This document discusses nutrition and malnutrition. It defines key terms like diet, nutrition, and malnutrition. It describes the different types of nutrients found in foods like proteins, fats, carbohydrates, vitamins, and minerals. For each nutrient, it provides sources, functions, dietary recommendations, and effects of deficiency. The document is intended to provide an overview of nutrition and preventive measures for malnutrition.

2. By- Nikhil Y. Kule
4th Yr. B.D.s
Dept. of Public Health Dentistry
Guided by- Dr. Swaroop Dhume,Dr. Abhishek Talathi
November 1, 2014 2

3. Diet-It is defined as the types and amounts
of food eaten daily by an individual
-(FDI 1994)
Nutrition – It is defined as the sum of
process by which an individual
takes in and utilizes food -(FDI 1994)
Malnutrition – A pathological state resulting from a
relative or absolute deficiency or excess of one or more
essential nutrients
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4. By Origin
foods of animal foods of vegetable
origin origin
By chemical composition By predominant function
Proteins Body building food
Fats (meat,milk,poultry)
Carbohydrates Energy giving food
Vitamins (cereals,sugars,roots)
Minerals Protective foods
(vegetables,fruit,milk)
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5. By Nutritive value
Cereals Animal foods
Millet Fats
Pulses Oils
Vegetables Sugar
Nuts Jaggery
Oilseeds
Fruits
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6. Proteins
Fats
Carbohydrates
Vitamins
Minerals
Preventive and social measures for malnutrition
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7. They are complex inorganic nitrogenous compound
composed of
Carbon+Hydrogen+Oxygen+Nitrogen+Sulphur
They traditionally regarded as Body-building foods
Major Functions
1.Body Building
2.Repair and maintenance of tissues
3.Synthesis of antibodies , plasma proteins
Hemoglobin enzymes and hormones
4.They supply energy (4Kcal Per gram)
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8. Proteins are obtained from :
Animal Sources (milk,meat,egg)
Vegetables Sources (pulses,cereals,nuts)
The Indian Council Of Medical Research ICMR has
recommended one gram protein/kg body weight for an
Indian adult
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9. They are Concentrated Sources of energy
Classified as :
1. Simple Lipids – Triglycerides
2. Compound Lipids - Phospholipids
3. Derived Lipids – Cholesterol
Major Functions :
1.They supply energy
2.They carry flavor of food
3.They add satiety and variety to a meal
4.They are an integral part of cells and cell membranes
5.They carry the fat soluble Vitamins A,D,E & K
6. They may act to reduce dental caries by coating the plaque,
thereby preventing fermentable carbohydrates from entering it
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10. Fats are Obtained from :
Animal Sources (ghee, butter, cheese, egg,
fat of meat & fish)
Vegetables Sources (groundnut, coconut,
mustard)
Other Sources ( Rice, Wheat, Jowar )
The Indian Council Of Medical Research ICMR has
recommended a daily intake of not more than 20 % of
total energy intake through fats
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11. It is the third major components of food
It is found in cereals, fruits, and vegetables and is essential in
the diet as the source of both glucose and cellulose, the major
source of energy
Major Functions:
1. They Supply Energy (4 Kcal/1 gram)
2. They are essential for oxidation of Fats
3. They are required for the synthesis of certain non-essential
amino acids
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12. Main Sources Of Carbohydrates :
Starches
Sugars
Cellulose
The Carbohydrate reserve of a human adult is about
500 grams which is rapidly exhausted when a person
is fasting.
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13. The word vitamins comes from Latin word VITA means Life
These are the substances which must be obtained by dietary
means because
It can not be synthesize by human body
They are part of the enzyme system
( Act either as coenzyme/catalyst for energy releasing reactions
from carbohydrates , lipids and proteins)
Fat soluble Water soluble
Vit. A,D,E,K Vit. B complex & C
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14. It is widely distributed in
Animal foods- Liver ,eggs ,butter ,cheese ,fish
Plant foods- Green leafy vegetables like
Fortified foods- Vanaspati ,fortified milk
Functions-
1. Contributes to production of retinal pigments
2. Necessary for maintenance of integrity
and normal function of the glandular
and epithelial tissues
3. Supports skeletal growth
4. An anti-infective
5. May protects against some cancers
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15. Recommended Daily intake is 600-1000 micro-grams for adults
Deficiency Causes-
Night blindness, Conjunctival xerosis , Corneal ulceration and
Keratomalacia
Hyperplasia of gingiva , gingivitis, periodontitis , altered taste
Odontogenic epithelium fails to undergo histo and morpho-differentiation
Delayed wound healing
Xerostomia
Candidiasis
Decreased formation of ameloblast
And odontoblast
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16. It is regarded as Hormone ” Kidney Hormone ”
It can be Produced in the body in adequate amounts by simple
exposure to sunlight even for 5 minutes per day
It is found in foods of animal origin(liver,egg yolk,butter,cheese)
Functions-
1. Promotes intestinal absorption and renal tubular
reabsorption of calcium and phosphorus
2. Stimulates mineralization of bone and enhances bone
resorption
3. Permits normal growth
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17. Ideal requirements is 2.5 micro-gram (100 IU) for adults
Deficiency Causes :-
Rickets in children and Osteomalacia in adults
Enamel hypoplasia
Formation of globular and hypocalcified
dentin with clefts and tubular dentin
Misalignment of teeth
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18. Delayed eruption of deciduous as well as permanent teeth
High caries index
Abnormal alveolar bone pattern
Decreased mineralization
Absence of lamina dura in some instances
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19. November 1, 2014 19

