Introduction of nutrition

 NUTRITION

BASIC TERMINOLOGY USED IN  NUTRITION

1.       Health :-   health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity (WHO)

2.       Nutrition :-  the science of food and its relationship to health

3.       Dietetics :-  practical applications of the principles of nutrition including the planning of meals for well and sick

4.       Nutrient :-  a substance essential for the growth, maintenance, function and reproduction of a cell or an organism

Ø  Macronutrients – required in large quantity and from the bulk of our food eg. Proteins , fats and carbohydrates

Ø  Micronutrients –required in small amounts but play an important role in the regulation of metabolic activities eg. Vitamins and minerals

5.       Nutritional status :- health of a person is influenced by the quality of body to utilize these foods to meet its needs

6.       Nourish :-  to provide food or other substances necessary for life and growth

7.       Malnutrition :-  impairment of health resulting from a deficiency excess or imbalance of nutrient

Ø  Over nutrition – is an excess of one or more nutritive value and usually of calories

Ø  Under  nutrition – is the deficiency of calories and one or more essential nutrients

Ø  Specific deficiency – deficiency of specific nutritive value such as vitamins deficiency

Ø  Imbalance nutritional deficiency 

8.       Kilocalorie :-  unit of heat used in nutrition. The amount of heat required to raise the                   temperature

9.       Metabolism :-  the sum total of building up reactions (anabolism) and breakdown reaction (catabolism) going on inside the body of a living organism

10.   Metabolic rate :-  the rate at which the energy is released from the fuel such as oxygen up take or carbon dioxide excretion

11.   BMR :-  rate of metabolism when an individual is at ret in a warm environment and is in postoperative state, energy is sufficient to meet only the essential needs of vital organs of the body

Introduction of nutrition :-

                                               Next to the air we breathe and water we drink food has been basic to our existence.  In  fact food has been the primary concern of human kind in its physical environment  throughout all recorded history . food is the primary necessity of life. Life cannot be sustained  without an adequate nourishment. We need adequate food for growth and development .  the concern of Todays health is the maintenance as well as the restoration of health . nurse as important members of health team are committed for maintaining the good health status of the people .

Definition of metabolism  :-

                                          Metabolism is the changes which takes place in nutrients from the time of their absorption until they are reached the end products of the various organs through which they pass. The changes included in the process of metabolism are divided in to two

Ø  Building up changes which are called anabolic changes or eg. The building up of the muscle from the amino acids obtained from the proteins

Ø  Breaking down changes which are called catabolic changes  or catabolism eg. The breaking down of glucose or fat into carbon dioxide and water to release energy for activity

Ecology of malnutrition :-

                        Malnutrition is manmade disease. It is a disease of human societies. It is the being quite commonly in the womb and ends with grave.

Factors related to malnutrition :-

Ø  Cultural influence

Ø  Social economic al factors

Ø  Food production

Ø  Health and other services 

Factors affecting the basal metabolic rate :-

Ø  Surface of the body

Ø  Sex

Ø  Age

Ø  Disease

Ø  Under prolonged or chronic nutritional problems

Ø  Stress

Factors affecting total energy requirement :-

                                   Total energy metabolism is a measure of the total amount of energy required during 24 hours, whether the person is resting or working and therefore includes the basal metabolic rate. There are certain factors which influence the total energy metabolism in the normal human being.

Ø  Weight

Ø  Specific dynamic action of food

Ø  Age

Ø  Temperature it includes to two main factors such as

1.       External temperature

2.       The amount of work done

Ø  Muscular activity

Ø  Pregnancy

Relationship of nutrition to health:-

                                        Nutrition has been an essential of human health. The struggle for food is not surprising even today. Many disease are generated from malnutrition. Food promotes the health treat and control the disease and help in prevention of health disease. Balanced diet keeps good health the influence of nutrition on the health of people is a subject of continuous research. Here the relationship between nutrition and health can be clarified on the basis on the following points.

