking oils and salad dressings to a minimum and save chocolate, crisps, sugary soft
drinks, sweets, jam, cream, cakes, pudding, biscuits and pastries for the occasional treat.
8.WRITE A DETAILED ACCOUNT OF BALANCED DIET AND FACTORS
AFFECTING IT.
A healthy diet is good for your physical and mental health. It can reduce the risk and
severity of obesity, heart disease, diabetes, hypertension, depression and cancer.A
balanced diet may be defined as that diet which contains all the nutrients in the
correct amount. In other words, ―A diet which consists of all the essential food
elements in proper quantity such as carbohydrates, fats, proteins, vitamins, minerals,
and water according to the requirement of the individual to maintain good health
FACTORS AFFECTING DIET
1. Age : The quantity of nutrient depends upon the age of a person. During the young
age much quantity of diet is needed comparatively to old age because of strong
metabolic rate.
2. Gender : Nutritional needs depend upon the gender of an individual. Males
required more amount of food in comparison to females.
3. Activity Level : Nutritional needs are influenced by the type and level of activity a
person performs .For example, a person who is employed in a job where heavy
physical work is needed, needs more amount of nutrient
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4. Climate : The quality and quantity of diet depends upon the climatic conditions. It
is accepted fact that we take more diet in winters as compared to summers.
5. State of health : Nutritional needs of a healthy individual are definitely more in
comparison to a unhealthy person.
6. State of nutrition: The state of nutrition decides how much an individual will
intake .If the state of nutrition is good it can be consumed easily and vice –versa
7. Economic Status: Income is a vital factor which affects the choice of food
products available. People with good income will choose healthy products whereas
people with average income may compromise in choosing products.
Functions of Balanced Diet / Importance of Balanced Diet and nutrition
A balanced diet means eating the right types of food to provide your body with
nutrition and energy. Good nutrition is important for healthy growth and
development. A balanced diet is important because it enables us to meet our daily
nutritional needs and enjoy a higher overall quality of life.
1.Disease prevention : Eating a balanced diet is the easiest way to protect ourself
from many diseases. Eating in a balanced way boosts our energy level and ensures
our body functions normally.
2. Meeting Nutritional Needs : Balanced diet is essential to meet the nutritional
needs of our body for proper functioning of various body systems.
3.Weight Control : Eating a balanced diet can be an important step towards weight
control .A balanced diet helps us to maintain body weight in the long run.
4. Immune System Health : Foods rich in vitamins C,D and E and other nutrients
boost immunity. Eating foods rich in vitamin C,D and E enhances the production of
white blood cells, antibodies, combat germs and eases inflammation making our
immune system strong and healthy.
5.Proper sleep : Eating a balanced diet enables us not only to sleep better without
the use of sleeping pills but also feel more rested when we wake up.
6. Mental Health : Eating a balanced diet improves the mental health especially after
middle ages men and women live without mental problems as compared to people
who eat imbalanced diet.
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7. Quality of life : Eating a balanced diet is important because it allows us to enjoy
life, have more energy, feel less stress and accomplish more in less time. 2 Meaning
of Nutrition Nutrition is a dynamic process in which body is made healthy by
9.DISCUSS THE NUTRITIONAL REQUIREMENTS DURING PREGNANCY AND
LACTATION.
Pregnancy and breastfeeding are the most nutritionally demanding times of a
woman's life. The body needs enough nutrients every day to maintain its needs and
also to support the growth of a baby. All of the nourishment the developing baby
needs comes from mom, either through the foods she eats or the supplements she
takes. Pregnant and breastfeeding women need more nutrients than other women.
Folate is essential because it reduces the risk of a baby being born with spinal cord
birth defects. It is important to consume 400 micrograms per day of folic acid before
pregnancy, and 600 micrograms per day during pregnancy. Breastfeeding women
need 500 micrograms per day. Foods such as broccoli, dark green vegetables and
oranges are high in folic acid.
Iron is needed to prevent iron-deficiency-related anemia. Pregnant women need
about 27 milligrams per day. The need for iron declines after birth, but women who
are breastfeeding still require about 10 milligrams per day. Fortified cereals, green
leafy vegetables, beans and lean meat are good sources of iron.
Calcium is needed by your baby for strong bones and a healthy heart, muscle system
and nervous system. If calcium is not supplied by the mother's diet, calcium is taken
from the mother's bones for the baby. Pregnant and breastfeeding women 19 years
and older need around 1,000 milligrams per day, and women under 19 years of age
need 1,300 milligrams per day.
Tips for Healthy Eating During Pregnancy and Breastfeeding

 Eat a variety of foods.
 Choose foods higher in fiber such as fruits, vegetables, dry beans, whole-grain breads and
cereals, and other whole-grain products.
 Exercise in moderation, on a regular basis (ask your doctor).
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 Drink plenty of fluids (approximately 3,000 milliliters per day or 12 eight-ounce glasses
for pregnant women, and approximately 700 milliliters more for breastfeeding women).
 Eat 3–5 meals and snacks per day.
 Pregnancy and breastfeeding increase the need for calories and most nutrients. Most
women who are pregnant or breastfeeding (and are a healthy weight) might need an
additional 300–500 calories per day to provide the extra energy the body needs. Three
hundred calories is equal to a regular snack, such as half of a peanut butter and jelly
sandwich and a glass of 1% milk.
General Meal Plans
Pregnant Women
2nd and 3rd
Food Group 1st Trimester What Counts as 1 Cup or Ounce?
Trimesters
1 cup raw or cooked vegetables or 100%
Vegetables 2.5 cups 3 cups juice
2 cups raw, leafy vegetables
1 cup fruit or 100% juice
Fruits 2 cups 2 cups
½ cup dried fruit
1 slice bread
Grains 6 ounces 8 ounces 1 ounce read-to-eat cereal
½ cup cooked pasta, rice or cereal
1 cup milk
8 ounces yogurt
Dairy 3 cups 3 cups
1.5 ounces natural cheese
2 ounces processed cheese
1 ounce lean meat, poultry or seafood
¼ cup cooked beans
Protein 5.5 ounces 6.5 ounces
½ ounce nuts or 1 egg
1 tablespoon peanut butter
Breastfeeding Moms
Breastfeeding Breastfeeding
Food Group What Counts as 1 Cup or Ounce?
Only Plus Formula
1 cup raw or cooked vegetables or 100%
Vegetables 3 cups 2.5 cups juice
2 cups raw, leafy vegetables
Fruits 2 cups 2 cups 1 cup fruit or 100% juice
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½ cup dried fruit
1 slice bread
Grains 8 ounces 6 ounces 1 ounce read-to-eat cereal
½ cup cooked pasta, rice or cereal
1 cup milk
8 ounces yogurt
Dairy 3 cups 3 cups
1.5 ounces natural cheese
2 ounces processed cheese
1 ounce lean meat, poultry or seafood
¼ cup cooked beans
Protein 6.5 ounces 5.5 ounces
½ ounce nuts or 1 egg
1 tablespoon peanut butter
10.WHAT ARE THE CONCEPTS OF A BALANCED DIET? DISCUSS STEPS YOU

WOULD CONSIDER WHILE PLANNING A DIET FOR AN EXPECTANT MOTHER.
Concept of Balanced Diet
A balanced diet may be defined as one which contains the various groups of food stuffs such
as energy yielding foods, body building foods and protective foods in the correct
proportions so that an individual is assured of obtaining the minimum requirements of all
nutrients.
 The components of a balanced diet will differ according to age, sex, physical
activity, economic status and the physiological state viz., pregnancy, lactation etc.,
 In addition a balanced diet should also provide biochemical compounds such as
dietary fiber, antioxidants and nutraceuticals which have positive health benefits.
 A balanced diet should provide around 60-70% of total calories from
carbohydrates, 10-15% from protein and 20-25% of total calories from fat.
 Balanced diets at high cost: such diets will include liberal amounts of protective
and protein-rich foods such as milk, eggs, meat, fish, fruits and moderate
quantities of cereals, pulses, nuts and fats.
 Balanced diets at moderate cost: These diets will include moderate amounts of
protective and protein-rich foods such as milk, eggs, meat, fish, fruits and fats and
liberal amounts cereal, pulses, nuts and green leafy vegetables.
 Balanced diets at low cost: These diets will include minimal amounts of
protective and protein-rich foods such as milk, eggs, meat, fish fruits, nuts and fats
and liberal amounts of cereals, pulses and green leafy vegetables.
 ill- Balanced diets: A diet is considered to be ill-balanced diet if it is deficient
in calories, proteins, essential vitamins and minerals as it is lacking in protein-rich
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and protective foods.
 At no other time in life is nutrition as important as before, during, and following

orange vegetable, two servings of dark green leafy vegetables, and one serving of
citrus fruit)
 Two to three servings of extra-lean meats, chicken without the skin, fish, or cooked
dried beans and peas
The guidelines for eating well for a healthy pregnancy are simple and easy to follow. When,
where, and how much they eat is flexible, and often is governed by necessity. A pregnant
woman in their first trimester might choose a snack for breakfast and a large evening meal if
they suffer from morning sickness, but select a larger breakfast and a light evening meal in
the last trimester when heartburn is more of a problem. Avoid or limit caffeine (such as
coffee, tea, and colas) and avoid alcohol and tobacco. Since no safe limit has been
established for alcohol, abstinence is a woman's best bet.
11.EXPLAIN THE NUTRITIONAL REQUIREMENTS DURING INFANCY

