NUTRITION

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GENERAL FEATURES OF NUTRITION

NUTRITION

CONTENTS
GENERAL FEATURES OF NUTRITION ............................................................................................................................. 4
ASSESSMENT OF NUTRITIONAL STATUS ....................................................................................................................... 4
FEATURES OF ASSESSMENT OF NUTRITIONAL STATUS ............................................................................................ 4
SHORT STATURE ........................................................................................................................................................ 5
MALNUTRITION ............................................................................................................................................................. 5
GENERAL FEATURES OF MALNUTRITION .................................................................................................................. 5
ACUTE AND CHRONIC MALNUTRITION ..................................................................................................................... 5
KWARSHIORKAR ........................................................................................................................................................ 6
MARASMUS............................................................................................................................................................... 6
MANAGEMENT OF MALNUTRITION.......................................................................................................................... 6
VITAMINS ...................................................................................................................................................................... 7
GENERAL FEATURES OF VITAMINS ........................................................................................................................... 7
GENERAL FEATURES OF VITAMIN A .......................................................................................................................... 7
FEATURES OF VITAMIN A DEFICIENCY ...................................................................................................................... 7
PROPHYLAXIS AND TREATMENT OF VITAMIN A DEFICIENCY ................................................................................... 8
HYPERVITAMINOSIS A ............................................................................................................................................... 9
VITAMIN D................................................................................................................................................................. 9
VITAMIN E ................................................................................................................................................................. 9
VITAMIN K ................................................................................................................................................................. 9
GENERAL FEATURES OF VITAMIN B ........................................................................................................................ 10
THIAMINE ................................................................................................................................................................ 10
RIBOFLAVIN ............................................................................................................................................................. 11
NIACIN ..................................................................................................................................................................... 11
VITAMIN B6 ............................................................................................................................................................. 12
VITAMIN B12 ........................................................................................................................................................... 12
PANTOTHENIC ACID ................................................................................................................................................ 13
BIOTIN ..................................................................................................................................................................... 13
VITAMIN C ............................................................................................................................................................... 13
FOLIC ACID .............................................................................................................................................................. 14
SCURVY ................................................................................................................................................................... 14
MINERALS ................................................................................................................................................................... 15
GENERAL FEATURES OF MINERALS ......................................................................................................................... 15

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GENERAL FEATURES OF NUTRITION

NUTRITION

IRON ........................................................................................................................................................................ 16
ZINC ......................................................................................................................................................................... 17
FLUORIDE ................................................................................................................................................................ 17
IODINE ..................................................................................................................................................................... 18
CALCIUM ................................................................................................................................................................. 18
COPPER ................................................................................................................................................................... 18
CHROMIUM............................................................................................................................................................. 19
SELENIUM ............................................................................................................................................................... 19
MILK AND EGG ............................................................................................................................................................ 19
MILK AND PASTEURISATION ................................................................................................................................... 19
EGG ......................................................................................................................................................................... 20
BREAST FEEDING ......................................................................................................................................................... 20
GENERAL FEATURES OF BREAST FEEDING .............................................................................................................. 20
BREAST MILK ........................................................................................................................................................... 20
COLOSTRUM ........................................................................................................................................................... 21
STORAGE OF BREAST MILK ..................................................................................................................................... 22
PROTEINS AND AMINOACIDS ..................................................................................................................................... 22
GENERAL FEATURES OF PROTEINS.......................................................................................................................... 22
PROTEIN INDICATORS ............................................................................................................................................. 23
FATTY ACIDS ................................................................................................................................................................ 23
FOOD FORTIFICATION ................................................................................................................................................. 24
TOXINS IN FOOD ......................................................................................................................................................... 24
FOOD ADULTERATION ................................................................................................................................................ 24
DIET ............................................................................................................................................................................. 24
DIETARY CYCLE AND NUTRITIONAL SURVEILLANCE ................................................................................................ 24
CALORIE REQUIREMENTS........................................................................................................................................ 25
CALORIE REQUIREMENTS OF ADULT ...................................................................................................................... 26
SUPPLEMENTARY NUTRITION IN ICDS .................................................................................................................... 26
RDA ......................................................................................................................................................................... 26
PRUDENT DIET ........................................................................................................................................................ 26
INDIAN REFERENCE MALE AND FEMALE ................................................................................................................. 26
FOOD STANDARDS .................................................................................................................................................. 27
DIETARY FIBRE ......................................................................................................................................................... 27
PROBIOTIC AND PREBIOTIC..................................................................................................................................... 27
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GENERAL FEATURES OF NUTRITION

NUTRITION

KEY TO THIS DOCUMENT

Text in normal font Must read point.
Asked in any previous medical entrance
examinations
Text in bold font Point from Harrisons
th
text book of internal medicine 18
edition
Text in italic font Can be read if
you are thorough with above two.

