Nutrition and Health

Nutrition and Health
Dr. K. Naga Ravalika
Public Health Dentistry
Manipal University

Contents
1. Introduction
2. Historical perspective
3. Basic considerations
4. Nutrition specialities
5. Classification of food
6. Nutritional requirements
7. Assessment of nutritional status

8. Social aspect of nutrition
9. Food surveillance
10.Nutritional problems in public health
11.Role of nutrition in oral health
12.Public health significance
13.Conclusion
14.References

Introduction
Nutrition: science of food and its relationship to health
Deals with all aspects of interaction between a living organism and the
substances which help the organism to grow and sustain itself
Concerned primarily with the part played by nutrients in body growth,
development and maintenance
Park K. Nutrition and Health. Textbook of Preventive and Social Medicine. 24th edition. Jabalpur: Banarasidas
Bhanot publishers;2017. Pg 646

Nutrient or food factor - specific dietary constituents such as proteins,
vitamins and minerals.
Dietetics is the practical application of the principles of nutrition and
includes the planning of meals for the well and the sick.
A proper diet is essential from the very early stages of life for proper growth,
development and to remain active.

Historical perspective
Whole history of nutrition was divided by Schneider into 3 eras:
The naturalistic era (400 BC - 1750 AD)
The chemical-analytic era (1750 - 1900)
Biological era (1900 onwards)
In 1955, another era called Cellular/Molecular era was categorised
Saxena A. Importance of biochemistry in nutrition. Text book of biochemistry. New Delhi: Discovery Publishing
House; 2006. Pg. 3

Naturalistic era:
Early man: vague ideas about food-taboos, magical power, medicinal
value
In 16th century, Sanctorius gave the theory of doctrine of longevity -
weight is not related to food
Laviosier conducted studies on oxidation, respiration and calorimetry.
Considered as Father of Nutrition
House; 2006. Pg. 4

Chemical analytical era:
Lebigs conducted studies on N, C, H
He stated that small amounts of these components in daily diet will result
in great growth and survival of organisms
In 1912, Dr. Casmir Funk established that amines are essential dietary
components and gave them the name vitamin.
Emphasis changed: Inter relationships between nutrients, their biological
roles & determination of human dietary requirements
House; 2006. Pg. 4
Semba RD. The Discovery of the Vitamins. Int. J. Vitam. Nutr. Res. 2012;82(5):310-5.

Biological era:
1930’s - William Rose discovered the essential amino acids, the building
blocks of protein
Upto 1940, 4 fat soluble and 6 water soluble vitamins were discovered
and in 1942, folic acid and B12 were discovered
In 1945, to meet world’s needs for food, an international body was setup:
FAO
1950’s, Linus Pauling discovered the spiral structure of proteins and was
known as founder of molecular biology
Spector AA, Kim HY. Discovery of essential fatty acids. J Lipid Res. 2015 Jan;56(1):11-21
House; 2006. Pg. 4

Discoveries of vitamins:

Cellular/Molecular era:
This era is based on latest technology involved in nutrition
4 major techniques were discovered:
Micro-chemical techniques
Electro-microscopic techniques
Immuno-bio technique
Radioisotopes
House; 2006. Pg. 5

WORLD FOOD DAY–OCTOBER 16
World Food Day is celebrated every year on 16th October,
commemorating founding of Food and Agriculture Organization (FAO)
It was proclaimed in 1979 with the aim to increase public awareness of
the world food problem, hunger, malnutrition and poverty.
Dr. Pal Romany, a Hungarian, was the key man behind this event.
Roy R, Saha I. Gupta and Mahajan textbook of preventive and social medicine. 4th edition. New Delhi:Jaypee
Publishers;2013

Basic considerations
Nutrition:
WHO: Science of food and its relationship to health. It is concerned
primarily with the part played by nutrients in body growth, development
and maintenance.
DCNA 2003: Science of how the body utilizes food to meet requirements
for development, growth, repair and maintenance
Park K. Nutrition and Health. Textbook of Preventive and Social Medicine. 24th ed. Jabalpur: Banarasidas
Whitney E, Rolfes SR. An overview of nutrition. Understanding nutrition. 15th ed. USA: Cengage Learning;
2007. Pg 2

Peter S. Nutrition and oral health. Essentials of public health dentistry. 6th ed. New Delhi: Arya medi publishing
house;2017. Pg 297
Nutrition. Available at https://en.oxforddictionaries.com/definition/nutrition last accessed on 18/01/2018.
Nizel AE, Papas AS. Nutrition in clinical dentistry. 3rd ed. Philadelphia:WB Saunders; 1989
FDI 1994: Sum of the processes by which an individual takes in and
utilizes food.
Oxford dictionary: The process of providing or obtaining the food
necessary for health and growth.
Nizel 1989: Science which deals with the study of nutrients and foods and
their effects on nature and function of organism under different
conditions of age, health and disease.

