Community Nutrition
a) Nutritional problems and
programs in India
b) Community food supply, food
hygiene and commercially
prepared and grown food available
locally.
c) National and international food
agencies – Central food training
research institute (CFTRI), Food
and agriculture organization
(FAO), National Institute of
Nutrition (NIN), Food Safety
and Standards Authority of India
(FSSAI), CARE (Cooperative
for Assistance and Relief
Everywhere), National Institute
of Public Cooperation and Child
Development (NIPCCD) etc.
🍄 Nutritional problem and programs in India
🍄 Enlist the nutritional problem in India:
protein energy malnutrition
low birth weight baby
xerophthalmia
nutritional anemia
Iodine deficiency disorder
Flurosis
Lathyrism
Obesity
Cardiovascular disease
Diabetes
Cancer
🍄 numerate the causes and high risk group of nutritional problem in India:
Poor nutrition
Under nutrition
Over nutrition
Pregnant women
Lactating mother
Infant
Preschool children
Adolescent girls
Elderly
Socially deprived
Describe the nutritional problem:
Protein energy malnutrition:
PEM refers to energy and protein deficiency in the body.
1-2% of pre school children in India suffer from PEM.
Main causes of PEM:
Inadequate intake of food both in quantity and quality.
Infection (diarrhea, respiratory infection, measles, intestinal worms)
Contributing factors to PEM:
Poor environmental condition
Large family size
Poor maternal health
Failure of lactation
Premature termination of breast feeding
Delayed supplementary feeding
Clinical forms of PEM:
Marasmus
Kwashiorkor
🍄 Marasmus:
A common type of PEM seen among children under 1 year of age.
Almost all are caused by nutrient deficiencies, especially protein and calories.
Extreme is characterized by extreme muscle wasting and
🍄 Kwashiorkor:
Kwashiorkor occurs between the ages of 2-3 years
Acute form of PEM due to protein deficiency in diet
Micronutrient deficiencies (fe, folic acid, iodine and vitamin C)
Caused by antioxidant deficiency.
Kwashiorkor is known as inflammation of the extremities and abdomen which is reducing their actual nutritional status.
🍄 Preventive measures of PEM:
HEALTH promotion measure
Promotion of breast feeding
Low cost weaning food
Nutritional education
Family planning and birth spacing
Protein energy rich food
Early diagnosis and treatment
Rehabilitation
🍄 LOW BIRTH WEIGHT:
Low birth weight (ie, birth weight less than 2500 g) is a major public health problem in many developing countries.
About 28% of babies born in India are LBW compared to 4% in some developing countries.
Causative factors:
Maternal malnutrition and anemia
Illness and infection during pregnancy
High parity
Close birth intervals
Factors modifying prevalence of LBW:
More institutional deliveries
Improving quality of ANC including no. of the ANC,
TT, WEIGHT, BP, EXAMINATION of blood, examination of urine
🍄 VITAMIN A DEFICIENCY:
VITAMIN A DEFICIENCY is recognized as a major manageable public health and nutrition problem in India.
An estimated 5.7% of children in India suffer from eye scars
VAD consists of….
Xerophthalmia
Bitot’s spots
Keratomalacia
Bilateral blindness
Prevention:
Short term action-
Oral administration of large dose of vitamin A
Medium term action-
food fortification with vitamin A
Long term action-
Encouraging consumption of leafy vegetables,
Immunization against infection.
NUTRITIONAL ANEMIA:
A condition in which the Hb content of the blood is lower than normal as a result of a deficiency of one or more essential nutrients.
Mainly due to lack of absorbable iron in food.
Interventions:
Iron and folic acid supplementation
Nutritional anemia prophylaxis program
Iron fortification – fortification of salt with iron
IODINE DEFICIENCY DISORDERS:
Diseases caused by iodine deficiency have some major nutritional problems.
Iodine deficiency diseases are as follows…
Goiter
Cretinism
Preventive measures:
Encourage sale of iodized salt and monitor its iodine content
Educate the community about iodine intake and iodine deficiency disease.
