The Science of Nutrition....................................... 3

Nutrients.................................................................. 3

Macronutrients......................................................... 4

Carbohydrates........................................................ 4

Proteins....................................................................... 7

Fats and Oils............................................................ 10

Micronutrients.............................................................. 13

Vitamins...................................................................... 13

Minerals....................................................................... 20

Water............................................................................... 22

Metabolism...................................................................... 23

Cellular Respiration........................................................ 23

Metabolic Disorders........................................................ 25

Anorexia Nervosa......................................................... 25

Bulimia Nervosa........................................................... 26

Malnutrition..................................................................... 26

Under- nutrition.............................................................. 26

Severe Protein-Energy Malnutrition.......................... 26

Moderate Malnutrition................................................ 27

Micronutrient Deciencies........................................ 28

Over- nutrition.............................................................. 31

Obesity...................................................................... 31

Body Mass Index....................................................... 34

Balanced Diet........................................................... 35

Food Labels............................................................ 37

Physical Fitness................................................... 38

Indoor Activities............................................... 38

Outdoor Activities.......................................... 39

Health and Hygiene........................................ 41

Personal Hygiene...................................... 42

Food Hygiene......................................... 43

Home Hygiene.................................... 44

3

Food is composed of different chemical elements,

arranged in a variety of ways to form molecules.

These molecules collectively give individual foods

their flavor, color, and texture, and affect their reaction

to heat and their digestion.

Body uses some of the molecules in food, to function

properly and to stay healthy. These are the nutrients.

No single food supplies all the nutrients the body

needs to function. Each nutrient is vital to life, and the

health of an individual will suffer if any one nutrient is

in excess / short supply. Thus nutrition can also be

defined as the study of nutrients and their relationship

with food and living things.

Nutrients are generally classified into Macronutrients

and Micronutrients.

The process by which a living organism assimilates food and

uses it for growth, liberation of energy, and replacement

of tissues is known as nutrition. Its successive stages

include digestion, absorption, assimilation, and

excretion. Nutritional science investigates

the metabolic and physiological

responses of the body to diet.

Nutrients

The Science of Nutrition

4

Macronutrients are consumed in larger quantities and provide

energy in the form of calories and helps in the growth and

development of human body. Macronutrients are

divided into carbohydrates,

proteins and fats/oils.

Carbohydrates

Macronutrients

Weight: 160 - 175 lbsshoulder/waist:49”/30”Biceps: 13-14Thighs: 21-23

Carbohydrates provide energy and constitute

bulk of the human diet. The main use of

carbohydrates in the body is to provide

energy for breathing, movement and

keeping warm. Some starch and

sugar is changed to body fat.

Weight: 190 - 205 lbsshoulder/waist:54”/33”Biceps: 15-16Thighs: 23-25

5

Carbohydrates exist in the form of monosaccharides e.g. glucose, or disaccharides e.g.

lactose and sucrose and polysaccharides such as starch or cellulose. Mono and

disaccharides are simple sugars and are present in fruits,

milk, table sugar, sweets, etc. Polysaccharides

are the complex carbohydrates and

found in bread, cereals, legumes,

rice, pasta and starchy

vegetables like potato

and tubers.

Classication & Sources

It slows digestion and thus facilitates absorption of nutrients in meals,

and helps to prevent obesity. Fiber is of two types: soluble and insoluble.

Fiber is the indigestible

part of plant foods that

pushes through our

digestive system,

absorbing water along

the way and easing

bowel movements. Fiber

makes feces soft and

bulky and absorbs

harmful chemicals,

and so helps to keep

the gut healthy.

Dietary Fiber

It adds bulk to the diet and has a laxative effect so

considered beneficial for the prevention of constipation. It does not dissolve

in water and passes intact through the digestive system speeding up the

passage of food and waste materials. The sources include whole wheat, whole

grains, wheat bran, seeds, nuts, barley, brown rice, broccoli, cabbage, green

beans, dark leafy vegetables, raisins and skin of fruits.

Carbohydrates are converted into glucose and other monosaccharides in the

presence of digestive enzymes (amylase, sucrase, etc) which are then

absorbed into the blood. Insulin helps in the uptake of these simple sugars

by the cells where they are metabolized to carbon dioxide and water along

with the release of energy.

