Nutrition sample

NUTRITION medpgnotes

NUTRITION

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1 GENERAL FEATURES OF 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

NUTRITION

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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

NUTRITION

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KEY TO THIS DOCUMENT

Text in normal font – Must read point.

Asked in any previous medical entrance

examinations

Text in bold font – Point from Harrison’s

text book of internal medicine 18th

edition

Text in italic font – Can be read if

you are thorough with above two.

NUTRITION

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GENERAL FEATURES OF NUTRITION

Man weighing 68 kg, consumes 325 gm of carbohydrate, 65 gram protein and 35 gram fat in diet

Proportion of carbohydrate, protein and fat is correct in accordance with balanced diet

Cereals and pulses are considered complementary because

Cereals are deficient in lysine, pulses are deficient is 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 rest, increase in heat production over basal level

Specific dynamic action

ASSESSMENT OF NUTRITIONAL STATUS

FEATURES OF ASSESSMENT OF NUTRITIONAL STATUS

Anthropometric measurement NOT of much change in 1-4 years

Mid arm circumference

Sensitive index of malnutrition in 3-6 years Mid arm circumference

Village health guide measures state of malnutrition in an under 5 child by


During nutritional assessment of a surgical patient, use of muscle protein is indicated by


Shakir tape Measurement of midarm circumference

Mid arm circumference (1-5 years) >13.5 – normal, 12.5 – 13.5 means malnourished, less than 12.5 means severely malnourished

Salter’s scale is a useful method employed in field to measure

Birth weight

Most important anthropometric characteristic of nutritional dwarfism

Normal birth weight and subsequent retardation of growth

Best indicator for nutritional status for a child Rate of increase of height and weight

Best indicator for long term nutritional status Height for age

Kanawati index MAC/HC NOT a method to assess nutrition in community Hb <11.5 gm% in third trimester pregnancy

NOT true about nutritional surveillance Done in all children < 5 years

NOT an indicator for assessment of nutritional program Prevalence of pregnant mothers having Hb<11.5g% in 3rd trimester

NOT a feature of nutritional surveillance Measurement of height Primary aim of applied nutrition programme Stimulation of production and consumption of

protective foods by education

Health status of children between 0 and 4 years affected by

Malnutrition, infections, birth weight less than 4 kg

Does NOT indicate poor nutrition in children Low birth weight

NUTRITION

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5 MALNUTRITION

A child’s weight for height is more than 2SD of mean, and his height for age is less than 2SD of mean. he is

Stunted

Gomez classification Age dependent Gomez classification is based on Weight retardation

SHORT STATURE

MC cause of short stature Constitutional

Short stature is seen in Maternal deprivation syndrome, Hypothyroidism, IUGR

Bone age is normal in Genetic short stature

MALNUTRITION

GENERAL FEATURES OF MALNUTRITION

A year old child has weight of 6.4 kg and has vitamin A deficiency. grade of malnutrition

Third degree

Reference standard on which classification of PEM based

80% of 50th

percentile of weight of age of American standard

Cell mediated Immunodeficiency is seen in Protein Energy Malnutrition Transverse ridging of nail and cellophane appearance is

associated with

Protein deficiency

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

ACUTE AND CHRONIC MALNUTRITION

Low weight for height Acute malnutrition Deficit in weight for height in a 3 year old child indicate Acute malnutrition

Best parameter for assessing acute malnutrition Weight for height

Best parameter for assessment of chronic malnutrition Height for age

Common to both acute and chronic malnutrition Weight for age

Education

Nutrition sample