Effective implementation of National Iodine
deficiency disease control program
FLOUROSIS:
In many parts of the world where drinking water contains excessive amounts of fluorine (3-50mg/1).
There are two types of fluorosis.
Dental Fluorosis
Skeletal Fluorosis
Prevention of Fluorosis:
Keep drinking water fluorine levels below 1mg/1
Defluoridation of water using Nalgonda technology
Avoid using fluoride toothpaste in areas of localized fluorosis
Prevent fluorine deficiency.
LATHYRISM:
It is a paralytic disease of humans and animals.
In humans, it is known as neurolatherism because it affects the nervous system and in animals it is known as osteolatherism because pathological changes occur in the bone.
The reason is the use of khesari dal.
Intervention:-
🍄 Removal of toxins:
i. Steeping method:
By soaking the beans in hot water for about two hours, the soaked water is completely trained off.
ii. Genetic method approach:
Developing less toxic varieties of lathyrns.
iii. Banning the crop:
Prevention of food adulteration act has banned latex in all forms in India.
: OBESITY:
The most common form of malnutrition.
Abnormal growth of adipose tissue occurs due to enlargement of fat cells, increase in number of fat cells or a combination of both.
Control of obesity:
Take food as per body requirement
At least 3-4 hours gap between meals
Avoid breakfast
Eat more leafy vegetables that are high in fiber
Avoid consuming fatty and fried foods
Do regular physical exercise.
🍄 CARDIOVASCULAR DISEASE:
One of the diseases related to food habit is CVD
Changes in dietary habits and lifestyle have increased the risk of CVD in the Indian population, mostly in the middle class and upper middle class groups.
🍄 CANCER:
80% of cancers are caused by environmental factors.
Dietary fat:
Colon cancer, positively correlated with breast cancer
Dietary fiber:
Colon cancer risk is inversely related
Micronutrients:
Lack of vitamin C and vitamin A increases the risk of stomach cancer and lung cancer.
Food additives:
Saccharine, cyclamate, coffee, alfa toxin, are associated with bladder cancer.
Alcohol:
liver cancer and rectal cancer
🍄 Explain the community nutrition program:
Integrated child development scheme
Vitamin A prophylaxis program
Prophylaxis against nutritional anemia
Scheme for Adolescence Girl (Kishori Shakti Yojana)
Iodine deficiency disorder program
Mid day meal programme
Balwadi nutrition programme
National program for nutrition support to primary education
Akshay patra yojana and private sector participation in mid day meal
Emergency feeding program 2001
Village grain bank scheme
Wheat based nutrition program
Smpoorna gramin rojgar yojana
National food for work programme
Pulse mission
National water supply and sanitation programme
Minimum need program
20 point program 1975
National rural health mission
The ICDS scheme was launched on 2nd October 1975 (5th Five Year Plan) in pursuance of the National Policy.
Starting with 33 experimental blocks for children
The success of the scheme led to its expansion to 2996 projects by the end of March 1994.
Now the aim (9th Five Year Plan) is to universalize ICDS across the country.
Beneficiaries:-
Children below 6 years
Pregnant and lactating women
Women in the age group of 15-44 years
Adolescent girls in selected blocks
Objectives:
Improving nutrition and health status of children aged 0-6 years
Lay the foundation for proper mental physical and social development of the child
Effective coordination and policy implementation between various departments
of general health and nutritional needs through appropriate…
Program launched by Ministry of Health and Family Welfare
Component of national program for control of blindness 1968,1976
Administering a single dose of vitamin A containing 2 lakh international units orally to all preschool children in the community every 6 months by peripheral health workers.
Iron and folic acid tablets are distributed to pregnant women and young children (1-12 years).
MCH Center and ICDS Project implement this programme.
Designed for all girls in the age group of 11-18 years.
Common services:
Watch over menarche
Immunization
General health check up once in every 6 months
Training for minor ailments
Deworming
Prophylactic measure against anemia, goiter, vitamin deficiency etc.