6

Soluble Fiber

It attracts water and forms a gel which slows down digestion

and is also beneficial for insulin sensitivity which may help in controlling diabetes.

Soluble fiber can also help in lowering the bad cholesterol (LDL) levels

by interfering with the absorption of dietary cholesterol.

It also binds to bile acids in the intestine

and prevents their re-absorption in the body.

The sources of soluble fiber include

oats, citrus fruits, apple, pear, lentils,

beans, chickpeas and peas.

cellulose: structural Insoluble Fiber

Soluble Fiberpectin:

Carbohydrate Metabolism

Insoluble Fiber

7

The short term effects include weight loss and lethargy while long term

effects result in nutritional deficiency diseases like kwashiorkor and

marasmus which are associated with the deficiency of protein and calories in

the diet, respectively.

Protein is required for growth and development of the body. When carbohydrates are

not provided in appropriate amounts the proteins burn and try to meet the energy

requirements. Proteins are large biological molecules consisting of one or more

chains of amino acids. The key elements of an amino acid are carbon,

hydrogen, oxygen, and nitrogen, though other elements

are found in the side-chains. The nutritional

classification divides them into:

When too much carbohydrate is consumed and not used for energy over an extended

period of time, it is stored as fat. Building up too much fat will increase body weight.

Dental caries are also associated with excessive consumption of carbohydrates.

Teeth should be brushed twice a day and foods high in sugar may be eaten with

main meals, rather than in between snacks to prevent dental caries.

Excessive Consumption of Carbohydrates

Lack of Carbohydrates

Proteins

Essential amino acids

Non essential amino acids

8

Essential amino acids are those which cannot be synthesized by the body and

are needed from the diet namely Histidine, Leucine, Isoleucine, Lysine, Methionine,

Phenylalanine, Threonine, Tryptophan, Valine.

can be synthesized by the body itself like Alanine, Non essential amino acidsAsparagine, Aspartic acid, Glutamic acid, Glycine. Some amino acids are

conditionally essential, though synthesized by the body but at some point during

growth and development they are needed in such large quantities that the body is unable

to meet the demands and therefore, they must be supplied in the diet as Arginine,

Cysteine, Glutamine, Ornithine, Proline, Selenocysteine, Serine, Tyrosine.

Proteins obtained from animal source like meat, milk, egg, etc. are complete

because they contain balanced proportions of all the essential amino acids.

For this reason they are the best proteins. Proteins obtained from plant

source like beans, legumes, etc. are incomplete, lacking one or more essential

amino acids.

Complete Proteins

Complementary Proteins

Sources

9

Proteins are digested in the gastrointestinal

tract and catabolized to peptides and

amino acids. These amino acids are

absorbed in to the blood and taken up by

the cells where they are utilized for the

synthesis of bodily proteins.

Antibodies: are specialized proteins involved in defending

the body from antigens (foreign invaders).

Contractile Proteins: are responsible for movement like actin and myosin.

These proteins are involved in muscle contraction and movement.

Enzymes: facilitate biochemical reactions in the body. They are often

referred to as biological catalysts because they speed up chemical reactions

e.g. enzymes lactase and pepsin. Lactase breaks down the

sugar lactose found in milk. Pepsin breaks down proteins.

Hormonal Proteins: are messenger proteins which help to

coordinate certain body activities e.g.

insulin which regulates glucose metabolism by controlling

the blood-sugar concentration.

Protein Metabolism

Functions of Proteins

10

Structural Proteins: are fibrous and provide support as keratin, collagen,

and elastin. Keratins strengthen protective coverings such as hair, quills,

feathers, horns, and beaks. Collagens and elastin provide support for

connective tissues such as tendons and ligaments.

Storage Proteins: store amino acids as ovalbumin and casein. Ovalbumin is

found in egg whites and casein is a milk-based protein.

Transport Proteins: are carrier proteins which move molecules from one

place to another around the body e.g. hemoglobin which transports oxygen

through the blood.

Fats and oils are dense source of energy. They consist of a wide group

of compounds that are generally soluble in organic solvents and insoluble

in water. Fatty acids are the building blocks of fats.

Fats are solid at room temperature e.g. ghee,

butter. Oils exist in liquid form at room

temperature e.g. vegetable oils.

