This presentation is prepared for the candidates not having a background in medical education. It briefly describes the basics of nutrition, types of body, assessment of nutritional assessment of person and nutritional condition in India

1. Nutrition: An overview and
issues in India
Dr. Rajeev Kumar
M.S.W., (TISS, Mumbai), M.Phil., (CIP, Ranchi), U.G.C- J.R.F., Ph.D., (IIT Kharagpur)
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Nutrition in Your Life
• Nutrition
• The science of foods and the substances they contain
• Food
• Derived from plant or animal sources
Provide energy and nutrients Used by the body for
maintenance, growth, and repair
• Diet
The foods one consumes. The quality of which affects
the risk of chronic diseases

3. What happens with nutrition?
What Is Metabolism?
is a collection of chemical
reactions that takes place
in the body's cells.
Metabolism converts the
fuel in the food we eat
into the energy needed to
power everything we do,
from moving to thinking
to growing.
Metabolism is a constant
process that begins when
we're conceived and ends
when we die.
It is a vital process for all life
forms — not just humans.
If metabolism stops, living
things die.
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4. Types of metabolism
• Anabolism: or constructive metabolism,
is all about building and storing: It
supports the growth of new cells, the
maintenance of body tissues, and the
storage of energy for use in the future.
• Catabolism : or destructive metabolism,
is the process that produces the energy
required for all activity in the cells.
• In this process, cells break down large
molecules (mostly carbohydrates and
fats) to release energy.
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5. Three types of body
• Ectomorph: Lean and long, with difficulty
building muscle.
• Endomorph: Big, high body fat, often pear-
shaped, with a high tendency to store
body fat.
• Mesomorph: Muscular and well-built, with a
high metabolism and responsive muscle
cells.
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6. How do they look?
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7. Where do you see ectomorph, endomorphic, and
monomorphic people ??
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9. Factors behind Food Choices
Socio-demographic factors
Personal preference
• Habit
• Ethnic heritage or
tradition
• Social interactions
• Availability, convenience,
economy
Psychological factors
• Positive and negative
associations
• Emotional comfort
• Values
• Body weight and image
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10. Culture and food
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Wheat and rice eating in India

17. Food choice and psychological factors: A case of binge
eating
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18. Body Composition
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Copyright 2005 Wadsworth Group, a division of Thomson Learning