Health: State of complete physical, mental and social wellbeing and not
merely an absence of disease or infirmity and the ability to lead a socially
and economically productive life (WHO 1948)
Nutritional epidemiology: Epidemiological assessment of nutritional status
of communities, nutritional and dietary surveys, nutritional surveillance,
nutritional and growth monitoring, nutritional rehabilitation, nutritional
indicators and nutritional interventions
Park K. Concept of health and disease. Textbook of Preventive and Social Medicine. 24th edition. Jabalpur:
Banarasidas Bhanot publishers;2017. Pg 14

Diet: Types and amounts of food eaten daily by an individual (FDI, 1994)
Balanced diet: one which contains varieties of foods in such quantities
and proportion that the need for energy, amino acids, vitamins, fats,
carbohydrates and other nutrients is adequately met for maintaining
health, vitality and general well being and also make provision for a
short duration of leanness
Peter S. Nutrition and oral health. Essentials of public health dentistry. 6th ed. New Delhi: Arya medi publishing
house;2017. Pg 297,301.

Nutritional specialties
Publishers;2013
Human nutrition deals with food and nutritional requirements of human
beings at different age, sex and physiological status, nutritional
imbalances in human beings and various measures for overcoming such
imbalances
Clinical nutrition branch dealing with the physiological, pathological and
therapeutic aspects of nutrition

Public health nutrition is the branch dealing with human health and the
services necessary to maintain human health.
Deals with whatever can be done through national health services and
other health related agencies and institutions to promote human nutrition.
Publishers;2013

Classification of food
Food
Origin
Chemical
composition
Predominant
function
Nutritive value

Animal
Plant
Based on origin

Carbohydrat
e
Proteins Fats Vitamins Minerals
Based on chemical composition

• Milk, meat, eggs, fish
Body building foods
• Cereals, sugars, fats, oils
Energy giving foods
• Vegetables, fruits
Protective foods
Based on predominant function

Nutritive value
Cereals,
millets
Vegetabl
es
Nuts and
oil seeds
Animal
foods
Sugar,
jaggery
Spices,
condime
nts
Pulses

Classification of Nutrients
 Organic and inorganic complexes
 Each one has specific functions in body
Proteins
Fats
Carbohydrates
Macro Vitamins
Minerals
Micro

PROTEINS
Complex organic nitrogenous compounds
Composed of carbon, hydrogen, oxygen, nitrogen, sulphur, phosphorus
and iron
Constitute about 20 % of the body weight in an adult
Sources:
Animal foods: Milk, Meat, Egg, Fish
Plant foods: Cereals, pulses, vegetables, fruits, nuts, soyabean
Others: Oils and fats; sugar and jaggery

Functions:
Body building
Repair and maintenance of body tissues
Synthesis of antibodies, haemoglobin, enzymes, hormones
Deficiency:
Fatigue, skin and hair changes, diarrhoea
Cachexia - condition that involves protein deficiency, depletion of
skeletal muscle and an increased rate of protein degradation, causes
weight loss
Kotler DP. Cachexia. Annals of internal medicine. 2000 Oct 17;133(8):622-34.