Functions

Some important functions of fats include energy storage, cell membrane

structure, hormone synthesis, bile acid synthesis, food palatability,

absorption of fat-soluble vitamins, organ insulation and protection, brain and

IQ development and skin and coat secretions.

Fats and oils contain different 'fat-nutrients'. These are saturated fatty

acids and unsaturated fatty acids including trans fatty acids and cholesterol.

Fats and Oils

11

Foods containing mainly saturated fatty acids

are: butter, ghee, cooking fat, whole milk,

cheese, fats from meats and meat products and

poultry, red palm oil and coconuts.

Unsaturated fatty acids can be obtained from

vegetable oils, groundnuts, soybeans, sunflower

seeds, sesame seeds, and oily fish. Two of the

unsaturated fatty acids are called 'essential

fatty acids' because the body cannot

synthesize them. These include omega-3 and

omega-6 fatty acids which are known to be

beneficial for health.

When vegetable oils are processed to make them harder (solid fats), some of the

unsaturated fatty acids are changed into trans fatty acids. These behave like saturated fatty

acids but can have adverse effects on health.

We should eat as little of the foods containing trans fatty acids as possible.

Trans fatty acids may be found in margarine, fried foods, doughnuts, baked

goods, biscuits, cakes and ice creams.

Saturated Fatty Acids

Unsaturated Fatty Acids

Trans Fatty Acids

12

Bad Cholesterol (LDL): High levels of 'bad'

cholesterol (low-density lipoprotein) seem to increase

the risk of heart disease. Eating foods containing

mainly saturated fats tends to increase the level of

bad cholesterol. It is found in animal fat, coconut oil, palm oil and butter.

Fat needs are expressed as 'percent of total energy needs'. The percent of total energy

that should come from fat in a healthy balanced diet is 15-30% for children and

adolescents. Part of the fat in diet is not added in the kitchen at home but is 'hidden' in

foods such as meat, milk and oilseeds as well as in fried foods. Foods rich in

un-saturated fatty acids are better for health of the heart, than foods high in saturated

or trans fatty acids.

Cholesterol is found only in animal foods but the body can make it from other

fat-nutrients. We need this cholesterol for our bodies to grow and function properly.

It is the precursor for most of the steroid hormones like testosterone, estrogen, etc.

Good Cholesterol (HDL): High levels of 'good' cholesterol

(high-density lipoprotein) seem to reduce the risk of heart

disease. Eating foods containing mainly unsaturated

fatty acids tends to increase the level of good

cholesterol. It is found in certain fish like

salmon and cod.

Cholesterol

Fat Requirements

13

Micronutrients are needed in much smaller amounts than the macronutrients

but are vital for maintaining health and body activities.

Vitamins are organic

compounds required

by the body as vital

nutrients in limited

amounts.

They are divided into

two categories depending

upon their solubility.

Vitamins A, D, E and K are

fat soluble while vitamins

B-complex and

C are water soluble.

Vitamin A

Vitamin A is required to prevent infections and to keep the immune system

working properly. It also helps in keeping the skin, eyes and lining of the gut

and lungs healthy and aids in seeing clearly in dim light.

Micronutrients

Vitamins

It is found in two forms: retinol, which is abundant in liver and whole milk;

and carotenoids, which are found in green leafy vegetables, carrots and yellow

colored fruits.

14

Vitamin E acts as an antioxidant and protects the body cells against damage.

It is mainly found in vegetable oils, nuts, seeds and wheat germ. Deficiency

of vitamin E is rare and reported to be associated with certain neurological disabilities.

Vitamin E

Vitamin D

Vitamin D is needed for the absorption of calcium and phosphorous from foods, and

thus helps in maintaining bone health. It also enhances immune function and improves

muscle strength. Vitamin D is found in the diet, but most of vitamin D is made in the

body by the action of UV rays on the skin. Vitamin D occurs naturally in some animal

products, including fish liver oils, oily fish, egg yolk, and butter. Cereals, margarine and

low fat spreads are also fortified with vitamin D.

15

Vitamin K

Vitamin K is needed for normal clotting of blood and is also required for

normal bone structure. Infants with its deficiency

are given vitamin K at birth.

Vitamin K is found in green leafy

vegetables e.g. broccoli, lettuce,

cabbage, spinach, meat and

dairy products.

