SHORT QUESTIONS FOR LECTURE

IN COMMUNITY NUTRITION
dr. Min Kyaw Htet, M. Med. Sc (PH)
Name
Student number
College

: Ayu Prima Dewi

: 030.09.036
: Faculty of Medicine, Trisakti University

1. Nutrition is important for all stages of life cycle. Please mention briefly about the
importance of low birth weight.
The causes and effects of low birth weight are complex and best considered within the lifecycle conceptual
framework. Poor nutrition often begins in the intrauterine environment and extends throughout the
lifecycle. Low birth weight is an intergenerational problem where low birth weight infants grow up to be
undernourished and stunted children and adolescents and, ultimately, undernourished women of
childbearing age, and undernourished pregnant women who deliver low birth weight infants. This amplifies
risks to the individuals health and perpetuates the cycle of poverty, undernutrition and disease. This is
especially so when adolescents become pregnant before their own growth is completed, leaving little to
fulfil their own or their infants nutritional requirements.
Undernutrition, evident by decreased maternal height (stunting) and below normal prepregnancy weight
and pregnancy weight gain, are among the strongest predictors of delivery of a low birthweight infant.
There are few well defined and proven effective nutritional interventions directed at adolescent girls and
women of childbearing age and during pregnancy. For those interventions proven to be scientifically
efficacious, progamme demands are great.
The lifecycle is further taken into account by the foetal origins of disease hypothesis. This hypothesis
(Barker hypothesis) states that foetal undernutrition at critical periods of development in the intrauterine
environment and during infancy leads to permanent changes in body structure and metabolism. These
changes result in increased adult susceptibility to coronary heart disease and non insulin dependent diabetes
mellitus. There is also growing evidence that those adults born with low birth weight suffer an increased
risk of high blood pressure, obstructive lung disease, high cholesterol and renal damage. Thus, a poorly
growing foetus is an undernourished foetus prone to reduced growth, altered body proportions, and a
number of metabolic and cardiovascular changes.

2. What is stunting? What is the right instrument to measure the length of under 2 year old
children? Briefly explain the consequences of stunting.
Stunting is having a height (or length) for age more than 2 SD below the median of the NCHS/WHO
international reference and a well established child health indicator for chronic malnutrition related to
environmental and socio-economic circumstances.
Depending on a childs age and ability to stand, measure the childs length or height.
If a child is less than 2 years old, measure recumbent length.
But, if a child less than 2 years old will not lie down for measurement of length, measure standing height
and add 0.7 cm convert it to length.
The equipment needs to measure length is a length board (sometimes called an infantometer) which should
be placed on a flat, stable surface such as a table.

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3. What is the right time to introduce the complementary feeding to the infant? Please explain
briefly about nutrient gap and energy gap.
The right time to introduce the complementary feeding to the infant at 6 months of age (180 days) while
continuing to breastfeed.
Since the age 6 months, the energy produced from breast milk is only 400 Kcal while at the age 6 until 8
months there are approximately 200 Kcal need to be completed for a day outside the energy from breast
milk. It indicates the energy gap, and its growing each months. There is 300 Kcal needed more in 9-11
months, and there is a bigger number of energy gap in 12-23 months which is 600 Kcal.
The nutrient gap starts to happen in children 12-23 months while the Iron percentage that is provided by
550 ml breast milk has only give approximately 10-15% but the number of daily needs is 100%. This
means theres approximately 85-90% iron gap. This also happens in Vitamin A , where in 550 ml breast
milk there is only75% of vitamin A, and there is still a 25% vitamin A gap.

4. What biochemical indicators will you measure to know the iron status of pregnant mother?
The biochemical indicators to know the iron status of pregnant mother is ferritin, transferrin saturation,
and iron.

5. Why do you think it is necessary to conduct dietary survey in the community? Please
mention your opinion?
Nutritional problems are complex in their aetiology, and there are many different nutritional deficiency
diseases. Knowing how they occur is one vital part of solving and, better still, preventing nutritional
problems. A great variety of data can throw light on the risks of malnutrition in a community. They often
included the collection of a broad range of dietary, clinical, biochemical, anthropometric and socioeconomic data.
I will explain more about dietary survey. There are two main types in the community. One relies on direct
observation of a sample of the population, with their food measured and weighed over a given period of
time. The other relies on inquiry, with a larger group of people questioned about their diet. Each type has a
disadvantage: the former is very time consuming, and the latter depends on the memory, integrity and
intelligence of the subjects questioned. Neither method takes account of past consumption or of
uncertainties of food composition. Such involved methods are rarely justified or practical. It is often better
to use cruder, simpler methods that provide data that reveal the causes of malnutrition and suggest
corrective measures.