Referral is made to PHC, District Hospital in case of need.
Launched in 1962
🍄 Use of iodine salt:
Replacing common salt with iodized salt is the cheapest method of controlling IDD.
🍄 Use of iodized tablets:
School children are given iodized tablets
🍄 Use of iodized oil:
A 1ml injection of iodized oil is used for people suffering from IDD, given orally as prophylaxis in IDD in some areas.
Mass communication:
Public awareness through mass media and public health programme
Also known as school lunch program
Program operation since 1961
Objectives:-
Meals should be complementary and not a substitute for the home diet.
Meals should provide at least 1/3 of the total energy requirement and half of the required protein.
The cost of food should be reasonably low.
Meals in schools should be easily prepared, not involving any complicated cooking process.
Locally available food should be used.
The menu should be changed frequently.
Started in 1970 under Department of Social Welfare
For children aged 3 to 6 years in rural areas
The program was implemented by the kindergarten
Food supplement
300 kcal and 10 g of protein/children/day
: 8. NUTRITIONAL PROGRAM FOR NUTRITIONAL SUPPORT TO PRIMARY EDUCATION:-
This system was called the provision of “dry rations”.
The Government of India will provide foodgrains free of charge and the state will bear the cost of other components, salaries and infrastructure.
On November 28, 2001, the Supreme Court of India directed that it became mandatory for state governments to provide cooked meals instead of dry rations.
Successfully engaged private sector participation in the programme
The program is managed with an ultra-model centralized kitchen run through a public/private partnership.
Food is delivered to schools in sealed heat-retaining containers before lunch break every day.
Provides cooked food especially for BPL people.
🍄 Implemented by the ministry of tribal affairs
Useful in providing a safe guard against starvation during periods of natural calamities or lean seasons and when marginalized food insecure households do not have sufficient resources to purchase rations.
Implemented by the Ministry of Women and Child Development
Implemented through ICDS
Provides nutritious/energetic food to children below 6 years of age and pregnant/lactating women from the disadvantage section.
50 lakh tonnes of food grains will be allocated free of cost to the states/UTs by the Ministry of Rural Development.
Implemented in tribal belts
Providing supplementary wage employment and food security
The scheme will provide 100 days of employment at minimum wages to at least one able-bodied person from every household in the country.
Production of pulses has been stagnant for 5 decades
Pulse mission (India’s food security mission) aims to increase the production of pulses.
Launched in 1956
To provide safe water supply and adequate drainage facilities for the entire urban and rural population of the country.
17.MINIMUM NEED PROGRAM :-
Launched on 1974
Objectives:-
To improve basic minimum needs and standard of living of the people there.
It includes:-
i. Rural health
ii. Rural water supply
iii. Rural electrification
iv. Elementary education
V. Adult education
vi. Nutrition
vii. Environmental improvement of urban slum
viii. House for landless labourers
Objectives:-
eradication of poverty
Raising productivity
Reducing inequality
Improving quality of life
National children’s fund 1979
This fund provided support to the voluntary organization that helps the welfare of children.
National plan of action for children 1990
United Nations Children’s Fund
National rural health mission
19.NATIONAL RURAL HEALTH MISSION:
Reduce the infant mortality rate and the maternal mortality ratio.
To have universal access to public health services
To prevent and control endemic diseases both communicable and non-communicable
To have access to integrated comprehensive primary health care.
Population stabilization, as well as creating gender and demographic balance.
To revive local health traditions and mainstream AYUSH.
Finally, to promote a healthy lifestyle.
⭐ Topic:
🍄 Community food supply and food hygiene
Define community:
A group of people living in the same place or having a certain characteristic in common. “Montreal’s Italian Community”
The state of sharing or having certain attitudes and interests in common. “The sense of community that organized religion can provide”
Define food:
Any food or drinkable substance (usually of animal or plant origin), containing nutritive and nutritional components such as carbohydrates, fats, proteins, essential minerals and vitamins, which (when ingested and absorbed through digestion) sustains life. , produces energy and provides growth, maintenance.
