2. Nutrition – it is that branch of science, which deals with
the study of dynamic process, in which the consumed food is
utilized for nourishing the body
( A PROCESS OF ASSIMILATION OF FOOD)
3. Macronutrients:
-Proteins (7-15 %)
-Fats (10-30 %)
-Carbohydrates (65-80 %)
Micronutrients:
-Vitamins
-Minerals
Organic and inorganic complexes contained in food
are called nutrients
Classification of nutrients
3
5. Trace elements
• Iron, iodine, fluorine, zinc, copper,
cobalt, chromium, selenium,
molybdenum and manganese
Essential trace
elements
• Nickel, vanadium, cadmium and
barium
Possibly
essential trace
elements
• Aluminium, lead, mercury, boron,
silver, bismuth etc.
Non essential
trace elements
11. Iron losses :
1 mg daily (12.5 mg/ 28 days)
Iron deficiency :
o Decreased storage
o Latent iron deficiency
o Overt iron deficiency
• Nutritional anemia
• Impaired immunity
• Diminished work performance
11
Hemosiderosis: excessive iron in the body
Hemochromatosis: iron is directly deposited in the tissues.
12. • Weakness, easy fatigability, lethargy
• Immuno-compromised
• Diminished physical and mental capacity
• Reduced work capacity, reduced endurance
General
• Weakness, diminished physical and mental capacity,
• Increased morbidity
• Increased risk of low birth baby, abortion, premature delivery, intra-
uterine growth retardation,
• Congenial fetal malformations, PPH, maternal mortality
Pregnant and Lactating Women
• Low birth weight, Perinatal mortality,
• Impaired cognitive performance and motor development,
• Psychological and behavioral effects
• Inattention, fatigue and insecurity
Children
Consequences of Anaemia . . .
12
13. Breastfeeding and appropriate weaning
Dietary modification
Deworming
Nutrition education
Iron supplementation & Iron fortification
Prevention & control
13
14. National Nutritional Anemia
Prophylaxis Program (NNAPP)
- Initiated in 1970.
- Prophylactic doses of iron and folic acid tablets distributed to
high risk groups by the local health workers.
- Food fortification and dietary diversification.
- Infants between 6 and 12 months, school children 6 to 10 year
old and adolescents 11 to 18 years old included in this program.
14
For children 6 to 60 months ferrous sulphate and folic acid are to be provided in a liquid
formulation containing 20 mg elemental iron and 100 mcg folic acid per ml of liquid formulation.
19. Absorption
• 30% small
intestine
• Skin and lungs
Storage
• 80% as iodo-
thyroglobulin in
thyroid gland
Excretion
• Kidney
• Saliva, bile,
skin and milk
(in lactating
women)
20. Pregnancy
Spontaneous Abortion,
Still births
Fetus
Abortions
Still births
Congenital anomalies
Increased perinatal
mortality
Increased infant mortality
Infant
Neurological Cretinism
Mental deficiency
Deaf mutism
Spastic diplegia
Squint
Myxedematous
Cretinism
Dwarfism
Psychomotor defects
Neonate
Neonatal goitre
Neonatal hypothyroidism
SPECTRUM OF IODINE DEFICIENCY DISORDERS
Child and
adolescent
Goiter,
Juvenile hypothyroidism
Impaired mental function
Subnormal intelligence (loss
of 10 to 15 IQ points)
Retarded physical development
Delayed motor milestones
Hearing and speech defects
Stunting and muscle disorder
Adult
Goitre and its complications
Hypothyroidism
Lack of energy
Impaired mental function
Lowered productivity
Animal
Reproductive failure
Decreased yield of milk, egg,
etc.
20
21. Under the National IDD Control Programme
four main components are :
1.Use of Iodized salt or oil
2. Iodine monitoring
3. Manpower training
4. Mass communication
Prevention & control
21
23. FLUORINE
• Found in bones and teeth
Functions :
Prevents development of dental caries
Development of bones
Inhibits activities of certain enzymes
23
26. Fluoride consumption
Water Food Toothpaste Air pollution etc.
Higher concentration in ground waters than surface waters
The optimum concentration for drinking purpose is 0.5 to 0.8 mg/L (ppm)
but the permissible upper limit is 1.5 mg/L (1.5 ppm).
‘A double edged sword’.
fluorine
26
27. fluoride
Excess Deficiency
Fluorosis Caries
(< 0.5 ppm )
- Dental fluorosis
(> 1.5 ppm, 0-7 yrs of life)
- Skeletal fluorosis
(> 10 ppm)
Health problem in rural districts of Andhra Pradesh (esp. Nellore, Nalgonda and Prakasham districts), Haryana, Karnataka,
Kerala, Punjab, Rajasthan and Tamil Nadu.
27
28. Prevention & control
Change in water source
Defluoridation—The Nalgonda Technique
(lime and alum precipitation)
Prohibit fluoride fortified water (0.5–0.8 ppm)/
toothpaste in endemic areas
28
30. ZINC
• Total content in body is 2g
• Intracellular element
• Found in prostate gland, pancrease and brain
30
31. Functions :
• Component of more than 300 enzymes
• Antioxidant
• Storage and secretion of insulin
• Promotes synthesis of retinol binding protein
• Wound healing
• Main content of Gusten protein
• Essential for growth of foaetus
32. Dietary requirements & Sources
◦ 10 – 15 mg/ day
◦ Increases by 50% in pregnancy and lactation.
37. Functions :
Essential component of enzyme
Synthesis of hemoglobin
Lysyl oxidase is necessary for cross linking structural
proteins
Ceruloplasmin
Synthesis of melanin and phospholipid
Development of bones and nervous system
38. Dietary requirements & Sources
◦ Adults –
◦ 2 to 3 mg/day
◦ Infants and children –
◦ 0.5 to 2 mg/day
41. Cobalt
Important as constituent of vitamin B12.
Functions are same as that of vit B12.
Stimulates production of hormone erythropoietin.
Prolonged administration results in polycythemia.
42.
43.
44. Molybdenum
Constituent of enzymes
Absorbed in small intestine
Excess absorption of molybdenum has been shown to
produce bony deformities.
Deficiency of molybdenum is associated with mouth and
oesophageal cancer.
47. References
1. K. Park; textbook of preventive and social medicine; 24th edition.
2. Textbook of public health & community medicine 1st edition;
AFMC Pune (2009); Ashok K. Jindal, Puja Dudeja.
3. Satyanarayana, U. (2008). Biochemistry. 3rd ed. Kolkata: Books and
allied (P) Ltd.
4. Minerals [Internet]. Linus Pauling Institute. 2020 [cited 17 January
2020]. Available from: https://lpi.oregonstate.edu/mic/minerals