Vitamin B1 – Thiamine

Thiamine is needed for the release of energy from carbohydrate. It is

involved in the normal functioning of the nervous system and also plays a role

in the production of DNA and RNA. Sources include whole grains, nuts, meat,

fruit, vegetables and fortified cereals. Its deficiency can cause beriberi.

Symptoms include weight loss, impaired sensory perception, weakness and

pain in the limbs, irregular heartbeat and edema (swelling of body tissues).

Vitamin B3 – Niacin

Niacin plays an important role in the metabolism of glucose and fats and

synthesis of nucleic acids. Niacin is also needed for the normal functioning

of the nervous system. Sources include meat, wheat flour, eggs, dairy

products and yeast. Deficiency of niacin can result in the disease Pellagra.

Symptoms can include dermatitis (itchy inflammation of the skin), dementia

(loss of brain function associated with impaired memory) and diarrhea.

16

Vitamin B2 – Riboavin

Riboflavin is needed for the release of energy from carbohydrate, protein

and fat. It is also involved in the transport and metabolism of iron in the

body and is needed for the normal structure and function of skin and body

linings. Riboflavin is found in milk, eggs, rice, fortified breakfast cereals,

liver, legumes, mushrooms and green vegetables.

17

Vitamin B5 – Pantothenic Acid

Coenzyme A, which is synthesized from pantothenic acid, is involved in the

synthesis of amino acids, fatty acids, cholesterol, steroid hormones,

neurotransmitters and antibodies. Pantothenic acid is found in meat, whole

grains, broccoli and avocado.

Vitamin B6 – Pyridoxine

Pyridoxine is involved in the metabolism of amino acids and lipids and in the

synthesis of hemoglobin and neurotransmitters. Dietary sources of

pyridoxine include meat, whole grain products, vegetables, nuts and bananas.

Vitamin B9 – Folate

Folate is important for the formation of healthy red blood cells. It is also needed for the

nervous system and specifically for the development of the nervous system in unborn

babies. Sufficient presence of folate in the mother's body can reduce the risk of neural

tube defects in a fetus, e.g. spina bifida.

Good sources of folate include green leafy

vegetables brown rice, peas, oranges,

bananas and fortified cereals.

18

Vitamin B7 – Biotin

Biotin is involved in cell growth and the metabolism of lipids, proteins and

carbohydrates. It is present in raw egg yolk, liver, leafy green vegetables

and peanuts.

19

Vitamin B12 – Cobalamin

Vitamin B12 is involved in the cellular metabolism of carbohydrates, proteins

and lipids. It is essential in the production of nerve sheaths, proteins and

blood cells in bone marrow.

It is found in meat, fish, cheese,

eggs, yeasts extract and fortified

breakfast cereals.

Vitamin C

Ascorbic acid is needed to make collagen which is required for the normal

structure and function of body tissues, such as skin, cartilage and bones. It

also acts as an antioxidant that protects the body from damage by free

radicals. Ascorbic acid also helps in the absorption of non-haem iron and also

participates in wound healing. Deficiency of vitamin C can result in scurvy, a

disease that is associated with spots on the skin, bleeding gums and loose or

loss of teeth. Sources of ascorbic acid include fresh fruits, especially citrus

fruits and berries, green vegetables, peppers and tomatoes.

20

Minerals are inorganic substances needed by the body for performing

various functions. Major minerals are required in larger amounts and

include calcium, phosphorus, potassium, sodium etc. Trace minerals

are needed in very minute amounts and include iron, iodine,

fluoride, etc. Whether major or trace, all minerals are vital and very

much needed for the normal functioning of the body.

Minerals

Iron Iron is needed to make hemoglobin, the protein in red

blood cells that carries oxygen to the tissues. Haem

iron is obtained from animal source and is readily

absorbed; whereas, non-haem iron, obtained from

plant source, has low bioavailability. Animal sources

of iron include liver, meat and eggs. Vegetable

sources include lentils, beans and green leafy

vegetables.

Sodium

Sodium is needed to regulate water content of the body and

electrolyte balance. It is also needed for the absorption of

some nutrients and water from the gut. Sodium is present in

very small amounts in raw foods. It is often added as salt

during food processing, preparation, preservation and

serving.