Infant nutrition is the description of the dietary needs of infants. A diet lacking
essential calories, minerals, vitamins, or fluids is considered inadequate. Breast milk
provides the best nutrition for these vital first months of growth when compared to
infant formula. For example, breastfeeding aids in preventing anemia, obesity, and
sudden infant death syndrome; and it promotes digestive health, immunity,
intelligence, and dental development. The American Academy of Pediatrics
recommends exclusively feeding an infant breast milk, or iron fortified formula, for
the first six months of life and continuing for one year or longer as desired by infant
and mother. Infants are usually not introduced to solid foods until four to six months
of age.
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Proper infant nutrition demands providing essential substances that support normal
growth, functioning, development, and resistance to infections and diseases. Optimal
nutrition can be achieved by the expectant mother making the decision to breastfeed
or bottle-feed the infant before birth and preparing for chosen decision.
Birth to six months
The World Health Organization (WHO) and the Pan American Health
Organization currently recommend feeding infants only breast milk for the first six
months of life. If the baby is being fed infant formula, it must be iron-enriched. An
infant that receives exclusively breast milk for the first six months rarely needs
additional vitamins or minerals. However, vitamins D and B12 may be needed if the
breastfeeding mother does not have a proper intake of these vitamins.
Using formula
 This form of nutrition may be used instead of breast milk due to lifestyle
choices or the fact that women cannot breastfeed. Formula provides all the
nutrition needed for a baby to thrive and grow.Every child is different and
may need different nutrition to help them grow and be comfortable.
 Babies may also have an allergy, may be premature, or may have a reason to
not consume breast milk. There are formulas specifically for an each type of
baby.
 It is important to know that some foods are restricted for infants. For example,
whether breast- or bottle-fed, infants do not need additional fluids during the
first four months of life. Excessive intake of extra fluids or supplements can
have harmful effects.
 Fluids besides human breast milk or iron-enriched infant formula are not
recommended. These substitutes, such as milk, juice, and water do not possess
what the infant needs to grow and develop, cannot be digested correctly, and
have a high risk of being contaminated.
 Water is acceptable only for mixing infant formula. Honey also must be
avoided because there is a high risk of botulism. Breast milk is the safest thing
to give, unless the mother is advised against it by a health care professional.
Newborn
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Newborns typically consume half an ounce for the first 2 days after birth but will
gradually increase to 1 or 3 ounces until 2 weeks after birth. They will begin to drink
2 to 3 ounces. You should expect to feed the baby every 8 to 12 times per day in a 24
hours span. Newborns will need to be fed throughout the night until their stomach can
hold in more liquid and nutrition.
2 months
Babies at 2 months of age will begin to drink 4 to 5 ounces every 3 to 4 hours.
4 months
A 4 month old baby should drink 4-6 ounces every 4 hours.
6 months
A 6 month old should drink 6-8 ounces every 4–5 hours.
Six to twelve months
Starting solids
Baby girl getting her first spoonful of rice
 Solid foods should be introduced from six months onward. Salt, sugar,
processed meat, juices, and canned foods should be avoided. Breast milk or
infant formula continues to be the primary source of nutrition during these
months, in addition to solid foods.
 Solid food can be introduced during this age because the gastrointestinal tract
has matured. Solids can be digested more easily, and allergic responses are
less likely.
 The infant has begun teething by now, which will aid in chewing of solid
food. Another milestone that the infant may have reached by now is properly
supporting and turning their head.
 They may do this to express a dislike in certain foods. The infant has also
developed enough to participate in feedings by grasping bottles and pieces of
food to feed themselves.
 When beginning solids it is important that the infant starts consuming solids
with iron. Infants store iron from the womb and by 6 months of age it has
depleted from their body.
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 Iron-fortified infant cereal has traditionally been the first solid introduced due
to its high iron content.
 Cereals can be made of rice, barley, or oatmeal. However, there is increasing
suggestion that iron-rich whole foods, such as meat and legumes, might be a
better choice than iron-fortified processed foods such as manufactured rice
cereals.
Health benefits of breast milk
 Preventing anemia
Breastfed infants are at a lower risk for acquiring iron-deficiency anemia.
Infants that only consume cow's milk become deficient in iron and are 50%
more likely to lose blood in their stool. If the infant is allergic to cow's milk, it
causes inflammation of the digestive system, resulting in chronic blood loss
and decreased absorption of iron. This is why infant formula must be iron-
enriched if breastfeeding is not possible.
 Preventing obesity
Breastfed infants tend to have lower incidence of obesity later in life. Breast
milk leads to a slower weight gain in early infancy, and is protective against
child obesity and development of type 2 diabetes. Diabetes is a serious health
problem where the body does not use insulin correctly. This diagnosis can
cause many complications of the skin, eyes, feet, nervous system, heart, and
kidneys.
 Preventing sudden infant death syndrome (SIDS)
Infant sleeping SIDS (crib death) is an unexplained death occurring in an
infant who is one year of age or younger. Most deaths occur when the infant is
sleeping. Breastfeeding helps reduce the risk of SIDS when done exclusively
for any length of time. It is recommended to breastfeed the infant from birth to
6 months exclusively to decrease the risk of SIDS by 50%.
12.EXPLAIN THE NUTRITIONAL REQUIREMENTS IN OLD AGE AND PLAN MENU
FOR
Special nutrient needs of older adults
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Eating right and staying active are important no matter what your age. As we get older our
bodies have different needs, so certain nutrients become especially important for good health.
 Calcium and Vitamin D
Adults older than 70 need more calcium and vitamin D to help maintain bone health than
they did in their younger years. To meet these needs, select calcium-rich foods and
beverages and aim for three servings of low-fat or fat-free dairy products each day. Other
sources of calcium include fortified cereals and fruit juices, dark green leafy vegetables,
canned fish with soft bones, and fortified plant-based beverages. Sources of vitamin D
include fatty fish, such as salmon, eggs and fortified foods and beverages. If you take a
calcium supplement or multivitamin, choose one that contains vitamin D.
 Vitamin B12
Some adults older than 50 may not be able to absorb enough vitamin B12. Fortified
cereal, lean meat and fish and seafood are sources of vitamin B12. Ask your doctor or a
registered dietitian nutritionist if you need a vitamin B12 supplement.
 Dietary Fiber
Eat fiber-rich foods to stay regular. Dietary fiber also may help lower your risk for heart
disease and reduce your risk for Type 2 diabetes. Eat whole-grain breads and cereals, and
more beans peas and lentils— along with whole fruits and vegetables which also provide
dietary fiber.
 Potassium
Consuming adequate potassium, along with limiting sodium (salt) intake, may lower your
risk of high blood pressure. Fruits, vegetables, beans and low-fat or fat-free dairy
products are all sources of potassium. Also, select and prepare foods with little or no
added salt. Add flavor to food with herbs and spices.
Extra specific advice for older people includes:
 Maintain healthy weight and muscle strength through physical activity. The benefits of
walking for older people]. It’s been shown people over 65 years often have better health
if they carry a little extra weight and have a slightly higher body mass index. Talk to your
healthcare professional if you need to lose or gain weight.
 If you’re on a budget, simply do your best with your food choices. Plan well, use what’s
available, and buy only what you need. Look out for quick and easy healthy recipes for
one or two people, and try to eat regularly with family and friends if possible.
 Be careful with your teeth. If nuts, grains and hard fruits and vegetables are difficult to
chew, try milled wholegrains, soft cooked and canned fruits and vegetables, and nut
pastes and butters.
 Prepare and store food safely. Follow food safety guidelines to avoid food-borne illnesses
which can be particularly bad for older people.
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 Limit your intake of foods containing saturated fats and trans fats. Remember those
‘extras’ or ‘sometimes foods’ referred to in the guidelines? Keep those to a minimum.
Foods like pies, pastries, fried and battered foods, chips, and chocolate are generally high
in saturated fat, and may contain dangerous trans fats.
 Talk to your doctor about your personal health needs, particularly about how best to
apply the dietary guideline that says to limit saturated fats, added salt, and added sugars
(above
 Eat plenty of fibre and drink plenty of fluids. Water is essential for hydration, digestion
and blood volume, but now you’re older, you may not feel as thirsty as you once did,
even when your body needs fluids. Try to drink water about 6–8 cups of fluid a day, and
more in warmer weather or when exercising.
 Use less salt. Everyone needs some salt, but too much can increase your risk of high
blood pressure and heart disease.
 Watch your alcohol intake. Follow Australian guidelines if you drink: no more than two
standard drinks on any given day for healthy men and women.
13.WHAT IS BALANCED DIET? DISCUSS STEPS THAT YOU CONSIDER WHILE
PLANNING FOR 70 YEARS PERSON.
Balanced diet
A healthy diet is a diet that helps maintain or improve overall health. A healthy diet
provides the body with essential nutrition: fluid, macronutrients, micronutrients, and
adequate food energy.
One of the many aspects of life that change as we get older are our nutritional
requirements. At any age, it’s important to aim for a varied and balanced diet, full of
vegetables and fruit, lean sources of protein and healthy fats. However, after the age
of 70, it can be useful to pay attention to particular nutrients. Read on to discover our
top tips to help those aged 70 and over get all the nutrition that they need.
Vitamins and minerals
Registered nutritionist, Jo Lewin says, ‘For older adults, vitamins are vital. Various
physiological and psychological changes occur as we age, which affect our nutritional
requirements. The body becomes less efficient at absorbing and using many vitamins
and minerals.
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Vitamin D
Vitamin D can be made by the action of sunlight on the skin, so when possible, try to
get out in the sun for at least 20 minutes a day without sunscreen (although if you are
out for longer than this, do take the appropriate steps to protect your skin from sun
damage). During the autumn and winter months the sun may not be strong enough for
the body to make vitamin D, so diet is another important source of this vital vitamin.
Foods such as eggs (with the yolks) and oily fish (such as salmon, sardines and
mackerel) along with fortified foods such as some spreads and breakfast cereals, are
good sources.
Vitamin B12
Vitamin B12 is important for many processes in the body, including producing red
blood cells, maintaining the nervous system and releasing energy from food. As we
age, our ability to absorb this nutrient becomes less effective, so maintaining an
adequate dietary intake is important. Foods that are rich in B12 include liver,
mackerel, fortified soya milk alternatives, yogurt, most meats, salmon, cod, milk,
cheese, eggs and fortified breakfast cereals. Check with your GP if you are concerned
about your vitamin B12 levels.
Keep salt levels low
Including some salt is important for good health, but eating too many pre-packaged
foods may mean we consume too much without realising. Furthermore, our sense of
smell and taste may become less acute as we get older, and it can be tempting to add
extra salt to our food to compensate. Instead, try using herbs, spices and other
strongly flavoured ingredients such as garlic, lemon juice, vinegar or mustard.
Eat enough fibre
Including fibre, also known as roughage, in your diet can help to keep your digestive
system healthy and promote regular bowel movements. Make sure that your diet
includes a wide variety of fibre-rich foods such as wholegrains, oats, fruits,
vegetables, beans and lentils. A small glass of prune juice in the morning may help to
alleviate constipation.
Stay hydrated
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It can be easy to forget to drink enough water, but it’s important to aim for around 6-8
glasses or cups a day. The good news is that this doesn’t all have to be plain water –
milk, sugar-free drinks and tea and coffee all count, but do bear in mind that
caffeinated drinks like tea and coffee can make the body produce urine more quickly.
14. DEFINE DIET PLAN? DESCRIBE THE ROLE OF A NURSE IN PLANNING A
DIET FOR AN ADULT.
Diet planning
 Planning diets refers to determining what usual nutrient intake should be.
Regardless of whether one is planning diets for individuals or groups, the
goal is to have diets that are nutritionally adequate, or conversely, to ensure
that the probability of nutrient inadequacy or excess is acceptably low.
 Nurses have the expertise and responsibility to ensure that patients and
clients’ nutritional needs are met. Providing nutrition screening and
appropriate nutrition advice is essential to improve healthy eating and
subsequent health outcomes.
Nurse roles in supporting nutrition
 In the healthcare settings, appropriate and adequate nutritional supports are
linked with patients’ quality of life and cost-effective service delivery. Nurses
play equally important roles which complement the role of the dietitian to
ensure adequate nutrition for patients (Jefferies, Johnson, & Ravens, 2011;
Mcclinchy et al., 2015). Nurses often fill the role of nutrition counsellors by
providing nutrition screening and/or nutrition advice to patients.
 Nurses’ roles in nutritional support have been documented in healthcare
guidance internationally. In Australia, the nurses’ role is to ensure patients are
well supported and their nutritional intake is well monitored and documented
 In the UK, National Health Service implementation guidance states that
nurses are expected to promote healthier lifestyle choices from the point of
admission through to discharge.
 Nutrition topic such as nutritional assessment and monitoring, diet therapy,
and enteral and parenteral nutrition have been included in the National
Council Licensure Examination for Registered Nurses.
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 The process of ageing affects nutrition needs and can be associated with
changes in lifestyle. It has been widely recognised for a long-term illness,
such as dementia, that prioritisation of nutrition is extremely important.
 Nurses play a significant role in understanding the importance of nutrition
basics and need to be able to explain the facts about healthy food choices to
patients. Nurses are expected to deliver healthy diet education.
 The Nursing and Midwifery Council, 2010). However, nurses working across
both primary and secondary care have inadequate knowledge in both their
nutrition education and their pivotal role in helping to detect risk factors in
order to improve patients’ health outcomes.
 Nurses must raise awareness of their role in nutritional supports for their
patients and clients. Moreover, interprofessional and collaborative working is
also encouraged to improve patients’ health outcomes.
15. WHAT IS THE CALORIE REQUIREMENT OF PRESCHOOLS? PREPARE A DIET
PLAN FOR THE PRESCHOOLS TO MEET THE REQUIREMENTS.
 Nutritional needs of pre-school children Through parental education, the practice
nurse plays an important role in ensuring the nutritional needs of children are
adequately met, writes Ruth Taylor Nutrition in children of all ages is
instrumental for healthy development in all areas of living physical,
psychological and social well-being.
 A diet inadequate in nutrient dense foods may result in delayed development,
psychomotor delay and behavioural disorders.
 These are all preventable by educating parents and families about basic nutrition.
Nutrition can be defined as what foods the individual consumes and how the
body uses them. Young children should not be regarded as young adults.
 As they are still growing, in order to achieve satisfactory growth children require
larger amounts of nutrients per unit of body weight than adults.
 Therefore, when children are fed foods which contain inadequate amounts of
nutrients, they may fail to grow and develop adequately. 1 Lack of adequate
nutrition will cause failure to gain weight in the short term and in the longer term
will result in small stature.
 Energy Energy requirements for pre-school children increase as the child grows
older: A one year old girl requires 1,165 kcal/day A one year boy needs 1,230
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kcal/day A four year old girl requires 1,545 kcal/day A four year a boy needs
1,715 kcal/day. 2 Fats A low fat diet for children can result in insufficient energy.
Fat is a concentrated source of energy, fat soluble vitamins and essential fatty
acids. Fats also make food more palatable. A diet with adequate amounts of fat
enables children to take in energy in a limited volume of food as they have small
stomachs and cannot eat large volumes
 Phytate, a substance associated with cereal fibre, can bind with and prevent the
efficient absorption of certain minerals such as calcium, phosphorus, iron, copper
and zinc.1 Children who may be eating sufficient amounts of these minerals but
are consuming too much fibre, may actually become deficient in these minerals.
Dietary fibre should be encouraged but not excessively so in small children.
 All pre-school children should have adequate intake of protein and they can eat
meat, dairy produce, eggs, chicken and fish to meet their protein needs.
Sample Menu for a Preschooler
During the preschool years, your child should be eating the same foods as the rest of the family,
with an emphasis on those with nutritional value. This includes fresh vegetables and fruits,
nonfat or low-fat dairy products (milk, yogurt, cheeses), lean meats (chicken, turkey, fish, lean
hamburger), and whole grain cereals and bread. At the same time, limit or eliminate the junk
food in your child's diet, and get rid of sugared beverages as well. See the following sample
menu ideas for a four-year-old child.
1 teaspoon = 1⁄3 tablespoon (5 mL)
1 tablespoon = ½ ounce (15 mL)
1 ounce = 30 mL
1 cup = 8 ounces (240 mL)
Breakfast
 ½ cup nonfat or low-fat milk
 ½ cup cereal
 4–6 oz. or ½ cup cantaloupe or strawberries or banana
Snack
 ½ cup fruit such as melon, banana, or berries
 ½ cup yogurt
Lunch
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 1 sandwich—2 slices whole wheat bread with 1–2 oz. of meat and cheese, veggie and
dressing (if needed) or peanut butter and jelly
 ¼ cup dark-yellow or dark-green vegetable
Snack
 1 teaspoon peanut butter with 1 slice whole wheat bread or 5 crackers or string cheese or
cut-up fruit
Dinner
 2 ounces meat, fish, or chicken
 ½ cup pasta, rice, or potato
 ¼ cup vegetable
If your family would like to include margarine, butter, or salad dressing as a "side" option to any
meal, choose low- fat or healthier versions, if possible, and only give 1 or 2 teaspoons to your
child.
16.WHAT IS THE CALORIE REQUIREMENT OF SCHOOLS AGE CHILD? PREPARE

A DIET PLAN FOR A 5 YEARS OLD SCHOOL CHILD.
NUTRITION SCHOOL AGE CHILDREN
Helpful feeding information for your school-age child

School-age children (ages 6 to 12) need healthy foods and nutritious snacks. They have a steady
but slow rate of growth and usually eat 4 to 5 times a day (with snacks). Many food habits, likes,
and dislikes are set during this time. Family, friends, and the media (chiefly TV) effect their food
choices and eating habits. School-age children are often willing to eat a wider variety of foods
than their younger siblings. Eating healthy after-school snacks is important, too, as these snacks
may contribute up to one-fourth of the total calorie intake for the day. School-age children can
also help with meal prep.
Helpful mealtime hints for school-age children

These are some helpful mealtime hints:
Always serve breakfast, even if it has to be "on the run." Some ideas for a quick, healthy breakfast include:
 Fruit
 Milk
 Bagel
 Cheese toast
 Cereal
 Peanut butter sandwich
 Take advantage of big appetites after school by serving healthy snacks, such as:
 Fruit
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 Vegetables and dip
 Yogurt
 Turkey or chicken sandwich
 Cheese and crackers
 Milk and cereal
 Set good examples for eating habits.
 Let children help with meal planning and preparation.
 Serve meals at the table, instead of in front of the TV, to avoid
distractions.
Healthy food choices

