Unit I - Work, Livelihood and Career

UNIT II

NUTRITION, FOOD SCIENCE

AND TECHNOLOGY

29

Rationalised 2023-24

Chapters.indd 29 8/12/2022 3:30:09 PM

 Our life is centred around food. Food is more than a biological necessity.
It contributes to our cultural identity, is a part of social and religious
Human Ecology and Family Sciences – Part 1

practices. Food also enables us to realise our creativity, is a symbol of

hospitality, status and power, among many other things. Our food choices
have far reaching effects. Food nourishes the body, promotes growth,
enables it to function and builds resistance to infection. If we eat nutritious
and wholesome food, our bodies can function optimally. Thus knowledge
about food and nutrition is essential.
Food and Nutrition / Food Science and Nutrition is a broad domain
consisting of several sciences that are distinct yet interrelated. As you
know, nutrition influences our health, well being and quality of life. Are
you aware that nutrition plays a significant role even before birth and
that it affects the health of an individual throughout life? Have you ever
thought of yourself as a biological being, that your body is made up of
carefully arranged atoms, molecules, cells, tissues and organs? Every cell
is regularly and continually replaced, some after a few days, some after
months and some after years, although your external appearance may
be relatively unchanged. For all these internal and external processes,
nutrients are required and food is the source of these nutrients.
However, many people do not have the correct knowledge; some do not
get adequate food to eat, some overeat, others have wrong food choices
because of various reasons, thus leading to malnutrition. In India, the
proportion of undernourished persons has been high, but in recent years,
prevalence of overnutrition is gradually increasing and many people
are now suffering from health problems such as obesity, heart disease,
hypertension, diabetes. Infectious diseases still continue to take their toll.
Nutrition is the cornerstone for promotion of health as well as prevention
and management of numerous disease conditions. Trained dietitians/
medical nutrition therapists are required to give advice about diet and
nutrition to the individual as well as the community. Trained public health
nutritionists are required to tackle public nutrition and health problems
at regional, national and international levels, for planning-implementing-
monitoring-evaluating various strategies and programmes.
India is a major producer of fruits and vegetables, milk, etc., but almost
1/5th to 1/3rd of the produce is wasted. This calls for concerted action
to prevent spoilage, preserve, process and convert foods into a variety of
forms. Cost of production in India is less than in many other countries and
foreign direct investment is high. Therefore, food processing industry has
been termed as the ‘sunrise sector’ of the Indian economy. Simultaneously
socio-economic and socio-cultural changes/transitions in the country
have tremendously increased the demand for ready to eat and processed
30 foods. Besides this, the increasing prevalence of disease has necessitated

Rationalised 2023-24

Chapters.indd 30 8/12/2022 3:30:09 PM

 development of foods for managing disease conditions. This has increased
the demand for trained personnel who can undertake development,
manufacture and marketing of various processed foods.
Increasing number of persons travel outside the home daily for

Unit II - Nutrition, Food Science

education, work, tourism. Also those who live in institutions of various
kinds such as old age homes, hospitals, orphanages, school and college
hostels, prisons, ashrams need to be fed daily. Nutritious, wholesome

And Technology
and safe food needs to be prepared and catered. This requires expertise
which can be achieved through appropriate training. With increasing
tourism, interest in ethnic foods and cuisinology, there is demand for
qualified persons.
However, availability of foods with varying shelf life is not enough. Safety
of the foods is crucial. ‘Safety culture’ of any organisation is important, be
it food processing/manufacturing/catering industry. Indian government
therefore has introduced several legislations and standards of food safety
from time to time. Ensuring that all consumers have access to safe, good
quality food, will require persons trained in food quality and safety.
The five areas dealt in this Unit will acquaint you with basic concepts
in each of these areas, give you insights about the professions and the
knowledge and skills you need to acquire for each of these.

31

Rationalised 2023-24

Chapters.indd 31 8/12/2022 3:30:09 PM

 2
Chapter

Clinical Nutrition
and Dietetics

Learning Objectives
After completing this chapter, the learner will be able to:
zz understand and describe the significance and scope of clinical
nutrition and dietetics.
zz describe the role and function of a dietitian/clinical nutritionist/
medical nutrition therapist.
zz explain the knowledge and skills required for a career in clinical
nutrition and dietetics.