21

Iodine

Iodine is required to make thyroid hormones that help to control

metabolism. Iodine is essential for the development of the brain and nervous

system in the fetus. The best source of iodine is the seaweed "Kelp"

followed by iodized salt. Presence of iodine in eggs and dairy products

depends largely upon the content of iodine in the feed of poultry.

Fluoride

Fluoride is needed for the formation of strong teeth and protects against

dental decay (caries). Fluoride can be found in drinking water and in small

amounts in saltwater fish.

Phosphorus

Phosphorus is essential for the structure of bones and teeth, for the

structure of cell membranes and for energy metabolism. The food sources of

phosphorus include milk, meat and soya.

Potassium

Potassium is essential for water and electrolyte balance

and normal functioning of cells, including nerves.

Potassium is present in all foods, but found richly in fruits

(dried fruits, bananas, and berries), leafy green vegetables

(e.g. spinach and broccoli), meat, nuts, seeds and pulses.

Calcium

Calcium is important for the formation and maintenance of strong bones

and teeth, as well as the normal functioning of nervous system and muscles.

It is also involved in blood clotting. Milk and dairy products are the most

important sources of calcium.

Zinc

Zinc is essential for growth and normal development,

for reproduction and for keeping the immune system

healthy. It is present in wheat germ, liver and meat,

dried watermelon seeds, peanuts and dark

chocolate.

22

Water is the most important nutrient of the body. It is involved in every bodily function,

and makes up 70-75% of the total body weight. Water

content of the body is highest in childhood and

keeps on decreasing with the increase in age.

Water helps in maintaining body

temperature, assists in metabolism, aids

digestion, lubricates and cushions

organs, transports nutrients, and

flushes toxins from the body.

Water

100% 80% 70% 50%

Presence of water in the human body

Fetus Baby at birth Normal adult Elderly Person

It also helps in making fluids such as tears, sweat and urine, and allows

chemical processes to happen in the body. Sufficient water also keeps the

skin healthy and moisturized and also prevents wrinkles.

One should drink 8 glasses of water every day.

Metabolism is the set of life-sustaining chemical transformations within the cells of living

organisms. These enzyme-catalyzed reactions allow organisms to grow and reproduce,

maintain their structures, and respond to their environments. The word metabolism can

also refer to all chemical reactions that occur in living organisms, including digestion and

the transport of substances into and between different cells.

Metabolism is usually divided into two categories.

breaks down organic matter, for example to harvest energy in cellular Catabolism

respiration.

Anabolism uses energy to construct components of cells such as proteins and

nucleic acids.

Cellular respiration is the set of the metabolic reactions and processes that

take place in the cells of organisms to convert biochemical energy from

nutrients into adenosine tri phosphate (ATP), and then release waste products.

Metabolism

foods

contain

Enery producing nutrients

body building nutrients

protective nutrients

are

fats carbohybrates

proteins

proteins mineral salts

water ,fats carbohybrates

vitamin mineral salts proteins fats

helps in

physical activity and maintenance of

essential functions

growth repair and replacement of

tissues

resistance against diseases

23

Cellular Respiration

It utilizes oxygen to convert glucose in to carbon dioxide and water with the

release of adenosine tri phosphate (ATP). ATP has high energy bonds and

releases energy upon breakdown

and is therefore, known as the

"energy currency" of the cell.

The following figure shows

respiration in mitochondria:

It is a form of respiration which takes place in the absence of oxygen.

Anaerobic respiration is usually carried out by eukaryotes in stress

conditions or by prokaryotes like bacteria.

Enzymes are biological catalysts that

speed-up the chemical reactions. Most of the

enzymes are proteins in nature and greatly

accelerate both the rate and specificity of

metabolic reactions.

Cofactors are non-protein chemical

compounds that are usually bound to

enzymes and assist in biochemical reactions.

Without enzymes, one would starve to death even a�er ingesting a meal. Digestion would not be possible as the nutrients would neither break-down, nor would they be able to get absorbed by the body and no energy would be yielded!

Aerobic Respiration

Anaerobic Respiration

Enzymes and Cofactors

24

Two common metabolic disorders are anorexia

nervosa and bulimia nervosa.

Anorexia nervosa may not be confused with

simple 'anorexia' which is a general loss of

appetite or no interest in food.

Anorexia Nervosa is a psychological disorder.

