nutrition

1104/13/2304/13/23 DR. P. P. SINGHDR. P. P. SINGH

MUNICIPALCORPORATION OF DELHIMUNICIPALCORPORATION OF DELHI

“ “ BASICS OF NUTRITIONBASICS OF NUTRITIONSPECIALY FOR INFANT & YOUNG CHILDREN”SPECIALY FOR INFANT & YOUNG CHILDREN”

PRESENTED By DR. P.P.SINGH.

MS/ SDNHOSPOITAL


1. CSSM 3. CARE OF WOMEN

FOR RTI/STI(AIDS)

2. FAMILY PLANING

4. ADOLESCENT HEALTH

RCH

R.C.H


NUTRITIONAL STATUS OF DELHINUTRITIONAL STATUS OF DELHIAS PER NHFS-II (2001)AS PER NHFS-II (2001)

IN WOMENIN WOMENFor heightFor height

Nutritionally at risk – 140 – 150 Cm.Nutritionally at risk – 140 – 150 Cm. DELHI MEAN- 153CmDELHI MEAN- 153Cm LOW SOCIO-ECONOMIC WOMEN – 3 Cm Less.LOW SOCIO-ECONOMIC WOMEN – 3 Cm Less. 10% are UNDER 145 Cm10% are UNDER 145 Cm 16% MUSLIMS.16% MUSLIMS. 15% OBC’s15% OBC’s

BMI –BMI – NORMAL 20 – 26.NORMAL 20 – 26. DELHI MEAN 24.DELHI MEAN 24. BELOW 18.5 – 12%,BELOW 18.5 – 12%, OVER WT. - - 32%OVER WT. - - 32% OBESE - - 9%OBESE - - 9%


ANAEMIA AMONGST WOMEN .IN INDIA – 50% POPULATION .

IN DELHI – 41%

MILD --30%

MODRATE --10%

SEVER -- 1%

HIGH IN SC & HINDUs

IN HIGH STANDERDS -- 37%

MEDIUM STANDERDS --49%

LOW STANDERDS -- 43%


INFANT FEEDING PRACTICESINFANT FEEDING PRACTICES

ONLY 24% BEGIN BREAST FEED IN 1ST HOUR.

51% BEGIN BREAST FEED IN ONE DAY.

1IN 5 GIVE BREAST FEED FOR 3 YEARS.

59.9% SQUEEZ 1ST MILK.

13% EXCLUSIVE BREAST FEED. NATIONAL IS 55%.

38% BREAST FEED & WATER

MEAN DURATION 21.4 MONTHs ( MALE 22.6 FEMALE 19.4)


NUTRITIONAL STATUS IN CHILDREN

WEIGHT FOR AGEHIEGHT FOR AGE -2SD- STUNTED.

3. WEIGHT FOR HIEGHT (BMI)--- WASTEDEXPRESSED IN STANDARD DEVIATION UNITS - (Z Score)

MORE THAN 2 SD – UNDER NOURISHED / UNDER WT MORE THAN 3 SD – SEVERLY UNDER NOURISHED

WEIGHT FOR AGE HIEGHT FOR AGE WEIGHT FOR HIEGHT -3SD -2SD -3SD -2SD -3SD -2SD10% 34% 18% 36% 4.1% 12.5%

NO MUCH DEFFRENCE IN MALE FEMALE.BIRTH ORDER – HIGHER THE ORDER HIGH NEGATIVE


37% ARE STUNTED.

10% UNDER NOURISHED .

18% LOW BMI (WASTED)

CORRELATION WITH MOTHER’S EDUCATION

ILLITRATE 53%

PRIMARY 42%

MIDDLE 41%

HIGH SCHOOL OR ABOVE 23%

STANDARD OF LIVING

MEDDLE CLASS 47%

HIGH CLASS 31%


ANAEMIA IN CHILDREN

TOTAL 69%MILD 22%.MODERATE 43%.SEVER 4%

CORELATION WITH MOTHER’S STATUS

NOT ANAEMIC 59%.MILD 77.7% MODERATE 84..8%TOTAL 69%


NUTRITION

NUTRICUS---- TO SUCKLE AT BREAST.

DEFINATION :- A STUDY OF FOOD & ITS RELATIONSHIP TO WELBEING OF HUMAN AT DEFFRENT

* AGE

* CONDITIONS -- a, PHYSIOLOGICAL.

b, PATHOLOGICAL .

CONSIDERING THE SOCIO- ECNOMIC STATUS.


WHY?.

GROWTH

RESISTANCE TO FIGHT INFECTION.

