Undernutrition and overnutrition are both problems according to a recent national survey. Undernutrition affects 1/3rd of children under 5 who are underweight or stunted. 67% of children and over half of women are anemic. Malnutrition has multiple forms and causes various direct and indirect effects. It is both a medical and social issue influenced by factors like infections, culture, socioeconomics, and food systems. Actions to address malnutrition are needed at family, community, national and international levels. These include education, supplementation, improving food production and access, integrating nutrition into development programs, and disaster relief coordination.

1. SOCIAL ASPECTS OF
NUTRITION

2. National Family Health Survey 2019-21 (NFHS-5)
1/3rd under five children  underweight and stunted
67% children (6-59 months)  anaemic
57% women and 1/4th men (15-49 years)  anaemic
1/4th men and women (15-49 years) overweight or
obese

3. Malnutrition
• “ a pathological state resulting from a relative or absolute
deficiency or excess of one or more essential nutrients”
• Four forms
Undernutrition
Overnutrition
Imbalance
Specific deficiency
Problems of malnutrition

4. Undernutrition Condition which results when insufficient food is taken for
extended period of time
Extreme cases  starvation
Overnutrition Pathological state results from consumption of excessive
quantity of food over extended period of time
Imbalance Pathological state result from disproportion among essential
nutrients with or without absolute deficiency of any nutrient
Specific deficiency Pathological state resulting from a relative or absolute lack of
an individual nutrient

5. Iceberg phenomenon of disease
Wasting
Stunting
Xerophthalmia
Nutritional anaemia
Endemic goitre
Hidden
malnutrition

6. Effects of malnutrition
Direct effects Indirect effects
Subclinical nutritional deficiency
diseases
Kwashiorkor, marasmus
Vitamin & mineral deficiencies
High morbidity and mortality
Retarded physical and mental growth & development
Lower productivity
Reduced life expectancy
Predisposes to infection
High rate of maternal mortality, still birth and low birth weight
Overnutrition health hazards
Obesity, Diabetes, Hypertension
Cardiovascular and renal diseases
Diseases of liver and gall bladder

7. • Malnutrition as problem in human ecology  approaches towards prevention
• Jeliffe listed ecological factors
Conditioning influences
Cultural influences
Socioeconomic factors
Food production
Health and other sevices
Ecology of malnutrition

8. Conditioning influences
• Infectious diseases
• Small children
Malnutrition – Infection cycle

9. • Food habits, customs, beliefs, traditions and attitudes
• Religion
• Food fads
• Cooking practices
• Child rearing practices
• Miscellaneous
Cultural influences

10. • Poverty
• Ignorance
• Insufficient education
• Lack of knowledge regarding the nutritive value of foods
• Inadequate sanitary environment
• Large family size
Socio-economic factors

11. • Uneven distribution of food between and within countries
• Properly organized and given adequate resources
Food production
Health and other services

12. Remedial measures taken by health sector
Nutritional surveillance Continuous monitoring of nutritional status in
order to make decisions that will lead to
improvement in nutrition in population.
Nutritional rehabilitation Severe PEM  hospital
Less severe PEM  domiciliary basis or
nutritional rehabilitation centres (NRCs)
Nutrition supplementation Target : mothers and children
Stop gap measure for nutritional rehabilitation
Health education Appropriate educational action

13. Action at family level
• Nutrition education – husband & wife  community health workers / MPW
• selection of right kinds of local food
• planning nutritional adequate diets
• within the purchasing power
• Promotion of breast feeding and Improvement in infant & child feeding practices
• Nutritional needs of expectant and nursing mothers
• Package of mother & child health, family planning and immunization services
Preventive and social measures

14. Action at community level
• Analysis of the nutritional problems 
• Extent, distribution and types of nutritional deficiencies
• Population groups at risk
• Dietary and non-dietary factors contributing
• Diet and nutritional surveys
• Magnitude of nutrition problem  Feasible approaches to control problem based
on local resources
• Increasing and equitable availability and of food in both quantity and quality

15. Action at community level……. contd
• Applied Nutrition Programmes  production of various types of protective foods by the
community for the community
• Integrated Child Development Services (ICDS)
• Supplementary nutrition , immunization, health check-ups, health and nutrition education for
mothers, non-formal education for school children
• Target groups – upto 6 yrs, pregnant & lactating, 15-44 yrs women
• Improvement in living condition of people
• Health education
• Improvement in water supply
• Control of infectious diseases

16. Action at National level
• Rural development
• Broad based programme of rural development to raise the living standards and purchasing
power of the people
• Increasing agricultural production
• Application of modern farming practices, use of fertilizers, better seeds
• Expansion of cultivated areas
• Effective food distribution system
• Irrigation projects
• Stabilization of population
• Birth spacing and small family norm

17. Action at National level…….contd
• Nutrition intervention programmes
• Iodised common salt
• Iron and folic acid tablets to pregnant
and nursing mothers
• Iron fortification of common foods
• Massive oral doses of Vitamin A to
children at risk
• Supplementary feeding programmes
for children
• Nutrition related health activities
• National Malaria Eradication project
opened up vast lands for cultivation
• Immunization programmes
• Programmes for improvement of
environment sanitation
• Programmes of family planning
• Overall socio economic development

18. Action at International level
• International cooperation 
• mitigating effects of acute emergencies – floods and droughts
• World Food programme
• Providing enough safe food to those in need
• Come to aid the victims of emergency
• FAO, UNICEF, WHO, World Bank, UNDP, CARE

19. THANK YOU
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