FATS
Solid at 20 deg. C; called oils if they are liquid at that temperature
Classified as :1. Simple: triglycerides
2. Compound: phospholipids
3. Derived: cholesterol
Sources:
Animal fats: Ghee, butter, milk, cheese, eggs, and fat of meat and fish.
Animal fats are mostly saturated fats
Vegetable fats: e.g., groundnut, mustard, sesame, coconut
Bhanot publishers;2017. Pg 648-9

Functions:
High energy foods: provide 9 kcal for every gram
Serve as vehicles for fat-soluble vitamins
Support viscera such as heart, kidney and intestine
Fat beneath the skin provides insulation against cold
Deficiency:
Result in deficiencies of vitamins A, D, E and K as body can absorb these
nutrients only in the presence of fat
Deficiency of DHA results in learning deficits and increase the risk for
certain types of dementia and Alzheimer's disease

CARBOHYDRATES
3rd major component of food
Main source of energy
Essential in diet as source of glucose and cellulose
Three main sources: Starch, Sugar, Cellulose
Sources:
Cereals
Fruits
Vegetables
Bread
Milk

Functions:
Supply energy: 4 kcal per 1 gram
Oxidation of fats
Synthesis of non-essential amino acids
Deficiency:
hypoglycemia, confusion, tremor, giddiness, fatigue, delirium, muscles
atrophy, reduced stamina
Acidosis and ketosis

VITAMIN A
Sources:
Plant foods: Green leafy vegetables, carrots, broccoli, sweet potato
Animal foods: Butter, cheese, fish, meat, eggs
Functions:
Production of retinal pigments – indispensable for normal vision
Maintains integrity & normal functioning of glandular & epithelial tissues
Deficiency: Night blindness, xerosis, corneal ulceration, keratomalacia

VITAMIN D:
Regarded as Kidney hormone
Sources:
Egg yolk, butter, cheese
Functions:
Promotes intestinal absorption and renal tubular reabsorption of calcium
and phosphorous
Stimulates mineralization of bone and enhances bone resorption
Deficiency: Rickets and osteomalacia

VITAMIN C:
Sources:
Fresh fruits, green leafy vegetables, germinating pulses
Functions:
Influences formation of haemoglobin and absorption of iron
Deficiency:
Scurvy: swollen, bleeding gums, delayed wound healing, subcutaneous
bruising or bleeding into joints

VITAMIN E
Sources:
vegetable oils, cotton-seed, sunflower seed, egg yolk and butter
Function:
Antioxidant: protects body tissue from damage caused by substances
called free radicals
Play a role in conditions related to aging
Deficiency:
Pancreatitis, short bowel syndrome, cystic fibrosis

VITAMIN K
Two forms --
K1: present in green leafy vegetables and cow’s milk
K2: synthesized by intestinal bacteria
Functions:
Stimulates production and release of coagulation factors
Deficiency:
Celiac disease, cystic fibrosis

VITAMIN B1: Thiamine
Present in cereals, wheat, pulses, groundnuts, milk, meat, fish, eggs
Deficiency causes Beriberi and Wernicke’s encephalopathy
VITAMIN B2: Riboflavin
Present in milk, eggs, green leafy vegetables
Deficiency causes angular stomatitis, cheilosis, glossitis

VITAMIN B3: Niacin
Present in meat, fish, legumes, ground nut
Deficiency causes Pellagra
Characterised by three D's – Diarrhoea, Dermatitis and Dementia
VITAMIN B6: Pyridoxine
Present in milk, meat, legumes, egg yolk
Deficiency causes peripheral neuropathy, seborrheic dermatitis, glossitis
and cheilosis

FOLIC ACID/ FOLATE:
Present in meat, milk, egg, fruits, cereals
Deficiency causes megaloblastic anemia, glossitis, cheilosis, diarrhoea
VITAMIN B12:
Sources are meat, fish, egg, milk, cheese
Also synthesized by bacteria in colon
Deficiency causes megaloblastic anemia

MINERALS
These can be divided into two major groups

CALCIUM:
Functions: Formation of bones and teeth, coagulation of blood, contraction
of muscles, cardiac action and relay of electrical and chemical messages
PHOSPHOROUS:
Function: Essential for the formation of bones and teeth.
IRON:
Functions: Formation of haemoglobin, brain development and function,
regulation of body temperature, muscle activity

FLUORINE
Most abundant element in nature.
About 96 per cent of the fluoride in the body is found in bones and teeth.
Essential for the normal mineralization of bones and dental enamel.
Sources:
Drinking water
Foods: Sea fish, cheese, tea
Deficiency/excess:
Two-edged sword
Prolonged ingestion of fluorides in excess is associated with dental and
skeletal fluorosis; and inadequate intake with dental caries

