community pharmacy

1. VIGNAN PHARMACY COLLEGE
(Approved by AICTE & PCI Affiliated to JNTU KAKINADA)
VADLAMUDI, GUNTUR DIST, ANDHRA PRADESH, INDIA, PIN: 522 213
Submitted By:-
MANNAM SANTHOSH KUMAR
16AB1T0013
Submitted to:
Satheesh S.Gottipati
B.Pharm ., MS ( USA ) ,R.Ph .,CIP( USA )
BALANCED DIET & TREATMENT &
PREVENTION OF DEFICIENCY DISORDERS

2. • Definition:
• A balanced diet is defined as the diet that contains the required amount of calories,
vitamins and minerals that are essential to keep a person healthy.
• A balanced diet is mixture of
• Carbohydrates (50%),
• Fats (32%)
• Proteins (12%)
• vitamins (3%)
• Minerals
• sufficient water

3. Carbohydrates:
These are chief source of energy (60 – 70% total energy)
Deficiency Disorders
• Acidosis
• Ketosis
• Hypoglycemia
• Fatigue & decreased energy levels
• Unhealthy weight loss
• Loss of sodium

4. Proteins:
These are the fundamental basis of cell structure & function.
Maintains osmotic pressure & have role in clotting of blood, muscle contraction.
Deficiency Disorders:
• Kwashiorkor
• Marasmus
• Mental retardation

5. Dietary vitamins and minerals
Calcium deficiency disorder
• Osteoporosis
• Rickets
• Tetany
Iodine deficiency disorder
• Goiter
Iron deficiency disorder
• Iron deficiency anemia
Vitamin Deficiency Disorders
• Vitamin B1 (thiamine) Disorders
• Vitamin B2 (riboflavin) Disorders
• Vitamin B3 (niacin) Disorders
• Vitamin B5 (pantothenic acid) Disorders
• Vitamin B6 (pyridoxine) Disorders
• Vitamin B7 (biotin) Disorders
• Vitamin B9 (folic acid) Disorders
• Vitamin B12 (cyanocobalamin) Disorders

6. Protein Deficiency Disorders
Kwashiorkor:
• Also called wet-protein energy malnutrition.
• Form of PEM characterized by protein deficiency.
• Refers to an insufficient protein consumption but with
sufficient calorie intake.
• Usually appear in the age of 12 months whenbreast feeding is
discontinued.

7. Signs and symptoms:
Change in skin pigment.
Diarrhea.
Decreased muscle mass.
Swelling(edema).
Fatigue.
Hair changes
Lethargy.
Increased & more severe infection due to damaged immune system.
Failure to gain weight & grow.

8. MANAGEMENT:
• The children affected with kwashiorkor should be fed with dietary protein gradually.
• Kwashiorkor can be corrected by eating more protein and more calories overall,
especially if treatment is started early.
• You may first be given more calories in the form of carbohydrates, sugars, and fats.
Once these calories provide energy, you will be given foods with proteins.
• Foods must be introduced and calories should be increased slowly because you have
been without proper nutrition for a long period. Your body may need to adjust to the
increased intake.

9. MARASMUS:
• Severe protein calorie malnutrition characterized by
energy deficiency and emaciation
• Causes stunted growth and wasting of muscles and
tissue
• Develop between the age of 6 months & 1 years in
children who weaned from breast feeding/who suffer
from weakening conditions like chronic diarrhea.

10. Symptoms
• Severe growth retardation.
• Loss of subcutaneous fat.
• Severe muscle wasting.
• Child looks thin and limbs
• Wrinkled skin.
• Bony prominence.
• Frequent watery diarrhea & acid stools.
• Temperature is abnormal.
• Edema absent.

11. VITAMIN DEFICIENCY
DISORDERS

12. Vitamin A deficiency disorder
Functions of vitamin A
• Vitamins plays several roles in the body for
• Vision
• Gene transcription
• Immune function
• Embryonic development and reproduction
• Bone metabolism
• Hematopoiesis
• Skin and cellular health
• Antioxidant activity

13. Deficiency Disorders
Night blindness,
Xerophthalmia,
Keartomalacia
Complete blindness
Impaired immune function
Birth defects

14. Management
Deficiency of vitamin a can be achieved by eating vitamin A rich foods and external
supplementation of vitamin A Preparations.
Foods rich in vitamin A
Vitamin A is found naturally in many foods:
Liver (beef, pork, chicken, turkey, fish)
Cheddar cheese (256 µg)
Carrot (835 µg)
Spinach (469 µg)
Sweet potato (709 µg)
Butter (684 µg)
Egg (140 µg)
Apricot (96 µg)
Papaya (55 µg)
Mango (38 µg)
Pea (38 µg)
Milk (28 µg)

15. Vitamin D deficiency disorder:
Function of vitamin D
• Maintain the normal calcium and phosphorus levels in the body to build strong bones, teeth and nails.
• Supporting the cell functions and other neuromuscular functions in the body.
• Controls the supply of calcium between the bones and the blood and supports bone mineralization
(hardening of bones) and bone remodeling by osteoblasts and osteoclasts.
• Preventing of rickets in children, and osteoporosis or osteomalacia in adults.
• Vitamin D as a powerful antioxidant and anti-carcinogen, it helps in combination depression, prostate
cancer, breast cancer, high blood pressure, cardiovascular diseases, phagocytosis activity and boosts
anti-tumor activity.
• Vitamin D helps in maintaining a health immune system in the body.