Introduction
Nutrition is the science of food, nutrients and other substances as well as
their digestion, absorption and utilisation by the body. Nutrition is also
concerned with the social, psychological and economic aspects of food and
eating. It is well known that optimum nutrition is important for providing
immunity and protection from infection, and to promote recovery from a
variety of illnesses as well as managing chronic diseases. When nutrient
intakes are inadequate, the body has difficulty in maintaining immune
defences, healing wounds, utilising medications, supporting organ
functions. Such persons may fall victims to additional complications.
Nutrition is also important in disease states. In some diseases, nutrition
plays a major role in management and treatment, and for some it

Rationalised 2023-24

Chapters.indd 32 8/12/2022 3:30:09 PM

 complements the medical treatment. Nutritional status and support, prior
to and after illness, play an important role in prognosis, recovery and even
duration of hospitalisation. Also, illness and disease can result in nutrient
imbalances even in a person who previously had good nutritional status.

Unit II - Nutrition, Food Science

Thus health and nutrition are intimately interlinked. Poor nutrition
not only leads to health problems but can also make existing problems
worse. The specialised area of nutrition which deals with nutrition during
illness is ‘Clinical Nutrition’. In recent times, this field is called Medical

And Technology
Nutrition Therapy.

Significance
Nutritional care has gained importance worldwide, more so in recent times.
Health problems/illness/disease and their treatment can affect nutritional
status in a variety of ways: by impairing a person’s ability to eat and/or
swallow, by interfering with digestion, absorption and metabolism as well
as excretion. Even if one function is initially affected, in some individuals,
if the health problem intensifies, other body functions may be affected.
Clinical nutrition focusses on the nutritional management of patients with
established disease.
It must be borne in mind that function of any organ/tissue/system
of the body can be affected due to disease, which can lead to minor and
acute to major and sometimes, chronic or long lasting problems. In all
these conditions, it is important to ensure that the person is adequately
nourished and the person who delivers this service is a trained dietitian/
medical nutrition therapist/clinical nutritionist. The professional clinical
nutritionist/dietitian uses a systematic and logical approach to the
nutrition care process, focussing on each person/patient’s unique needs
and addresses them in an individualistic and holistic manner. The patient
is the primary focus of the nutritional care process.
The 20th and 21st centuries have witnessed tremendous advances in
the field of medicine and pharmacology, enabling us to control many
communicable and infectious diseases. However, newer diseases such
as HIV/AIDS have emerged. Prevalence of non-communicable diseases
such as obesity, heart disease, hypertension and diabetes is not only
increasing, but these are occurring at a much younger age. In fact,
India is likely to be the diabetes ‘capital’ of the world. Further, older
persons require special attention. Thus, the proportion of population
which requiresnutritional care, support and diet counseling is increasing.
The clinical nutritionist/medical nutrition therapist plays an important
role in preventionof diseases and promotion of good health, besides
recommending therapeutic diets for management of various diseases.
New scientific knowledge is being generated about physiological and
33
metabolic disturbances in chronic and acute diseases; newer methods of

Rationalised 2023-24

Chapters.indd 33 8/12/2022 3:30:10 PM

 nutritional assessment are being developed and adopted, newer
techniques and supplements for nourishing the patient are being
Human Ecology and Family Sciences – Part 1

used. With advances in the food and pharmaceutical industry basic

research in nutrition has shed light on the role of various nutrients and
other substances such as nutraceuticals, phytochemicals / bioactive
substances resulting in the growth of the discipline of clinical nutrition.
Researchers and scientists continue to discover the role of individual
nutrients ranging from a role in gene expression, metabolic regulation
and in the prevention and treatment of disease. For example, antioxidants
like beta-carotene, selenium, vitamin E and vitamin C, particularly from
food, appear to have a protective role.

According to the FSSAI, foods for special dietary uses or functional

foods or nutraceuticals or health supplements means foods which
are specially processed or formulated to satisfy particular dietary
requirements which exist because of a particular physical or
physiological condition or specific diseases and disorders and which
are presented as such, wherein the composition of these foodstuffs
must differ significantly from the composition of ordinary foods of
comparable nature, if such ordinary foods exist, and may contain one
or more of the following ingredients, namely:
(i) plants or botanicals or their parts in the form of powder,
concentrate or extract in water, ethyl alcohol or hydro alcoholic
extract, single or in combination;
(ii) minerals or vitamins or proteins or metals or their compounds
or amino acids (in amounts not exceeding the Recommended
Daily Allowance for Indians) or enzymes (within permissible
limits);
(iii) substances from animal origin;
(iv) a dietary substance for use by human beings to supplement
the diet by increasing the total dietary intakes.
Medical foods are those products that are specially manufactured for
persons with specific needs. Such foods are regulated and can be used
only with a doctor’s prescription for the specific dietary management
of a disease or condition.
Phytochemicals/Bioactive compounds are non-nutrient constituents
present in foods that have physiological or biological activity and
influence health.

