Basics of Nutrition

1. Contents
• Introduction to Nutrition
– Definitions
– Changing Concept of food & Nutrition
– Historical mile stones in Nutrition
• Role of nutrition in maintaining health
• Factors affecting food and nutrition: socio-
economic, cultural, tradition, production,
system of distribution, life style and food
habits etc.
• Role of Health Care Professionals in food and
Nutrition

2. INTRODUCTION
• Nutrition, nourishment, or aliment refers to the
nurturing of our body to keep it healthy and
functioning as it is supposed to do. Nature has
provided a variety of foods for man to consume and
be healthy. We consume food for maintenance of
health, growth and to develop greater resistance
against infections.
• Nutrition as a science was found by Lavoiser (the
father of chemistry and also the father of nutrition)
towards the end of 18nth century.
• The science of nutrition is one of the youngest of the
sciences.

3. DEFINITIONS
FOOD: Food is the material consisting essentially
of protein, carbohydrate, and fat used in the
body of an organism to sustain growth, repair,
and vital processes and to furnish energy;
also: such material together with
supplementary substances (as minerals,
vitamins, and condiments)
NUTRITION: Nutrition is an art and also a
N
foods, the nutrients and other substances,
they are in action, interaction and balancing in

4. HEALTH: Health is a state of complete physical, mental,
and social well-being and not merely the absence of
disease or infirmity. World Health Organization
NURSING: Nursing is "the unique function of the nurse
is to assist he individual, sick or well, in the
performance of those activities contributing to health
or its recovery (or to peaceful death) that he would
perform unaided if he had the necessary strength,
will, or knowledge, and to do this in such a way as to
strength, will or knowledge, and to do this is such a
way as to help him gain independence as rapidly as
possible". - Virgnia Henderson

5. CHANGING CONCEPTS OF NUTRITION
• The essential nutrients, proteins, fats and
carbohydrates have been recognized in the early
19nth century.
• Specific Nutritional disorders were identified such as
protein energy mal nutrition, Vitamin A deficiency,
Endemic goiter, Nutritional Anemia, Nutritional
blindness etc. and measures were found to prevent
and contol these disorders.
• The science of Nutrition was extended to other fields
like agriculture, animal husbandry, economics and
T

6. CHANGING CONCEPTS OF NUTRITION
• During recent years the science of nutrition has extended to
Nutritional epidemiology.
• T
factorial and integrated approach of sectors is essential to
• The main objectives of the National Health Policy are:
vPromotion of proper nutritional status of individual, families
& communities
vPrevention of nutritional deficiency disorders.
vMaintenance of the health of the individuals
vSupplementation of essential nutrients to all the vulnerable
groups
vIEC related to healthy Nutrition.

7. HISTORICAL MILESTONES IN NUTRITION
• In pre-agricultural era, entire mankind consumed meat as early
man was a hunter. Possibly he ate from plants sources which
grew in the wilderness.
• With the advent of agriculture as an outcome of civilization,
man acquired the ability to cultivate what he wanted, as by now
he was influenced to some extent by the selection of the food
that he wanted to eat.
• The Bible, Book of Daniel - Daniel was captured by the King of
Babylon and had to serve in the King's court. Daniel objected to
being fed fine foods and wine, saying he preferred vegetables,
pulses and water. The chief steward reluctantly agreed to a trial,
comparing Daniel's dietary preference to those of the court of
the King of Babylon. For ten days Daniel and his men had their
vegetarian diet, while the King's men had theirs. The trial
revealed that Daniel and his men were healthier and fitter, so
they were allowed to carry on with their diet.

8. History Contn...
• 400 B.C: Hippocrates (Greece, ca460BC - ca370BC) the
F M
matter what they have been eating, or where they have
H A
H
famous for having said "Let thy food be thy medicine and
thy medicine be thy food."
• 400 B.C: Foods were often used as cosmetics in the
treatment of wounds. One story describes the treatment
of eye diseases, now known to be due to Vitamin A
deficiency, by squeezing the juice of liver onto the eye.
Vitamin A is stored in large amounts in the liver.
• Scientist and artist Leonardo Da Vinci compared
the process of metabolism of the body to the burning of a
candle.