1.       Physical and mental growth:-

                                    Nutrition is an essential for the physical and mental development and day to energy requirement in the human lifespan from childhood to old age. In short health is not possible in absence of proper nutrition.

2.       Specific nutritional deficiency:-

                                    The root cause behind protein nutrition is goiter, anemia, blindness etc. this problems can be solved by a good balanced diet.

3.       Immunity:-

               Due to malnutrition resistance of the individual disease wild chance to get infection increase good and proper nutrition protect the individual from the individual.

4.       Maternal  child and family health:-

                                 Nutrition is an important factor in high maternal and infant mortality fertility and infertility are also affected by nutritional status. Similarity the health status of those family is higher where nutrition is adequate and balanced.

5.       Non communicable diseases:-

                                      On one hand malnutrition is responsible for communicable disease many studies indicate that disease like diabetes, coronary heart disease, hypertension and cancer with nutritional upset.

6.       Primary health care:-

                        For the achievement of health for all nutrition is one out of the components of the primary health care which prove the importance of nutrition in health. Nutrition is an important determinant of the national health policy. In short it can be said that the health and nutrition cannot be separated.

                                                                           

      NUTRITIONAL PROBLEMS IN INDIA 

1.       Protein energy malnutrition

Ø  Kwashiorkor    

2.       Nutritional  marasmus

3.       Vitaminosis:-

Ø  Vitamin A deficiency

Ø  Thiamine deficiency

Ø  Deficiency of B complex

Ø  Ascorbic acid deficiency

Ø  Other nutritional deficiency

4.       Obesity and other:-

Ø  Obesity

Ø  Hyper vitaminosis A

Ø  Hyper vitaminosis D

5.       Disease of blood forming organs:-

Ø  Iron deficiency anemia

Ø  Other deficiency anemia

          NATIONAL NUTRITIONAL POLICY {NNP}

In the government of India adopted a nutritional national policy (NNP) which aims at the eradication of malnutrition to achieve high standard of nutrition in the community through multi sector policy. The features of NNP care as follows follow working policy. This is the multi sector and includes nutritional solution and development policy.

1.       Direct measures:- 

Ø  To utilize the nutrition education impaired to mothers under integrated child development services (ICDS)

Ø  To approach adolescent boys and girls

Ø  To better coverage of pregnant women

Ø  To control and eliminate micro nutritional deficiencies

Ø  To popularize cheaper food articles

Ø  To fortify food articles

Ø  To prevent vitamin A deficiency disorders

2.       Long term measures:-

Ø  To ensure safety of food at domestic level

Ø  To bring reforms in dietary practices

Ø  To improve the purchasing power of food

Ø  To strengthen public distribution system

Ø  Land reforms

Ø  Better coverage of health and family welfare services

Ø  Basic health and nutrition education

Ø  Information, education and communication regarding nutrition

Ø  Improvement in status of women

Ø  To transfer the food and nutrition board

           Food and  nutrition board

The food and nutrition board was formed in 1964 under the ministry of agriculture to bring variety in the dietary habits with the dual objective of reducing the demand of food and to make the individual diet more nutritious. In April 1993 the board way brought under the woman and child development in accordance with the national nutrition policy.

                          Activities of food and nutrition board

1.       Education and training in nutrition:-

Ø  Training in domestic  preservation of fruits and vegetables

Ø  Integrated nutrition  (16 October.)

Ø  To observe nutrition weeks (1-7 September.)

Ø  To observe world breast feeding week (1 – 7 august)

2.       Development and enhancement of nutritive foods :-

Ø  Assessment  of regularity and quality of supplementary food in anganwadi

Ø  To encourage production nutrition food in the community

3.       Fortification of food :-

Ø  To fortify milk with vitamin A

Ø  To fortify salt with iodine

4.       Food analysis

5.       Research and development programs

6.       National Nutritional policy and its implementation

Ø  Constitution of standing committee for implementation of national program

Ø  Activities for control of micro nutritional deficiencies

Ø  Nutritional surveillance

Ø  Planning of district level diet and nutritional programs and their implementation.

