Nutrition in Health and Illness: For 2 Yr Nursing Students

NUTRITION IN HEALTH
AND ILLNESS
For 2nd yr Nursing students

Chapter 1
Introduction to Human Nutrition

Chapter Objectives
 Define food, nutrition, diet and malnutrition
 History of nutrition
 Nutrient classification
 Explain the dietary guidelines
 Why human beings need food? Discuss Mention
the fundamental causes of malnutrition
 Discuss the traditions that favor the nutrition
condition
Definitions
 Food: - is defined as any solid or liquid which
when ingested will enable the body to carry out any
of its life function.
 Nutrition: - is the sum total of the process by
which living things receive and utilize the
necessary materials for survival, growth and
maintenance of worn out tissues.
Definitions
 Malnutrition: - is the condition that results from
an imbalance between dietary intake and
requirements. It includes under nutrition and over
nutrition.
 Diet:- is defined as food containing all the
nutrients in a sufficient amount and in proper ratio.
Definitions
 Foodscience :-Study of the nature of foods and the
changes that occur in them naturally and as a result
of handling and processing.
 Nutrient: - Is an active ingredient in the food that
play specific structural or functional role in the
body’s lively activity.
Definition
 What is nutrition? Science of food and nutrients
and their actions within the body (including
ingestion, digestion, absorption, transport,
metabolism, storage and excretion)
 Utilization of foods by living organisms for normal
growth, development and maintenance of health.
 Provision, to cells and organisms, of the materials
necessary (in the form of food)to supporting life.
Branches of nutrition
 Clinical Nutrition
- Use of nutrition as a means of treating illnesses.
 Public health Nutrition
- Promotion of good health with the primary

prevention of nutrition related diseases.
History of nutrition
 1857- Claude Bernard isolated glycogen.
 1864 - Chemical methods for analysis of food stuffs
were developed.
-A number of amino-acids were isolated.
 1899 - Emil Fisher began classic studies of protein
composition.
 1883/87 - Energy studies in small animals and farm
animals were initiated.

 Vitamins were discovered, essential aminoacids
identified
 Essential fatty acid was identified
 Certain minerals found to be essential
 First recommended dietary allowances(RDAs)
established
 The electron microscope (1933), made possible the
study of nutrition at cellular level.
 First fortified food produced(iodizedsalt)
 1917 – First food groups were published
The five food groups are
–Milk and meat
–Vegetables and fruits
–Cereals
–Fats and fat foods
–Sugars and sugary foods
Staple foods
Staple foods are foods, which form the largest part of
a nation’s diet.
They are of plant origin and are classified into three
main groups.
1.The grain and cereals
2.The roots and tubers
3.The starchy fruits
Scope of Nutrition
A. Normal nutrition
Is planned for healthy person according to their age, sex,
physical activity and physiological status.
B. Therapeutic nutrition
Is planned to maintain or restore good nutrition in the
patient.
C. Community nutrition/public health nutrition:
It concerned with those problems of nutrition that affect
large numbers and that can be solved most effectively
through group action.
Why human beings need food?
 Provide energy for the essential physiological functions like
 Respiration
 Circulation
 Digestion
 Metabolism
 Maintaining body temperature
 Growth and repair body Tissues
 Provide materials used for growth and maintenance.
 Supply substances which regulate the body function.
Nutrients Classification
Macronutrients
 Carbohydrate
 Protein
 Lipids
 Water
Micronutrients
Vitamins
Minerals
Organic nutrients
-carbohydrate
-protein
-lipids
-vitamins
Inorganic nutrients
-mineral
-water
Essential nutrients
Chemical substances found in food that cannot be
synthesized at all or insufficient amounts in the body, and
are necessary for life, growth and tissue repair.
– Must be obtained from food sources, because
• the body either does not produce them or
• produces them in amounts too small to maintain growth
and health.
include : Water, carbohydrates, Proteins, fats, Vitamins and
minerals.
Conditionally essential nutrients
These are required in specific physiological states
when the body can’t synthesize in sufficient amount
to meet the physiological needs. E.g. Pathological
states
Nonessential nutrients Nonessential nutrients are
manufactured in the body and donot need to be
obtained from food.
E.g.Cholesterol
Nonnutrients
 - Alcohols
 - Phytochemicals
 - Additives
Phytochemicals: –non nutrient compounds found in

plant derived foods that have biological activity in the
body
What is an Optimum Nutrition?
 Supplies sufficient energy used by the body