9. History Contn...
• Antoine Lavoisier (France, 1743-1794) - became known as the
father of chemistry and also the father of nutrition. He became
famous for the statement "Life is a chemical process". He also
designed the "calorimeter", a device which measured heat
produced by the body from work and consumption from
different amounts and types of foods.
• Christiaan Eijkman (Holland, 1858-1930) - a famous physician
and pathologist (doctor who identifies diseases by studying
cells and tissues under a microscope). He noticed that some of
the people in Java developed Beriberi, a disease which leads to
heart problems and paralysis.
• Dr. James Lind (Scotland, 1716-1794) - a pioneer on hygiene in
the Scottish and Royal (British) navies. He stressed the
importance of good ventilation, cleanliness of sailor's bodies,
clean bedding, below deck fumigation, fresh water by distilling
sea water, and the consumption of citrus fruits to prevent and
cure scurvy.

10. History Contn...
• Dr. William Beaumont (USA, 1785-1853) - a surgeon
in the US Army. He became known as the Father of
gastric physiology for his research on human
digestion. He stated that
üThe stomach is not a grinder.
üThere is no internal "spirit" selecting good purpose
foods one way and discarding bad purpose foods to
waste.
üDigestion occurs because of digestive juices which
are secreted from the stomach.
üFoods are not digested separately and sequentially,
but rather all the time and at different rates.
üStomach rumblings are caused by stomach
contractions, and nothing else.
üFat is digested slowly.

11. History Contn...
• E It was discovered that foods are
composed primarily of four elements: Carbon,
Nitrogen, Oxygen and methods were developed for
determining the amounts of these elements.
• 1840: Justus Liebig, Germany, a pioneer in early plant
growth studies, was the first to point out the chemical
make up of carbohydrates, fats and proteins.
• Dr. Stephen Babcock (USA, 1843-1931) - an
agricultural chemist. He is known for his Babcock test
which determines dairy butterfat in milk and cheese
processing. He is also known for the single-grain
experiment that eventually led to the development of
nutrition as a science.

12. History Contn...
• Joule (1818-89) - 1850 the English physicist Joule
(1818-89) proved that heat and energy were
interchangeable entities and that one could be
measured in terms of the other.
• 1912: Dr. Casmir Funk was the first to coin the term
V
• 1925 - Edwin B. Hart discovered that trace amounts
of copper are essential for iron absorption.
• 1927 - Adolf Otto Reinhold Windaus synthesized
Vitamin D, for which he won the Nobel Prize in
Chemistry.
• 1928 - Albert Szent-Györgyi isolated ascorbic acid
(Vitamin C). In 1932 he proved that it was Vitamin C
by preventing scurvy. In 1937 he synthesized Vitamin
C and won the Nobel Prize.

13. History Contn...
• 1930s - William Cumming Rose identified essential
amino acids which the body cannot synthesize, but
which are necessary protein components.
• 1935 - Eric John Underwood and Hedley Marston
discovered the necessity of cobalt. They were not
working together - the discoveries were made
independently.
• 1936 - Eugene Floyd Dubois demonstrated that
school and work performance is linked to caloric
intake.
• 1938 - Erhard Ferhnholz discovered the structure of
Vitamin E, which was later synthesized by Paul
Karrer.
• 1940s: The water soluable B and C Vitamins were
identified.

14. History Contn...
• 1941 - The National Research Council (USA) set up
the first RDAs (Recommended Dietary Allowances).
• 1992 - The Department of Agriculture (USA) set up
the Food Guide Pyramid, which was to be
subsequently criticized by nutritionists throughout
the world for different reasons.
• 1992 - Integrated Development Foundation (IDF)
was formed.
• 2002 - A link between violent behavior and nutrition
was revealed in a Natural Justice study (USA).
• 2005 - Researchers found that the adenovirus is a
cause of obesity, as well as bad nutrition.

