Hygienic requirements on
organization of rational and
treatment-preventive
nutrition
Аuthor:
Lototska O.V
1
Nutrition may be defined as the science of food
and its relationship to health. It is concerned primarily
with the part played by nutrients in body growth,
development and maintenance.
Function of nutrition
Provision of energy
Body building and repair
Maintenance and regulation of
tissue functions
In various historical times structure of
nutrition and character of a nutrition
changed depending on
 development of industrial forces of a
society,
 climate-geographical conditions,
 direction of economic activity and so
on.
The character of nutrition of the
population was formed gradually
depending on an economic and cultural
level of development of the country, in
view of national customs and features.
Through centuries, food has been
recognized as important for human
beings in health and disease.
Good nutrition is a basic component of health.
The relation of nutrition to health may be seen from
the following view points:
Growth
and
development:
Good
nutrition is essential for
the attainment of normal
growth and development.
Not only physical growth
and development, but
also
the
intellectual
development,
learning
and
behaviour
are
affected by malnutrition.
Specific deficiency: Malnutrition is directly responsible
for certain specific nutritional deficiency diseases.
Good nutrition therefore
is essential for the
prevention of specific nutritional deficiency diseases
and promotion of health.
Resistance to infection: Infection, in turn, may aggravate
malnutrition by affecting the food intake, absorption
and metabolism.
Mortality and morbidity: The
indirect
effects
of
malnutrition
on
the
community are even more
striking - a high general
death
rate,
high
infant
mortality rate, high sickness
rate and a lower Expectation
of life.
'You are what you eat',
some people say.
If you eat rubbishy food,
you can't really expect to
grow up strong and
healthy.
But if you eat goodquality food, you've a
good chance of doing
so.
Generally, a healthy diet is said to include:
•Sufficient calories to maintain a person's metabolic
and activity needs. For most people the
recommended daily allowance of energy is 2,000
calories, but it depends on age, sex, height, weight,
and physical activity.
•Sufficient quantities of fat, including monounsaturated
fat, polyunsaturated fat and saturated fat, with a
balance of omega-6 and long-chain omega-3 lipids.
The recommended daily allowance of fat is 65-80
grams.
•Maintenance of a good ratio between carbohydrates
and lipids (4:1): four grams of the first for one gram of
the second.
•Avoidance of excessive saturated fat
•Avoidance of trans fat.
•Essential micronutrients such as
vitamins and certain minerals.
•Sufficient essential amino acids ("complete protein") to
provide cellular replenishment and transport proteins.
All essential amino acids are present in animals. A
select few plants (such as soy and hemp) give all the
essential acids. A combination of other plants may also
provide all essential amino acids (except rice and
beans which have limitations).
•Avoiding directly poisonous (e.g. heavy metals) and
carcinogenic (e.g. benzene) substances;
•Avoiding foods contaminated by human pathogens
(e.g. E. coli, tapeworm eggs);
•Avoiding chronic high doses of certain
foods that are benign or beneficial in small
or occasional doses, such as
foods that may burden or exhaust normal
functions (e.g. refined carbohydrates without
adequate dietary fiber);
foods that may interfere at high doses with
other body processes (e.g. refined table
salt);
foods or substances with directly toxic
properties at high chronic doses (e.g. ethyl
alcohol).
•Combination of foods eaten and timing of meals so
that hunger is kept in check.
CLASSIFICATION OF FOODS
1.Classification by predominant functions:
Energy-giving foods. These constitute fats and
carbohydrates. They are also called protein sparer. Proteins
also produce energy to some extent. Cereals, roots and tubers,
dried fruits, sugars and fats belong to this group. They supply
heat and energy to the body.
Body building foods. These are foods rich in proteins,
mineral salts and water. Milk, meat, fish, pulses, oilseeds and
nuts fall in this category.
Protective foods. These constitute inorganic salts, vitamins
and minerals. They include proteins and water. Milk, eggs,
liver, green leafy vegetables and fruits are included in this
group. They build our bones, teeth, muscles, soft tissues, blood
and other body fluids. They provide material for repair in the
body as wear and tear goes on constant.