20. It is an anti-oxidant
It may prevent heart disease
It is also promoted as the anti-aging vitamin
Functions :-
It protects cell membranes and tissues from
damage by oxidation
It aids in the formation of red blood cells and the use of vit.K
Promotes function of healthy circulatory system
Sources :-
It is found in corn ,nuts, olives, green leafy vegetables, vegetable
oils and wheat germ sometimes supplements may needed
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21. Dietary requirements :-
0.8 mg per gram of essential fatty acids
Deficiency effects :-
Erythrocyte hemolysin newborns
Neuro muscular disorders in adults
Fibrocystic breast disease
Intermittent claudication
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22. Vitamin K plays a key role in helping the blood clot, preventing
excessive bleeding. Unlike many other vitamins, vitamin K is
not typically used as a dietary supplement.
It is fat soluble vitamin which occurs in two forms
1.K1
2.K2
Function:-
It stimulates production or release of coagulation factors
some people have looked to vitamin K2 to treat osteoporosis
and steroid-induced bone loss
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23. Sources:-
Vegetables like spinach, asparagus,
and broccoli
Beans and soybeans
Eggs
Strawberries
Meat
Dietary requirements :-
0.3 mg per kg for adults
Deficiency effects :-
Gingival bleeding
Post extraction hemorrhage
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24. It is a water soluble vitamin which helps to maintain the
cementing material that holds the body cells together
Functions :-
It promotes the healthy immune system
It helps in wound to heal
It maintains connective tissue
& also aids in absorption of iron
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25. Sources:-
Fresh citrus fruits, green leafy vegetables and germinating
pulses
Dietary requirements :-
Daily requirement is 60 mg
Deficiency effects :-
It causes SCURVY characterized by weakness, anemia, bruising
bleeding gums and loose teeth
Inflamed bleeding gums
Delayed wound healing
Inhibits fibroblast, osteoblast &
odontoblast activity
ANUG
Tooth exfoliation
Foul mouth odor
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26. Thiamine was named "the antiberiberi factor“ (1926)
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27. Sources:-
Fortified breads ,fish ,cereals, lean meats and milk
Dietary requirements :-
1.5 mg/day
Deficiency effects :-
Hypersensitive: teeth and mucosa
– Mucosa - satiny appearance
– Old - rose colour
– Prominent of fungi form papilla
– Herpetic like vesicle: palate buccal mucosa
and tongue also between skin and vermilion
border
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28. November 1, 2014 28

29. Sources:-
Cereals,nuts,egg,milk,green leafy vegetables, lean meat
Dietary requirements:-
1.7 mg/day
Dietary deficiency :-
– Magenta coloured:
– Tongue, buccal mucosa and lips
– Opalescent coating
– Prominent of fungiform papilla
– Atrophy of filliform papilla
Angular stomatitis
Cheilosis
Glossitis
Sore throat
Seborrheic dermatitis
Pruritus
Photophobia
Normocytic, normochromic anemia
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30. November 1, 2014 30

31. Sources:-
Daily,fish,poultry,lean meat, nuts and
eggs
Daily Requirements:-
19 mg /day
Dietary deficiency:-
• Nicotinic acid (niacin)
– Atrophic Glossitis
– Oral ulceration ‘lateral border of tongue tongue’
– Severe painful
– ANUG*
– Angular Cheilosis
– pellagra; 3D (Diarrhoea, Dermatitis,
Dementia
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32. November 1, 2014 32