16. Deficiency Disorders
• osteomalacia (softening of the
bones) in elders
• rickets in children.
• Avoiding the exposure to sun may
result in low blood calcidiol (25-
hydroxy-vitamin D) and that may
causes vitamin D deficiency
disorder.

17. Management
Dietary supplementation of vitamin D2 (mushrooms) and vitamin D3 (fish liver oils, egg and
beef liver.
Sources of vitamin D
The man source of vitamin D s exposure of an individual is to sun’s UVB rays. Apart from
this, vitamin D is found in various types of fish such as herring, mackerel, salmon, and
sardines. It is also available in other food sources such as egg yolk, orange juice, cereals,
green leafy vegetables, fish liver oils, yogurt, cheese, etc. fortified foods are other common
sources of vitamin D.

18. Vitamin E deficiency disorder
Functions
• Prevents the oxidative damage of the cell membranes
• Prevents unnecessary growth of the smooth muscle.
• Responsible for the repair of wounds
• Vitamin E plays a role in neurological functions.
• It inhibits platelet aggregation.
• Vitamin E also protects lipids and prevents the oxidation of polyunsaturated fatty
acids (PUFAs).

19. Deficiency Disorders
 Spinocerebellar ataxia
 Myopathies
 Peripheral neuropathy
 Ataxia
 Skeletal myopathy
 Retinopathy
 Impairment of the immune response
 Erythrocyte hemolysis
 Male infertility

20. Treatment
Individuals who cannot absorb fat may require a vitamin E supplement because some
dietary fat is needed for the absorption of vitamin E from the gastrointestinal tract.
Dietary sources
Vitamin is found mostly abundantly in wheat germ oil, sunflower oil, safflower oil, nuts
and nut oils, like almond and hazelnuts palm oil. It is also found in high value green,
leafy vegetables like spinach, turnip, broccoli, avocados, asparagus, kiwifruit (green)
pumpkin, sweet potato, mangoes, tomatoes, rockfish, and papaya.

21. Vitamin K deficiency disorder
• The functions of vitamin K are concerned with blood clotting process
• It brings about post-translational modification of certain blood clotting factors
• The clotting factors II, VII, IX and X are synthesized as inactive precursors in
the liver
• Vitamin K act as a coenzyme for the
• carboxylation of glutamic acid residues present in the protein and this reaction is
catalyzed by a carboxylase (microsomal)
• Warfarin is a synthetic analogue that can inhibit vitamin K action

22. Deficiency Disorders
• Petechae
• Hematomas
• Stomach pains
• Cartilage calcification
• Risk of massive uncontrolled bleeding
• Oozing of blood at surgical or puncture sites
• Deposition of insoluble calcium salts in the walls of arteries
• In infants, it can cause some birth defects such as underdeveloped face, nose, bones, and
fingers.

23. Dietary sources of vitamin K
Vitamin K is found in green, leafy vegetables and in oils, such as soybean, cottonseed,
canola, and olive oils. It can also be synthesized from colonies bacteria. Diet is the
main source of vitamin K.
Management
Dietary supplementation of vitamin K

24. Deficiency disorders of vitamin B complex
• The vitamin B complex is essential to
• Support and increase the rate of metabolism
• Maintain healthy skin, hair and muscle tone
• Enhance immune and nervous system functions
• Promote cell growth and division, including that of the red blood
cells that help prevent anemia
• Reduce the risk of pancreatic cancer
• Reduce the symptoms of attention deficit hyperactivity disorder

25. S.No VITAMIN NAME DEFECIENCY DISORDER
1 Vitamin B Thiamine Beriberi
2 Vitamin B2 Riboflavin Ariboflavinosis
3 Vitamin B3 Niacin Pellagra
4 Vitamin B5 Pantothenic acid Acne and Paresthesia
5 Vitamin B6 Pyridoxine Microcytic anemia, Depression, Dermatitis, High Blood Pressure
6 Vitamin B7 Biotin Impaired growth and Neurological disorders in infants.
7 Vitamin B9 Folic acid Macrocytic anemia and Elevated levels of homocysteine.
8 Vitamin B12 Cobalamin Deficiency results in a macrocytic anemia, Elevated
Peripheral neuropathy, Memory loss and other Cognitive deficits.

26. Dietary sources of vitamin B complex
B-complex vitamins are found in completely unprocessed foods. Processed
carbohydrates such as sugar and white flour tent to have lower B vitamin than their
unprocessed counterparts. For this reason, thiamine, riboflavin, niacin, and folic acid is
added to white flour after processing. B vitamins are richly present in tuna and turkey
meat in fish liver. Good sources for vitamins include whole grains, potatoes, bananas,
lentils, chilli peppers, tempeh, beans, nutritional yeast, brewer’s yeast, and molasses.