2. Classification by origin:
• Foods of animal origin
• Foods of vegetable origin
3. Classification by chemical
composition:
• Proteins
4. Classification by nutritive value:
• Fats
•Cereals and millets
• Carbohydrates
•Pulses (legumes)
• Vitamins
•Vegetables
• Minerals
•Nuts and oilseeds
•Fruits
•Animal foods
•Fats and oils
•Sugar and jaggery
•Condiments and spices
•Miscellaneous foods
Balanced diet is one, which will meet a person's
caloric need and contain all nutrients, particularly
proteins, and vitamins. In addition, the food should
satisfy the taste and desire of a person and should
have enough roughage to promote the peristalsis.
Balanced diet should have 50-60 % carbohydrates
30-35 % fats and 10-15 % proteins with necessary
vitamins and minerals. A balanced diet must
contain foods from the above three groups.
Importance of the main components
of food in nutrition of the human
Nutrients are organic and inorganic
complexes contained in food. There are about
50 different nutrients which are normally
supplied through the foods we eat. Each
nutrient has specific functions in the body.
Most natural foods contain more than one
nutrient. These may be divided into :
(i) Macronutrients: These are proteins, fats and
carbohydrates which are
often
called
"proximate principles" because they form the
main bulk of food.
(ii) Micronutrients : These are vitamins and
minerals. They are called micronutrients
because they are required in small amounts
which may vary from a fraction of a milligram
to several grams.
PROTEINS
The word "protein" means that which is of first importance.
Indeed they are of the greatest importance in human nutrition.
Proteins are composed of carbon, hydrogen, oxygen, nitrogen
and sulphur in varying amounts. Some proteins also contain
phosphorus and iron and occasionally other elements. Proteins
differ from carbohydrate and fat in the respect that they
contain nitrogen. Proteins are made up of simpler substances,
called amino acids. These are the building blocks of protein
Some 22 amino acids are stated to be needed by the human
body, out of which eight are called "essential".
Proteins are needed by the body:
For growth and development: They furnish the building
material, the amino acids from which the body
proteins are synthesized.
For repair of body tissues and their maintenance: It has
been shown that the body proteins are constantly
being broken down; they have to be replaced for
which fresh protein intake is required.
For synthesis of antibodies, enzymes and hormones:
Antibodies, enzymes and hormones contain protein.
The body requires protein to produce them.
Proteins can also furnish energy to the body, but
generally the body depends for its energy on
carbohydrates and fats rather than proteins.
Sources of protein
Animal sources:
Plant sources:
Protein requirements
Doctors recommended 1,0 g. protein/kg
body weight for an adult.
Daily allowances recommended by experts of
the World Health Organization (Geneva, 1976)
is 37 g of protein per day for the standard man
with mass of body 65 kg for professions of
average hardness (II group) and 29 g of protein
for the standard woman with body mass 55 kg.
Effects of protein deficiency:
Adults:

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Loss of weight,
underweight,
poor musculature,
anemia,
increased susceptibility to infection,
frequent loose stools,
general lethargy,
incapacity to sustained work,
delay in wound healing,
cirrhosis of liver,
oedema,
ascitis, etc.
CARBOHYDRATES
Chemically
carbohydrates
are
composed of carbon, hydrogen and
oxygen
as
the
name
implies.
Polysaccharides are various starches
which are converted into two
molecules saccharides i.e. cane sugar,
beet sugar, milk sugar and malt sugar.
These on further, glucose and
digestion change into single molecule
monosaccharides fructose.
Foods that are high in
carbohydrates: Breads,
pastas, beans, potatoes, bran,
rice and cereals.
The original source of all starches and sugars is green
plants. When plants have excessive sugar and they need
to store it, as reserve supply of food, plant body is
capable of changing its sugar into starch. Carbohydrates
are abundantly present in food. All carbohydrates have
to be changed into glucose and fructose before they can
be absorbed into the body.
1 gm of carbohydrates yields 4.1 calories of heat.
The daily requirement of carbohydrates varies from
50 to 60% of total energy intake.
