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GENERAL FEATURES OF NUTRITION 1
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 2
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 3
NUTRITION
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GENERAL FEATURES OF NUTRITION 4
NUTRITION
Man weighing 68 kg, consumes 325 gm of Proportion of carbohydrate, protein and fat is correct in
carbohydrate, 65 gram protein and 35 gram fat in diet accordance with balanced diet
Cereals and pulses are considered complementary Cereals are deficient in lysine, pulses are deficient is
because methionine
NOT a dietary change advised by WHO Decrease in complex carbohydrate consumption
NOT a dietary reference intake Food based dietary advice
Good source of vitamin A, C, calcium, Iron Green leafy vegetables
Fenugreek is found to be Anti carcinogenic
When food is taken by an individual at Specific dynamic action
rest, increase in heat production over
basal level
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MALNUTRITION 5
NUTRITION
SHORT STATURE
MALNUTRITION
A year old child has weight of 6.4 kg and has vitamin A Third degree
deficiency. grade of malnutrition
th
Reference standard on which classification of PEM 80% of 50 percentile of weight of age of American
based standard
Cell mediated Immunodeficiency is seen in Protein Energy Malnutrition
Transverse ridging of nail and cellophane appearance is Protein deficiency
associated with
Enzymatic reaction depressed in malnutrition Oxidation
Severe malnutrition is indicated by Loss of buccal pad of fat
Severe Acute Malnutrition Weight for height z score less than 3 SD from WHO
standards median
Features of protein energy malnutrition Insulin decreased, GH and cortisol is
increased
Infection in PEM child Gram negative bacteria
NOT altered in PEM Phagocytosis
Finding NOT seen in Protein Energy Malnutrition Nail Changes
Acute complications of PEM Hypothermia, Hypoglycemia, Hypokalemia
Bad prognosis in PEM Hypothermia, Hypoalbuminemia, Hepatomegaly
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MALNUTRITION 6
NUTRITION
KWARSHIORKAR
MARASMUS
MANAGEMENT OF MALNUTRITION
Most important factor to overcome PEM in children less Early supplementation of solids in infants
than 3 years Immunization to child
Child is suffering from severe PEM, calories to be given 200 kcal
per kg body weight to regain weight
Calorie supplementation for severely malnourished 175 cal/kg
child
Hypoglycemia in PEM is corrected by 10 % dextrose
Severely malnourished children should be given Dextrose
Protein requirement in kwarshiorkar child 2-3 g/kg/day
Initial phase treatment F 75
Rehabilitation phase F 100
Iron therapy in PEM Only after a week
Primary failure in treatment of PEM Failure to gain weight by atleast 5 g/kg of
body weight per day by day 10
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VITAMINS 7
NUTRITION
VITAMINS
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VITAMINS 8
NUTRITION
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VITAMINS 9
NUTRITION
HYPERVITAMINOSIS A
VITAMIN D
VITAMIN E
VITAMIN K
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VITAMINS 10
NUTRITION
THIAMINE
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VITAMINS 11
NUTRITION
RIBOFLAVIN
NIACIN
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VITAMINS 12
NUTRITION
VITAMIN B6
VITAMIN B12
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VITAMINS 13
NUTRITION
PANTOTHENIC ACID
BIOTIN
VITAMIN C
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VITAMINS 14
NUTRITION
synthesis
Aminoacyl tRNA NOT required for Hydroxyproline
Vitamin C deficiency leads to Defective osteoid formation
Pseudoparalysis is associated with Vitamin C deficiency
Vitamin C deficiency is associated with Corkscrew hair, coiled hair
In vitamin C deficiency, post translational modification Lysine
of which aminoacid is defective
Bleeding manifestation with normal PT and CT Vitamin C deficiency
Vitamin deficiency diagnosed by Rump Vitamin C
Leed test
FOLIC ACID
SCURVY
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MINERALS 15
NUTRITION
MINERALS
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MINERALS 16
NUTRITION
IRON
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MINERALS 17