 Contributes a level of protein sufficient for:
Growth, Defense mechanism, Tissue repair and
maintenance,
 Contains sufficient lipid to supply: -Essential fatty
acid (EFA):n-3 & n-6 FA
 Adequate vitamin & mineral intake.
 Foods and the human body are made of the same classes of
chemicals.
Protein rich food( beef )
• 53% ---water
• 29% ----fat
• 18% ---protein and major minerals
Carbohydrate rich foods(corn)
• 74% ------water
• 3% ---fat
• 23% ---CHO, protein and major minerals
The human body
 60% ---water
• 20% ---fat
• 20% ---protein, CHO and major minerals.
Balanced Diet
 Balanced diet/Healthy diet:- is a diversified diet
that contains all the essential nutrients in the
proportion that is required for optimal health and
long-term survival.
 Help to maintain good health
In approximation, balanced diet will contain:

 Carbohydrate 60-70%
 Protein 10-21%
 Fats 22-25%
Food pyramid
 Food guide: gives recommendation on the kind and
amounts of various types of food that together
provide a nutritionally satisfactory diet
Developed based on:
 Established nutrient standards ( Dietary reference
intakes-DRI)
 Dietary guidelines
 The composition of foods
 Food intake pattern of the target population

Food pyramid
The food guide pyramid is developed based on the
principles of balance,variety and moderation.
 Balance: It means choosing food from different
food groups.
 Variety: This means including different foods
within each food group

 Moderation: This means keeping serving sizes
reasonable.
Food pyramid
The Six Diet-planning principles
 Adequacy
 Balance
 Energy control
 Nutrient density
 Moderation
 Variety
Malnutrition
Malnourishment or Malnutrition:- is a condition that

results from eating a diet in which nutrients are not
enough or are too much that it causes health
problems.
1. Undernutrition results from lack of nutrients such
us carbohydrates, protiens and fats.
2. Overnutrition results from excessive consumption
of foods far more than dietary needs. This leads to
heart disesase and obesity.
Malnutrition
Causes of malnutrition
 Lack of knowledge in selecting food stuff with high nutritive value
 Poverty and infectious diseases
 Drought
 Uneven distribution of the available foods
 Social arrest and civil conflicts,
 Transport problems (inaccessibility)
 Increased populations
 Poor management of resources

 Topographical differences in different regions (variation in productivity)

 Loss of food through destruction by insects
Nutrition in Ethiopia
 80 % of the population employs in subsistence agriculture
 poverty is still a big obstacle to overcome
 Nearly 1/3 of the population lives below the poverty line
 Chronic and acute food insecurity are prevalent
 About 10 % of Ethiopia’s citizens are chronically food
insecure
 more than 2/5 (two out of every five) children in Ethiopia
are stunted
 16.5 % of its GDP each year loose due to chronic
malnutrition
Best practices which favor nutrition
 Breast feeding
 Mixing of foods E.g. Injera with wat prepared from
- Cereals - Legumes - Vegetable Traditional use

of dark green leaves “Hbesha Gommen.”
 Eating cereals in the form of kolo (roasted) and
nefro (cooked)
 Additional high calories and high protein diet for
pregnant and lactating mothers

Harmful traditional practices with regard to nutrition
 During period of fasting important nutrients are

not eaten, such as milk, eggs, butter, meat, fish,
meal pattern, etc.
 Lack of sun light (lack of Vitamin D) during
infancy to protect the child from the “evil eyes”
 Delay to start complementary food
 Discrimination in feeding among family members,
adults before children, adult males over adult
 Giving butter to neonate to swallow, hoping to
keep the intestine smooth
 Refusing to give the child meat for fear of infection

 Feeding children with diluted milk
 Feed children with left over and may be
contaminated
Good nutrition must meet the needs of varying ages
and activities and always with individual differences.
Therefore, the planning of food to meet especial needs
begins with:
 Pregnant women
 Nursing mothers
 Infants
 Adolescents and
 Adults
The energy requirements of individuals depend on
♦ Physical activities
♦ Body size and composition
♦ Age may affect requirements in two main ways
– During childhood, the infant needs more energy because it
is growing
– During old age, the energy need is less because aged
people are engaged with activities that requires less energy.
♦ Climate: Both very cold and very hot climate restrict
outdoor activities.
A well-nourished individual:-
 Is alert mentally and physically fit
 Has optimistic outlook on life
 Has good resistance to infection
 Shows numerous other signs of good health such as
an increased life span extending the active and

vigorous period of life.
 Actions taken from government of Ethiopia
 MDG 1: Eradicate extreme poverty and hunger
 Productive Safety Net Program
 Household Asset Building Program
 Addressing malnutrition today is about ensuring
sustainable development in Ethiopia.