The carbohydrates are chief sources of energy. In the
active muscles, the glucose is oxidized for the
production of energy and warmth. Glucose which cannot
be used immediately, is converted into glycogen and
stored in the liver and muscles or converted into fat and
stored under the skin.
There are three main sources of carbohydrate:
Starches:
These are present in cereals
(rice, wheat); roots and
tubers (potatoes).
Sugars:
(a) Monosaccharides: glucose, fructose,
galactose.
(b) Disaccharides: Sucrose, lactose, maltose.
(c) Cellulose: This is the tough fibrous lining
found in vegetables, fruits, cereal, etc.
It is hard to digest and has no nutritive value.
However, cellulose acts as "roughage" and
prevents constipation.
Fats are composed chemically of carbon, hydrogen
and oxygen, only in different proportion than they are
contained in carbohydrates. There is less of oxygen in
fats than in carbohydrates. Fats are a form of
concentrated food and like carbohydrates, they are
used as body fuels for the production of heat and
energy. As fats are not soluble in water, the process
of digestion changes the fat into an emulsion form for
their absorption into the body. Liquid fats and those
which melt at body temperature are somewhat better
digested than those which are much harder.
Fats serve the following functions:
• Dietary fat is a concentrated source of energy.
One gram of fat supplies 9 calories of energy.
• Fats are carriers of fat-soluble vitamins, e.g., vitamins
A, D, E and K.
• Dietary fat supplies "essential fatty acids".
Linoleic acid, one of the essential fatty acids, prevents
scaly skin formation.
• The fat layer below the skin plays an important role in
maintaining our body temperature.
• Fats provide support for many organs in the body
such as heart, kidney, intestine etc.
• Foods containing fats are tasty.
Animal sources:
These are ghee, butter, fat of
meat, fish oils, etc.
Vegetable sources: These are various
vegetable oils such as groundnut,
gingely, mustard, cottonseed,
safflower (kardi) and coconut oil.
VITAMINS
These are complex organic substances contained
in food and are very essential for the normal
growth and nutrition of animals. In fact, they are
vital accessory food factors required for the
maintenance of optimum, health. They are present
in various foods in minute quantities and diet
devoid of vitamins, if taken for some period, gives
rise to certain diseases known as deficiency
diseases and may ultimately even cause death.
They do not supply energy but are simply
protective foods.
vitamins
Fat -soluble
Vitamins
Water-soluble
Vitamins
Thiamine (B1)
Riboflavin (B2)
A (retinol)
E (tocopherol)
Niacin (B3)
D (calciferol)
Pyridoxine (B6)
Pantothenic acid
Cobalamin (B12)
Ascorbic acid
Folic acid
K (menadione)
Diseases, that is direct or mediate
related with a nutrition
1. Alimentary disease,
illness caused by
deficiency or
surplus of
components of
nutrition.
The
secondary
illnesses of insufficiency
or excessive nutrition,
which is developed as
complication
on
a
background
of
wearisome
illnesses
(surgical,
infectious,
oncology and others.)
2.
3. Disease of
multifactor nature
that very much
frequently
develops on a
background of
genetic
predilection, for
example,
atherosclerosis,
gout, idiopathic
hypertension, etc.
4. Disease, which
are transferred by a
nutritional way
(some infections
diseases and
intestinal worms,
alimentary
poisonings).
5. Alimentary
intolerance atypical reaction to
nutrition, for
example alimentary
allergy,
idiosyncrasy.