Nutritional requirements
Variety of terms: optimum requirements, minimum requirements,
recommended intakes or allowances, safe level of intake
“Recommended Daily Intake/Allowance” (RDA) has been widely accepted

A procedure was devised by the FAO Committee on calorie requirements
in 1950
Energy intake recommendations are formulated for a "reference man" and
a "reference woman"
Their profiles are described and then necessary adjustments are made for
subjects who deviate from this standard reference

Indian reference man:
20 - 39 years of age
weighs 60 kg
free from disease and physically fit
for active work
employed for 8 hours
Indian reference woman:
20 - 39 years of age
weighs 50 kg
healthy
engaged for 8 hours in general
household work/industry/in
other moderately active work

Vulnerable groups:
1. Pregnant women:
The energy requirements of women are increased in pregnancy (+ 300
kcal daily) and lactation (+ 550 kcal daily during the first 6 months, + 400
kcals daily during the next 6 months)
2. Children:
Because of their rapid growth rate, young children require
proportionately more energy for each kilogram of body weight than
adults

Assessment of nutritional status
Result of many interrelated factors
Influenced by the adequacy of food intake both in terms of quantity and
quality
Main objective is to obtain precise information on the
- prevalence and geographic distribution of nutritional problems of a
given community
- identification of individuals / population groups at risk or in need of
assistance

Assessment methods:
‣ Clinical examination
‣ Anthropometry
‣ Biochemical evaluation: Hb estimation, stools & urine tests
‣ Assessment of dietary intake:
- Weighment of raw foods
- Weighment of cooked foods
- Oral questionnaire method

‣ Vital and health statistics: mortality & morbidity data
‣ Ecological studies:
- Food balance sheet
- Socio-economic factors
- Health and educational service
- Conditioning influences

Social aspect of nutrition
Nations and civilizations are linked together not only by ideas, but also by
bread
Hunger and malnutrition are problems everywhere and have harassed
mankind and threatened peace throughout history

Malnutrition:
defined as “a pathological state resulting from a relative or absolute
deficiency or excess of one or more essential nutrients”
comprises four forms

Undernutrition:
Consuming insufficient food over
an extended period of time, e.g.
starvation
Overnutrition:
Consuming excessive food over an
extended period of time, e.g.
obesity, atheroma and diabetes in
western societies

Imbalance:
Disproportion among essential
nutrients with/without the absolute
deficiency of any nutrient
Specific deficiency:
Pathological state resulting from a
relative or absolute lack of an
individual nutrient

Nutritional deficiency diseases:
Highest priority:
kwashiorkor
marasmus
xerophthalmia
nutritional anaemias
endemic goitre

Effects on the community:
‣ Direct effects: Occurrence of frank deficiency diseases such as
kwashiorkor and marasmus
‣ Indirect effects: High morbidity and mortality, lowered vitality of
people leading to lowered productivity and reduced life expectancy

Food surveillance
WHO has defined food safety/food hygiene:
''All conditions & measures that are necessary during production,
processing, storage, distribution & preparation of food to ensure that it is
safe, sound, wholesome and fit for human consumption''
Primary aim of food hygiene is to prevent food poisoning and other food-
borne illnesses

MILK HYGIENE
Milk is an efficient vehicle for a great variety of disease agents
Source of infection may:
FAO/WHO Expert Committee (1970) on Milk Hygiene classified milk-borne
diseases as:
-- Infections transmitted to man from animals
-- Infections transmitted to man from milk
Animal
Human
handler
Environ
ment

MEAT HYGIENE:
Diseases transmitted by eating unwholesome meat are:
Tape worm infestations: Tinea solium, T. saginata, Fascicola hepatica.
Bacterial infections: anthrax actinomycosis, tuberculosis and food poisoning

FISH HYGIENE:
Fish deteriorates / loses its freshness because of autolysis after death and
because of the bacteria in which they become infected
Fish is intermediate host of tape worm, Dibothriocephalus latus
Hepatitis A virus - concentrated in shellfish such as oysters
The signs of fresh fish are:
-- stiffness / rigor mortis
-- bright red gills
-- clear and prominent eyes

EGG:
Freshly laid eggs are sterile inside but the shells become contaminated by
faecal matter from the hen
Microorganisms like pathogenic Salmonella penetrate a cracked shell and
enter the egg