The patient has a distorted body image and

an irrational fear of becoming overweight,

so he/she deliberately attempts to lose weight.

Even though the majority of patients

are female, men can also suffer

from Anorexia Nervosa.

Anorexia Nervosa

25

Patients su�ering from anorexia nervosa have a distorted image disorder. Although they are very thin, when they look in the mirror, they �nd themselves fat and ugly and thus starve themselves.

Metabolic Disorders

Bulimia Nervosa is also a psychological disorder. The patient experiences

regular bouts of serious overeating, which are always followed by a feeling

of guilt, which can then lead to extreme reactions such as purging

(deliberately vomiting), crash dieting and excessive exercise.

Malnutrition is a broad term which refers to both under-nutrition and over-

nutrition. Malnutrition can be defined as the insufficient, excessive or

imbalanced consumption of nutrients. Several different nutrition disorders

may develop, depending on which nutrients are lacking or consumed in excess.

According to the World Health Organization (WHO), malnutrition is the

gravest single threat to global public health.

Inadequate nutrition resulting from lack of food or failure

of the body to absorb or assimilate nutrients properly is

known as under-nutrition. It occurs when people

do not eat or absorb enough nutrients to cover their

needs for energy and growth, or to maintain a healthy

immune system. There are three broad forms

of malnutrition:

1· Severe protein-energy malnutrition

2· Moderate malnutrition

3· Micronutrient deficiencies

This is the severest form of malnutrition in infants and young children

resulting in marasmus and kwashiorkor. The affected children are at the risk

of death and immediately need hospitalization and nutrition intervention. If

proper treatment is given, the children can quickly recover and continues

nutritional support can help them in living a healthy life.

Bulimia Nervosa

Malnutrition

Severe Protein-Energy Malnutrition

26

Under-nutrition

Kwashiorkor is a consequence of prolonged protein

deficiency. There is decreased muscle mass due

to failure of weight gain and linear growth. It is

characterized by swollen belly which is a result

of edema (water retention) and lipid build-up

around the liver. There are changes in

skin pigmentation along with hair

thinning and lightening. The children

are at an increased risk of infections

and diarrhea.

Kwashiorkor

This form of malnutrition can be classified into stunting,

wasting and underweight.

Marasmus is a condition which results due to

insufficient caloric intake. This severe form of

malnutrition is accompanied by gross weight

loss and absence of subcutaneous fat or

muscle. The affected children are ravenously

hungry and eventually starve to death.

27

Marasmus

Moderate Malnutrition

Stunting is due to inadequate nutrition over a longer period of time,

leading to failure of linear growth. It is a condition in which the

height of children is shorter than average/normal for their age.

Wasting

Wasting is acute inadequate nutrition leading to rapid weight loss

or failure to gain weight. It is a condition in which the weight of

children is less than average /normal for their height.

Underweight

Underweight is a form of growth impairment in which the weight

of children is less than average/normal for their age. It could occur

as a result of wasting, stunting, or both.

Micronutrient Deciencies

Micronutrient deficiencies are generally known as hidden-hunger

and result when the body lacks one or more

micronutrients (e.g. iron, iodine, zinc, vitamin A or folate).

Stunting

1.87m

1.63m

1.74m

1.52m

boysgirls

28

As the name implies, Iron Deficiency Anemia is due to insufficient iron. The body needs

iron to make hemoglobin, a substance in red blood cells that enables them to carry

oxygen. When there is lack of iron in the body, it leads to Iron Deficiency Anemia which

is associated with breathlessness, lack of energy, abnormal paleness, poor appetite,

brittle nails, tachycardia, dizziness, headache, Irregular menstrual cycle, enlarged

spleen or liver, impaired wound healing and soreness of tongue.

It can be treated with vitamin and mineral supplements and diet or bone marrow transplant.

Lack of iodine in the diet may result in Iodine Deficiency Disorders (IDD) associated with

impaired mental development and low IQ levels. The two known forms of Iodine Deficiency

are goiter and cretinism. Goiter is a condition which is accompanied by the swelling of

thyroid gland present at the base of neck. When there is not enough iodine present in the

body, the gland enlarges to absorb as much iodine as possible.