NUTRITION
ZINC
FLUORIDE
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MINERALS 18
NUTRITION
NOT true about fluorosis Fluorosis is most common cause of dental caries in
children
Defluoridation of water is done by Nalgonda technique
Nalgonda technique used in Endemic fluorosis
Sequence of Nalgonda technique Lime + alum
IODINE
CALCIUM
COPPER
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MILK AND EGG 19
NUTRITION
anemia
Copper deficiency cause Myelopathy similar to subacute combined
degeneration
Menkes disease Defect in copper binding ATPase,
associated with poor growth, lax joints
and thin skin, reduced levels of
ceruloplasmin, NOT associated with
hepatitis and cirrhosis
CHROMIUM
SELENIUM
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BREAST FEEDING 20
NUTRITION
EGG
Egg are reference protein because of Increased biological value and NPU
Egg is ideal protein because it has Best quality of protein
NPU value for egg 96
In egg, egg white contribute 58%
Energy in one egg 70 Kcal of energy
Source of invisible fat Egg
Vitamin NOT present in egg Vitamin C
Egg is poor in Carbohydrate and vitamin C
BREAST FEEDING
BREAST MILK
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BREAST FEEDING 21
NUTRITION
As compared to cows milk, breast milk has More iron, More lactose
Breast milk Coefficient of uptake of breast milk is 70%, Calcium
absorption of human milk is better than that of cows
milk, Provides 70 kcal per 100 ml
Human milk Contains more vitamin D, Higher percentage of linoleic
acid and oleic acid, Better iron bioavailability
Mothers milk Best even in preterm baby, Lactoferrin promotes
lactobacilli in babys gut, Prevents allergy and asthma
Carbohydrate in human milk than cow Higher
Protein in breast milk 1.1
Sodium content in human milk Less
Anti infective property in milk by Lactoferin, lysozyme
Substance having anti infective property in milk Lactalbumin, Lactoferrin, Lysozyme
Protective effects of breast milk associated with IgA antibodies
Paraaminobenzoic acid in breast milk prevent infection Plasmodium vivax
of
Bifidus factor and lactobacilli in breast E.coli
milk prevent infection of
Glycosaminoglycans in breast milk protect Malaria
infection against
Lipase in breast milk protects infection Amoeba and giardia
against
Peroxisomes in breast milk protect Bacterial infection
Amount of calcium in human milk in 100 ml 28 mg
Whey casein ratio in breast milk 7:3
Ratio of casein to albumin ratio in breast 1:2
milk
Casein is a Phosphoprotein
Percentage of lactose in human milk 7.2 gram
Lactose in human milk High
Iron content in 100 gm breast milk 100 microgram
Level of protein in human milk 1.1 gm
Preterm milk is rich in Proteins
Less concentration in preterm milk Lactose, Ca, P
Hind milk is richer in Fat
Least amount of protein in 100 gm of milk Human milk
Breast milk deficient in Vitamin K
NOT present in milk Vitamin C, iron
Breast milk is known to transmit Tuberculosis
90% of milk is obtained by breast feeding infant in 4 minutes
Maximum output of breast milk 5-6 months
NOT true about breast milk Maximum output 12 weeks
COLOSTRUM
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PROTEINS AND AMINOACIDS 22
NUTRITION
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FATTY ACIDS 23
NUTRITION
PROTEIN INDICATORS
FATTY ACIDS
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FOOD FORTIFICATION 24
NUTRITION
FOOD FORTIFICATION
TOXINS IN FOOD
FOOD ADULTERATION
DIET
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DIET 25
NUTRITION
CALORIE REQUIREMENTS
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DIET 26
NUTRITION
RDA
PRUDENT DIET
Man of 68 kg, consumes 325 gm carbohydrate, 65 mg Proportion of proteins, fats, carbohydrates is correct
protein, 35 gm fat in his diet. most applicable statement and in accordance with a balanced diet
Dietary change for prevention of heart disease Reduction of cholesterol to below 100 mg per 1000 kcal
per day
Prudent diet Diet for dietary goal achievement
Dietary fat in prudent diet 15-20%
TRUE statement about Prudent diet Protein Should Be 10-15% Of Diet
Protein in prudent diet 10-15%
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DIET 27
NUTRITION
FOOD STANDARDS
DIETARY FIBRE
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