Basic Concepts
The dietitian/ medical nutrition therapist’s role is to provide advice and
34
translate technical information into dietary guidelines. They provide advice

Rationalised 2023-24

Chapters.indd 34 8/12/2022 3:30:10 PM

 to patients and if necessary, give prescriptions to healthy individuals at
different stages of the life cycle, from the womb to the tomb (i.e., pregnancy,
infancy and childhood up to old age) in order to help them maintain good
nutritional status and remain healthy. Besides this, nutrition and diet

Unit II - Nutrition, Food Science

therapy are used to improve the overall health of patients with a wide
range of conditions. Examples of these conditions are diarrhea, vomiting,
food allergies, anemia, fever, typhoid, tuberculosis, ulcers, hyperacidity
and heart burn, epilepsy, gastrointestinal problems, AIDS, hypertension,

And Technology
cancer, osteoporosis, obesity, burns, metabolic disorders, including
diabetes, and kidney, liver, and pancreatic disorders. Patients who are to
undergo surgery also need pre and post operative nutritional intervention/
support. Clinical Nutrition and Dietetics, therefore, is concerned with nutritional
requirements of patients suffering from different diseases and prescribing the
right type of diet for them. The objectives of diet therapy are:
(i) promotion of recovery formulation of the diet to meet the needs of
the patient taking into consideration her or his food habits.
(ii) modification of the existing diets to ameliorate the disease condition
and to keep it under control;
(iii) correction of nutritional deficiencies; if any
(iv) prevention of short-term and long-term complications in case of
chronic diseases;
(v) education and counselling of the patient regarding the need to
adhere to the prescribed diet.
A dietitian also needs to look at the effect of illness on food acceptance and
utilisation. Some of the factors that are considered include (a) nutritional
stress (b) psychological stress (c) effect of illness on food acceptance and
(d) acceptability of modified therapeutic diets.
Thus, Nutritional care during illness is an organised group of activities and
consists of :
zz Assessing nutritional status
zz Diagnosis of nutritional problems
zz Planning and prioritising nutrition intervention(s) to meet
nutritional needs
zz Monitoring and evaluating nutritional care outcomes and making
changes if necessary.
The nutritional care process is applied to individuals or groups in any
setting from healthy persons who are clients of fitness/wellness centres/
programmes, pregnant women, elderly persons, persons being treated for
illness in private physicians’ clinics to hospitalised patients, regardless of
35
whether they are in municipal, government, charitable or private hospitals.

Rationalised 2023-24

Chapters.indd 35 8/12/2022 3:30:10 PM

 A study of clinical nutrition and dietetics enables the professional to:
zz Plan diets appropriately to meet the nutritional requirements at
Human Ecology and Family Sciences – Part 1

various stages of the life cycle.

zz Modify diets in various disease conditions, keeping in mind the
physical state, occupation, cultural, ethnic and socio-economic
background, the treatment regimen and the individual’s likes and
dislikes.
zz Plan diets for athletes/sports persons, for individuals in special
situations such as nutrition in space, persons working in submarines,
defence personnel, industrial workers, etc.
zz Promote health and well-being of patients admitted to hospital or in
outpatient clinics as well as in institutional settings.
zz Manage food services in a variety of institutional settings such as old
age homes, schools, orphanages etc.
zz Help patients with chronic diseases such as diabetes and heart disease
in management, to prevent complications and improve quality of life.
zz Promote better health in the community and better efficacy of
services in health care institutions/ establishments in terms of better
patient care management, holistic care, and contribute to better
survival and recovery.

Nutritional assessment is required to obtain information on the

patient’s nutritional status and nutrient needs. It involves:
zz Obtaining detailed information on health, diet, personal and
medication histories
zz Anthropometric measurements
zz Relating the information on laboratory and physical measurements
with the above and the physician’s diagnosis
zz Interpreting all of the above to identify potential nutritional
deficiencies and risk of future deficiencies.