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GENERAL FEATURES OF NUTRITION

NUTRITION

GENERAL FEATURES OF NUTRITION

Man weighing 68 kg, consumes 325 gm of
carbohydrate, 65 gram protein and 35 gram fat in diet
Cereals and pulses are considered complementary
because
NOT a dietary change advised by WHO
NOT a dietary reference intake
Good source of vitamin A, C, calcium, Iron
Fenugreek is found to be
When food is taken by an individual at
rest, increase in heat production over
basal level

Proportion of carbohydrate, protein and fat is correct in

accordance with balanced diet
Cereals are deficient in lysine, pulses are deficient is
methionine
Decrease in complex carbohydrate consumption
Food based dietary advice
Green leafy vegetables
Anti carcinogenic
Specific dynamic action

ASSESSMENT OF NUTRITIONAL STATUS

FEATURES OF ASSESSMENT OF NUTRITIONAL STATUS
Anthropometric measurement NOT of much change in
1-4 years
Sensitive index of malnutrition in 3-6 years
Village health guide measures state of malnutrition in
an under 5 child by
During nutritional assessment of a surgical patient, use
of muscle protein is indicated by
Shakir tape
Mid arm circumference (1-5 years)

Salters scale is a useful method employed in field to

measure
Most important anthropometric characteristic of
nutritional dwarfism
Best indicator for nutritional status for a child
Best indicator for long term nutritional status
Kanawati index
NOT a method to assess nutrition in community
NOT true about nutritional surveillance
NOT an indicator for assessment of nutritional program
NOT a feature of nutritional surveillance
Primary aim of applied nutrition programme
Health status of children between 0 and 4 years
affected by
Does NOT indicate poor nutrition in children

Mid arm circumference

Mid arm circumference
Mid arm circumference
Mid arm circumference
Measurement of midarm circumference
>13.5 normal, 12.5 13.5 means
malnourished, less than 12.5 means
severely malnourished
Birth weight
Normal birth weight and subsequent retardation of
growth
Rate of increase of height and weight
Height for age
MAC/HC
Hb <11.5 gm% in third trimester pregnancy
Done in all children < 5 years
Prevalence of pregnant mothers having Hb<11.5g% in
3rd trimester
Measurement of height
Stimulation of production and consumption of
protective foods by education
Malnutrition, infections, birth weight less than 4 kg
Low birth weight

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MALNUTRITION

NUTRITION
A childs weight for height is more than 2SD of mean,
and his height for age is less than 2SD of mean. he is
Gomez classification
Gomez classification is based on

Stunted
Age dependent
Weight retardation

SHORT STATURE
MC cause of short stature
Short stature is seen in
Bone age is normal in

Constitutional
Maternal deprivation syndrome, Hypothyroidism, IUGR
Genetic short stature

MALNUTRITION
GENERAL FEATURES OF MALNUTRITION
A year old child has weight of 6.4 kg and has vitamin A
deficiency. grade of malnutrition
Reference standard on which classification of PEM
based
Cell mediated Immunodeficiency is seen in
Transverse ridging of nail and cellophane appearance is
associated with
Enzymatic reaction depressed in malnutrition
Severe malnutrition is indicated by
Severe Acute Malnutrition
Features of protein energy malnutrition
Infection in PEM child
NOT altered in PEM
Finding NOT seen in Protein Energy Malnutrition
Acute complications of PEM
Bad prognosis in PEM

Third degree
th

80% of 50 percentile of weight of age of American

standard
Protein Energy Malnutrition
Protein deficiency
Oxidation
Loss of buccal pad of fat
Weight for height z score less than 3 SD from WHO
standards median
Insulin decreased, GH and cortisol is
increased
Gram negative bacteria
Phagocytosis
Nail Changes
Hypothermia, Hypoglycemia, Hypokalemia
Hypothermia, Hypoalbuminemia, Hepatomegaly

ACUTE AND CHRONIC MALNUTRITION

Low weight for height
Deficit in weight for height in a 3 year old child indicate
Best parameter for assessing acute malnutrition
Best parameter for assessment of chronic malnutrition
Common to both acute and chronic malnutrition

Acute malnutrition
Acute malnutrition
Weight for height
Height for age
Weight for age

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