The MyPlate icon is a guideline to help you and your child eat a healthy diet. MyPlate can help
you and your child eat a variety of foods while encouraging the right amount of calories and fat.
The USDA and the U.S. Department of Health and Human Services have prepared the plate to
guide parents in choosing foods for children age 2 and older.
The MyPlate icon is divided into 5 food group categories, emphasizing the nutritional intake of
the following:
 Grains. Foods that are made from wheat, rice, oats, cornmeal, barley, or another cereal
grain are grain products. Examples include whole-wheat, brown rice, and oatmeal. Aim
for mostly whole-grains.
 Vegetables. Vary your vegetables. Choose a variety of colorful vegetables, including
dark green, red, and orange vegetables, legumes (peas and beans), and starchy vegetables.
 Fruits. Any fruit or 100% fruit juice counts as part of the fruit group. Fruits may be fresh,
canned, frozen, or dried, and may be whole, cut up, or pureed. The American Academy
of Pediatrics recommends children age 7 to 18 should limit juice to 8 ounces or 1 cup of
juice per day.
 Dairy. Milk products and many foods made from milk are considered part of this food
group. Focus on fat-free or low-fat products, as well as those that are high in calcium.
 Protein. Go lean on protein. Choose low-fat or lean meats and poultry. Vary your protein
routine. Choose more fish, nuts, seeds, peas, and beans.
 Oils are not a food group, yet some, like nut oils, have vital nutrients and can be included
in the diet. Animal fats are solid fats and should be avoided.
 Exercise and everyday physical activity should also be included with a healthy dietary
plan.
Nutrition and activity tips
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Here are tips to follow:
 Try to control when and where food is eaten by your children by providing regular daily
meal times. Include social interaction and demonstrate healthy eating behaviors.
 Involve children in picking and preparing foods. Teach them to make healthy choices by
giving them a chance to choose healthy foods.
 Select foods with these nutrients possible: calcium, magnesium, potassium, and fiber.
Select foods with these nutrients when possible.
 Most Americans need to cut the number of calories they consume. When it comes to
weight control, calories do count. Controlling portion sizes and eating nonprocessed
foods helps limit calorie intake and increase nutrients.
 Parents are encouraged to provide recommended serving sizes for children.
 Parents are encouraged to limit children’s screen time to less than 2 hours daily. Instead,
encourage activities that call for more movement.
 Children and adolescents need at least 60 minutes of moderate to vigorous physical
activity on most days for good health and fitness and for healthy weight during growth.
 To prevent dehydration, encourage children to drink fluid regularly during physical
activity and to drink several glasses of water or other fluid after the physical activity is
completed.
SAMPLE MEAL PLAN
Here is a sample meal plan by Dr Ambily, Lead Nutritionist, Truweight for
growing children between the age of 5 – 12 years.
 Waking up: A glass of warm low fat milk
 Breakfast: Vegetable egg omelet with onion, tomato, spinach, whole grain bread
slices, one apple
 Mid Morning: Fruit salad with strawberry flavored low-fat yoghurt
 Lunch: Lean chicken- capsicum-onion -zucchini stir fry - whole grain roll, mango
lassi
 Evening: Spinach- mushroom-peas cutlet, a handful of almonds, fresh mixed fruit
juice (Apple Guava, lime)
 Dinner: Whole multigrain phulkas, dal, paneer-peas-mushroom mixed vegetable
curry
 Bed time: A glass of warm low fat milk.
Caution: Dr Kashissh A Chhabriaa feels that one can do away with wheat
completely from a kid’s diet. “It contains gluten which makes intestines sticky and
hard to pass food through them. Many kids are today diagnosed of being gluten
intolerant and it’s better to remove wheat from the diet.
17.DEFINE BALANCED DIET. DISCUSS THE IMPORTANCE OF BALANCED DIET.
A balanced diet supplies the nutrients your body needs to work effectively.
Without balanced nutrition, your body is more prone to disease, infection, fatigue,
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and low performance. Children who don't get enough healthy foods may face growth
and developmental problems, poor academic performance, and frequent infections.
Importance of a Balanced Diet
 Eating a healthy diet is all about feeling great, having more energy, improving
your health, and boosting your mood. Good nutrition, physical activity, and
healthy body weight are essential parts of a person’s overall health and well-
being.
 There’s no questioning the importance of healthy food in your life. Unless you
maintain a proper diet for a healthy body, you may be prone to diseases,
infection, or even exhaustion.
 The importance of nutritious food for children especially needs to be
highlighted since otherwise they may end up being prone to several growth
and developmental problems.
 Some of the most common health problems that arise from lack of a balanced
diet are heart disease, cancer, stroke, and diabetes.
 Being physically active manages many health problems and improves
mental health by reducing stress, depression, and pain. Regular exercise helps
to prevent metabolic syndrome, stroke, high blood pressure, arthritis, and
anxiety.
What falls under a balanced diet?
A balanced diet includes some specific healthy food groups under it:
 Vegetables such as leafy greens, starchy vegetables, legumes like beans and peas, red and
orange vegetables, and others like eggplant
 Fruits that include whole fruits, fresh or frozen fruits but not canned ones dipped in syrup
 Grains such as whole grains and refined grains. For example, quinoa, oats, brown rice,
barley, and buckwheat
 Protein such as lean beef and pork, chicken, fish, beans, peas, and legumes
 Dairy products such as low-fat milk, yogurt, cottage cheese, and soy milk
 A wide variety for the selection of food choices should be from each of five food groups
in the specific amounts recommended. These food sources from each food group provide
a similar amount of key micro and macro-nutrients to meet the body requirements.
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 A balanced diet typically contains 50 to 60 percent carbohydrates, 12 to 20 percent
protein, and 30 percent fat. All the organs and tissues need proper nutrition to work
effectively by consuming the right amount of nutrients and calories to maintain an ideal
weight. The overall health and well-being of a person are dependent on good nutrition,
physical exercise, and healthy body weight.
 A proper meal pattern is a complete combination of food ingredients, food items and
quantities required for breakfast, lunch, snack, and dinner for each specific age group. All
you need is protein for your muscle mass and blood cells which brings oxygen and
nutrients to your muscles.
 The body requires quality carbohydrates, lean protein, essential fats and fluids
accompanied by regular exercise in maintaining physical health and well-being.
 These are effective in preventing excess weight gain or in maintaining weight loss but
healthier lifestyles are also associated with improved sleep and mood. Physical activity
particularly improves brain-related function and outcomes.
18.DISCUSS THE PRINCIPLES AND POINTS TO BE CONSIDERED WHILE
PLANNING BALANCED DIET.
 Eat a variety of different foods. No one food contains all the proteins,
carbohydrates, fats, vitamins and minerals you need for good health, so you
have to eatarangeofdifferentfoods
 Eat staple foods with every meal. Staple foods should make up the largest
part of a meal. These foods are relatively cheap and supply a good amount
of carbohydrates and some proteins. Staples include cereals (such as rice,
maize, millet, wheat and oats), pulses (such as lentils, beans, chick peas and
barley) and starchy roots (such as potatoes and cassava). Unrefined staples
like whole grains, brown unpolished rice, millet, barley and potatoes provide
more sustained energy over a longer period of time and are also a good source
of protein and a wide range of vitamins and minerals. Refined foods like white
rice and white flour have much less nutrientsandfibre.
 Eat legumes every day. These foods provide a person with
the proteins needed to develop and repair the body and also to build up strong
muscles. They are good sources of vitamins, minerals and fibre and help to
keep the immune system active. Legumes include beans, peas, lentils,
groundnuts (including peanut butter) and soybeans. When eaten with staple
foods the quality of protein is increased. Legumes are a cheaper protein source
than animal foods, such as beef and chicken, and should
beeateneveryday,ifpossible.
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 Eat vegetables and/or fruits every day. Vegetables and fruits are an
important part of a healthy and balanced meal. They supply the vitamins and
minerals that keep the body functioning and the immune system strong. Eat a
wide variety as each one providesdifferent vitamins, minerals anddietary fibre.
 Use little fats and sugar. Fats, oils and sugars are good sources of energy and
play an important part in a healthy and balanced diet. Even small amounts can
provide lots of energy. Fats include butter, lard, margarine, cooking oil
(vegetable, coconut and palm oil) and coconut cream. They are also found in
avocados, oilseeds (sunflower, groundnut and sesame), fatty meat and fish,
curds and cheese.
 Eat animal and milk products regularly. Foods from animals and fish
should also be eaten as often as you can afford them but not in excess as they
interfere with the cholesterol level. They supply good-quality proteins,
vitamins and minerals and extra energyThese foods include all forms of meat,
poultry (birds), fish, eggs and dairy products such as milk, sour milk,
buttermilk, yoghurt and cheese. If insects, such as caterpillars or grasshoppers,
are part of your diet, they also provide good nutrients.
 Eat the right amount of food to keep a healthy weight and exercise
regularly. The correct amount of food for an individual will depend on sex,
height, age and lifestyle as well as other factors. Choose foods that provide
lots of nourishment but are low in fat.
Points to be considered while planning a balanced diet
1. Consider nutritional needs
2. Include seasonal foods
3. Include all five food groups for diningin a day
4. Should be cost effective
5. Attractive, colorful, variety etc.
19. DISCUSS THE DIETARY GOALS AND GUIDELINES FOR CALCULATING
INDIVIDUAL NUTRIENTS.
Dietary goals
 Maintenance of a state of positive health and optimal performance in populations

at large by maintaining ideal body weight.
 Ensuring adequate nutritional status for pregnant women and lactating mothers.
 Improvement of birth weights and promotion of growth of infants, children and

adolescents to achieve their full genetic potential.
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 Achievement of adequacy in all nutrients and prevention of deficiency diseases.
 Prevention of chronic diet-related disorders.
 Maintenance of the health of the elderly and increasing the life expectancy.
Dietary Guidelines
1. Eat variety of foods to ensure a balanced diet.

2. Ensure provision of extra food and healthcare to pregnant and lactating women.
3. Promote exclusive breastfeeding for six months and encourage breastfeeding till two
years or as long as one can.
4. Feed home based semi solid foods to the infant after six months.
5. Ensure adequate and appropriate diets for children and adolescents, both in health and
sickness.
6. Eat plenty of vegetables and fruits.
7. Ensure moderate use of edible oils and animal foods and very less use of ghee/ butter/
vanaspati.
8. Avoid overeating to prevent overweight and obesity.
9. Exercise regularly and be physically active to maintain ideal body weight.
10. Restrict salt intake to minimum.
11. Ensure the use of safe and clean foods.
12. Adopt right pre-cooking processes and appropriate cooking methods.
13. Drink plenty of water and take beverages in moderation.
14. Minimize the use of processed foods rich in salt, sugar and fats.
15. Include micronutrient-rich foods in the diets of elderly people to enable them to be fit and
active
20.DISCUSS THE NUTRITIONAL REQUIREMENTS OF INFANT. DISCUSS