It must be borne in mind that physicians are ultimately responsible

for ensuring that all the patient’s medical needs are met. Based on the
doctors’ diagnosis of the disease condition and the nutritional assessment
done, the dietitian prescribes the diet, ensures provision of food in the
hospital according to the diet restrictions and provides dietary counseling
to the patient. For the implementation of the diet prescription, the
physician relies on the dietitian/medical nutrition therapist. Today, the
field of clinical nutrition has evolved into a practice that is increasingly
incorporated into mainstream medical treatment and the deititian forms
36
an integral part of the medical team.

Rationalised 2023-24

Chapters.indd 36 8/12/2022 3:30:10 PM

 The dietitian has the primary responsibility for ensuring that the
patient receives appropriate diet and optimal nutritional care, after
assessing the nutritional status of the patients, analysing nutrient needs
(nutritional requirements change in different illness/disease states) and

Unit II - Nutrition, Food Science

developing the nutrition care plan by administering suitable regimens
to patients who are hospitalised or counseling those in the outpatient
department (OPD).

And Technology
Both normal and therapeutic diets are planned to maintain or restore
good nutrition in the individual. This is done by the medical nutrition
therapist/dietitian taking into account the food pattern and frequency of
intake of different types of food, diagnosis of disease and prescription given
by the doctor, the health status and physical condition including ability
to eat, chew, swallow, digest and absorb the food eaten, feeling of hunger,
physical activity and life style, dietary and other supplements consumed,
cultural/ethnic practices and religious beliefs.
Let us get acquainted with some basic terms used by clinical nutritionists
and dietitians.
Types of Diets : Any nutritional care plan involves providing for adequate
intake of all nutrients vis-à-vis the requirements based on age, sex,
physiological state, occupation and health status.
zz A standard, normal or regular diet is one that includes all groups of
foods and meets the needs of healthy individuals. However, in the
hospitals a regular diet would be low in fried fatty foods, sweets,
spices and condiments.
zz Modified diets are those that are adjusted to meet the medical
needs of a patient, which may involve one or more of the following:
(1) change in consistency and/or texture (e.g., fluid and soft diets),
(2) an increase or decrease in the energy intake, (3) include greater
or lesser amounts of one or more nutrients e.g., increase in protein
intake in case of surgery, lower protein intake in case of kidney
failure, high or low in fibre, lower fat intake, restriction in sodium
intake, restriction in fluid intake, restricted intake of certain foods as
these may be rich in a non-nutritive dietary constituent e.g., spinach,
because spinach is rich in oxalates, and (4) change in the number
of meals, or modification in intervals of feeding or special plan for
patients when route of feeding is altered.
Changes in Consistency: Depending on the condition, patients may be
advised liquid, soft or regular diet (i) Liquid diets are primarily fluid in
consistency at room temperature. Also known as full fluid diets, these
include foods which are free from fibre and are nutritionally adequate. The
advantage is that the nutrients are easily absorbed if the gastrointestinal
37
tract is functioning normally. Such a diet is advised for persons who are

Rationalised 2023-24

Chapters.indd 37 8/12/2022 3:30:10 PM

 unable to chew or swallow normally. For example, coconut water, fruit
juice, soup, milk, buttermilk, milk shakes, etc. A variation of this is also
Human Ecology and Family Sciences – Part 1