Iron Deciency Anemia

Iodine Deciency

29

Vitamin A deficiency is linked to blindness and increased severity of

infections. Night blindness is one of the first signs of vitamin A deficiency.

When this deficiency gets severe, it develops in to xerophthalmia

(dry conjunctive and cornea) and if untreated, transforms in to keratomalacia

(ulceration, perforation and liquefaction

of cornea) followed by complete

blindness. Foods rich in vitamin

A like carrots, yellow fruits, liver and

supplements may be helpful in

prevention and control of

vitamin A deficiency.

30

Cretinism is a severe form of iodine deficiency which is associated with mental

and physical retardation. IDDs can be easily overcome by the regular use of

iodized salt in diet.

Vitamin A Deciency

Deficiency of vitamin D is associated with rickets which is a disease in

children leading to softening of bones and skeletal deformities.

Osteomalacia is a similar disease occurring in adults due to vitamin D

deficiency. Sufficient exposure to UV light and dietary supplements can be

useful in the treatment and prevention of vitamin D deficiency.

Rickets

(Deformed bones)

It is a form of malnutrition in which nutrients are over consumed relative to

the amounts required for normal growth, development, and metabolism. Over

a period of time it may result in over-weight leading to obesity.

Obesity is a condition in which excess body fat accumulates to the extent

that it may have an adverse effect on health, leading to reduced life

expectancy or increased health problems. It is a leading preventable cause

of death worldwide, with increasing prevalence in adults and children, and it

is viewed as one of the most serious public health problems of the 21st century.

Vitamin D Deciency

Over-nutrition

31

Obesity

Endomorph Mesomorph Ectomorph

Causes

At an individual level, a combination of excessive food energy intake and lack

of physical activity are thought to explain most cases of obesity. A limited number of

cases are due to genetics or psychiatric illness. Body build also plays a role in developing

obesity. There are three types of body forms: Endomorph, Mesomorph and Ectomorph.

Endomorph individuals have larger trunks and shorter limbs and have more tendencies

towards obesity. Mesomorph individuals have proportionate limbs and trunk and

athletic build and have less tendency towards obesity. Ectomorph individuals are tall,

slender, have long limbs and shorter trunks and have very little tendency towards

obesity. Every person also has a difference in the utilization of food energy which is

dependent on the degree of fatness or leanness, physical activity and basal metabolic

rate. Hormonal influences can also contribute to obesity like hypothyroidism.

External factors like foods rich in calories and fats, meal patterns and micronutrient

deficiencies play a role in development of obesity. Other factors include lack of fiber in

the diet, lack of exercise, overfeeding in infants, emotional stress and climate.

32

TheVicious Cycle

OfChildhood

Obesity

Treatment

Dieting and physical exercise are the main treatments for

obesity. Diet quality can be improved by reducing the consumption of energy-

dense foods such as those high in fat and sugars, and by increasing the

intake of dietary fiber. Diet programs may result in weight loss for short

term, but maintaining this weight loss is often difficult. Therefore, regular

exercise and low calorie diet must be made a permanent part of an

individual's lifestyle.

33

Asthma, Diabetes MusculoskoletalDisease, Prevent

Exercise and Bring on Depression &

Low Esteem

Healthy Child

ObeseAdultCoronary Artery DiabetesPuimonary DiseaseHigh medicalbillsMortality

Television Video

Games

High FatFoods

All StudyNo Action

MildlyObese Child

I am not good in sports

I’m too tired to climb stares

Extra 10 Lbs.Inhibits

Movement

ModeratelyObese Child

Extra 20-25 LbsExercise

Uncomfortable & Painful

SeverelyObese Child

other kidsmake fun

of me

Body Mass Index (BMI) is a measure for body shape and is calculated from

the weight and height of an individual. For children and adolescents, BMI is

calculated in two steps.

Step 1: BMI Calculation

BMI calculation based on age and sex is often called BMI-for-age and is

calculated as: 2 BMI = mass (kg) / Height (m)

Example: A 15 years old boy has 45 kg weight and is 5 feet (1.52 meters)

tall, his BMI would be: 2 2 BMI = 45kg / (1.52m) = 19.48 kg/m

Step 2: Percentile Ranking2

After calculation, the obtained BMI (19.48 kg/m ) is plotted on the BMI-

for-age growth charts for either girls or boys to obtain a percentile ranking.