Enlist the purpose of food supply:
The purpose of FSDS (food supply and distribution system) analysis is to identify the strengths and weaknesses of each component of the FSDS along with the factors influencing their efficiency and dynamics.
To improve the FSDS (food supply and distribution system), it is necessary to:…
Understand the structure of FSDS;
interpret how the FSDS works;
Identify and analyze the constraints faced by various FSDS players.
The various functions performed by the FSDS can be grouped into two subsystems:
Food production in urban and peri-urban areas is receiving increasing attention as it can contribute to:…
local supply of fresh, nutritious food such as poultry, lean meat, fruits, vegetables and dairy products;
alleviating poverty and improving food security through consumption of self-grown produce, employment and income generation;
Cost-effective environmental management through productive use of organic waste for compost,
Appropriate and productive use of waste and waste contributes to space, biodiversity and watershed management…
Describe problems in food production and supply in urban and periurban areas:
There are a number of problems associated with urban and periurban food production that arise from proximity to densely populated areas that share the same air, water, and soil resources.
Food production in the polluted environment of cities can contaminate food.
Inadequate use of chemicals, solid and liquid wastes in agriculture can contaminate food, soil as well as water resources used for drinking and food processing…
Describe the need of food production in urban community:
Increasing quantities and varieties of fresh and processed food are required to meet the needs of urban dwellers. Other requirements are:…
Land-use management to maintain suitable land in urban and peri-urban areas for efficient and sustainable food production.
To protect human health and environment from pollution..
To provide adequate water supply for the quantity and quality of food production, processing and drinking water…
To provide adequate supply of fuel wood for food processing and cooking…
To provide adequate parking, loading and unloading facilities for the growing number of food trucks…
Away from city centers, for additional wholesale markets with plenty of facilities and professional management…
To provide easily accessible, adequately equipped and well managed retail outlets, especially in low income areas.
For facilities for spontaneous markets…
For food producer markets, traveling traders and retail trade associations in low income districts.
For private investment in food shops, market improvements, transport facilities etc.
To make proper arrangements to manage the increasing volume of waste from markets and slaughterhouses.
To obtain market information for better production and marketing decisions..
To adopt good packaging and handling practices to reduce food loss.
To create simple, consistent and well-understood food production, processing and marketing regulations.
Describe about food processing, preparation, food handling, food packaging, food storage, supply and transportation:
Food processing:
Processing means changing the form, presentation and substance of a product.
Food can be processed many times before a given food item is consumed, in advance (after harvest) or before the product reaches the consumer….as a processing unit, restaurant or street food…
To meet the demand for processed products, there should be …
Food preparation and food handling.
🍄 [PREPARATION AND FOOD HANDLING:
Preparation includes cleaning, sorting and grading.
At all stages of the marketing chain the product has to be packed and unpacked, loaded and unloaded, put into stores and taken out again.
Each individual handling cost may not be high but the aggregate amount of all such handling costs may be substantial.
FOOD PACKAGING:
Most products require packaging.
Packaging serves three basic purposes.
First, it provides a convenient way of handling and transporting the product.
Secondly, it provides protection to the product.
Finally, packaging can be used to divide the product into convenient units for retail sale and to make the product more attractive to the consumer.
Thus increasing the final selling price.
Market for processed product;
Sufficient raw materials, inputs and stable quantities of safe water,
Processing Technology
Infrastructure, facilities and services, including visibility, logistics and practice.
🍄 FOOD STORAGE:
The main purpose of storage is to extend the availability of the produce for a longer period than when the crop is sold immediately after harvest.
The assumption behind all commercial storage is that while the product is in storage the price will increase sufficiently to cover the cost of storage.
These types of costs will vary depending on the cost of building and operating the store, but also on the cost of capital.
Used to purchase stored product.