clear liquid diet, which is even more thin in consistency, e.g., clear soups
or juices (without pulp), very light tea, etc. Clear liquid diet is prescribed
just after surgery. However, the limitation is that it is not easy to meet the
nutritional requirements of the person completely. (ii) Soft diets provide
semi-solid foods that are lightly seasoned, do not contain much fibrous
or gas forming foods. Such diets are easy to chew and digest. Examples
of foods included in soft diets are khichdi, sago kheer, etc. Foods included
should minimise the risk of indigestion, abdominal distention, nausea,
cramping or any other gastrointestinal problems.
There are certain modifications we make even for normal adults in
the older age group. This is called mechanical soft diet which includes
soft, mashed and pureed foods for the elderly with problems in chewing.
A soft diet, on the other hand, is a therapeutic modification. It is soft
in consistency and includes only simple, easily digestible food with no
harsh fibre, high fat or spicy foods. Such diets are given when rest to the
digestive system is recommended.
Feeding Routes: The best and most preferred way / route for feeding
the patient is orally or by mouth. However, there are patients who may
not be able to chew or swallow e.g., if the person is unconscious or if
there is a problem with the esophagus. For such individuals there are two
options (a) tube feeding which is introdussed through the nose into the
stomach or (b) intravenous feeding. In tube feeding, nutritionally complete
feeds are delivered through a tube. These are preferred over intravenous
feeding which is introduced through the nose into the stomach as long
as the gastrointestinal tract is functional and the person is able to digest
and absorb whatever is fed. Intravenous feeding means that the patient is
nourished with special solutions which are given through a drip in a vein.
Prevention of Chronic Diseases: Besides being important for persons
with disease, diet and good nutrition (as well as a healthy lifestyle) can
control and delay the age of onset of chronic diseases. The foods we
consume today, especially processed foods, contain many additives, are
high in fat and/or sugar, often are prepared from highly refined foods and
are therefore low in fibre and many other important constituents which
confer health benefits. This is why we need help in making appropriate
choices.
Can you identify the types of changes that have occurred in the diets
of urban Indians over the past decade? It is seen that fat consumption has
increased, refined sugar consumption has increased. There is a reduced
intake of fibre as well as several vitamins and minerals. In non-vegetarian
38 populations, consumption of animal protein has also increased.

Rationalised 2023-24

Chapters.indd 38 8/12/2022 3:30:10 PM

 What are the consequences of these dietary changes? Broadly speaking,
such changes have been associated with increased incidence of chronic
diseases such as obesity, cancer of the colon, diabetes, cardiovascular
disease and hypertension. For example, the increase in sugar and fat

Unit II - Nutrition, Food Science

consumption, along with the decrease in fibre consumption and less
physical activity, play a role in causing of obesity and diabetes. It has also
been found that high consumption of highly salted convenience foods,
processed foods with high sodium content, decreased intake of potassium-

And Technology
rich fruits, vegetables, grains and legumes, possibly low calcium intakes,
less physical activity as well as stress are associated with increased risk of
hypertension (high blood pressure).
Clinical nutritionists can play a very important role in preventing
development of such problems by providing appropriate diet counselling
and guidance. They can also be appointed for guidance to various groups
such as schools and colleges, etc.

E Scientists have found connection between diet and disease.

X For example in a clinical study of 20,000 men, consuming fish
E once a week was linked to a 52 per cent reduction in the risk of
R sudden death from heart attack. Fish is high in omega-3 fatty
C acids, which are essential components of cells and can protect
I the heart from abnormal heart rhythm.
S
In another clinical study of more than 42,000 women, those who
E
ate lots of fruits, vegetables, whole grains, low-fat dairy products,
and only lean meats lived longer. High intake of fruits, vegetables,
1 and legumes was associated with a lower risk of developing heart
disease.
What can you conclude about (a) role of the diet in disease
causation? (b) role of the diet in disease prevention?

Preparing for a career

The professional clinical nutritionist or dietitian must have:
zz Knowledge of physiological changes in disease conditions, changes
in RDAs/nutrient requirements in illness and types of dietary
modifications required, traditional and ethnic cuisines.
zz Skills in assessing nutritional status of patients using clinical and
biochemical criteria, diet planning customised to requirements of
individual patients and specific disease conditions, recommending and
administering diets to patients, communication for diet counselling,
39
adapting to cultural milieu, food taboos and overcoming fads/myths.

Rationalised 2023-24

Chapters.indd 39 8/12/2022 3:30:10 PM

 It is absolutely essential to have knowledge (both theoretical and
practical) of the subject areas of nutrition, food science, food composition,
Human Ecology and Family Sciences – Part 1

clinical nutrition and dietetics or the more recently used terminologies

such as medical nutrition therapy or medical nutrition management.
For this, the clinical nutritionist and dietitian needs to have thorough
knowledge and understanding of the basic biological and physical sciences
including chemistry, biology, physiology, biochemistry. Since food safety,
especially in institutional settings, is critical, s/he must have knowledge of
microbiology and food microbiology and safety, food quality and assurance,
food laws and regulations, physics to be able to effectively use and ensure
maintenance of the various equipments used in food preparation, storage
and service. Knowledge of food service management including quantity
food production is essential. Basic knowledge and understanding of
bookkeeping and accounts, record–keeping, management, especially
personnel management, are important. One of the most important aspects
of the job profile of a dietitian is counselling patients. Disease changes
the body and mind. It can have a major impact on both the physiological
and mental/emotional condition of the body. Counselling is an art and a
science. A dietitian requires knowledge of psychology, sociology, education
and counselling in order to become a good diet counsellor.
Clinical nutritionists would need to have additional knowledge of
epidemiology and the patterns of prevalence and incidence of nutritional
disorders and diseases, skills in surveying patient populations, laboratory
research using biochemical parameters, skill in conducting experimental
research with patients to find out the usefulness of various diets, drugs
and nutritional supplements.