15. BRIEF HISTORY OF NUTRITION IN INDIA
• Until World War I the significance of nutrition was
recognized by a relatively small group of scientists and
physicians.
• Some progresses were stimulated by national
emergencies like inadequate Food Production, series
of Famines, florid Nutritional Deficiency Disorders like
Beriberi, Pellagra and Scurvy, Severe under-nutrition
and malnutrition among children, High infant and
child mortality rates, Very low literacy levels and
nutritional awareness. Others depended on technical
development of the supporting sciences. Nutrition
research in India, as beri beri inquiry was started in
1918, under the guidance of Sir Mc Carrison at
Coonoor in South India.

16. History Contn...
• At Hyderabad called National Institute of Nutrition
(NIN) was set up. This national institute comes under
the Indian Council of Medical Research (ICMR).
• The Constitution of India states explicitly in Article 47
that the "State shall regard the raising of the level of
the nutrition and the standard of living of its people
and the improvement of public health among its
• The "Green Revolution" did help the country in
overcoming the famines. The country succeeded in
eliminating classical nutritional deficiency syndromes
like Cardiac Beriberi, Pellagra, Scurvy. Kwashiorkar of
the classical kind and Kerotomalacia which used to
be a major cause of nutritional blindness in children
during 1960s, have almost disappeared.

17. History Contn...
• The Infant Mortality Rate (IMR) reduced from 146 in
1951-61 to 67.6 in 1999. The Under 5 Mortality Rate
has reduced from 236 in 1960 to 105 in 1998.
Maternal Mortality Rate (MMR) has reduced from
570 per 1,00,000 in 1990 to 408 in 1998.
• During 1960s the Food and Nutrition Board (FNB) was
established in the Department of Food, Ministry of
Agriculture.
• Applied Nutrition Programme, highlighting production
of protective foods through home gardens, school
gardens, poultry farms, demonstration and promoting
consumption and National Goiter Control Programme
for addressing the problem of Goiter in Sub-
Himalayan Region through iodisation of salt were
launched in 1962.

18. History Contn...
• The Crash Feeding Programme (Special Nutrition
Programme) was launched in 1970 for bridging the
energy and protein gap in daily diets of pre-school
children in urban slums, tribal areas and backward
rural areas.
• Recognizing the multi-faceted problem of
malnutrition, the Integrated Child Development
Services (ICDS) Scheme was launched on 2nd
October, 1975. Universal Immunisation Programme,
Oral Rehydration Therapy, Nutrition Promotion
through poverty alleviation programmes, public
distribution of food, health and family welfare
measures, adult education, were among the
important indirect nutrition interventions
undertaken by the Government.

19. History Contn...
• The adoption of National Nutrition Policy (NNP) by
the Government under the aegis of the Dept. of
Women & Child Development in 1993.
• The Nutrition Policy recognized that "Nutrition
affects development as much as development effects
nutrition".
• A National Plan of Action on Nutrition (NPAN)
highlighting the role of 14 concerned sectors of the
Government was announced in 1995.
• The India Nutrition Profile, giving the district-wise
picture of malnutrition from 187 districts of 18
States/Union Territories was released in July, 1998.

20. History Contn...
• A Task Force on Micronutrients (Vitamin A and
Iron) was constituted in 1995 for accelerating the
control of Vitamin A and Iron deficiencies.
• A Food and Nutrition Council (FNC) was constituted
in November 1997
• The National Rural Health Mission (NRHM), a
National effort at ensuring effective healthcare,
especially to the poor and vulnerable sections of the
society was launched (on 12th April, 2005in India
for a period of seven years (
2005
-
2012
))
throughout the Country with special focus on
nutrition for vulnerable groups, supplementary
feeding, rehydration therapy etc..