Standards suggested for Restaurants and Eating houses in India under the
Model Public Health Act:
Location
Shall not
be near
open
drain,
stable,
manure
Infrastruc
ture
Rooms
>100 sq
ft
Walls
upto 3 ft,
easily
washable
Storage
Separate
rooms for
long
storage,
temperatu
re control
Disposal
collected
in
covered,
impervio
us bins &
disposed
twice a
day
Water
supply
independ
ent
source,
adequate,
continuou
s and safe

FOOD BORNE DISEASES
“A disease usually either infectious or toxic in nature, caused by agents
that enter the body through the ingestion of food”
Increased throughout the world with the increase in urbanization,
industrialization and tourism.

Classified as:
1. Due to naturally occurring toxins in some foods: Lathyrism (beta oxalyl
amino-alanine), Endemic ascitis (Pyrrolizidine alkaioids)
2. Due to toxins produced by certain bacteria: Botulism, Staphylococcus
poisons
3. Due to toxins produced by some fungi: Aflatoxin, Ergot, Fusarium toxins
4. Food-borne chemical poisoning :
- Heavy metals, e.g., mercury (fish), cadmium (shellfish), lead (canned
food)
- Pesticide residues

Nutritional problems in public health
Low birth weight:
Low birth weight (i.e., birth weight less than 2500 g) is a major public
health problem in many developing countries.
Causes: maternal malnutrition, short maternal stature, very young age,
close birth intervals

Protein energy malnutrition:
Identified as a major health and nutrition problem
Occurs particularly in weaklings and children in the first years of life
Important cause of childhood morbidity and mortality and leads to
permanent impairment of physical and possibly, of mental growth of
those who survive
Two clinical forms:

Park K. Nutrition and Health. Textbook of Preventive and Medicine. 24th edition. Jabalpur: Banarasidas Bhanot
publishers;2017. Pg 678
Xerophthalmia: (dry eye)
Refers to all the ocular manifestations of vitamin A deficiency
Most widespread and serious nutritional disorder leading blindness
particularly in South-East Asia
Most common in children aged 1-3 years

Endemic fluorosis:
Observed in many parts of the world where drinking water contains
excessive amounts of fluorine (3-5 mg/L)
Reported mostly in Andhra Pradesh (Nellore, Nalgonda, Prakasam
districts), Punjab, Haryana, Karnataka, Kerala and Tamil Nadu.
The toxic manifestation of fluorosis comprise the following:
 Dental fluorosis
 Skeletal fluorosis
 Genu valgum

Lathyrism:
Paralysing disease of humans and animals - referred to as neurolathyrism
as it affects the nervous system
Characterised by gradually developing spastic paralysis of lower limbs in
adults consuming the pulse, Lathyrus sativus in large quantities
Prevalent in parts of Madhya Pradesh, Uttar Pradesh, Bihar, Orissa,
Maharashtra, West Bengal, Rajasthan, Assam and Gujarat

Role of nutrition in oral health
Fluoride and their role in prevention of caries
Fluoride deposits in calcified structures such as bones and teeth when they
are in active stage of mineralization - via the systemic route when lattice
is developing and maturing
Developing tooth enamel: fluoride is deposited within the body of the
crystal
Fully formed enamel: fluoride is deposited in the surface layer of the tooth
Nizel AE, Papas AS. Fluoride and their role in dental caries prevention. Nutrition in clinical dentistry. 3rd ed.
Philadelphia:WB Saunders; 1989. Pg 169.

Mechanism of action of fluoride:
1. Increased enamel resistance or reduction in enamel solubility
2. Increased rate of post eruptive maturation
3. Remineralisation of incipient lesions
4. Interference with plaque micro-organisms
5. Modification in tooth morphology
Peter S. Fluorides. Essentials of public health dentistry. 6th ed. New Delhi: Arya medi publishing house;2017. Pg
339

Water fluoridation:
Dean’s classic surveys of children from 21 different cities with various
amounts of fluoride in the water supplies showed that caries
experience decreased as fluoride concentrations in communal water
supplies increased from 0.5 to 1.5 ppm.