Preparing for a Career

In order to choose any of the career options offered by Clinical Nutrition
and Dietetics, you need to have passed 10+2 level followed by completion
of a B.Sc. degree in Home Science or B.Sc. with a specialisation in
Nutrition / Food Technology. In case you want to be a dietitian you must at
least complete a Postgraduate Diploma in Dietetics with an internship to
qualify to be a registered dietitian. Those who have a B.Sc. degree in Home
Science, Life Sciences, Biochemistry, Microbiology or Biotechnology can
enter this area at the Postgraduate Diploma level. M.Sc. in Food Science
and Nutrition or Dietetics helps one to specialise in this field and are
preferred in many places of employment A dietitian, after finishing her/his
university education, can go further and qualify to obtain the credential
of a “Registered Dietitian”. Many countries have regulatory laws regarding
this. If you choose a career focussing on teaching and research, a number
of options open up in universities, colleges and research institutions. In
40
order to qualify for teaching posts it is now essential to successfully clear

Rationalised 2023-24

Chapters.indd 40 8/12/2022 3:30:10 PM

 the National or State Eligibility Tests conducted by University Grants
Commission (UGC). It is advisable to complete your Ph.D. too in case you
want to pursue a career in academics or research.

Unit II - Nutrition, Food Science

Scope
Clinical Nutrition and Dietetics offers rich scope and potential for a

And Technology
satisfying career as a dietitian, diet counsellor, teacher, researcher or
corporate consultant. The primary career and wellness possibilities in this
field include becoming a dietitian, diet counsellor or clinical nutritionist
engaged in research and/or teaching. Besides this, clinical nutritionists also
have career opportunities in the food industry, research and development
(R&D) and production of medical foods, nutraceuticals, tube feeds, various
types of nutritional support formulations or functional foods.
If you have a keen interest in improving the way in which we use food
to control, prevent and treat disease conditions, clinical nutrition and
dietetics is the field you should choose. Clinical Nutrition and Dietetics has
a promising future. While most of us have an idea of the role of dietitians
and diet counsellors, we may not be aware that there is expanding scope
for research into the physiological and psychosocial changes brought
about by disease conditions. The relevance of nutritional considerations
in preventing, treating and curing different types of disease conditions is
being increasingly accepted. Research has led to the development of drugs
and nutritional supplements, rehabilitation of patients in community
settings; development of dietary guidelines and nutrition education.
Further, clinical nutritionist can have a role in delineation of public
policy, in designing and implementing preventive and promotive nutrition
programmes to tackle nutritional deficiency disorders. You could expect
jobs as a dietitian in hospitals/ clinics, wellness centre, gyms, slimming
clinics with consultants, teacher / faculty in a university or college,
researcher in medical research establishments and nutrition research
laboratories, consultant in companies developing therapeutic foods and
supplements, food service manager/ provider in hospitals etc. You can
also work as a freelancer, diet consultant or dietitian running your own
enterprise.

Career Avenues:
zz Dietitians with consultants/physicians, in health clubs or
gymnasiums
zz Dietitians in hospitals including speciality departments; a key
member to provide nutrition support in the healthcare team
41

Rationalised 2023-24

Chapters.indd 41 8/12/2022 3:30:10 PM

 zz Freelance Dietitian.
Human Ecology and Family Sciences – Part 1

zz Dietitians in catering services for hospitals, schools, industrial

canteens, etc.
zz Entrepreneurs who develop and supply speciality foods for
specific health purposes
zz Teaching and Academics
zz Research including Clinical Research
zz Nutrition Marketing
zz Technical Writing.

Key Terms
Dietetics, clinical nutrition, dietary modification, therapeutic diets,
dietitian, nutrition counselling.

Review Questions

1. What is the significance of the study of clinical nutrition and

dietetics?
2. What are the types of dietary modifications that a medical nutrition
therapist may make?
3. Why do we need dietary changes to prevent chronic diseases? How
are they linked with lifestyle?
4. What are the roles performed by a dietitian? How does the
dietitian form a team in patient care with other health care
professionals?
5. How can we prepare for a career in clinical nutrition and dietetics?
6. How does illness/disease affect nutritional status of a person?