19. The Nutrients
• Organic nutrients
•Carbohydrates
•Lipids
•Proteins
•Vitamins
• Inorganic nutrients
• Minerals
• Water
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20. The Nutrients
• Essential nutrients
• Macronutrients vs. micronutrients
• Macronutrients are: protein, carbohydrates and fat.
• Micronutrients are comprised of vitamins and minerals which are
required in small quantities to ensure normal metabolism, growth
and physical well‐being.
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22. Vitamines
• Vitamins – these are essential organic nutrients, most of which are
not made in the body, or only in insufficient amounts, and are
mainly obtained through food.
• When their intake is inadequate, vitamin deficiency disorders are
the consequence.
• Although vitamins are only present and required in minute
quantities, compared to the macronutrients, they are as vital to
health and need to be considered when determining nutrition
security.
• Each of the 13 vitamins known today have specific functions in the
body: vitamin A, provitamin A (Beta‐carotene), vitamin B1, vitamin
B2, vitamin B6, vitamin B12, biotin, vitamin C, vitamin D, vitamin E,
folic acid, vitamin K, niacin and pantothenic acid.
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23. Minerals
• Minerals – these are inorganic nutrients that also play a key role in
ensuring health and well‐ being.
• They include the trace elements copper, iodine, iron, manganese,
selenium and zinc together with the macro elements calcium,
magnesium, potassium and sodium.
• As with vitamins, minerals they are found in small quantities within
the body and they are obtained from a wide variety of foods.
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24. Vitamin A
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25. Folate (folic acid)
• Folate (folic acid) – this is a generic term for a group
of B vitamins including folic acid and naturally
occurring folates.
• Folic acid is a synthetic folate compound used in
vitamin supplements and fortified food because of
its increased stability.
• Folates are found in egg, dairy products, asparagus,
orange juice, dark green leafy vegetables, beans and
brown bread, and they play a key role in the
metabolism of amino acids and the production of
proteins, the synthesis of nucleic acid (the
molecules that carry genetic information in the
cells), and the formation of blood cells.
• Women who suffer from folate deficiency prior to
and during pregnancy, have an increased risk of
giving birth prematurely to children, with a lower
birth weight and malformations of the brain and
spinal cord, together with other birth defects such
cleft lip and palate, certain heart defects and limb
malformations.
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26. Iodine
• Iodine – Some 2 billion people worldwide (both
in developing and developed countries) have an
insufficient iodine intake.
• Iodine is an element found in soil and water and
as its concentration is variable, so in turn is the
iodine concentration of foods ‐ both plant and
animal.
• Seaweed and fish are rich sources but in many
countries the addition of iodine (known as
iodization) to salt is an important source.
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27. Iron
• Iron – Iron has a number of key functions within the body. It acts as
a carrier for oxygen from the lungs to the body’s tissues – it does so
in the form of hemoglobin – and it also integral to the working of
various tissues through the role that it plays in enzymatic reactions.
• Iron deficiency ultimately leads to iron deficiency anemia, the most
common cause of anemia, a condition in which the blood lacks
healthy red bloods cells required to carry oxygen, and which results
in morbidity and death.
• Iron deficiency is the most widespread health problem in the
world, impairing normal mental development in 40‐60% of infants
in the developing world, debilitating the health and energies of 500
million women, and leading to more than 115,000 deaths during
childbirth a year.
• In the worst affected countries it can account for lost productivity
of up to 2% of GDP.
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29. Zinc
• Zinc – is found in a range of foodstuffs including liver, eggs, nuts,
cereals and seafood.
• The absence of zinc is associated with a number of conditions
including, short stature, anemia, impaired healing of wounds, and
impaired cognitive and motor function.
• It can also lead to appetite disorders, as well as contributing to the
increased severity and incidence of diarrhea and pneumonia.
• The most important effect of zinc deficiency is its impact on
children’s resistance to infectious diseases including the risk of
infection, the recurrence of infections and the severity of infection.
• This is well document in the case of diarrhoea. Zinc nutrition is
therefore an important determinant of mortality in children.
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31. Why balanced diet?
• No single food contains all of the vitamins and minerals we need and,
therefore, a balanced and varied diet is necessary for an adequate
intake.
• A balanced diet is one that gives your body the nutrients it needs to
function correctly. To get the proper nutrition from your diet, you
should consume the majority of your daily calories in:
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32. What should include in
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34. Requirement for difference age and sex
groups
• children ages 2 to 8 years: 1,000 to 1,400 calories
• girls ages 9 to 13 years: 1,400 to 1,600 calories
• boys ages 9 to 13 years: 1,600 to 2,000 calories
• active women ages 14 to 30 years: 2,400 calories
• sedentary women ages 14 to 30 years: 1,800 to 2,000 calories
• active men ages 14 to 30 years: 2,800 to 3,200 calories
• sedentary men ages 14 to 30 years: 2,000 to 2,600 calories
• active men and women over 30 years: 2,000 to 3,000 calories
• sedentary men and women over 30 years: 1,600 to 2,400 calories
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35. Diet requirement and gender
The essentials of a healthy diet are similar for men and women. Eat
when hungry, stop when full. Choose fruits, vegetables, whole grains,
protein, and dairy sources that are low in saturated fat. Avoid trans
fat, excessive sodium, and added sugar.
Take, for starters, caloric needs. Because men generally have an
overall larger body (both height and weight) and greater muscle mass
than women, they also have increased caloric needs compared to
women.
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36. Continued …..
• The average-sized, moderately physically active 30-year-old female
needs about 2000 calories per day while her male counterpart needs
about 2800 calories per day.
• Even if they were the same height and weight, the Dietary Reference
Intakes (DRIs) approximate that the man burns about 400 calories
more per day than the woman.
• Although the recommended breakdown of carbohydrate, protein,
and fat are the same for both genders, because men generally need
more calories, they also require higher total intake of each of the
macronutrients.
• Women need fewer calories than men, but in many cases, they have
higher vitamin and mineral needs.
• Adequate intake of calcium, iron, and folic acid are of special
importance for women.
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37. Special dietary need of women?
• Due to the hormonal changes associated with menstruation and child-
bearing, women are more susceptible than men to weakened bones
and osteoporosis. For this reason, the average post-menopausal
woman requires more calcium than her male counterpart (1000 mg for 51-
to 70-year-old women compared to 800 mg for 51- to 70-year-old men).
Recommended calcium intakes at other ages are the same for both genders.
• Women also are at increased risk of iron-deficiency anemia compared to
men due to the monthly blood loss associated with menstruation. The
average pre-menopausal woman needs about 18 milligrams of iron per day
compared to 8 milligrams for men.
• Both men and women need about 400 micrograms of the B vitamin folic
acid, but the DRIs specifically recommend that all women of childbearing age
take a multivitamin with at least 400 micrograms of folic acid to prevent
brain and spinal cord defects in a growing fetus.
• These devastating consequences can occur in the early weeks gestation,
before a woman even knows that she is pregnant. Once a woman is
pregnant, the DRIs recommend 600 micrograms per day.
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38. Energy-Yielding
Nutrients
• Calories and
kilocalories
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Copyright 2005 Wadsworth Group, a division of Thomson Learning

39. Energy Density
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41. Small activity
• Calculation of body mass
index of adult (above 19
years old)
• Make a chart of weight and
height (for healthy
individuals)
• (10-15 minutes)
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42. BMI of children 2-20 years
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43. Calculating using BMI percentile chart
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44. Interpretation of BMI percentile
Weight Status Category Percentile Range
Underweight Less than the 5
th
percentile
Healthy Weight 5
th
percentile to less than the 85
th
percentile
Overweight 85
th
to less than the 95
th
percentile
Obesity Equal to or greater than the 95
th
percentile
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45. Problem of malnutrition in India
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53. Who are vulnerable and why??
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55. Other side of malnutrition
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56. Small discussion on food changing habit
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57. Food and infection
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59. Expansion of vicious cycle
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60. To be continued......................
Thanks
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