🍄 SUPPLY OF FOOD:
Cities depend to varying degrees on imported food.
Imports require infrastructure, facilities and services, administrative arrangements and regulations.
The relevance issues of analysis of FSDS are:..
Implementation of import control regulations for health and environmental purposes,
Efficiency of administrative system to clear imported goods,
Dockside storage conditions, control of imports by importers etc….
RURAL AND PERIURBAN-URBAN FOOD TRANSPORT:
In many countries the primary form of transportation may be the farmer or his laborers, carrying the produce themselves or using carts drawn by cattle.
The transportation cost will vary according to the distance between the farmer and the market.
Food Shops:
Many small, family-run food shops compete for the local market.
Such competition has been made more difficult by the increasing presence of supermarkets and hypermarkets,
And the lack of entrepreneurial mindset as well as technical and managerial skills, are responsible for low and negative returns, which, in turn, do not stimulate self-development and expansion…
🍄 Define food hygiene:
Are practices followed for food preservation…?
“Food hygiene refers to the conditions and practices that help preserve food and prevent it from becoming contaminated.
🍄 Describe practices used in food hygiene:
Food hygiene is concerned with practices related to food handling and cooking to prevent food contamination, prevent food poisoning, and reduce the transmission of disease to other foods, humans, or animals.
🍄 Food practices include:
Cleaning and disinfection of food-preparation areas and equipment (for example using designated cutting boards for preparing raw meat and vegetables).
Cleaning may involve the use of chlorine bleach, ethanol, ultraviolet light, etc.
Carefully avoid meat contaminated with trichina worms, salmonella and other pathogens; Or cook the suspect meat completely.
Prepare raw foods like sushi and sashimi with utmost care.
Sanitize institutional dishes by washing them with soap and clean water.
Wash hands thoroughly before touching any food.
Wash hands after touching cooked food while preparing food.
Do not use the same utensils to prepare different foods.
Do not share cutlery while eating.
Do not lick fingers or hands during or after eating.
Do not reuse serving utensils that have been licked.
Proper storage of food to prevent contamination by insects.
Storing food in refrigeration. (And not storing food where proper refrigeration is not possible in the environment.)
Labeling food to indicate when it was produced (or, as food manufacturers prefer, to indicate its “best before” date).
Dispose of uneaten food and packaging properly.
⭐ Topic:
🍄 National and international food agencies
Introduction:
The Food Safety and Inspection Services is the public health agency of the US Department of Agriculture responsible for ensuring that the nation’s commercial supply of meat, poultry, and egg products is safe, wholesome, and properly labeled and packaged.
List all the types of national and international food agencies:
Central food technological research institute
Food and agriculture organization
National institute of nutrition
Food safety and standards authority of India
CARE
National institute of public co-operation and child development
➤ Abbreviated as CFTRI is one of the 40 National Research Laboratories in India.
➤ It was opened on 21 October 1950 in Mysore, Karnataka.
➤ CFTRI Mysore center also has extended resource centers in Hyderabad, Lucknow and Mumbai, which provide technical assistance to entrepreneurs.
➤ There are sixteen research and development departments, including laboratories, which focus on food, biotechnology, microbiology, sensory science and food safety.
➤ The institute is engaged in research in production and management of grains, pulses, oilseeds, spices, fruits, vegetables, meat, fish and poultry.
➤ Develops technology to increase organization efficiency and reduce post-harvest losses, add convenience, increase exports, find new sources of food products, integrate human resources.
➤ Food New sources of food products, to integrate human resources in food industries, reduce losses and modernize..
➤ Brief FAO is an agency of the United Nations that leads international efforts to defeat hunger.
➤ It was opened on 16 October 1945. Quebec City, Canada.
➤ It is headquartered in Rome, Italy.
➤FAO Currently (2014) Director General – Jose Graziano da Silva. (Jose Graziano da Silva.)
➤ FAO is also a source of knowledge and information, and helps developing countries and countries in transition to modernize and improve agricultural, forestry and fisheries practices, ensuring good nutrition and food security for all.