VARIOUS PRINCIPLES OF WEANING.
Infant nutrition is the description of the dietary needs of infants. A diet lacking
essential calories, minerals, vitamins, or fluids is considered inadequate. Breast milk
provides the best nutrition for these vital first months of growth when compared to
infant formula. For example, breastfeeding aids in preventing anemia, obesity, and
sudden infant death syndrome; and it promotes digestive health, immunity,
intelligence, and dental development. The American Academy of Pediatrics
recommends exclusively feeding an infant breast milk, or iron fortified formula, for
the first six months of life and continuing for one year or longer as desired by infant
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and mother. Infants are usually not introduced to solid foods until four to six months
of age.
Proper infant nutrition demands providing essential substances that support normal
growth, functioning, development, and resistance to infections and diseases. Optimal
nutrition can be achieved by the expectant mother making the decision to breastfeed
or bottle-feed the infant before birth and preparing for chosen decision.[2]
Birth to six months
The World Health Organization (WHO) and the Pan American Health
Organization currently recommend feeding infants only breast milk for the first six
months of life. If the baby is being fed infant formula, it must be iron-enriched. An
infant that receives exclusively breast milk for the first six months rarely needs
additional vitamins or minerals. However, vitamins D and B12 may be needed if the
breastfeeding mother does not have a proper intake of these vitamins.
Using formula
This form of nutrition may be used instead of breast milk due to lifestyle choices or
the fact that women cannot breastfeed. Formula provides all the nutrition needed for a
baby to thrive and grow.
WEANING PRINCIPLES
 Weaning means accustoming the child to alternative foods in place of breast
milk or formula foods. After about 4-6 months of age, breast milk is
insufficient to meet with the caloric as well as nutritive requirements of the
child. Hence it has to be supplemented with food from outside.
 Weaning is the first step in the development of a diet pattern of the child and
has far reaching consequences in defining the food habits in the future.
Successful weaning is an essential step in the overall growth and development
of the child.
 Weaning should be done gradually and with maximum comfort of the mother
and the baby. Readiness is the key, at the same time voluntary efforts are
needed to achieve it. One food item should be introduced at a time. Cereals,
vegetables, fruit, eggs, dairy and lastly poultry and fish, is the sequence in
which foods should be introduced. Foods rejected once should be reintroduced
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after a while. A balance of carbohydrates, proteins, fats, fibre and water is
needed to prevent problems due to weaning.
 Force feeding, anxiety and punishment are to be avoided completely. Rather,
the child should be encouraged to participate in self feeding with lots of
praise, cuddling and positive reinforcement.
 The common problems encountered are resistance to weaning by the child,
poor intake, moods, rejection of food, vomiting, diarrhea or constipation,
disturbances of digestion, colic, nutritional deficiencies, growth failure,
anaemia, infections and allergies. A patient approach is needed to tackle these
problems and to get to the goal.
 Homoeopathy helps greatly in treating problems in this crucial phase of
development of the child. Right from emotional reactions to infections and
allergies, homoeopathy has answer to all. Homoeopathy treats every child
distinctly, and provides holistic solutions to the problems.
21.EXPLAIN VARIOUS FACTORS TO BE CONSIDERED WHILE PLANNING
BALANCED DIET.
Factors affecting food and nutrition
The following factors affects food and nutrition
 Basal metabolic rate
 Weight
 Age
 Sex
 Climate and environment
 Physical activities
 Physiological state
 Socio economic factors
 Cultural factors
 Life style and food habits
 Food fads
 Cooking practices
 Child rearing practices
 Religion
 Traditional factors
 Food production and distribution.
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Variety of foods essential for a balanced diet
 Nutrition is a basic prerequisite to sustain life.
 Variety in food is not only the spice of life but also the essence of nutrition and health.
 A diet consisting of several food groups provides all the required nutrients in proper
amounts.
 Cereals, millets and pulses are major sources of most nutrients.
 Milk which provides good quality proteins and calcium must be an essential item of the
diet, particularly for infants, children and women.
 Oils and nuts are calorie-rich foods, and are useful for increasing the energy density.
 Inclusion of eggs, flesh foods and fish enhances the quality of diet. However, vegetarians
can derive almost all the nutrients on cereal/pulse/milk-based diets.
 Vegetables and fruits provide protective substances such as vitamins / minerals /
phytonutrients.
 Choose a variety of foods in amounts appropriate for age, gender, physiological status
and physical activity.
 Use a combination of whole grains, grams and greens. Include jaggery or sugar and
cooking oils to bridge the calorie or energy gap.
 Prefer fresh, locally available vegetables and fruits in plenty.
 Include in the diets, foods of animal origin such as milk, eggs and meat, particularly for
pregnant and lactating women and children.
 Adults should choose low-fat, protein-rich foods such as lean meat, fish, pulses and low-
fat milk
22.DEFINE MENU PLANNING. MENTION THE PRINCIPLES OF MEAL PLANNING.
Menu planning is the process of deciding what you will eat for each meal, including
main dishes, side dishes, and desserts. It also entails knowing how many meals to
plan for and when to serve them. Daily activities and scheduling variations may
complicate the menu planning process. Knowing what types of foods can be prepared
according to the activities and schedules for a particular day is an important part of
meal planning.
Basic Principles of Menu Planning
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Careful menu planning is a fundamental process for successful child care food service
programs. Making an effort to plan menus saves time and money; you
increase efficiency, streamline ordering, and ensure that menus are in compliance
with CACFP for meal reimbursement. Menu planning also allows for nutritionally
adequate, balanced meals to be served to the children in your facility.
Basic menu planning principles include:
1. Strive for balance. Menus should balance important nutrients like protein, carbohydrate,
fiber, vitamins, and minerals with fat and sodium. Menus should also balance flavors so
that menus are not too spicy or too bland.
2. Emphasize variety. Including a variety of foods not only helps ensure adequate nutrient
intake, but also keep menus interesting and appealing. Include different forms of foods
and vary how they are served from day to day.
3. Add contrast. A daily menu should offer contrasting textures, flavors, and colors. For
instance, you would not want to serve a breakfast of oatmeal, applesauce, and milk to
older children because they are all “soft” foods and do not include varying textures.
4. Consider color. Use combinations of colors that go well together. A good practice is to
include at least two different colors in each meal.
5. Create eye appeal. Foods should look inviting and enticing when they are served to
encourage consumption.
23.WHAT IS THERAPEUTIC DIET? ENUMERATE VARIOUS PRINCIPLES OF
THERAPEUTIC DIET.
Therapeutic diet refers to a meal plan that controls the intake of certain foods or
nutrients. They are adaptation of the normal, regular diet. Some common examples
of therapeutic diets Page 3 3 include clear liquid diet, diabetic diet, renal diet,
gluten free diet, low fat diet, high fibre diet etc.
PRINCIPLES OF THERAPEUTIC DIET
A well planned diet providing all the specific nutrients to the body helps to achieve
nutritional homeostasis in a normal, healthy individual. However, in disease
conditions, the body tissues either do not receive proper nutrients in sufficient
amounts or cannot utilize the available nutrients owing to faulty digestion, absorption
or transportation of food elements, thus affecting the nutritional homeostasis of the
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sick person. The diet, therefore needs to be suitably modified. However, it is
imperative that the basis for planning such modified diets should be the normal diet.
Principles
 To maintain good nutritional status
 To correct deficiencies
 To afford rest to the body
 To metabolize the nutrients
 To make changes in body weight when necessary
Purpose of therapeutic diets
 Regulate amount of food Assist body organs to maintain normal function Aid
in digestion
 To improve specific health conditions Increase or decrease body weight
Modify the intervals of feedings
24.ENUMERATE DIFFERENT TYPES OF THERAPEUTIC DIET AND USE OF
NATUROPATHY DIET IN MAINTAINING HEALTH.
Types of Therapeutic Diets A therapeutic diet is a meal plan that controls the intake of certain
foods or nutrients. It is part of the treatment of a medical condition and are normally prescribed
by a physician and planned by a dietician. A therapeutic diet is usually a modification of a
regular diet. It is modified or tailored to fit the nutrition needs of a particular person. Therapeutic
diets are modified for
(1) Nutrients,
(2) Texture, and/or
(3) Food allergies or food intolerances.
Common reasons therapeutic diets may be ordered:
• To maintain nutritional status
• To restore nutritional status • To correct nutritional status
• To decrease calories for weight control
• To provide extra calories for weight gain
• To balance amounts of carbohydrates, fat and protein for control of diabetes
• To provide a greater amount of a nutrient such as protein
• To decrease the amount of a nutrient such as sodium
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• To exclude foods due to allergies or food intolerance
• To provide texture modifications due to problems with chewing and/or swallowing Common
therapeutic diets include:
Nutrient modifications
o No concentrated sweets diet
o Diabetic diets • No added salt diet
o Low sodium diet
o Low fat diet and/or low cholesterol diet
o High fiber diet
o Renal diet
 Texture modification
o Mechanical soft die
o Puree diet
3.Food allergy or food intolerance modification
o Food allergy
o Food intolerance
o Tube feedings
o Liquid tube feedings in place of meals
o Liquid tube feedings in addition to meals
4.Additional feedings – In addition to meal, extra nutrition may be ordered as:
o Supplements – usually ordered as liquid nutritional shakes once, twice or three
times per day; given either with meals or between meals
o Nourishments – ordered as a snack food or beverage items to be given between
meals mid-morning and/or mid-afternoon
o HS snack – ordered as a snack food or beverage items to be given at the hour of
sleep.
Uses of naturopathy
The main features of Naturopathy are:
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1. All diseases, their causes and treatment are one. Except for traumatic and environmental
conditions, the cause of all diseases is one i.e. accumulation of morbid matter in the body.
The treatment of all diseases is elimination of morbid matter from the body.
2. The primary cause of disease is accumulation of morbid matter. Bacteria and virus enter
and survive in the body only after the accumulation of morbid matter when a favourable
atmosphere for their growth is established in body. Hence, the basic cause of disease is
morbid matter and bacteria secondary causes.
3. Acute diseases are self-healing efforts of the body. Hence, they are our friends, not the
enemy. Chronic diseases are outcome of wrong treatment and suppression of the acute
diseases.
4. Nature is the greatest healer. The human body itself has the healing power to prevent
itself from disease and regain health if unhealthy.
5. In Nature Cure it is not the disease but the entire body of the patient which is caused and
is renewed.
6. Naturopathy Cures Patients suffering from chronic ailments are also treated successfully
in comparatively less time by Naturopathy.
7. In Nature Cure the suppressed diseases are brought to surface and are removed
permanently.
8. Naturopathy treats all the aspects like physical, mental, social and spiritual at the same
time.
9. Naturopathy treats the body as a whole.
10. According to Naturopathy, “Food is only the Medicine”, no external medications are
used.
11. Performing prayer according to one’s spiritual faith is an important part of treatment
II. SHORT ESSAY

1. What are the different food groups.
Foods from the basic food groups provide the nutrients essential for life and growth.
These foods are also known as ‘everyday foods’. Each of the food groups provides a
range of nutrients, and all have a role in helping the body function. In particular,
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vegetables, legumes and fruit protect against illness and are essential to a healthy diet.
The basic food groups are:

 breads, cereals, rice, pasta, noodles and other grains
Breads, cereals, rice, pasta, noodles and other grain-based foods provide carbohydrates,
which the body uses for energy. The best choices from this group are wholemeal and
wholegrain breads, cereals and savoury biscuits. Other good choices include brown rice,
couscous, wholegrain pasta and polenta.
 vegetables and legumes
Fruit and vegetables provide vitamins, minerals and fibre, and should be included in
meals and snacks each day. Choose a variety of fruits, vegetable and legumes (including
different colours, textures and flavours) to provide a wide range of vitamins and minerals.
Milk, yoghurt, cheese and/or alternatives Plain milk, cheese and yoghurt are the most
common dairy foods, and main dietary sources of calcium. Having enough calcium is
important for healthy bones and teeth.
 Fruit ,Vegetables, legumes and fruit
 Fruit and vegetables provide vitamins, minerals and fibre, and should be included in
meals and snacks each day. Choose a variety of fruits, vegetables
and legumes (including different colours, textures and flavours) to provide a wide range
of vitamins and minerals.
 milk, yoghurt, cheese and/or alternatives
Milk, yoghurt, cheese and/or alternatives Plain milk, cheese and yoghurt are the most
common dairy foods, and main dietary sources of calcium. Having enough calcium is
importantforhealthybonesandteeth.
Milk is not recommended for babies under 12 months, but small amounts in breakfast
cereal, and other dairy products such as yoghurt, custard and cheese, can be given after
nine months. Full-cream plain milk is recommended for children aged one to two years,
and reduced-fat plain milk is suitable for children over the age of two years. If children do
not drink cow’s milk, or eat cow’s milk products, they can have a calcium-fortified soy
drink instead. Rice and oat milks are not recommended and should only be given to
children after medical advice.
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 lean meat, fish, poultry, eggs, nuts and legumes.
This group includes red meat (such as beef, lamb and kangaroo), white meat (such as
pork, chicken and turkey), fish and eggs. Non-animal products in this group include nuts,
legumes and tofu. Meat and its alternatives are rich in protein, iron and zinc, and essential
for children’s growth and development. It is best to choose lean meat and skinless poultry
to ensure children’s diets do not contain too much fat.
2. Define exclusive Breast feeding and advantages of Breast feeding
Exclusive breastfeeding is defined as feeding infants only breast milk, be it directly
from breast or expressed, except drops or syrups consisting of vitamins, mineral
supplements or medicine. Exclusive breastfeeding is one of the essential actions for
infant development and survival.
The Advantages of Breastfeeding
There are many benefits to breastfeeding for both mother and child. Breastfeeding is the
most natural way to feed your baby. Your body was created as the ideal way to supply
your child with the perfect source of nutrition. Here are some of the top reasons to nurse
your infant.
Breast Milk Is the Healthiest Food for Your Child
Breastfeeding provides your baby with a variety of health and developmental benefits.
The natural ingredients found in breast milk help protect your baby from illness and
disease during infancy. They also continue to provide your child with better health as
they grow, even after weaning.
Breastfeeding Is Good For Your Health
Women who breastfeed tend to recover from childbirth faster than women who choose
not to nurse their babies. Breastfeeding may reduce your risk of ovarian and breast
cancer. It may also decrease your chances of developing rheumatoid arthritis, diabetes,
hypertension, and cardiovascular disease as you age.
Breast Milk Tastes Good to Your Child
Breast milk is sweet and creamy, a flavor that is much different and, arguably, better than
formula. Also, the taste of the foods you eat is passed along to your baby, which can
diversify their diet right from the start.
Breastfeeding Is Convenient
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Your breasts are the perfect way to supply your baby with optimal nutrition at the perfect
temperature. There's no need to worry about preparing and heating formula, and there
aren't any bottles to clean up after feedings.
Breastfeeding Is Economical
Breastfeeding can save you thousands of dollars. If you exclusively nurse your baby, you
will not need to buy formula, bottles, and supplies. Breastfeeding also helps keep your
child healthier, which can lower medical costs and reduce the amount of work you miss
to care for a sick baby.
Nigh ttime Feedings Are Faster and Easier
When you breastfeed, you don't have to make and warm bottles in the middle of the
night. Breastfeeding can also be relaxing for you. While you're breastfeeding, your body
releases a hormone called oxytocin, a feel-good hormone that promotes relaxation. It also
provides you with time each day to take a break, sit down with your feet up, and spend
quality time with your baby.
3. Define weaning and explain the principles of weaning
 Definition of waning
The definition of waning in the dictionary is to act of showing a gradually
decreasing portion of illuminated surface, between full moon and new moon.
Other definition of waning is the act of decreasing gradually in size, strength,
power, etc.
 Weaning means accustoming the child to alternative foods in place of breast milk
or formula foods. After about 4-6 months of age, breast milk is insufficient to
meet with the caloric as well as nutritive requirements of the child. Hence it has to
be supplemented with food from outside.
 Weaning is the first step in the development of a diet pattern of the child and has
far reaching consequences in defining the food habits in the future. Successful
weaning is an essential step in the overall growth and development of the child.
 Weaning should be done gradually and with maximum comfort of the mother and
the baby. Readiness is the key, at the same time voluntary efforts are needed to
achieve it. One food item should be introduced at a time. Cereals, vegetables,
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fruit, eggs, dairy and lastly poultry and fish, is the sequence in which foods should
be introduced.
 Force feeding, anxiety and punishment are to be avoided completely. Rather, the
child should be encouraged to participate in self feeding with lots of praise,
cuddling and positive reinforcement.
 The common problems encountered are resistance to weaning by the child, poor
intake, moods, rejection of food, vomiting, diarrhea or constipation, disturbances
of digestion, colic, nutritional deficiencies, growth failure, anaemia, infections
and allergies. A patient approach is needed to tackle these problems and to get to
the goal.
 Homoeopathy helps greatly in treating problems in this crucial phase of
development of the child. Right from emotional reactions to infections and
allergies, homoeopathy has answer to all.. Homeopathic medicines are safe and
without any side effects, which make them best suited for long term use to tide
over multiple problems during weaning.
4. What is colostrum?. Explain the advantages of breast feeding
Colostrum is the first form of milk produced by the mammary glands of mammals
immediately following delivery of the newborn. Most species will begin to generate
colostrum just prior to giving birth.
Advantages of breast feeding
The Advantages of Breastfeeding
There are many benefits to breastfeeding for both mother and child. Breastfeeding is the
most natural way to feed your baby. Your body was created as the ideal way to supply
your child with the perfect source of nutrition. Here are some of the top reasons to nurse
your infant.
Breast Milk Is the Healthiest Food for Your Child
Breastfeeding provides your baby with a variety of health and developmental benefits.
The natural ingredients found in breast milk help protect your baby from illness and
disease during infancy. They also continue to provide your child with better health as
they grow, even after weaning.
Breastfeeding Is Good For Your Health
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Women who breastfeed tend to recover from childbirth faster than women who choose
not to nurse their babies. Breastfeeding may reduce your risk of ovarian and breast
cancer. It may also decrease your chances of developing rheumatoid arthritis, diabetes,
hypertension, and cardiovascular disease as you age.
Breast Milk Tastes Good to Your Child
Breast milk is sweet and creamy, a flavor that is much different and, arguably, better than
formula. Also, the taste of the foods you eat is passed along to your baby, which can
diversify their diet right from the start.
Breastfeeding Is Convenient
Your breasts are the perfect way to supply your baby with optimal nutrition at the perfect
temperature. There's no need to worry about preparing and heating formula, and there
aren't any bottles to clean up after feedings.
5. How does economic status and food budget of the family affect menu planning?
Many factors influence the acceptability of a meal. Customers select what appeals most
to them from a menu card based on individual likes and dislikes, budget, the popularity of
items, etc.
However, while planning meals the following factors need to be considered:
The most important consideration in menu planning is to ensure that the meal fulfills the
nutrient needs of the individual consuming the meal. For example, if the meal is planned
for industrial workers, it must meet the RDAs for that age group. Foods from all basic
food groups should be included in each meal so that the meal is balanced and
diets).
The spending power of the clientele has to be kept in mind and meals have to be planned
within the budget. Low-cost nutritious substitutes should be included in the menu to keep
the costs low. The food cost should be maintained if the organization has to run
profitably.
Food Service
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Menus should be planned concerning the type of food service, whether it is a cafeteria,
seated service, buffet, etc.
The menu should be planned, keeping the available equipment and workspace in mind.
Deep freezers, refrigerators, grinders, dough kneaders, deep fat fryers, boilers, etc. should
be adequate.
Leftover Food
Food Habits
Food habits of the customer is another important criteria which need to be considered as
food served has to be acceptable to the customer. Special attention should be paid when a
particular type of community is catered to. Religious considerations should be known to
the meal planner.
Availability
quality is better. Today, practically all fruits and vegetables are available throughout the
year because of advanced preservation technology. However, seasonal fruits and
vegetables should be given preference. Regional availability influences menu planning.
For example, fish and seafood are fresh and cheaper in coastal areas.
The meal timings and number of meals consumed in a day, whether meals are packed or
served at the table, also influences the selection of food items on the menu. The age,
activity level, physiological state, work schedule, and economic factors need to be known
before planning meals for institutional catering.
Variety
This is one of the most important considerations while planning meals. A variety of foods
from different food groups should be included.
 Variety in food ingredients
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 Variety in recipe
 Method of cooking
 Colour, texture, and flavour
 Variety in presentation and garnish.
6. Define diet consistency. Classify diets based on consistency.
Definition of diet consistency
Foods like puddings and gravies need to be the correct consistency — that is, the right
thickness or texture — for the dish. It would not be good, for example, for gravy to have
the consistency of cottage cheese. The noun consistency also refers to uniformity or
compatibility between things or parts.
It is important to understand the names and differences between the different "Types of
Diets" there are in regards to food consistency to best understand
Solids:
There are different textures of foods and liquids that can make it easier and safer for a
person to swallow. These textures make it easier to chew and move food in the mouth
and reduce the risk of food or liquid going into the windpipe or trachea, which leads to
the lungs
 Thin puree: Food is smooth, moist, and pourable texture
o Ex: smoothie, ice cream, apple sauce
 Thick puree: Food that has a moist, thick puree texture. It does not need chewing. It will
hold its shape on a plate. Food must be an even consistency with no lumps.
o Ex: yogurt (without fruit chunks), pureed meats, pureed vegetables, baby foods
 Pre-mashed: Food that is soft, tender, and moist and needs very little chewing. It has
been mashed. It usually needs a very thick smooth sauce or gravy
o Ex: mashed potatoes, mashed bananas, mashed avocado
 Fork mashable: Food is tender and moist but needs some chewing. Food can be easily
mashed with a fork. It usually needs a thick smooth sauce or gravy
o Ex: banana, avocado, cooked carrots, canned tuna, soft meats
 Mechanical soft: Food is soft, and easy to chew and swallow.
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o Ex: Ground cooked chicken, turkey, beef or pork, thinly shaved deli meats, eggs,
soft cooked vegetables (without seeds or skins, and chopped into small pieces),
bread
 Regular: Food that is hard to chew and requires jaw strength to chew.
o Ex: Tough, chewy meat, poultry or fish, foods with chewy skins (fried),
nuts/seeds, dried fruits or fruits with skins, raw vegetables, crunchy foods
(pretzels, chips)
Liquids:
There are different thickened consistencies for liquids that will be recommended by a
Speech Language Pathologist for a person who is having difficulty swallowing liquids.
Drinking thickened liquids can help prevent choking and stop fluid from entering the
lungs.
 Thin: regular liquids with no thickener added
 Nectar: liquids that are easily pourable and are comparable to apricot nectar or thicker
cream soups.
 Honey: liquids that are slightly thicker, are less pourable, and drizzle from a cup or bowl.
 Pudding: liquids that hold their own shape. They are not pourable and are usually eaten
with a spoon.
7. Discuss various special feeding methods.
1.Tube Feeding:
This is done by passing a tube into the stomach or duodenum through nose which is
nasogastric feeding. Into the stomach it is termed as gastrostomy, or into the intestine
where is termed as enterostomy, or into the jejunum where is termed as jejunostomy.
2. Parenteral Feeding:
There are numerous occasions when it is desirable for a hospitalized patient to be given
nutrients parenterally. This gives special attention to the provision of energy nutrients by
peripheral or central vein.
3. Total Parenteral Nutrition [TPN]:
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The most sophisticated method of nutritional support is the total parenteral nutrition
[TPN]. It involves feeding the patients with sterile solution or glucose, amino acids, and
micro-nutrients usually via an indwelling catheter inserted into the large central vein (i.e.
superior vena cava). TPN entails either continuous infusion of nutrient solution round the
clock or in a cyclic pattern of infusion in which there is set period of time.
4. Enteral Nutrition Delivery System:
The enteral nutrition is utilized when the patient cannot or will not take in adequate oral
nutrients. Enteral route is preferred to parenteral nutrition as the later involves invasive
procedures which are more expensive, painful and may cause local or systemic infections
and sepsis.
Gastrostomy:
This procedure is frequently used in patients with mechanical or functional obstructing
lesions of head, neck or esophagus or in neurologically impaired patients. Potential
complications of gastrostomy include bleeding, leakage of gastric contents of feeding
formula into the peritoneal cavity, tube dislodgement, skin erosion and wound infection
leading to bowel obstruction. Immobility of the patient may lead to pulmonary
complications.
Jejunostomy:
Intrajejunal feeding eliminates the problem of gastric over load, reflux vomiting and
aspiration associated with gastric feeding.
8. Explain role of nurse in balanced diet.
Nurse educates about healthy and balanced diet to the peoples.
2. Gives knowledge about recommendations required by different age and gender groups.
3. Educated about best and easy ways to achieve good nutritious diet.
4. Managing easy nutrients from locally available foods
5. Education about the Menu planning.
Hospitals
9. Nurse working in different wards of hospital are very vigilant in maintaining adequate nutrition
levels for the client admitted.
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1. In hospital nurse has to take care of nutritional aspects of the admitted client in ward.
2. Educates the client as well as family members regarding the importance of the healthy
and nutritious diet.
3. Nurse maintains the adequate diet plans for the client.
4. Helps in monitoring the conditions of the client like vomiting, input-output, electrolyte
monitoring, in order to add different components in the diet.
5. Maintaining parental nutrition for the client.
6. Maintenance of adequate hydration.
Community
10. In community nurse focuses on the prevention aspect i.e. helps in giving the basic education
regarding prevention of certain nutritional deficiency disease. At the community level the nurse
can act as:
1. Community health nurse.
2. School health nurse.
And work in different sectors where she mainly works at grass root levels to correct the
nutritional deficiencies in the client.
1. Nurse rectifies the different patterns of the nutrition opted by the people.
2. Nurse collaborates with government and non-govt. agencies working for nutritional
betterment of public sectors.
3. Nurse plays a role in school health programs as school health nurse, helps in
identification of malnourished children and maintains growth charts.
4. Involvement of family.
11. What are the factors affecting menu planning.
The most important consideration in menu planning is to ensure that the meal fulfills the
nutrient needs of the individual consuming the meal. For example, if the meal is planned
for industrial workers, it must meet the RDAs for that age group. Foods from all basic
food groups should be included in each meal so that the meal is balanced and
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diets).
The spending power of the clientele has to be kept in mind and meals have to be planned
within the budget. Low-cost nutritious substitutes should be included in the menu to keep
the costs low. The food cost should be maintained if the organization has to run
profitably.
Food Service
Menus should be planned concerning the type of food service, whether it is a cafeteria,
seated service, buffet, etc.
The menu should be planned, keeping the available equipment and workspace in mind.
Deep freezers, refrigerators, grinders, dough kneaders, deep fat fryers, boilers, etc. should
be adequate.
Leftover Food
Food Habits
Food habits of the customer is another important criteria which need to be considered as
food served has to be acceptable to the customer. Special attention should be paid when a
particular type of community is catered to. Religious considerations should be known to
the meal planner.
Availability
quality is better. Today, practically all fruits and vegetables are available throughout the
year because of advanced preservation technology. However, seasonal fruits and
vegetables should be given preference. Regional availability influences menu planning.
For example, fish and seafood are fresh and cheaper in coastal areas.
160
The meal timings and number of meals consumed in a day, whether meals are packed or
served at the table, also influences the selection of food items on the menu. The age,
activity level, physiological state, work schedule, and economic factors need to be known
before planning meals for institutional catering.
Variety
This is one of the most important considerations while planning meals. A variety of foods
from different food groups should be included.
 Variety in food ingredients
 Variety in recipe
 Method of cooking
 Colour, texture, and flavour
 Variety in presentation and garnish.
12. Prepare diet plan for a schooler
Eat a good breakfast. Studies show that skipping breakfast detracts from

scholastic achievement. When there isn’t time to sit down and enjoy your morning
meal, grab a bagel, piece of fruit and some juice. Most of these items can be easily
stored in your residence hall room.
If you must eat fast foods, choose wisely. Choose pizza with half the cheese, a
regular size roast beef sandwich, baked potato or green salad with reduced calorie
dressing. Limit high fat offerings like French fries, fried chicken or fish
sandwiches.
Keep healthy snacks on hand. This way, if hunger strikes during a late night
study session, you won’t be tempted by vending machine candy, chips or ice
cream. Possibilities include fresh or dried fruit, pretzels, unbuttered popcorn, rice
cakes or whole wheat crackers. If you have a refrigerator, consider raw vegetables
with low-fat yogurt or cottage cheese dip
Eat plenty of foods rich in calcium. People in their early twenties need to be
building up stores of calcium in their bodies to prevent osteoporosis later in life. If
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you don’t like milk, try to include ample amounts of low-fat yogurt, low-fat cheese
and green leafy vegetables in your diet.
If you need to lose weight, do it sensibly. Starvation and/or diets that offer a
quick fix usually backfire and are harmful. There is no truth to the theories that
suggest eating foods in any particular combination will promote weight loss. The
only safe way to lose weight, feel good while doing it, and keep it off, is to eat a
balanced diet and exercise.
Limit your sugar intake – Sugar provides calories in your diet but few other
nutrients, and it contributes significantly to tooth decay. Use it sparingly and
consider sweetening coffee, tea, cereal, and fruit with diet sweeteners instead.
Visit the dining hall salad bar. The dining hall salad bar can be either an asset or
a detriment to your diet depending on how you choose from it. Of course, leafy
greens, raw vegetables, and fresh fruits are beneficial. But, if you choose a lot of
creamy dressings, bacon bits and mayonnaise-based salads, the calories and fat
may equal or even exceed those of a burger and fries—so choose wisely!
Limit your alcohol intake. If you drink alcohol, keep in mind that it supplies
calories but no nutritional value. A light beer, a glass of wine or an ounce of liquor
each has about 100 calories. There may also be health problems associated with
drinking alcohol.
Drink lots of water. Your body needs at least eight glasses a day, and, if you
exercise vigorously, you may need more. To remind yourself, carry a water bottle
along to class and keep it handy during late night study sessions.
Enjoy your food. Food is a lot more than nourishment for our bodies, so take the
time to enjoy and savor it!
13. What are objectives of planning a menu to an infant?

 Meal Planning for the Infant It is clear that the nutrient requirement is
considerably high during infancy. The crucial aspect to consider then is how to
meet these requirements. What are the foods that should be given to the infant that
would help meet the requirement?
 It is the best food for the baby. But after four to six months, breast milk alone is
not sufficient to ncet the growing needs of the infant. Certain other foods need to
be provided along Meal PlaMiDg for tbe Mmt .ad Rcscbder with breast milk so as
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to supplement the shortfall in the nutrients. This process of introducing foods
other than breast milk in the diet of the infant ir called supplementary feeding.
 It is also referred to as weaning. Supplementary feeding is a gradual process
which begins from the moment pther foods(1iquid food preparations and solid
food preparations) are started and continues till the time the child is completely
taken off the breast.
 Any food other than breast milk given to the infant is referred to as a supplement
or supplementary food. But what are supplementary foods that can be given to the
infant? What is the right age to introduce these supplementary foods? Which food
would be easily accepted and tolerated by the infant? How much of these foods
should be given? You will find the answer to these questions in this section.
The specific considerations
One should keep in mind in addition to those mentioned in- I the margin are discussed
below:
 Whom are we planning for?
 What is the stage of infancy - 0-4 months, 4-6 months, 6-8 months or 9-12
months?
 What is the expected body weight of the infant at that particular age? T
 What is the income level of the family to which the infant belongs?
 Where does the infant live (region)?
 Information on these aspects will help you decide on the RDIs and kind and
amount of food to be served to the infant. Based on the information first list the
RDIs for the infant. Which are the nutrients of particular importance? The need
for the following nutrients is considerable during infancy.
14. What are factors promoting adequate supply of breast milk.
. Breastfeed more often
Breastfeed often and let your baby decide when to stop feeding.
When your baby suckles your breast, hormones that trigger your breasts to produce milk
are released. That’s the “let-down” reflex. The let-down reflex is when muscles in your
breasts contract and move the milk through the ducts, which happens shortly after your
baby begins breastfeeding. The more you breastfeed, the more milk your breasts make.
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Breastfeeding your new baby 8 to 12 times a day can help establish and maintain milk
production. But this doesn’t mean that more or fewer feedings indicates a problem.
2. Pump between feedings
Pumping between feedings can also help you increase milk production. Warming your
breasts before pumping can help make you more comfortable and pump easier, too.
Try pumping whenever:
 You have milk left over after a feeding.
 Your baby has missed a feeding.
 Your baby gets a bottle of breast milk or formula
3. Breastfeed from both sides
Have your baby feed from both breasts at each feeding. Let your baby feed from the first
breast until they slow down or stop feeding before offering the second breast. The
stimulation of having both breasts breastfed from can help increase milk production.
Pumping milk from both breasts simultaneously has also been foundTrusted Source to
increase milk production and result in a higher fat content in the milk.
4. Lactation cookies
You can find lactation cookies in stores and online on Amazon or you can make your
own. While there’s no research available on lactation cookies specifically, some of the
ingredients have been linked to an increase in breast milk. These foods and herbs contain
galactagogues, which may promote lactationTrusted Source. More research is needed,
though.
Some of these include:
 whole oats
 wheat germ
 brewer’s yeast
 flaxseed meal
Easy lactation cookie recipe
Ingredients
 2 cups white flour
 2 cups oats
 1 tbsp. wheat germ
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 1/4 cup brewers’ yeast
 2 tbsp. flaxseed meal
 1 cup butter, softened
 3 egg yolks
 1/2 cup white sugar
 1/2 cup brown sugar
 1/4 cup water
 1 1/2 teaspoons pure vanilla extract
 1 tsp. baking soda
 1/2 tsp. salt
Directions
1. Preheat oven to 350°F (175°C).
2. Mix the flaxseed meal with water in small bowl and let soak for at least 5 minutes.
3. Cream the butter and white and brown sugar in a large mixing bowl. Add egg yolks and
vanilla extract. Beat on low for 30 seconds or until ingredients are combined. Stir in
flaxseed meal and water.
4. In a separate bowl, mix flour, baking soda, brewer’s yeast, wheat germ, and salt. Add to
butter mixture, and stir just until combined. Fold in the oats.
5. Roll dough into 2-inch balls and place 2 inches apart onto a baking sheet.
6. Bake for 10 to 12 minutes or until edges start to golden. Let the cookies stand on the
baking sheet for 1 minute. Cool on a wire rack.
You also can add dried fruit, chocolate chips, or nuts for some variety.
5. Other foods, herbs, and supplements
There are other foods and herbs that may increase breast milk production, according to
the Canadian Breastfeeding Foundation. Some, such as fenugreek, have been found to
take effect in as little as seven days. These foods and herbs include:
 garlic
 ginger
 fenugreek
 fennel
 brewer’s yeast
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 blessed thistle
 alfalfa
 spirulina
Always talk to your doctor before taking a new supplement, especially when
breastfeeding. Even natural remedies can cause side effects.
15. What are the reasons for weaning of infants.