Practical 1
Theme: Modification of a normal diet to soft diet for elderly person.
Tasks: 1. Interviewing and recording of one day’s diet / food intake
for an adult,
2. Assessing the diet to determine whether it is nutritionally
balanced,
42

Rationalised 2023-24

Chapters.indd 42 8/12/2022 3:30:10 PM

 3. Modifying the diet to suit the needs of an elderly person
who needs a soft diet,
4. Assessing the modified diet to determine whether it is
nutritionally balanced, and

Unit II - Nutrition, Food Science

5. Interacting with an elderly person to determine whether the
modified diet is acceptable.
Purpose: This practical will enable students to understand the basic

And Technology
concepts of diet modification for a specific purpose and the importance
of providing a well-balanced, nutritious diet, keeping in mind the age, sex
and health status of the individual. It will also give them an opportunity to
interview a person and recording diet intake.

Conducting the Practical

Note to the Teacher: The first part of the practical (Tasks 1 and 2)
is to be done with an adult person within 60 years of age and the
modification of the diet (Tasks 3, 4 and 5) has to be done for an
elderly person, as given on page 68.
This practical can be done individually or in pairs.
1. Each individual student/pair should interview an adult man or woman
who is below 60 years of age, in your family or neighbourhood.
2. One day’s diet, i.e. food intake including all liquids and beverages, are
to be recorded in the format given herein. An example is given for your
reference.
3. The diet should then be assessed to determine whether it is nutritionally
well-balanced, using the guide given.
4. This diet should then be modified to a soft diet (easy to chew and
swallow) for the following situations: (Note to teacher: One case of
the following to be assigned to each student/pair)
a) An elderly man/woman who has no teeth - age > 70 years
b) An elderly man/woman who has no teeth and has difficulty in
swallowing
c) An elderly man/woman who has dentures ( age about 60-65
years)
d) An elderly man/woman who does not have molar teeth.
5. Assess the modified diet to determine whether it is nutritionally
balanced.
6. Interact with an elderly person in your family or neighbourhood.
43

Rationalised 2023-24

Chapters.indd 43 8/12/2022 3:30:10 PM

 7. The diet plan is to be shared with them, and their comments and
suggestions should be recorded
Human Ecology and Family Sciences – Part 1

8. Teacher to facilitate a class discussion about the exercise.

Record of 24-hour dietary intake

Time of Day Meal Menu Item Ingredients Amount Remarks*

consumed (in
household
measures)
Early morning Bed tea
Morning Breakfast
Mid morning
Afternoon Lunch
Evening
Night Dinner
At bed time

* Note any additional ingredients added e.g., sugar to milk, ghee on chapati
or rice, supplement in milk, sugar or jaggery or honey eaten with bread or
chapati, etc.

Example for recording the food intake

Time of Day Meal Menu Ingredients Amount Remarks*

Item consumed
(household
measures)
Example Bed tea Tea Milk 1 mug 2 tsps sugar
6.30 am Sugar added
7.30 am Breakfast Bread Bread 2 slices
with Butter 1 tsp
omelette Egg -1 1 omelette
Oil
Onion
Coriander
Milk Milk 1 mug Sugar added
1 tsp
Supplement
added (e.g.)
1 tablespoon
44

Rationalised 2023-24

Chapters.indd 44 8/12/2022 3:30:10 PM

 Guide for assessing diet quality and whether the diet is nutritionally
balanced

Food group No. of No. of servings Difference

servings recommended between

Unit II - Nutrition, Food Science

consumed recommended
and consumed
Cereals and Millets Approx 10

And Technology
Pulses and Legumes 2– 3

Green leafy vegetables ½ to 1 katori

cooked
Other vegetables 2 katorisb
cooked
Roots and tubers ½ to 1 katori

Fruits 2-3 servingsA

Milk/milk products e.g., 1 glass / 1 katori

curd
Visible fats and oils 6 tsps*
including butter, ghee etc.
Sugar and jaggery 4 tsps*

Note: * The maximum desirable intake

(a) At least one of the fruits should be a source of vitamin C
(b) including salads

45

Rationalised 2023-24

Chapters.indd 45 8/12/2022 3:30:10 PM