Food and Agriculture Association is functioning
Seven sections below:…
Administration and finance
Economic and social development
Natural resources management and environment
Technical co-operation
Agriculture and consumer protection
Forestry
Fisheries and aquaculture
➤ Abbreviated NIN is an Indian public health, biotechnology and translational research center located in Hyderabad, India.
➤ NIN was founded in 1918 in Coonoor and shifted to Hyderabad, Telangana, India in 1958.
➤ This institute is one of the oldest research centers in India and the largest center under Indian Council of Medical Research, located near Osmania University.
➤ The organization has associated clinical and pediatric nutrition research awards in various hospitals like Nilofer Hospital for Women and Children, Government Maternity Hospital, Gandhi Medical College and Osmonia General Hospital, Hyderabad.
➤ National Center for Laboratory Animal Science and the Food and Drug Toxicology Research Center, National Nutrition. Monitoring Bureau is another wing of NIN…
➤ Abbreviated FSSAI is an agency of the Ministry of Health and Family Welfare, Govt. FSSAI in India was formed in August 2011.
➤ FSSAI is established under the Food Safety and Standards Act, 2006 which is a consolidated law related to food safety and regulation in India.
➤ FSSAI is responsible for the protection and promotion of public health by regulating and monitoring food safety.
➤ FSSAI is headquartered at New Delhi. The agency also has 8 regional offices in Delhi, Chandigarh, Lucknow, Guwahati, Mumbai, Kolkata, Cochin and Chennai.
CARE was established in 1945. It is the largest and oldest humanitarian aid organization focused on fighting global poverty.
CARE also advocates for policy change and the rights of poor people at local, national and international levels.
Care programming falls under the following broad themes…
Gender and women’s empowerment:
CARE implements prevention programs in 50 countries to prevent sexual and gender-based violence and increase awareness and adoption of non-violent behaviours.
Food security:
CARE provides emergency food assistance and helps prevent malnutrition, by demonstrating appropriate breastfeeding.
Health:
CARE health programs focus on mental health and HIV/AIDS.
climate changes:
Education:
To educate girls..
Water sanitation and hygiene:
Care builds and maintains clean water systems and latrines and provides education about hygiene and waterborne disease.
Economic development:
CARE helps enhance market linkages, promotes diversified livelihoods, organizes rural savings and loan associations and provides entrepreneurship training.
Advocacy:
CARE advocates for improved development policy directed at local and national governments, as well as international organizations such as the United Nations.
NIPCCD is a Govt.
It is an agency formed in 1966.
NIPCCD works for the development of women and children.
⭐ Topic:
Nutritive value of common food items
Define nutritive value:
The degree of nutrition in food is called nutritive value.
Classify general and common food articles:
Cereals with millets
Pulses
Vegetables
Milk and milk products
Fats and oils
Meat, fish and eggs
Chilies and spices
Sugar and jaggery
Beverages
Cereals and millets:
Cereals mainly consist of wheat, rice and maize, while millet consists of coarse grains.
Cereals like Jowar, Bajri, Ragi etc. provide about 70 to 80% of the total energy requirement.
100 grams of cereal provides about 350 kcal of energy.
Some of these are described below…
🎗️ 2. Wheat:
Wheat is the staple food next to rice.
Wheat flour and Maida are its other forms.
Wheat contains 9 to 16% protein.
It is also a major source of energy.
Eggs contain most of the nutrients; Egg protein contains all 9 essential amino acids, except for vitamin C, all other vitamins are obtained from eggs.
Boiled eggs are considered more nutritious than raw eggs.
Eggs are very low in carbohydrates.
Soft drinks contain carbon dioxide, sugar, citric or tartaric acid, and coloring and flavoring.
Fruit juices are comparatively more nutritious.
Alcoholic beverages include beer, rum, whiskey, gin, etc. Most of these have no nutritional value but in limited amounts they act as appetite stimulants.