The great dental health benefits of communal fluoridated water programs
were clearly demonstrated by the studies done in
 Grand Rapids - Muskegon
 Newburgh - kingston study
 Brantford - Sarnia study
 Evanston - Oak park study
 Tiel - Culemborg study

Diet related problems of oral mucosa and tooth enamel
Nutritional deficiencies are no longer considered to be only an acute
lack of individual vitamins as no nutrient can carry out its function
without adequate supplies of other related nutrients
Oral tissues can undergo three major changes as reactions to a
nutritional deficiency, an irritant, or a change in the oral environment
Nizel AE, Papas AS. Nutritional management of diet related problems of oral mucosa and tooth enamel.
Nutrition in clinical dentistry. 3rd ed. Philadelphia:WB Saunders; 1989. Pg 256.

Cheilosis and Angular Stomatitis:
Characteristics: Cracks at the corners of the mouth, inflammation and
infection at the junction (commissures) of the upper and the lower lips
and the adjoining skin
The inflammatory changes seen in the mucosa of lips, particularly at the
commissures, may be a sign of a deficiency of one or more of the
following nutrients: Riboflavin, niacin, pyridoxine, folic acid, vitamin b12
Nizel AE, Papas AS. Nutritional management of diet related problems of oral mucosa and tooth enamel. Nutrition
in clinical dentistry. 3rd ed. Philadelphia:WB Saunders; 1989. Pg 266.

Glossitis:
Tongue is sensitive to nutrition aberrations as rapid growth of the
epithelial cells covering the dorsum requires high amounts of nutrients
Deficiency may actually reduce thickness of the epithelial protection
• Iron deficiency anaemiaPallor
• Increased vascularity/atropy of papillaeAbnormal redness
• Vit B complex deficiencyReddening at tip & lateral
• riboflavin deficiency
Purple / magenta

Gingivitis:
Niacin deficiency can predispose the gingiva to a fusospirochetal
bacterial infection - vincent’s infection / acute necrotising ulcerative
gingivitis - wedge-shaped punched out ulcers in interdental papillae
Vit C deficiency contributes to gingivitis along with local irritants
through the defects in the capillary walls produced by a failure in
collagen formation and in severe cases, teeth may exfoliate because of the
extensive destructions of periodontal structures

Role of nutrition in prevention and management of periodontal disease
Food and nutrition affect periodontal disease at three levels
1. Contributing to microbial growth in the gingival crevice
2. Affecting the immunological response to bacterial antigens
3. Assisting in the repair of connective tissue at the local site after
injury from plaque, calculus and so forth
Nizel AE, Papas AS. The role of nutrition in prevention and management of periodontal disease. Nutrition in
clinical dentistry. 3rd ed. Philadelphia:WB Saunders; 1989. Pg 309.

In the state of malnutrition, activity of phagocytes in immune may be
impaired
Due to rapid rate of epithelial turnover of the epithelial cells of the
gingival sulcus there is a continuous need of nutrients like protein, folic
acid, vit C.
Vit C is involved in connective tissue formation + zinc hastens repair
process
Calcium & phosphorus are important for promoting alveolar bone density
Nizel AE, Papas AS. The role of nutrition in prevention and management of periodontal disease. Nutrition in
clinical dentistry. 3rd ed. Philadelphia:WB Saunders; 1989. Pg 310.

Milk and dental caries
In vivo and in vitro demineralisation and remineralisation experiments
indicated the low cariogenic potential of milk and also demonstrated its
caries-protective role
These actions would appear to be due to
(a) lactose being the least cariogenic of dietary sugars
(b) the protective role of casein and possibly fats
(c) the protective role of calcium and phosphorus
Nizel AE, Papas AS. Food composition, preparation, processing and labelling. Nutrition in clinical dentistry. 3rd
ed. Philadelphia:WB Saunders; 1989. Pg 219.

Public health significance
Nutritional programs in India
1. Vitamin A prophylaxis programme:
National Programme for Control of Blindness: A single massive dose of an
oily preparation of vitamin A (200,000 IU) was administered orally to all
preschool children every 6 months
Launched by Ministry of Health & Family Welfare in 1970 on basis of
technology developed at NIN at Hyderabad

2. Prophylaxis against nutritional anaemia:
A national programme for the prevention of nutritional anaemia was
launched by the Govt. of India during the fourth Five Year Plan
Distribution of iron and folic acid (folifar) tablets to pregnant women and
young children (1-12 years)
Mother and Child Health (MCH) Centres in urban areas, primary health
centres in rural areas and ICDS projects are engaged in the
implementation of this programme