33. Functions
Transamination and decarboxylation of AA
Gluconeogenesis
Formation of niacin/serotonin from tryptophan
Synthesis of lecithin, RNA, sphingolipids, heme
Immune function (IL-2, lymphocyte proliferation)
Steroid hormone modulation
Dietary sources:
Meats, fish
Whole grains
Vegetables
Nuts
Recommended daily requirements
Children 0.6 mg
Female 1.6 mg
Pregnancy 1.9 mg
Male 2.0 mg
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34. Dietatary deficiency :-
Stomatitis, Glossitis, Cheilosis
Seborrheic dermatitis
Irritability, confusion, depression
Sideroblastic anemia
Stomatitis, glossitis, cheilosis
Seborrheic dermatitis
Irritability, confusion, depression
Sideroblastic anemia
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35. November 1, 2014 35

36. Sources:-
Beans and legumes, Citrus fruits and juices, whole grain, dark
green leafy vegetables, poutrypork, shellfish and liver
Daily intake:-
1 mg/day
Dietary deficiency:-
Macrocytic or megaloblastic anemia
Glossitis, fatigue, diarrhea
Progressive neurologic deterioration
Neuropathy, ataxia, seizures, mental retardation
Failure to thrive
Detection
Serum or RBC folate
 Homocysteine level
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37. It is an anti pernicious anaemic factor and it has been used in
the treatment of trigeminal neuralgia
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38. Sources:-
Egg,meat,poultry,shellfish,milk and milk products
Daily requirements:-
100mcg/day
Dietary deficiency:- PERNICIOUS ANEMIA
Glossitis
Beefy red tongue
Loss of taste
Diarrhea, dyspepsia, anorexia
Impotence
Vaginal atrophy
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39. The mineral (inorganic) elements constitute only a small
proportion of the body weight
Minerals perform several vital functions which are absolutely
essential for the very existence of the organism
Classification:
Principal elements : (Macro-minerals) 60-80% of body’s
inorganic material
Required in amt. greater than 100 mg/day
Calcium,phosphorus,magnesium,sodium,potassium,chloride &
sulphur
Trace elements : (Micro-minerals)
Required in amt. less than 100 mg/day
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40. Essential trace elements :
Iron, copper, iodine, manganese, zinc, molybdenum,
cobalt, fluorine, selenium, chromium
Possibly essential trace elements
Nickel, vanadium, cadmium and barium
Non-essential trace elements
Aluminium, lead, mercury, boron, silver, bismuth
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41. Most abundant among the minerals in the body
Total content in adult man is about 1 to 1.5 kg
99 % of it is present in the bones and teeth
Functions :
Formation of bones and teeth
Coagulation of blood
Contraction of muscles
Milk production
Keeping the cell membrane intact
Metabolism of enzymes and hormones
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42. Sources:-
Milk and milk products, eggs, fish
Dietary requirements :-
Adult men and women – 800 mg/day
Disease states –
Rickets
Osteoporosis
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43. It is also important for the formation of bones and teeth
Intake should be almost equal to the calcium
80 % found in the bones and teeth
10 % found in the muscles and blood
Remaining 10 % in various chemical compounds
Functions:-
Essential for development of bones and teeth
Imp. for activation of enzymes & proteins by Phosphorylation
Buffering agent in pH maintenance of blood
Reqd. for formation of DNA & RNA
Reqd. for formation of ATP , GTP
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44. Sources:-
Milk , cereals , Leafy vegetables , meat & eggs
Dietary Requirements:-
The ratio of Ca: P is 1:1
800mg/day
Deficiency:
Decreased serum phosphate level seen in renal rickets
&hyperparathyroidism
Serum phosphate level is elevated in
hyperparathyroidism
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45. Functions:-
Formation of hemoglobin
Brain development and functions
Regulation of body temperature
Muscles activity
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46. Sources:-
Meat , liver, fish, cereals, green leafy vegetables, nuts, dried fruits
Dietary Requirements:-
0.9 mg and 2.8 mg is reqd. for adult males and females
Deficiency:
Iron deficiency anemia
Impaired cell mediated immunity
Reduced resistance to infection
Increased Morbidity and mortality
Diminished work performance
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47. Functions:-
Synthesis of thyroid hormones
Normal growth and development
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48. Sources:-
Sea-foods, cod liver oil, vegetables , fruits grown on sea board,
drinking water
Dietary Requirements:-
150 micro-grams is required for adult
Deficiency:
Most obvious deficiency is goiter
Hypothyroidism
Retarded physical and mental development
Dwarfism
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49. Fluoride is mostly found in bones & teeth
t0he beneficial effects of fluoride in trace
amounts are overshadowed by its
harmful effects caused by excessive
consumption
Functions :-
It prevents the development of dental caries
It is necessary for the proper development of bones
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50. Sources:-
Meat of fish,Jowar banana potatoes,
Plants like taro,yams & cassava
Rock salt(40-200 ppm)
Fluoridated tooth pastes
Dietary Requirements:-
Intake of less than 2ppm of fluoride
will meet the daily requirements
Deficiency:
Dental caries
Fluorosis
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51. Hyper calcification of bones of limbs, pelvis and spine
Calcification of ligaments of spine and collagen of bones
Acute fluoride toxicity:-
Abdominal cramps , vomiting ,diarrhea, increased salivation,
dehydration and thirst.
Chronic fluoride toxicity:-
Dental Fluorosis
Skeletal Fluorosis
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52. Pre-eruptive effects
Malnutrition can cause irreversible changes in the teeth that
could predispose them to develop caries
Enamel maturation, physical and chemical composition, time of
eruption, tooth morphology and size are all affected by pre
eruptive nutrient intake
Dental dysplasias asso. With malnutrition are:-
1.Odontoclasia in deciduous dentition
2.Yellow teeth condition seen permanent dentition
3.Infantile melanodontia observed in deciduous dentiton
4.Lesion Cauque-linear hypoplasia of deciduous teeth due to
def. of Vit.A or C or neonatal infection
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53. November 1, 2014 53