PHYSICAL DEVELOPMENT

INTELLECTUAL ( I.Q)

GOOD DIETBAD DIET

MORBIDITY.

MORTALITY


TYPES OF NUTRITION.

1. BODY BUILDING -- - RICH IN PROTIENS

( MILK,FISH,MEAT,PULSES)

2. ENERGY --- -RICH IN FAT / CARBOHYDRATE.

( CEREALS / SUGAR/ TUBER)

3. PROTECTIVE --- RICH IN PROTINES/VITAMINS

& MINERALS

( MILK,EGG,LEAFY VEGITABLES)


BALANCE DIET.

ACCORDING TO SOCIOECONOMIC STATUS, PALATABLE DIET CONTAINING

CARBOHYDRATE

FAT

PROTINE

MINERAL

VITAMINS

WATER


COMPOSITION OF HUMAN BODYPROTINES - 17%.

FATS - 12%

CARBHYDRATE 1%.

MINERALS 7%. ( IRON, CALICIUM 2% BODY WT, ZINC.,SODIUM,POTASSIUM IODINE ETC)

WATER. 63%

Digestion

Absorption

Transportation to different parts.

Excretion of waste.

Prevention of heat .

Shock absorber.


FOOD STUFFS

•Cereals.

•Pulses & legumes.

•Nuts & oilseed.

•Green leafy vegetables.

•Root Vegetables.

•Fruits.

•Sugar & jiggery.

•Meat, Fish & Eggs.

•Milk & Milk products

•Beverages - Alcoholics


FOOD PROCESS•Parboiling.

•Milling.

•Fermentation.

•Parching & Puffing.

•Canning.

•Salting & Pickling.

•Sugaring.

•Cooking.

•Pasteurization.

•Cooling & Refrigeration

Taste,

Appearance,

Digestibility.

Handling,

Transportation

Storage

Preservation


1. BODY MASS INDEX --- Weight /Height m2

2. PONDERAL INDEX --- HIGHT IN cm / CUBERROT BODY WEIGHT

3. BROCA INDEX -- HIGHT cm – 100.

4. LORENIZ FORMULA -

HIGHT cm - 150

HIGHT cm – 100 X ---------------------

2 (WOMEN) 4(MEN)

5. CORPULENCE INDEX = WEIGHT / DESIRABLE WEIGHT.

= 1.2 Normal


LABORATORY ASSESSMENT.

• N2 BALANCE

P INTAKE/6.25( gm p/Gn) – 24 Hr UREA NITROGEN + 2.5. = 0.3 NORMAL= UPTO 1 MILD = UPTO 2 MODERATE = UPTO 3 SEVERE

• BODY WEIGHT

ACTUAL Wt/ IDEAL Wt X 100 . = 100 Normal = 80 Mild = 70-80 Moderate < 70 Severe

• ADEPOSE TISSUE SKIN FOLD IN mm (8-23 MALE , 10-30 FEMALE)• 24 HOUR URINE CREATININE / HEIGHT (Male 10.5 normal, 5.8 female)• SERUM TRANSFERRIN : 200-260 NORMAL• SEUM ALBUMIN (Gms/ Lit) : 40• TLC / Micro Lit : >1800• SKIN TEST TUBERCULIN mm : > 10


DAILY REQUIRMENTCARBOHYDRATE 40%. 4.1Kcal / gm.

PROTINE 1 gm /Kg b.wt. 4.3Kcal / gm..

FAT Balance 9.1Kcal / gm.

MAN 55Kg 2400 – 3300 Kcal

WOMAN 45Kg 1900 – 3000 Kcal.

INFANT 0 – 6 Months 120 Kcal/Kg

7– 12 Months 100 Kcal/Kg.

CHILD 1 – 3 YEARS 1200 Kcal.

4 – 6 YEARS 1500 Kcal.

7 – 9 YEARS 1800 Kcal

10 – 12 YEARS 2100 Kcal.

13 – 15 YEARS 2200- 2500 Kcal.

16 – 19 YEARS 2400 - 3000Kcal

PREGNANCY + 300 – 500 Kcal .

LACTATION + 700 – 1000 Kcal.


BREAST FEEDING – ADVANTAGES.

B EST

R ESPONSE TO VACCINE REDUCES ALLERGY

E CONOMICAL.

A NTIBODIES.

S TOOL INOFFENSIVE.

T EMPRATURE.

F RESH

E MOTIONALLY BINDING

E COLOGICAL SOUND.

D IGESTED EASILY.