The Reasons Women Wean Early
Some mothers choose to wean early, and others have to stop breastfeeding before they
want to. Here are some of the many reasons a mother may wean sooner than expected:
1. Pain: Pain is perhaps the most common reason for early weaning, and it’s
understandable. However, breastfeeding should not hurt. Many common breastfeeding
problems such as sore nipples, breast engorgement, plugged milk ducts,
and mastitis can lead to pain. If you can find and treat the underlying cause, it can help
you to keep breastfeeding longer.
2. Concern over a low milk supply: It is rare that a mother cannot make enough breast
milk for her child. Most moms can make enough even if they think they can’t. If you feel
you have a low breast milk supply, talk to your doctor or a lactation professional before
you give up.
3. Lack of support: It is difficult to continue to breastfeed if you don’t have
support. Studies show that the approval and encouragement of a partner is one of the
most important factors that predict the duration and success of breastfeeding. A
breastfeeding woman’s mother and her friends are others whose support or lack thereof
can influence early weaning.
4. Fatigue: Healing from childbirth and making breast milk takes up a lot of energy. If you
also have other children and responsibilities, you may feel even more drained. It can
be difficult to breastfeed when you’re always exhausted.
5. Return to work or school: Some moms have to return to work or school within weeks of
having their child. It can be tough and time consuming to pump at work.
6. Breastfeeding difficulty: When a baby is born with a medical issue such as a tongue-
tie or a cleft lip, breastfeeding can be frustrating and challenging to continue.
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7. The need to begin medication or treatments: Many prescription medications are safe to
take while you’re breastfeeding, but some are not. For example, chemotherapy drugs for
cancer and radioactive iodine for an overactive thyroid are not compatible with
breastfeeding, so weaning is necessary.
8. Embarrassment: Breastfeeding tends to expose part of your breast. While some women
aren’t bothered by it and can breastfeed anywhere at any time, others are more modest
and may even feel anxious about breastfeeding around others especially in public. It’s
possible to practice and become very good at breastfeeding discreetly, but even then,
some moms are just too embarrassed and prefer to stay covered. As the baby grows,
staying covered can become even more difficult, so some moms choose to wean.
9. The desire to have another child: It can be more challenging to get pregnant again
when you’re breastfeeding. Even more so during the first six months if you’re
breastfeeding exclusively. Some women, especially older moms or moms who have
struggled with infertility and fear it may take a long time to have another child, may
decide to stop breastfeeding after six weeks or a few months to try to get pregnant again
right away.
16. Define Balanced diet.
A balanced diet is a diet that contains differing kinds of foods in certain quantities and
proportions so that the requirement for calories, proteins, minerals, vitamins and
alternative nutrients is adequate and a small provision is reserved for additional nutrients
to endure the short length of leanness.
17. Define Weaning
Weaning is the process of gradually introducing an infant human or another mammal to
what will be its adult diet while withdrawing the supply of its mother's milk. The process
takes place only in mammals, as only mammals produce milk.
18. Diet for elderly.
 A healthy eating plan emphasizes fruit, vegetables, whole grains and low-fat or
fat-free dairy; includes lean meat, poultry, fish, beans, eggs and nuts; and is low in
saturated fats, trans fats, salt (sodium) and added sugars.
 Nutrition is about eating a healthy and balanced diet so your body gets the
nutrients that it needs. Nutrients are substances in foods that our bodies need so
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they can function and grow. They
include carbohydrates, fats, proteins, vitamins, minerals, and water.
 Good nutrition is important, no matter what your age. It gives you energy and can
help you control your weight. It may also help prevent some diseases, such
as osteoporosis, high blood pressure, heart disease, type 2 diabetes, and certain
cancers.
 But as you age, your body and life change, and so does what you need to stay
healthy. For example, you may need fewer calories, but you still need to get
enough nutrients. Some older adults need more protein.
 Eat a wide variety of foods from the five food groups : plenty of colourful
vegetables, legumes/beans; fruit; grain (cereal) foods, mostly wholegrain and high
fibre varieties; lean meats and poultry, fish, eggs, tofu, nuts and seeds; milk,
yoghurt, cheese or their alternatives, mostly reduced fat.
19. Explain Nurses role in importance of Breast feedinT
The role of nurse in supporting breast feeding
The nurse can provide information about, and support of, breast feeding. The prenatal
nurse can inform the mother of the advantages of breast feeding to herself and her baby.
The labour and delivery nurse can aid the mother in her first contact with the baby and
reassure the mother who has a Caesarean birth, or a premature or sick infant, that she too
can nurse. The postpartum nurse can help breast feeding to continue by providing
frequent maternal-infant contact during the mother's hospital stay. The nursery nurse
supports breast feeding by refraining from giving the baby other fluids. The paediatric
nurse continues the helping pattern by reinforcing the statements and actions of others
which will further impress the mother with the appropriateness of her infant feeding
method. Mothers need to be informed about infant feeding options in order to make a
knowledgeable choice based on awareness of alternatives. The nurse's role in support of
breast feeding varies with the time and place where patient care is provided. In each
setting, however, the nurse plays a significant role in helping the mother to begin breast
feeding and to enjoy it, at the same time providing her infant with optimum nutrition for
his early growth and development.
Importance’s of Breast feeding.
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Benefits for life, breastfeeding may result in:
 Lower risk of breast cancer.
 Lower risk of ovarian cancer.
 Lower risk of rheumatoid arthritis and lupus.
 Less endometriosis.
 Less osteoporosis with age.
 Less diabetes.
 Less hypertension decreases blood pressure.
 Less cardiovascular disease.
Breast milk helps keep your baby healthy.
 It supplies all the necessary nutrients in the proper proportions.
 It protects against allergies, sickness, and obesity.
 It protects against diseases, like diabetes and cancer.
 It protects against infections, like ear infections.
 It is easily digested – no constipation, diarrhea or upset stomach.
 Babies have healthier weights as they grow.
 Breastfed babies score higher on IQ tests.
20. Chemical composition of Milk.
Composition of milk.
Main constituent Limits of variation Mean value
Water 85.5 – 89.5 87.5
Total solids 10.5 – 14.5 13.0
Fat 2.5 – 6.0 3.9
Proteins 2.9 – 5.0 3.4
21. Explain the Nutritional needs of teenagers

 Food selection is based mainly on availability, convenience and time, rather than
food value
 Influence of peers, mass media, prevalent body image
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 Personal self-esteem and body image guide the eating behaviour
 Missing meals and snacking are very common
 Fast food joints are mainly patronized by adolescents. These spoil the appetite for
regular meals and are high on calories and low on nutrients.
 Helps in achieving rapid growth and full growth potential
 Helps in timely sexual maturation
 Ensures adequate calcium deposition in the bones and helps in achieving normal
bone strength
 Establishes good eating habits and sets the tone for a lifetime of healthy eating.
This prevents obesity, osteoporosis (weak bones due to deficiency of calcium),
and diabetes in later life.
Balanced Diet
A young person should eat a diet balanced across the five food groups. They should eat:
 plenty of fruit and vegetables
 adequate quantities of rice and other cereals, potatoes, noodles and pasta
 some milk and dairy products such as yoghurt and cheese and
 some meat, fish, poultry, eggs and/or nuts and legumes.
 The relative proportion of the five groups is depicted in the diagram 1.
 In addition, they should:
 Choose foods that are low in salt and
 Limit foods that contain a lot of fat or sugar.
22. What is Calcium requirements for a pregnant and lactating woman.
According to ACOG, you and your baby need these key nutrients for a healthy
pregnancy:
 Calcium. Helps to build strong bones and teeth. ...
 Iron. Helps red blood cells deliver oxygen to your baby. ...
 Vitamin A.
 Vitamin C.
 Vitamin D.
 Vitamin B6. ...
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 Vitamin B12. ...
 Folate (Folic Acid)
How Much Calcium Does a Breastfeeding Mother Need?