     COMMUNITY NUTRITIONAL PROGRAMS

The government of India conducts different nutritional programs for the prevention of dietary deficiency and nutritional disease some of the community   nutritional programs are

1.       Applied nutrition program

2.       Vitamin A prophylaxis program

3.       Prevention of nutritional anemia

4.       Midday meals programs

5.       Balwadi  nutritional  programs

6.       Iodine deficiency disorders control programs

      FACTOR AFFECTING FOOD AND NUTRITION

A number of factor influence the food habits. These includes educational and economic level of the community, culture, tradition, production system of distribution style and food habits etc.

1.       Food habit, custom, belief and tradition and life style:-

                                                 Food habits are among the oldest and most deeply entrenched aspects of any culture. They have deep psychological roots and care associated with love, affection,  self-image  and social prestige. The family play an important role in shaping the food habits. This habits are passed from generation to generation. Some examples such as papaya is avoided during  pregnancy  because it is believed to cause abortion.

Ø  In Gujarat valuable food such as dhal, Greenleaf, rice and fruits are avoided by the nursing mother

Ø  Then there are certain beliefs about hot and cold foods, light and heavy foods

2.       Religion :-

           Religion has a powerful influence on the food habits of the people. Hindu does not eat beef and Muslim do not pork. These are known as ‘’food taboos’’ which prevents the people from consuming nutrition foods event when these are easily available.

3.       Food fads :-

                            In the  selection of food. Personal likes and dislikes play an important part. These are called food fads

4.       Cooking practice:-

                      Draining away the rice water of the end of cooking prolonged boiling in open pans, peeling of vegetables all influence the nutritive values of food

5.       Miscellaneous :-

                       In some communities men eat first and women eat last and poorly the health of woman in this societies may adversely affected

6.       Traditional beliefs :-

                             These are still prevent with foods habits are still prevent with a large majority of the population who illiterate or ignorant regarding nutritive value of foods  for example in India consumption of papaya fruits by pregnant woman is believed to lead to abortion . in some parts of India is was believed that consumption of milk and fish will lead to leprosy. Other similar beliefs includes the following

Ø  Consumption of tongue of the goat by children will make them talkative

Ø  Eating goats leg by children will lead the improper development of knees and joints

Ø  In some parts of Africa it is believed that eggs if gives to children before the teeth have erupted will load to stupide

7.       Hot and cold :-

                 Foods are classified as hot and cold be different cultures in many countries meat eggs, nuts and oilseeds are supposed to be hot foods while fruits, vegetables and milk are supposed to be cold foods

8.       Pica :-

               Pica is a common practice among pregnant woman and children in many countries. Pica is a habit of eating non eating  material such as mud, dirt, clay, chalk, ashes etc.

9.       Food fads and cults:-

                                 Food fad of various kinds have persisted ever since. For example

Ø  Bitter gourd is reputed to cure diabetes mellitus

Ø  Garlic cures high blood pressure

Ø  Foods cooked in aluminum will cause cancer

Ø  The following combination of foods  are poisonous milk and fish and orange juice or other citrus fruits

Ø  A good way to diet is to skip breakfast

Ø  Honey is not fattening

Ø  Meats gives strength

Ø  White shelled eggs are more nutritious then brown shelled eggs

Ø  No need of milk for adult

Cults :-

          For many year vegetarianism has been practiced on religious grounds by Hindu and Jains etc. strict vegetarians do not even consume milk and hence suffer from vitamin B 12 deficiency

Changing food habits :-

                              Food fad and faulty food habits are the important contributory cause for the wide prevalence of malnutrition among preschool children expectant and nursing mothers in developing countries. These can be overcome only by education in nutrition.