I MMEDIATELY AVILABLE.

N UTRITIONALY OPTIMUM

G ASTTROENTRITIS LOW


EXCLUSIVENESS OF BREAST FEEDING

INCREASES -- I Q PROTECTION FROM CANCER.

DECREASES -- ASTHMA. COLIC SIDS

INFANT 6 – 12 MONTHS - CONT - BREAST FEEDING.

COMPLEMENTRY 3- 5 TIMES.

UNDILUTED MILK.

12 – 2YR. 5 TIMES , NO SPICY FOOD., FAMILY FOOD.

2 YR & ABOVE FAMILY FOOD.

NO BOTTLE FEED.

NATIONAL NUTRITION POLICY FORMULATED BY DEPARTMENT OF WOMEN & CHILD DEVELOPMENT GOI 1993.


TEMPERANCE FOR EATING

Diet should be Adequate & Balance.Diet should be Adequate & Balance. Regularity – time ,mastication.Regularity – time ,mastication. Variety.Variety. Cheaper food are not necessarily less.Cheaper food are not necessarily less. Eating in excess is not desirable.Eating in excess is not desirable. Food Fads Taboos ,Food Fads Taboos , Care is taken preservation Care is taken preservation Excessive of spices be avoided.Excessive of spices be avoided.

04/13/2304/13/23 DR. P. P. SINGHDR. P. P. SINGH 2222


bread, cereal, rice bread, cereal, rice groupgroup 6-11 servings6-11 servings

vegetable groupvegetable group 3-5 servings3-5 servings

fruit group fruit group 2-4 servings2-4 servings

dairy productsdairy products upto 3 servingsupto 3 servings

meat, poultry, fish, meat, poultry, fish, eggseggs 2-3 servings2-3 servings

oil, fat & sweetsoil, fat & sweets use sparinglyuse sparingly


Food ItemFood Item

Adult manAdult man Adult womanAdult woman

SedentarySedentary

workworkModerateModerate

workworkHeavyHeavy

workwork

SedentSedentaryary

workwork

ModerModerateate

workwork

HeavyHeavy

workwork

CerealsCereals 460460 520520 670670 410410 440440 575575

PulsesPulses 4040 5050 6060 4040 4545 5050

Leafy Leafy vegetablesvegetables 4040 4040 4040 100100 100100 5050

Other Other vegetablesvegetables 6060 7070 8080 4040 4040 100100

Roots and Roots and tuberstubers 5050 6060 8080 5050 5050 8080

MilkMilk 150150 200200 250250 100100 150150 200200

Oil and FatOil and Fat 4040 4545 6565 2020 2525 4040

Sugar or Sugar or JaggeryJaggery 3030 3535 5555 2020 2020 4040


Various expert committees of WHO have Various expert committees of WHO have recommended certain dietary goals. recommended certain dietary goals.

Some of them are as follows:Some of them are as follows:

i. Dietary fats should be limited to approximately 20-30% of total daily intake.i. Dietary fats should be limited to approximately 20-30% of total daily intake.

ii. Saturated fats should not contribute more than 10% of the total energy ii. Saturated fats should not contribute more than 10% of the total energy intake. For the remaining fat requirement, unsaturated vegetable oils should be intake. For the remaining fat requirement, unsaturated vegetable oils should be substituted.substituted.

iii. Proteins should account for 15-20% of the daily intake. iii. Proteins should account for 15-20% of the daily intake.

iv. Take carbohydrates rich in natural fiber.iv. Take carbohydrates rich in natural fiber.

v. Salt intake should be reduced to an average of 5 gm. per day (salt intake in v. Salt intake should be reduced to an average of 5 gm. per day (salt intake in India, at an average, is 15 gm. per day).India, at an average, is 15 gm. per day).

vi. Avoid excessive consumption of refined carbohydrates, fats and alcohols.vi. Avoid excessive consumption of refined carbohydrates, fats and alcohols.

vii. Reduce junk foods such as colas, ketchups and other foods that supply vii. Reduce junk foods such as colas, ketchups and other foods that supply empty calories. In certain conditions such as pregnancy, lactation, physical empty calories. In certain conditions such as pregnancy, lactation, physical activity, medical disorders (diabetes) and according to the needs of growth, activity, medical disorders (diabetes) and according to the needs of growth, above recommendations for daily food intake do not apply. above recommendations for daily food intake do not apply.

nutrition

Health & Medicine

weight desirable weight

nourished weight

years1200 kcal

years1500 kcal

years2100 kcal

body wt

children weight

sd severly