3. Control of iodine deficiency disorders:
The National Goitre Control Programme was launched by the Govt. of
India in 1962
Iodised salt supply in place of common salt

4. Special nutrition programme:
Started in 1970 for the nutritional benefit of children below 6 years of
age, pregnant women and nursing mothers
The supplementary food supplies about 300 kcal and 10-12 grams of
protein per child per day
The beneficiary mothers receive daily 500 kcal and 25 grams of protein.
This supplement is provided to them for about 300 days in a year

4. Balwadi nutrition programme:
Started in 1970 for the benefit of children in the age group 3-6 years in
rural areas under charge of the Department of Social Welfare
Programme is implemented through Balwadis which also provide pre-
primary education to these children
The food supplement provides 300 kcal and 10 grams of protein per
child per day

6. Integrated Child Development Services (ICDS) programme:
Started in 1975
There is a strong nutrition component in this programme in the form of
supplementary nutrition, vitamin A prophylaxis and iron and folic acid
distribution.
Beneficiaries: preschool children below 6 years, and adolescent girls 11
to 18 years, pregnant and lactating mothers

7. Mid-day meal programme (MDMP):
Also known as School Lunch Programme.
Started in 1961
Major objective is to attract more children for admission to schools
and retain them so that literacy improvement of children could be
brought about

8. Mid-day meal scheme:
National Programme of Nutritional Support to Primary Education
Launched as a centrally sponsored scheme on 15th August 1995
and revised in 2004
Objective: universalisation of primary education - increasing
enrolment, retention and attendance and simultaneously impacting
on nutrition

Moynihan P, Petersen PE, Diet, nutrition and the prevention of dental diseases; Public Health Nutr. 2004 Feb;
7(1A): 201–226
Dietary counselling for the prevention and control of dental caries:
Important for the prevention of dental caries especially for the patients
who are highly caries prone
Information is obtained as to why, where, when and what specific foods
are eaten, how frequently, and what feelings are expressed

Moynihan P, Petersen PE, Diet, nutrition and the prevention of dental diseases; Public Health Nutr. 2004 Feb;
7(1A): 201–226
Includes
1. frequency of snacking between meal
2. physical form and retentiveness of sugar sweetened snacks on and
between the teeth
3. the amount of sugar added to food or beverages for sweetening
Diet counselling also involves giving advice on food selection based on
the individual’s reasons for liking or not liking certain foods

Conclusions
Changing our diet can have an enormous impact on health – for
better or worse.
A balance diet and appropriate meal timings are important for a
healthy body and mind.

Nutrition education is an important factor in overall improvement
for society health and prevention of all forms of malnutrition.
Most countries nowadays implement health education programme
in schools which include feeding to students, vitamin and mineral
supplementation, etc.

References
1. Park K. Park’s text book of preventive and social medicine. 24th edition.
Jabalpur: Banarsidas bhanot publishers;2017.
2. Saxena A. Text book of biochemistry. New Delhi: Discovery Publishing
House; 2006
3. Semba RD. The Discovery of the Vitamins. Int J Vitam Nutr Res 2012;82
(5):310-5
4. Spector AA, Kim HY. Discovery of essential fatty acids. J Lipid Res. 2015
Jan;56(1):11-21

5. Roy R, Saha I. Gupta and Mahajan textbook of preventive and social
medicine. 4th edition. New Delhi:Jaypee Publishers;2013
6. Whitney E, Rolfes SR. Understanding nutrition. 15th ed. USA: Cengage
Learning; 2007.
7. Peter S. Essentials of public health dentistry. 6th ed. New Delhi: Arya medi
publishing house;2017.
8. Nutrition. Available at
https://en.oxforddictionaries.com/definition/nutrition last accessed on
18/01/2018.

9. Nizel AE, Papas AS. Nutrition in clinical dentistry. 3rd ed.
Philadelphia:WB Saunders; 1989
10.Kotler DP. Cachexia. Annals of internal medicine. 2000 Oct
17;133(8):622-34.
11.Moynihan P, Petersen PE, Diet, nutrition and the prevention of dental
diseases; Public Health Nutr. 2004 Feb; 7(1A): 201–226

Nutrition and Health

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Nutrition and Health

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