• At the end of this session will be able to:- List the goals of this PHC element.- Illustrate the contents at different level of PHC- Explain the nutrients in food items.- Construct food guide pyramid- Verify Food composition table
• Promotion of food supply and proper nutrition is the 2nd element of PHC. This session will shed light on three level of PHC concerning the implementation of nutritional program to achieve community health.
• The objectives of the nutrition component in PHC include:- Promotion of activities that can improve food supply at the family level.- Correction of faulty feeding practices in infants and young children and sick persons.
- Education on the nutrient contents of locally available foodstuffs.- Treatment and rehabilitation of malnourished children- Treatment and prevention of prevalent nutritional problems such as anemia and vitamin A deficiency.- Promotion of better nutrition for pregnant and lactating women.
• Efficient utilization of available resources to increase and improve food supply.• Maintenance of exclusive breast feeding and timely introduction of adequate complementary (weaning) foods from the family diet.• Improvement of food processing, preservation, and utilization though use of appropriate technology.
• Proper distribution of food among the family members on base of high needs.• Utilization of available services on nutrition education and growth monitoring.• Early detection of proper care of malnutrition.
• Assessing the overall situation of food and nutrition in the community.• Stimulating and cooperating in activities leading to improvement of food production, storage, and marketing including home gardening and the use of communal organization for health and nutrition education.
• Technical and logistic support to facilitate work at home and communal level including training and supervision of CHWs provision of growth chart, scales, educational materials food supplementations etc.
• Identification and canalization of external resources to the communities.• Organization of adequate referral system for the care of severely malnourished subjects.• Updating protocols for management of different cases of malnutrition.
• Food is classified into four categories, including:- Milk and milk products- Meats and legumes- Cereals and starchy roots- Vegetables and fruits
• The food items of four categories when consumed by human are broken down into main parts:1- nourishing elements which include three classes:- Body building elements: like protein, iron, calcium, and iodine.- Energy producing elements: such as carbohydrate, fat, and protein.- Catalyst and protective elements like vitamins and metals.
2. Non- nourishing elements which may be useful (like fiber) or harmful ( like toxins and infectious agents that pollute or contaminate food during production, storage, transport, preparation, or serving.
Classes of Nutrients1. Proteins a. Used for replacement and repair of body cells and for growth b. Made up of amino acids c. Found in eggs, milk, cheese, and meat d. Essential amino acids must be supplied by food.
2. Carbohydrates a. The main source of energy for your body b. Made up of carbon, hydrogen, and oxygen atoms; energy holds these atoms together c. Sugars are simple carbohydrates; starch and fiber are complex carbohydrates. d. Sugars are found in fruits, honey, and milk. e. Starches are found in potatoes and pasta. f. Fiber is found in whole-grain breads, beans, and peas.
3. Fats a. Also called lipids b. Provide energy and help your body absorb vitamins c. Because fat is a good storage unit for energy, any excess energy is converted to fat. d. Classified as unsaturated or saturated based on their chemical structure e. Saturated fats are associated with high cholesterol.
4. Vitamins a. Needed for growth, regulating body functions, and preventing disease b. A well-balanced diet usually gives your body all the vitamins it needs. c. Two groups: water-soluble and fat-soluble
5. Minerals a. Are inorganic nutrients b. Regulate many chemical reactions in your body c. Calcium and phosphorous are used most by the body.
6. Water a. Required for survival. b. Cells need water to carry out their work. c. Most nutrients your body needs must be dissolved in water. d. The human body is about 60 percent water. e. You lose water each day when you perspire, exhale, and get rid of wastes.
• The daily requirements for an individual is estimated on basis of daily requirement of the different nutrients expressed as recommended intakes.
• The daily nutrient requirements are defined as the minimum amounts of nutrients needed to maintain normal health and growth. Requirements may be affected by age, sex, body, weight, energy expenditure and certain physiological states such as pregnancy and lactation.
• The recommended intake are equal to the nutrients requirement plus a safety margin to allow for individual variation. This safety margin is equal to (+2 standard deviation of the mean requirement).
• The amount of food from each item is calculated on the base of calorie yield of the item in addition to the content of other nutrients.• The preparation of so balanced meal that gives the optimum requirements of different nutrients (or the recommended intake) is called nutrition planning.
• The daily food requirement should be derived from food items that collectively yield the daily requirement of calories from CHO (65% of calories), fat (20%), and protein (15%).• These food items should also collectively give the daily requirement of the different important nutrients.• To achieve this goal Food Composition Table should be used.
• It is a table reflecting the ( composition and contents ) of the different nutrients in 100 grams of edible part of contents of the locally available food items.• It is helpful in nutritional planning, it should reflect at least the caloric, protein, fat and carbohydrate.
• A useful one should reflect the contents of other important nutrients for growth like iron, calcium, and retinol.• HE on uses of FCT is important in prevention of malnutrition and in promotion of proper nutrition.
1. Nutrition planning2. Study of feeding practices3. Management of malnutrition4. Food security ( estimate the food store in term of caloric requirements).
• It is prepared to help in blind nutritional planning ( in absence of food composition table). It guides briefly in planning the amounts of different food categories in day- food.
• For control of DM the following are advised:- Stop alcohol and stop smoking- Take 5-6 small meals instead of 2-3 big meals- Caloric intake should not exceed the daily requirements for the body weight.- Reduce fat intake- Avoid saturated fat- Take fiber-rich foods like vegetables and whole cereals- Reduce sugar intake and use natural sugar like fruits and vegetables.- Reduce salty food- Regular exercise for quarter to half hour every other day.