54. Post-eruptive effects-
The post-eruptive effects of malnutrition lead to decrease
salivary lysozyme and secretary IgA levels
In children with protein-calorie malnutrition, IgA reduced in
the secretion thereby increasing caries susceptibility
Cariostatic elements :- F,P
Mildly Cariostatic :- Mo,V,Cu,Sr,B,Li,Au
Doubtful :- Be,Co,Mn,Sn,Zn,Br,I
Caries inert :- Ba,Al,Ni,Fe,Pd,Ti
Caries promoting :- Se,Mg,Cd,Pt,Pb,Si
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55. Balanced diet or Prudent diet is one which contains a
variety of foods in such quantities and proportions
that the need for energy, amino acids, vitamins,
minerals, fats, carbohydrates, and other nutrient is
adequately made for maintaining health Vitality &
general well being
The Indian balanced diet is composed of cereals (rice,
wheat, jowar), pulses, vegetables, roots and
tubers,milk and milk products, fats and oils,sugar
and groundnuts. meat, fish and eggs are present in
the non-vegetarian diets.
In case of vegetarians,an additional intake of milk
and pulses are recommended.
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56. The food guide pyramid can help to choose variety of foods to
help achieve a balanced diet and provides many nutrients
needed by the body
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57. November 1, 2014 57

58. Dietary fat should be 20-30% of total daily intake
Saturated fats not more than 10% of total energy intake
Excessive consumption of refined carbohydrates to be avoided
Energy rich sources like fats and alcohols to be restricted
Salt intake reduced to not more than 5gm/day
Protein:- 15-20 % of daily intake
Reduce consumption of COLA’s and KETCHUP’s that provides empty
Calories- WHO
proteins,
20%
fats, 30%
Carbohydrates
50%
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59. The problem of malnutrition can be solved only by taking
action simultaneously at various levels
( Family ,Community ,National & International )
Along with
co-ordinate approach between many disciplines
(Nutrition , food technology, health administration
health education , marketing etc.)
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60. November 1, 2014 60

61. 1. Through nutritional education about the selection of right
kind of foods and planning for nutritionally adequate diet
2. Identification and correction of harmful food taboos and
dietary prejudices
3. Promotion of breast feeding improvements in infant and
child feeding practices
4. Promotion of kitchen garden or keeping poultry
5. Community health workers and multipurpose workers can
impart nutritional education to families
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62. Analysis of the extent, distribution, and types of
Nutritional deficiencies
Populations groups at risk
Dietary and Non-dietary factors contributing to
malnutrition
Conduct Diet and nutritional surveys
Planning realistic and feasible approaches in developing countries
1. Direct intervention measures to be started(temporary measures)
2.Supplementary feeding programs
3.Midday school meals
4.Vitamin A prophylaxis programs
Real solution can only be obtained through fundamental measures
which corrects the basic cause of malnutrition-increasing
the Quality and Quantity of available food
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63. 1. By rural development
2. Increasing agricultural productions
3. Stabilization of population
4. Nutritional interventional programs
(Iodized salt, iron and folic acid tablets for anemia , vit. A
for blindness)
5. Nutritional related health activities
(Malaria eradication program)
November 1, 2014 63

64. FAO,UNICEF, WHO, World Bank, UNDP and CARE are
some agencies helping national governments in different parts
of the world in their battle against malnutrition
November 1, 2014 64

65. Nutrition is vital for human development ,
growth, and Health Maintenance
The Dental visits which is usually longer in duration than the
medical visits affords better opportunities for motivational
interventions to enhance self care and health care decision
November 1, 2014 65

66. Textbook of Public Health
Dentistry(Soben Peter)
Internet
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