 Establishing of IYCF,NNP and NNS……….and so on
NB-Breast feeding rates alone has the potential to

prevent up to 10% of deaths among children under five.
Why nutrition matters in Ethiopia?
 Nutrition is important in Ethiopia since There is recurrent food
insecurity at the national and house hold level

 There is high rate of both macro and micronutrient deficiency
 There is intergenerational link of the undernutrition
The impact of such high rate of under nutrition was estimated to be

huge interms of
• Increased susceptibility to infection(diseases)
• Poor physical and mental capacity
• High cost for care of those affected by malnutrition
• Under development of the country
 Research has shown that improving the vitamin A
status of vulnerable populations can reduce;
 Under-five mortality rates by atleast 23 percent,
 Preventing between 1.3 and 2.5 million deaths
each year and
 saving hundreds of thousands of children from
irreversible blindness
Iron deficiency is also a serious cause of ill health
 The WHO Global Burden of Disease report ranks
iron deficiency anemia as second among leading

causes of disability.
 Its effects are high in women and children
 Improvements in the iron status of affected
populations
• can increase levels of national productivity by 20%
• reduce maternal mortality by 20 %too.
Iodine Deficiency Disorder
 The most common cause of preventable mental
retardation and brain damage. Still affects 50million

children worldwide
 An estimated 1.6 billion people worldwide are iodine
deficient
 Iodine deficiency is associated with an average 13.5
point reduction in IQ for a population

 Iodine deficiency in school children leads to reduced
cognitive function
Significance of Nutrition
Nutrition is a foundation for development.
• Tackling global nutrition problems is essential for achieving the SDGs.
• Good nutrition is a human right.
• Nutrition is ever more important in the light of the recent financial and
food price crisis.
• Nutrition remains a concern in emergencies like conflict or natural
disaster
• Under nutrition has adverse intergenerational effects.
• The double burden of malnutrition
• Micronutrient deficiencies- being the risk factor for many diseases.
• Nutritional status is an outcome of a series of determinants clustered in to
food, health and care
Dietary guidelines
 Eat a wide variety of food.
 Maintain a healthy weight.
 Choose a diet with low fat, saturated fat, and
cholesterol.
 Choose a diet with plenty of vegetables, fruits and
grain products.
 Use sugar in moderation.
 Use salt in moderation.
 If you drink alcohol, do so in moderation.
Conclusion
 Causes and consequences of poor nutrition are better
understood now, and so are the ways to prevent and
manage it. Low food intake and infections are the
immediate causes of malnutrition. The underlying causes
are insufficient household food security, inadequate
childcare and insufficient basic health services in the
community. It includes poor living conditions, lack of
education, heavy physical work, and frequent
childbearing. And the basic causes are economic
structure, political and ideological superstructure.
Thank you!

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NUTRITION IN HEALTH

For 2nd yr Nursing students

Introduction to Human Nutrition

- Promotion of good health with the primary

animals were initiated.

Phytochemicals: –non nutrient compounds found in

 Supplies sufficient energy used by the body

In approximation, balanced diet will contain:

 The composition of foods

 Food intake pattern of the target population

within each food group

Malnourishment or Malnutrition:- is a condition that

 Poverty and infectious diseases

 Uneven distribution of the available foods

 Social arrest and civil conflicts,

 Transport problems (inaccessibility)

 Poor management of resources 

 Mixing of foods E.g. Injera with wat prepared from

- Cereals - Legumes - Vegetable  Traditional use

pregnant and lactating mothers

  During period of fasting important nutrients are

 Has optimistic outlook on life 

 Has good resistance to infection 

 Shows numerous other signs of good health such as

an increased life span extending the active and

 Productive Safety Net Program

 Household Asset Building Program

 Addressing malnutrition today is about ensuring

sustainable development in Ethiopia.

NB-Breast feeding rates alone has the potential to

insecurity at the national and house hold level

 There is intergenerational link of the undernutrition

The impact of such high rate of under nutrition was estimated to be

iron deficiency anemia as second among leading

 Improvements in the iron status of affected

retardation and brain damage. Still affects 50million

point reduction in IQ for a population

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 Transport problems (inaccessibility)

 Poor management of resources

- Cereals - Legumes - Vegetable Traditional use

 During period of fasting important nutrients are

 Has optimistic outlook on life

 Has good resistance to infection