Calcium is important for everyone for good bone health. However, it is imperative for
nursing mothers to consume 1000 milligrams of calcium every day. A vegetarian diet
supplies only about 600-700 milligrams of calcium a day. Contrary to popular notion,
however, a vegetarian diet (which is often rich in paneer, yoghurt, milk and milk products) is
often more likely to supply you with adequate calcium than a non-vegetarian diet. The reason
is that meat (which contains phosphorus) does not allow the body to absorb calcium well; so
a diet consisting of a heavy amount of animal protein may not be able to meet your daily
calcium intake.
23. Precaution of introduction of weaning diet.
 Continue to give your baby breast milk or formula. This will be your baby's main source
of calories and nutrition until their first birthday, and if you eliminate it too soon your
baby will be at risk of nutrient deficiencies and delayed development.
 Avoid giving your baby cow's milk until they are 1. Only breast milk and infant formula
are recommended until then.
 Your baby does not need any water before 6 months, and they won't need a lot of water
even when they begin to eat solids. They will get most of their hydration from breast milk
or formula. You can offer a small amount of water in a sippy cup at mealtimes, but not
too much until they're fully weaned.
 Don’t avoid giving your baby foods that are common allergy culprits, just monitor them
closely the first few times they try them. It’s important to introduce one new food at a
time and wait for 3 – 5 days to observe for allergic reactions such as rashes, difficulty
breathing, diarrhoea or vomiting. Foods to keep an eye on include peanuts and other nuts,
eggs and shellfish. If you suspect your baby is having an allergic reaction to something
they eat, take them to the A&E. You may work with a doctor or dietitian to identify the
specific food allergen.
Essential nutrients
As your baby takes in more solids, and the weaning process comes to an end, it's
important to ensure they are getting a balanced diet, especially as their breast milk or
formula intake decreases.
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Key nutrients to include in your baby's diet are:
 Iron, because iron levels become depleted in the months after your baby is born. Some
iron-rich foods include meat, green leafy vegetables such as spinach, and fortified cereal.
 Zinc, which will boost your baby's immunity. Try offering cheese, chickpeas, lentils and
red meat.
 Fibre, to assist in healthy digestion. Prunes, pears, plums, and oatmeal are all high-fibre
foods.
 Calcium, which will help your baby build strong bones. Include yoghurt, hard cheese,
cottage cheese and broccoli in your baby's meals. Make sure any cheese you offer is
pasteurised.
 Protein, to help your baby's overall growth and development. Lean meat such as chicken,
fish and peanut butter are all good sources.
24. Define Exclusive breast feeding.
 Exclusive breastfeeding means that the infant receives only breast milk. No other
liquids or solids are given – not even water – with the exception of oral rehydration
solution, or drops/syrups of vitamins, minerals or medicines.
III.SHORT ANSWERS
1. WHAT IS FOOD PYRAMID
A food pyramid is a representation of the optimal number of servings to be eaten each
day from each of the basic food groups. The first pyramid was published in Sweden in
1974. The 1992 pyramid introduced by the United States Department of Agriculture was
called the "Food Guide Pyramid" or "Eating Right Pyramid".
2. EXPLAIN 5 FOOD GROUP SYSTEM.
Dairy and/or their alternatives: the foods in this group are excellent sources of calcium,
which is essential for strong and healthy bones. Fruit: fruit provides vitamins, minerals,
dietary fibre and many phytonutrients (nutrients naturally present in plants), Grain
(cereal) foods: always choose wholegrain and/or high fibre varieties of bread, cereals,
rice, pasta, noodles, etc. Lean meats and poultry, fish, eggs, tofu, nuts and seeds and
legumes/beans: our bodies use the protein we eat to make specialised chemicals such as
haemoglobin and adrenalin. Protein also builds, maintains, and repairs the tissues in
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our body Vegetables and legumes/beans: vegetables should make up a large part of your
daily food intake and should be encouraged at every meal (including snack times).
3. EXPLAIN 11 FOOD GROUP SYSTEM.
The following nine food groups reflect foods with generally similar nutritional
characteristics: (1) cereals, (2) starchy roots, (3) legumes, (4) vegetables and fruits,
(5) sugars, preserves, and syrups, (6) meat, fish, and eggs, (7) milk and milk products, (8)
fats and oils, and (9) beverages.
4. FRUITS AND VEGETABLES
Fruits and vegetables contain important vitamins, minerals and plant chemicals. They
also contain fibre. There are many varieties of fruit and vegetables available and many
ways to prepare, cook and serve them. A diet high in fruit and vegetables can help
protect you against cancer, diabetes and heart disease. Eat five kinds of vegetable and
two kinds of fruit every day for good health.
5. CEREALS.
A cereal is any grass cultivated for the edible components of its grain, composed of the
endosperm, germ, and bran. The term may also refer to the resulting grain itself.
6. PULSES.
A legume is a plant in the family Fabaceae, or the fruit or seed of such a plant. When
used as a dry grain, the seed is also called a pulse. Legumes are grown agriculturally,
primarily for human consumption, for livestock forage and silage, and as soil-enhancing
green manure.
7. WHAT IS COMPOSITION OF MILK
In general, the gross composition of cow's milk in the U.S. is 87.7% water, 4.9% lactose
(carbohydrate), 3.4% fat, 3.3% protein, and 0.7% minerals (referred to as ash). Milk
composition varies depending on the species (cow, goat, sheep), breed (Holstein, Jersey),
the animal's feed, and the stage of lactation.
8. COLOSTRUM
Colostrum is the first stage of breast milk. It develops during pregnancy and lasts for
several days after birth. Colostrum is yellow and thick in consistency or can appear clear
and runny. Babies need small amounts of food, and the mother’s colostrum is perfect in
components and volume.
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9. EXPLAIN NATUROPATHY DIET.
The concept of diet is little different in modern medicine. In Naturopathy food is
classified as acidic or alkaline, live or dead food, eliminative, soothing, constructive,
vegetarian or non-vegetarian, liquid, fruit, and mono fruit diet, etc. Naturopathy gives
more emphasis on raw food rather than cooked food.
10. WHAT IS SOFT DIET
A mechanical soft diet or edentulous diet or soft food(s) diet is a diet that involves only
foods that are physically soft, with the goal of reducing or eliminating the need to chew
the food. It is recommended for people who have difficulty chewing food, including
people with some types of dysphagia (difficulty swallowing), the loss of many or all
teeth, pain from recently adjusted dental braces, or surgery involving the jaw, mouth,
or gastrointestinal tract.
11. WHAT IS BLAND DIET.
A healthy diet is a diet that helps maintain or improve overall health. A healthy diet
provides the body with essential nutrition: fluid, macronutrients, micronutrients, and
adequate food energy.
12. EXPLAIN INTRAVENOUS FEEDING
Parenteral nutrition, or intravenous feeding, is a method of getting nutrition into your
body through your veins. Depending on which vein is used, this procedure is often
referred to as either total parenteral nutrition (TPN) or peripheral parenteral
nutrition (PPN).
13. EXPLAIN TUBE FEEDING
Tube feeding is a way of getting your body the nutrition it needs. Tube feed is a liquid
form of nourishment that's delivered to your body through a flexible tube. The nutrients
within the tube feed are similar to what you would get from normal food, and are also
digested in the same way.
14. WHAT ARE CLEAR FLUIDS
A clear liquid diet consists of clear liquids — such as water, broth and plain gelatin —
that are easily digested and leave no undigested residue in your intestinal tract. Your
doctor may prescribe a clear liquid diet before certain medical procedures or if you have
certain digestive problems.
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15. WHAT IS LIQUID DIET
A liquid diet is a diet that mostly consists of liquids, or soft foods that melt at room
temperature (such as ice cream). A liquid diet usually helps provide sufficient hydration,
helps maintain electrolyte balance, and is often prescribed for people when solid food
diets are not recommended, such as for people who suffer with gastrointestinal illness or
damage, or before or after certain types of medical tests or surgeries involving the
mouth or the digestive tract.
16. BREAST MILK
Breast milk or mother's milk is milk produced by mammary glands, located in the breast
of a human female. Breast milk is the primary source of nutrition for newborns,
containing fat, protein, carbohydrates and variable minerals and vitamins.
17. EXCLUSIVE BREAST FEEDING
Exclusive breastfeeding means that the infant receives only breast milk. No other
liquids or solids are given – not even water – with the exception of oral rehydration
solution, or drops/syrups of vitamins, minerals or medicines.
18. WHAT IS SEMISOLID DIET
A semi-solid diet usually begins three to four weeks following a gastric bypass surgery.
It is also referred as the soft/pureed foods diet and is the third stage of returning to solid
foods following surgery. This diet is designed to retrain the stomach to begin eating solid
foods after consuming a liquid diet. The semi-solid diet includes foods high in protein
and low in fat, fiber, calories and sugar. Soft fruits and vegetables can also be pureed and
included in the diet. It is essential to get enough protein right after surgery to make sure
that wounds heal properly and help preserve muscle tissue, so weight can be lost via fat
instead of muscle tissue,
19. WHAT ARE SUPPLEMENTARY AND COMPLEMENTARY FEEDS
 Complementary foods are those that complement breast milk or any other foods.
Similarly, supplementary foods could supplement many other foods, if not breast milk
that is considered to be a complete food.
 food supplement or nutritional supplement, is a preparation intended to supplement
the diet and provide nutrients, such as vitamins,minerals, fiber, fatty acids, or amino
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acids, that may be missing or may not be consumed in sufficient quantities in a
person's diet.
Examples of Complementary Foods and Feeding Frequencies for Infants 6 to 12
Months Old in Central America
 Ground, cooked grains in cereal or drink such as rice, corn, oats and barley.
 Mashed bananas and plantains.
 Mashed potatoes and yucca.
 Mashed beans.
 Mashed egg.
 Mashed avocado.
 Mashed mango.
20. WHAT IS BEVERAGE?
A drink is a liquid intended for human consumption. In addition to their basic function
of satisfying thirst, drinks play important roles in human culture. Common types of
drinks include plain drinking water, milk, coffee, tea, hot chocolate, juice and soft
drinks.
21. MENTION THE USES OF IODIZED SALT
People combine iodine with table salt to reduce iodine deficiency. There are many
other health benefits to using iodized salt in your diet, as well. Boosts thyroid function.
Your thyroid gland relies on iodine to increase the production of thyroid hormones, like
triiodothyronine and thyroxine.
22. WHAT IS LIGHT DIET
A diet consisting of all foods allowed in a soft diet, plus whole-grain cereals, easily
digested raw fruits, and vegetables. Foods are not pureed or ground. This diet is used
as an intermediate regimen for patients who do not require a soft diet but are not yet
able to resume a full diet.
23. WHAT IS PROTEIN DIET.
A high-protein diet is a diet in which 20% or more of the total daily calories comes from
protein. Most high protein diets are high in saturated fat and severely restrict intake of
carbohydrates. Example foods in a high-protein diet include lean beef, chicken or
poultry, pork, salmon and tuna, eggs, and soy.
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UNIT – XI
ROLE OF NURSE IN NUTRITIONAL PROGRAMME
I. SHORT ESSAY
1. Enumerate various national nutritional programmes of India
Currently major nutrition supplementation programs in India are:
1) Integrated Child Development Services Scheme (ICDS); 2) Mid-day
meal Programs (MDM); 3) Special Nutrition Programs (SNP); 4) Wheat
Based Nutrition Programs (WNP); 5) Applied Nutrition Programs (ANP);
6) Balwadi Nutrition Programs (BNP); 7) ... National Nutritional Anaemia
Prophylaxis Program (NNAPP); 8) National Program for Prevention of
Blindness due to Vitamin A Deficiency; and 9) National Goiter Control
Program (NGCP).
Nutritional Programmes in India
 The government of India have initiated several large scale supplementary feeding programmes
aimed at overcoming specific deficiency diseases through various Ministers to combat
malnutrition.
1.VitaminAprophylaxisprogram:
One of the components of National Programme for control of Blindness is to administer a
single massive dose of an oily preparation of Vitamin A orally to all pre-school children in the
community every 6 months through peripheral health children in the community every 6
months through peripheral health workers.
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 2. Prophylaxis against nutritional anaemia:
In view of its public health importance, a national programme for the prevention of
nutritional anaemia was launched by the Govt. Of India during the fourth five year plan.
The programme consists of distribution of iron and folic acid tablets to pregnant women
and young children.
 3. Special Nutrition Programme:
This special programme was started in 1970 for the nutritional benefit of children
below 6 years of age, pregnant and nursing mothers and is in operation in urban slums,
tribal areas and backward rural areas.
4. Balwadi Nutrition Programme:
This programme was started in 1970 for the benefit of children in the age group 3-6 years in
rural areas. It is under the overall charge of the Department of Social Welfare. Balwadis also
provide pre-primary education to children.
ICDS programme:
Integrated Child Development Services(ICDS) programme was started in 1975 in pursuance
of the National Policy for children. The workers at the village level who deliver the sevices are
called Anganwadi workers. Each Anganwadi unit covers a population of about 1000.
6. Mid-day meal programme:
The mid-day meal programme(MDMP) is also kown as school launch programme. This
programme has been in operation since 1961 throughout the country. The major objective of the
programme is to attract more children for admission to schools and retain them so that literacy
improvement of children could be brought about.
7. Mid-day meal scheme:
Mid-day meal scheme is also known as National Programme of Nutritional Support to Primary
Education. It was launched as a centrally sponsored scheme on 15th August 1995 and revised in
2004.
Some suggestions for preparation of nutritious and economical mid-day meals are as under:
Parboiled rice, single dish meals, cereal pulse combination, sprouted pulses, leafy vegetables,
fermented food items etc. Only 'iodised salt' should be used for cooking mid-day meals.
grammes aimed at overcoming specific deficiency diseases through various Ministers to combat
malnutrition.
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2. List various agencies working towards food and nutrition.
I n India the Food Safety and Standards Authority of India (FSSAI) is the
apex food regulator. It is empowered by and functions under the Ministry of Health
and Family Welfare, Government of India. The FSSAI implements and
enforces food regulations as prescribed in the Food Safety and Standards Act, 2006
(FSS Act).
Other international organizations working on public nutrition
 FAO: Food and Agriculture Organization of the United Nations, for a world without
hunger.
 WHO | World Health Organization.
 UNSCN - United Nations Standing Committee on Nutrition.
 WFP | United Nations World Food Programme - Fighting Hunger Worldwide.
3. What are the various ways to assess the nutritional status?
A comprehensive nutritional assessment includes (1) anthropometric measurements of body
composition; (2) biochemical measurements of serum protein, micronutrients, and metabolic
parameters; (3) clinical assessment of altered nutritional requirements and social or
psychological issues that may preclude adequate intake;
There are four forms of nutritional assessment: surveys, surveillance, screening, and
interventions.
1. Anthropometric Methods
liAnthropometry is the measurement of body height, weight & proportions. It is an
essential component of clinical examination of infants, children & pregnant women.
2.Clinical assessment Good nutritional history should be obtained General clinical
examination, with special attention to organs like hair, angles of the mouth, gums, nails,
skin, eyes, tongue, muscles, bones & thyroid gland. Detection of relevant signs helps in
establishing the nutritional diagnosis
3. Dietary assessment Nutritional intake of humans is assessed by five different
methods. These are: a. 24 Hours Dietary Recall .A trained interviewer asks the subject to
recall all food & drinks taken in the previous 24 hours. b. Food Frequency Questionnaire
< In this method the subject is given a list of around 100 food items to indicate his or her
intake (frequency & quantity) per day, per week & per month. It is inexpensive, more
representative & easy to use.
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4. Initial Laboratory Assessment Laboratory tests based on blood and urine can be
important indicators of nutritional status, but they are influenced by non-nutritional
factors as well. Lab results can be altered by medications, hydration status, and disease
states or other metabolic processes, such as stress. As with the other areas of nutrition
assessment, biochemical data need to be viewed as a part of the whole.
>Hemoglobin estimation is the most important test & useful index of the overall state of
nutrition. Beside anemia it also tells about protein & trace element nutrition. Stool
examination for the presence of ova and/or intestinal parasites. Urine dipstick &
microscopy for albumin, sugar and blood
4. Define nutrition education. Explain in detail the methods of imparting nutrition
education.
Nutrition education definition
Nutrition education can be defined as any set of learning experiences designed to facilitate the
voluntary adoption of eating and other nutrition-related behaviors conducive to health and well-
being. It is an integral part of providing nutrition services to older persons.
Nutrition education should be practical and should be easily adaptable to the socioeconomic
status, food habits and the available local food resources generally needed for the purpose of
demonstration and feeding of the locally available audience.
Nutrition Education of Community: Importance, Methods and Other Details
 Training in nutrition can be broadly classified as:
 The various important methods of nutrition education are:
 Lectures and Demonstration:
 Workshops:
 Film Shows and Slide Shows:
 Posters, Charts and Exhibition:
5. Discuss the role of nurse in nutritional education.
"All nurses who provide patient care are responsible for addressing patients' nutritional needs,"
the ANA explains. This can take many forms: from conducting nutrition screening and
performing nutrition assessment and interventions to providing mealtime
assistance, nutrition support or dietary therapies, and more.
1. In hospital nurse has to take care of nutritional aspects of the admitted client in ward.
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2. Educates the client as well as family members regarding the importance of the healthy and
nutritious diet.
Nurse maintains the adequate diet plans for the client.
4. Helps in monitoring the conditions of the client like vomiting, input-output, electrolyte
monitoring, in order to add different components in the diet.
5. Maintaining parental nutrition for the client.
6. Maintenance of adequate hydration.
Community
Go to
In community nurse focuses on the prevention aspect i.e. helps in giving the basic education
regarding prevention of certain nutritional deficiency disease. At the community level the nurse
can act as:
1. Community health nurse.
2. School health nurse.
And work in different sectors where she mainly works at grass root levels to correct the
nutritional deficiencies in the client.
1. Nurse rectifies the different patterns of the nutrition opted by the people.
2. Nurse collaborates with government and non-govt. agencies working for nutritional betterment
of public sectors.
3. Nurse plays a role in school health programs as school health nurse, helps in identification of
malnourished children and maintains growth charts.
4. Involvement of family.
6. Explain National nutritional programmes (NNP).
National Nutrition Program
The Government has developed the National Nutrition Program (NNP) in order to reduce the
magnitude of malnutrition; to coordinate, harmonies and scale up current nutrition interventions
with a greater focus in community based and high impact interventions; and to harmonize
government strategies and various donors programs.
NNP is a long-term initiative that is implemented in two phases for the next 10 years, each phase
lasting five years. Currently NNP phase I (July 2008 to June 2010) is being implemented. The
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NNP targets the most vulnerable i.e. under 5 year children, particularly those under 2 years as
well as pregnant and lactating women and adolescents.
It also gives priority to the rural population while recognizing that significant malnutrition exists
in low income urban areas. Moreover, a key constraint to be addressed in the NNP is the need for
sound institutional arrangements and capacity building which will help to institutionalize, and
improve the expansion and sustainability of nutrition programs, while improving the nutrition
information system and multi-sectoral linkages.
The SNP is to provide supplementary nutrition and health care services including supply of
vitamin A solution and iron and folic acid tablets to pre-school children, and pregnant and
lactating mothers of poor groups in urban slums and tribal areas.
One of the earliest nutritional programmes This project was. started Ensure their
consumption by pregnantPromoting production and of protective food such Vegetables and
fruits  Later extended to Tamilnadu and UP Objectives: in Orissa on 1963 & lactating women
and children.
7.Explain Mid day meal programme.
 Mid-day meal (MDM) is a wholesome freshly-cooked lunch served to children in
government and government-aided schools in India.
 The Midday Meal Scheme is a school meal programme in India designed to better
the nutritional standing of school-age children nationwide. ... Serving
120,000,000 children in over 1,265,000 schools and Education
Guarantee Scheme centres, it is the largest of its kind in the world.
 Tamil Nadu was the first to initiate a massive noon meal programme to children.
Neither a child that is hungry, nor a child that is ill can be expected to learn.
Realizing this need the Mid-Day Meal (MDM) Scheme was launched in primary
schools during 1962-63.
Mid-Day Meal improves three areas:
1. School attendance
2. Reduced dropouts
3. A beneficial impact on children’s nutrition.
The Central Government supplies the full requirement of food grains for the programme
free of cost. For its implementation in rural areas, Panchayats and Nagarpalikas are also
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involved or setting up of necessary infrastructure for preparing cooked food. For this
purpose NGOs, women’s group and parent-teacher councils can be utilized. The total
charges for cooking, supervision and kitchen are eligible for assistance under Poverty
Alleviation Programme. In several states,
Objectives:
The objectives of the mid day meal scheme are:
1. Improving the nutritional status of children in classes I – VIII in Government, Local
Body and Government aided schools, and EGS and AIE centres
2. Encouraging poor children, belonging to disadvantaged sections, to attend school more
regularly and help them concentrate on classroom activities.
3. Providing nutritional support to children of primary stage in drought-affected areas
8.Explain Vitamin A deficiency prophylaxis programme.
The National Prophylaxis Programme against Nutritional Blindness due to Vitamin A
Deficiency (NPPNB due to VAD) was initiated in 1970 with the specific aim of
preventing nutritional blindness due to keratomalacia2. The Programme was started as a
100 per cent centrally sponsored programme. hese recommendations focus exclusively
on vitamin A supplementation in populations in which vitamin A deficiency is an
important public health problem (3). Vitamin A supplements are given in two main
contexts: as prophylaxis to groups of eligible individuals and as part of the treatment
of sick individuals.
 Vitamin A deficiency increases the severity of and mortality from measles and diarrhoea
 Increased infectious morbidity and mortality is apparent even before the appearance of
xerophthalmia
 Improving the vitamin A status of deficient children aged 6 months to 6 years can
dramatically reduce their morbidity and mortality from infection
 Prompt administration of large doses of vitamin A to children with moderate to severe
measles, particularly if they may be vitamin A deficient, can reduce individual mortality
by 50% and prevent or moderate the severity of complications
 The National Prophylaxis Programme against Nutritional Blindness due to vitamin A
deficiency (NPPNB due to VAD) was started in 1970
– with the specific aim of preventing nutritional blindness due to keratomalacia
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– As an urgent measure to combat the unacceptably high magnitude of xerophthalmic
blindness in the country seen in the 1950s and 1960s
• The Programme was started as a 100 per cent centrally sponsored programme
• In 1994, under the National Child Survival and Safe Motherhood (CSSM)
Programme, the age group of eligible children was restricted to 9 to 36 months of age
– One dose, 1,00, 000 IU along with measles immunization (operational feasibility)
– 8 doses at six – monthly intervals of 2.00, 000 IU
National Vitamin A Prophylaxis Programme – Current Scenario (2016)
Clinical VAD has declined drastically during the last 40 years
There has been virtual disappearance of keratomalacia, and
a sharp decline in the prevalence of Bitot spots
• Vitamin A supplementation (VAS) is implemented through the PHCs and sub-
centres.
The female multipurpose worker and other paramedics at the village level sub-
health centres are responsible for administering vitamin A solution.
The services of ICDS functionaries are also utilized for Programme
implementation.
• Universal supplementation of vitamin A to Indian children is being undertaken
irrespective of their family background and nutritional status
9.Explain National Iodine deficiency disorders programme.
The programme started in April, 1986 in a phased manner. To date, the annual production
of iodated salt in our country is 65 lakh metric tones per annum. Nodal Ministry: Ministry
of Health & Family Welfare is the nodal Ministry for implementation of National Iodine
Deficiency Disorders Control Programme (NIDDCP).
Rationale:
The National Iodine Deficiency Disorders Control Programme (NIDDCP) started in our
state since Dec'1989. It is a 100% Central Plan Scheme. Iodine Deficiency Disorders are a
group of diseases starting from a visible goitre in the neck to many physical and mental
disorder like dwarf. Cretin, squint, abortion, stillbirths and impaired mental functions due
to low intake of Iodine in food.
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Objectives :
 The aim of the programme is to prevent Iodine Deficiency Disorders like the incidence of
Goitre: Physical & Mental disorders cretinism & deaf mutism etc. in the State.
 To conduct the I.D.D Surveillance through Medical Colleges/Research Institutions in
endemic districts as per guide line of Govt. of India.
Strategies:
 Assess the magnitude& distribution of I.D.D Prevalence.
 Identify high-risk population.
 Monitoring progress towards achieving long-range goals to create awareness among the
people through I.E.C activities regarding use and benefits of lodised Salt.
 Evaluation of Control Programmes.
Activities:
10. How can nutritional anemia be prevented.