The weight status can be categorized according to the percentile range:

Body Mass Index

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Balanced Diet

Underweight: th

Less than the 5 percentile

Healthy weight:th th 5 percentile to less than the 85 percentile

Overweight: th th

85 to less than the 95 percentile

Obese: th Equal to or greater than the 95 percentile

A 15 year old boy with BMI of 19.48 would be in the healthy weight category th

(5 percentile t tho less than 85 percentile) according to the growth charts.

A healthy diet is one that helps to maintain or improve general health. Eating

a balanced diet is choosing a wide variety of foods and drinks from all the

food groups. It also means eating certain things in moderation, namely

saturated fat, trans fat, cholesterol, refined sugar and salt. It is important

for lowering many chronic health risks, such as obesity, heart disease,

diabetes, hypertension and cancer.

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The diet should have adequate energy and

nutrients to meet the needs of an individual.

Right amount of each type of food must be

consumed – not too much, not too little.

Choose foods that give you the most

nutrients for the least food energy. Avoid

empty calories like sweets and fats.

Eat when you're hungry.

Stop when you feel satisfied. Avoid

eating junk foods.

Chose a variety of foods from various

food groups.

Adequacy:

Balance:

Nutrient Density:

Moderation:

Variety:

Milk and dairyfoods

Fats and sugars

Bread, cereals and potatoes

Meat,sh and other proteins

Fruit and other vegetables

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Healthy Eating

28%

28%

8%

18%

18%

Breakfast

Porridge, paratha with yogurt or vegetable

curry and lassi OR bread, egg, fruit jam, butter,

milk with any seasonal fruit

Lunch

Chapatti or rice with meat/lentil/beans curry and fresh salad.

Dinner

Rice/noodles/pasta with stir-fried vegetables

and fruit. Remember to drink 8-10 glasses

of safe water every day.

Food labels provide information from the food manufacturer to the consumer.

Detailed labeling requirements are laid down under the Food Safety Act.

Reading food labels help to know what we are buying, as labels:

Provide information about the food products, inform about correct use of food

products with preparation and storage instructions.

Enables one to make food choices according to the dietary requirements.

One can choose foods that are low in fat or high in fiber by reading and

comparing the nutritional label. If someone wants to lose weight they can

work out the energy value of the food product from the label.

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Examples of Good Mixed Meals

Food Labels

Physical fitness is a state of wellbeing which ensures sufficient capacity and

energy to do a variety of physical activities without undue fatigue. Physical

fitness is generally achieved through good nutrition, exercise, hygiene and

rest. Good nutrition comes from healthy eating. Exercise can be done by a

variety of indoor and outdoor activities. Good hygiene must be practiced to

avoid illnesses and maintain wellbeing. Rest is necessary for the body cells

and systems to rejuvenate after stress and exercise.

There could be number of indoor activities that can ensure enough physical

activity without going outside. The combination of few of the listed

indoor activities would be sufficient to ensure physical fitness.

Helping mom with household chores

Cleaning/rearranging your room

Jumping rope

Juggling

Exercise

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Stretching

Physical Fitness

Indoor Activities

If the circumstances permit, outdoor activities can be very helpful in

maintaining physical fitness and healthy lifestyle.

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Outdoor Activities

Swimming

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Riding bicycle

Jogging

Cricket

Football

Brisk walking

Gardening

Health is a state of complete physical,

mental, and social well-being free

from illness, injury or pain.

Hygiene is a set of practices performed

for the preservation of health.

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Health and Hygiene

Hockey

Tennis

Martial arts

Gym

Neighborhood walks/Exploring (in a safe area)

Take a bath – smell clean

Clean clothes

Clean towel

Clean shoes

Clean hair and proper haircut

Clean, trimmed nails

Wash hands with soap after defecation and before eating

Clean teeth

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Personal Hygiene

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Food Hygiene

Always wash fruits and vegetables

Cover food with clean cloth or lid

Store foods at proper temperature

Protect food from ies

Beware of insects and cockroaches

Use safe drinking water

Refrigerate foods within 2 hours after cooking

Separate raw and cooked foods

Always Keep the house clean

Proper sanitation facility

Wash bathrooms and toilets regularly

Clean the kitchen

Proper waste disposal

Cover the drains

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Home Hygiene