The guiding principles in the educational process are

Ø  Change cannot be superimposed  but must be integrated in to the existing cultural pattern

Ø  Proposed changes should be minimal and use such foods which are familiar to the familiar to the people concerned

Ø  The individuals should be satisfied that the changes food habits have improved their health

Socio economic factors :-

                                   Malnutrition is largely the by product of poverty, ignorance , insufficient education, lack of knowledge regarding the nutritive value of foods etc. this factors bear mast directly as the quality of life and are the true determinants of malnutrition in society.

Food production :-

 Increased food production should lead to increased food consumption, but increased food production will not cure the basic problems of hunger and malnutrition in much of the developing world.

It is said that there will be very little malnutrition in India today , if all the food available can be equitably distributed in accordance with physiological needs.

Life style :-

 In our country the nutritional behavior of people is continuously changing. In cities individuals are shifting their food selection from traditional foods to processed foods. In rural india also people have started liking buffet system in place of traditional sitting or portal system.

Junk/fast food:

 With the advent of the fast food culture people like to eat more package food and fast food. E.g. pizzas, burgers, chips and soft drinks. Our food consumption habits are changing. More intake of these foods leads to intake which disturbances cause obesity. Due to obesity occurance of diabetes and rate of heart attack is increased.

   Nutrition for Nurse

Being an important part of health team it is essential  for the nurse to be familiar with all the facts about nutrition and diet therapeutic . the objectives and importance of studying  nutrition by the nurse can be highlighted as under

Ø  To know about the nutritional status of the individual, family and to asses and evaluate it

Ø  To observe the patient reaction to diet, cooking, preservation of food, prevention of food .

Ø  To know the principles of nutrition their  relationship with disease and to prescribe diet

Ø  To provide pleasant and right environment to patients during meals

Ø  To study the nutritional requirements of handicapped weak individuals and other groups

Ø  To educate patients and their relatives about prescribing the proper diet

Ø  To make modification and changes in the patients diet according to his like and dislike and according to disease conditions

Ø  To understands the community nutritional problems and to participate in nutritional programs

 Food and classification of food

Food – any substance used for energy, physical growth, development and repair or rebuilding in the body can be termed as food. It means helps in producing heat and energy formation

Function of food :-

Ø  Physical growth and development

Ø  Producing of energy or power

Ø  Protection against diseases

Ø  For maintenance of tissues

         Classification of foods

1.       Functional classification:-

Ø  Energy providers food example rice, sugar, oil, wheat etc.

Ø  Body builder foods example milk, meat, pulses, oil seeds etc.

Ø  Protective foods example milk, vegetables, fruits etc.

2.       Original (source)classification :-

Ø  Animal source example milk, meat etc.

Ø  Vegetables source example pulses, cereals, fruits etc.

3.       Chemical composition classification:-

Ø  Protein

Ø  Fat

Ø  Carbohydrate

Ø  Minerals

Ø  Vitamins

Ø  Water

4.       Geographical classification :-

                                    In our country food can be classified as north, south, Bengali food etc.

5.       Clinical/medical  classification:-

Ø  Full diet

Ø  Bland diet

Ø  Special diet

Ø  Soft diet

Ø  Liquid diet

6.       Nutritive value classification:-

Ø  Cereals

Ø  Vegetables

Ø  Fruits

Ø  Milk and milk products

Ø  Sugar and jiggery

Ø  Meats and eggs

Ø  Pulses

Ø  Oil seeds

Ø  Fat and oils

Ø  Spices

This is a way food can be classified on different basis for medical concern of nutrition. Classification based on function clinical and nutritional values are more important

Nutrients :-

             Nutrients are organic and inorganic compounds food in diet.  Nutrients as constitutes of food these are

Nutrients

Ø  Water

Ø  Fats

Ø  Vitamins

Ø  Protein

Ø  Carbohydrate

Ø  Minerals .

Nutrients can be divided into two main categories:-

1.       Macro nutrients :-  proteins ,fats and carbohydrates are kept in
this category. This are the bulk of food and are the main source of energy.

2.       Micro nutrients:-  this category include minerals and vitamins. These are required in small quantities.

Water is such a vital nutrients without which like cannot be imagined so it suppressed all other nutrients.