21. RELATION BETWEEN NUTRITION AND HEALTH
1. Achievement of optimal growth and development,
2. Maintenance of the structural integrity and functional
efficiency of body tissues necessary for an active and
productive use.
3. Mental well-being
4. Ability to withstand the inevitable process of aging with
minimal disability and functional impairment.
5. Ability to combat diseases such as
a. resisting infections (immunocompetence)
b. preventing the onset of degenerative diseases
c. resisting the effect of environmental toxins/ pollutants

22. FUNCTIONS OF FOOD AND NUTRITION
1. Good Nutrition Provides Energy
2. Good Nutrition Provides Raw Materials
3. The "Little Helpers"
4. Good Nutrition Means Good Health
5. Prevention of Infections
6. Body development and maintenance
7. Nourishing and caring
8. Social functions of food
9. Psychological functions of food

23. STATES OF NUTRITION
Optimal Nutrition: The term "Optimum Nutrition" can be defined
as eating the right amounts of nutrients on a proper schedule
to achieve the best performance and the longest possible
lifetime in good health, assuming that external negative
influences like accidents and infectious diseases can be
avoided.
Mal Nutrition: Malnutrition is a broad term which refers to both
undernutrition (sub nutrition) and over nutrition. Individuals
are malnourished, or suffer from under nutrition if their diet
does not provide them with adequate calories and protein for
maintenance and growth, or they cannot fully utilize the food
they eat due to illness.
Over Nutrition: Over nutrition is frequent or habitual over
consumption of nutrients by eating too much food to the point
that it becomes dangerous to the health.
Under Nutrition: Under nutrition is the opposite of over nutrition,
meaning that it is a nutrient deficiency from not eating enough
food.

24. DETERMINANTS OR THE FACTORS AFFECTING
FOOD AND NUTRITION OF AN INDIVIDUAL
• Development
• Gender
• Genetics
• Beliefs about Food
• Experience
• Personal Preference
• Nutritional habits
• The quality of food
• The quantity of food
• The efficiency of our digestive system
• Biochemical availability

25. • Nutritional requirements
• A person activity level
• Education
• Health
• Disease
• Family
• Knowledge about nutrients
• Status of the women
• Appetite
• Deficiency of nutrients
• Other factors e.g,. Recreationalactivities, drugs,
smoking and drinking

26. ROLE OF NURSE AND OTHER HEALTH CARE
PROVIDERS IN NUTRITION
ü Assess the nutritional status of the individual, family and
community
ü Analyze the nutritional demands of the individuals.
ü Determine the factors influence the nutritional status like
BMI, age, sex, education, socio economic status, culture,
availability of nutrient rich foods while planning the meal.
ü Conduct a nutritional surveillance of the community to
know the health status of the community.
ü Plan and provide a nutritional health education
programme.
ü Encourage the health professionals to participate actively
in the nutritional programmes.
ü Create awareness among the public about nutritional
supplementation programmes.

27. ü Special consideration should be given for the vulnerable
groups in providing care.
ü Demonstrate the preparation of nutritional recipes and
therapeutic diets.
ü Encourage women to grow kitchen gardens.
ü Help them in choosing, storing and preparing the
nutritionally rich foods.
ü Maintain records and reports of nutritional surveys and
identified cases of nutritional deficiencies.
ü Participate actively in National Nutritional Programmes.
ü Conduct inservice education programmes for health care
professionals related to nutritional related trends and
issues.
ü Participate in research activities and develop nutritional
knowledge so as to improve the health status of the
community.

28. Role of Nurse in Nutrition
v Assess nutritional health needs
vNutritional surveillance
vHealth education
vNutritional supplementation
vNational nutrition programmes
vIn service education, training
vSpecial care for vulnerable groups
vCommunity participation
vReferrals
vRecords and reports
vParticipate in research
vEvaluation

29. THANK YOU