Preventing iron deficiency and anaemia
During and after childbirth:
 Control bleeding by encouraging women to:
 Be delivered by a trained birth attendant or at a maternity unit if there is a risk of
complications.
 Start breastfeeding within ½ hour of birth. Breastfeeding makes the mother's uterus
tighten and reduces bleeding.
 Wait two minutes after birth before clamping the umbilical cord so the baby gets more
blood from the placenta.
Give prophylactic supplements
 Give oral iron and folic acid supplements to pregnant and lactating women, to females of
reproductive age and to low birth weight babies – see Table 2.
 Do not give routine prophylactic iron or folic acid to children in malaria endemic areas as
it may increase adverse effects and mortality unless they are proven to be iron-deficient2.
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 Explain the importance of taking supplements regularly for the full duration and how to
deal with possible side
11. Explain ICDS programme.
Integrated Child Development Services (ICDS) scheme is world's largest community
based programme. The scheme is targeted at children upto the age of 6 years, pregnant and
lactating mothers and women 16–44 years of age. The scheme is aimed to improve the health,
nutrition and education (KAP) of the target community. Launched on 2 October 1975, the
scheme has completed 25 years of its operational age. The article describes in brief, the
organisation, achievements and drawbacks of this national programme. It also suggests various
thrust areas for its betterment and further improvement.
The main thrust of the scheme is on the villages where over 75 percent of the population lives.
Urban slums are also a priority area of the programme.
Objectives
The main objectives of the scheme are :
 i) Improvement in the health and nutritional status of children 0–6 years and pregnant and
lactating mothers.
 ii) Reduction in the incidence of their mortality and school drop out
 iii) Provision of a firm foundation for proper psychological, physical and social
development of the child.
 iv) Enhancement of the maternal education and capacity to look after her own health and
nutrition and that of her family
 v) Effective co-ordination of the policy and implementation among various departments
and programmes aimed to promote child development.
Beneficiaries
The beneficiaries are:
 i) Children 0–6 years of age
 ii) Pregnant and lactating mothers
 iii) Women 15–44 year of age
 iv) Since 1991 adolescent girls upto the age of 18 years for non formal education and
training on health and nutrition.
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Services
The programme provides a package of services facilities [3] like:
i) Complementary nutrition
ii) Vitamin A
iii) Iron and folic acid tablets
iv) Immunization
v) Health check up
vi) Treatment of minor ailments
vii) Referral services
viii) Non-formal education on health and nutrition to women
ix) Preschool education to children 3–6 year old and
x) Convergence of other supportive services like water, sanitation etc.
12. What is the role of FAO to improve nutrition of people of all countries?
Good nutrition is our first defence against disease and our source of energy to live and be active.
Nutritional problems caused by an inadequate diet can be of many sorts, and when they affect a
generation of youngsters, they can lower their learning capacities, thus compromising their
futures, perpetuating a generational cycle of poverty and malnutrition, with severe consequences
on both individuals and nations.
FAO Nutrition Strategy seeks to improve diets and raise levels of nutrition through a people-
centered approach:
 Support and facilitate action in the follow-up of ICN2, the 2014 Second International
Conference on Nutrition; as well as co-convene the UN Nutrition Decade of Action on
Nutrition, declared in April 2016 by the UN General Assembly, and lead the
implementation its WORK PROGRAMME jointly with the World Health Organization
(WHO), in collaboration with key partners.
 Research on and release of evidence, data and guidelines on food-based nutrition
including food composition, nutrition assessment and food-based indicators, and human
requirements ).
187
 Develop countries’ capacities to evaluate and monitor nutrition situations, analyze
options, and implement agricultural policies and programmes that impact positively on
nutrition.
 Provide tools, guidance and support for the scaling up of proper nutrition education and
consumer awareness at national and local levels.
13. Explain Nutritional Assessment.
1. Anthropometric Methods
liAnthropometry is the measurement of body height, weight & proportions. It is an
essential component of clinical examination of infants, children & pregnant women.
2.Clinical assessment Good nutritional history should be obtained General clinical
examination, with special attention to organs like hair, angles of the mouth, gums, nails,
skin, eyes, tongue, muscles, bones & thyroid gland. Detection of relevant signs helps in
establishing the nutritional diagnosis
3. Dietary assessment Nutritional intake of humans is assessed by five different
methods. These are: a. 24 Hours Dietary Recall .A trained interviewer asks the subject to
recall all food & drinks taken in the previous 24 hours. b. Food Frequency Questionnaire
< In this method the subject is given a list of around 100 food items to indicate his or her
intake (frequency & quantity) per day, per week & per month. It is inexpensive, more
representative & easy to use.
4. Initial Laboratory Assessment Laboratory tests based on blood and urine can be
important indicators of nutritional status, but they are influenced by non-nutritional
factors as well. Lab results can be altered by medications, hydration status, and disease
states or other metabolic processes, such as stress. As with the other areas of nutrition
assessment, biochemical data need to be viewed as a part of the whole.
>Hemoglobin estimation is the most important test & useful index of the overall state of
nutrition. Beside anemia it also tells about protein & trace element nutrition. Stool
examination for the presence of ova and/or intestinal parasites. Urine dipstick &
microscopy for albumin, sugar and blood
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NUTRITION

I YEAR B.sc NURSING

1. EXPLAIN THE HISTORY OF NUTRITION.

2.Explain in detail digestion and absorption of carbohydrates.

3. The small intestine, pancreas, and liver

3.Write note on excessive intake of carbohydrates and what happens in deficiency.

There is some weight loss. There is severe weight loss.

The thinning of muscles and limbs. The thinning of limbs.

Fatty liver cells

Voracious feeder. Poor appetite.

The texture of the skin

Flaky paint appearance on the skin. Dry and wrinkled skin.

Adequate amounts of proteins,

5.What is the daily requirement of carbohydrates? Explain the metabolism of

2. Write the clinical features of Kwashiorkor

1. DESCRIBE LIPIDS UNDER THE FOLLOWING HEADINGS, CLASSIFICATION,

The Functions of Fats in the Body

2.Define lipids and explain the classification of lipids.

3. Explain in detail the functions of lipids.

 inflammatory bowel disease

excessive intake of fats causes

This article lists 8 symptoms of low protein intake or deficiency.

3. Explain in detail digestion, absorption, and metabolism of proteins.

6. What are incomplete proteins/class II proteins?

1. What is Calorific Value?

 Body Mass Index (BMI)

1. DEFINE VITAMINS, CLASSIFY VITAMINS; EXPLAIN THE DIETARY

Life Stage Recommended Amount

2. DEFINE VITAMINS. CLASSIFY VITAMINS; EXPLAIN THE DIETARY

Life Stage Recommended Amount

Vitamin E Antioxidant; protects cell Polyunsaturated plant oils (soybean,

4. EXPLAIN THE DIETARY SOURCES, FUNCTIONS, DEFICIENCY

 Helping to protect cells and keeping them healthy

Lack of vitamin C can lead to scurvy.

 Citrus fruit, such as oranges and orange juice

How common is vitamin C deficiency?

Life Stage Recommended Amount

5. DESCRIBE THE DIETARY SOURCES, DEFICIENCY MANIFESTATIONS

 Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to

Age Male Female Pregnancy Lactation

Birth to 6 months* 0.2 mg 0.2 mg

7–12 months* 0.3 mg 0.3 mg

1–3 years 0.5 mg 0.5 mg

4–8 years 0.6 mg 0.6 mg

9–13 years 0.9 mg 0.9 mg

14–18 years 1.2 mg 1.0 mg 1.4 mg 1.4 mg

19-50 years 1.2 mg 1.1 mg 1.4 mg 1.4 mg

51+ years 1.2 mg 1.1 mg

6. DESCRIBE THE DIETARY SOURCES, DEFICIENCY MANIFESTATIONS

 Vision maintenance: Vitamin A is essential for maintaining the light-sensing cells in the

RDA (IU / mcg) UL (IU / mcg)

Infants 0–6 months 1,333 / 400 2,000 / 600

7–12 months 1,667 / 500 2,000 / 600

Children 1–3 years 1,000 / 300 2,000 / 600

4–8 years 1,333 / 400 3,000 / 900

9–13 years 2,000 / 600 5,667 / 1700

19–70 years 2,333 / 700 10,000 / 3000

Men 14–18 years 3,000 / 900 9,333 / 2800

19–70 years 3,000 / 900 10,000 / 3000