Illnesses caused by improper nutrient
consumption
NUTRIENTS
DEFICIENCY
EXCESS
Calories
Starvation
Obesity, diabetes
mellitus, Cardiovascular
disease
Simple
carbohydrates
Marasmus,
starvation
diabetes mellitus
Complex
carbohydrates
Marasmus,
starvation
Obesity
Saturated fat /
trans fat
none
Cardiovascular disease,
Unsaturated fat
Rabbit
starvation
Obesity
Cholesterol
none
Cardiovascular
disease
Protein
Marasmus
Sodium
hyponatremia
Iron
Anemia
Ketoacidosis,
Rabbit starvation,
kidney disease
Hypernatremia,
hypertension
Hepatitis C,
cirrhosis, heart
disease
Iodine
Goiter,
hypothyroidism
Iodine Toxicity
(goiter,
hypothyroidism)
Vitamin A
Xerophthalmia and
Night Blindness
Vitamin B1
Beri-Beri
Vitamin B2
Cracking of skin and
Corneal Unclearation
Niacin
Pellagra
Vitamin B12
Pernicious Anemia
Vitamin C
Scurvy
diarrhea causing
dehydration
Vitamin D
Rickets
Hypervitaminosis D
(dehydration, vomiting,
constipation)
Vitamin E
Hypervitaminosis A
(cirrhosis, hair loss, birth
defects)
dyspepsia, cardiac
arrhythmias, birth defects
Hypervitaminosis E
(anticoagulant: excessive
bleeding)
Nutritional Diseases:
1. Protein Calorie Malnutrition
(PCM).
(i)
Kwashiorkor. It results from
consumption of very low protein in
diets of low biological values, yet
providing just enough energy to
satisfy the needs of the child. This
condition is usually seen in children
between the age group of 1-4 years.
This symptom is characterized by
pitting
oedema,
anemia,
retarded growth, loss of
appetite, diarrhoea, scanty
hair growth...
• (ii) Marasmus. It is a clinical condition
of
protein
energy
malnutrition,
primarily due to total deprivation of
the requisite calories required by the
body. It usually occurs in the age
group of 1/2 to 5 years. This
syndrome is characterized by failure
to gain weight, wasting of
muscles and of subcutaneous fat.
The child feels good appetite but
is irritable.
• (iii) Marasmic-Kwashiorkor. Patients
suffering from Marasmic-Kwashiorkor
show clinical symptoms of both
Marasmus and Kwashiorkor.
3. Mineral Deficiencies
(i) Deficiency of iodine in water and feed leads to
goitre or cretinism.
3. Mineral Deficiencies
(ii) Lack of flourine ( < 0.5
ppm) in water leads to
caries.
(iii) Calcium deficient diets
lead to rickets and
osteomalacia.
3. Mineral Deficiencies
(iv) Iron deficiency diets lead to anaemia,
(v) There are other important minerals like copper,
selenium etc. Usually their requirements are so
little that deficiency conditions do not occur.
4. Vitamins Deficiencies
(i)Lack of vitamin A results in xerophthalmia,
Bitot's
spots,
night
blindness
and
keratomalacia.
4. Vitamins Deficiencies
(ii) B Complex:
Deficiency of Thiamine
leads to beriberi.
Niacin deficiency results in
pellagra.
Riboflavin deficiency
symptoms
are
angular
stomatitis,
cheilosis,
scrotal
dermatitis
and
corneal
vascularisation.
(iii) Vitamin C deficiency leads to scurvy, spongy bleeding
gums, haemorrhages in skin and other haemorrhages,
(iv) Vitamin
osteomalacia.
D
deficiency
result
in
rickets
and
(v) Vitamin K deficiency leads to hypoprothrombinaemia,
which further leads to haemorrhages.
5. Problems of Overnutrition (eating too much)
Proteins/fats/carbohydrates
•
Cardiovascular disease
•
Some cancers
•
Diabetes mellitus
•
Insulin resistance
•
•
Obesity The main features of obesity are
overweight and fatness. It is mostly caused by
overeating and intake of abundance of calories
Metabolic syndrome
Vitamin poisoning
•
(i) Hypervitaminosis A is at times caused by excess
of vitamin A therapy. The manifestation are
headache, nausea, vomiting, irritability and anorexia.
Carotenaemia is also caused due to excessive
consumption of carrots which is characterised by
yellow skin with normal conjunctiva
Vitamin poisoning
(ii) The toxic manifestations of hypervitaminosis D are
anorexia, nausea, vomiting, thirst, polyuria and
drowsiness. Calcium and phosphorus levels in
serum and urine are raised. Calcium may be
deposited in many tissues also
(iii)
Fluorosis
occurs
if
fluorine is available > 1,5
mg in 1 liter water. It is
characterised by (a) dental
fluorosis,
i.e.,
mottled
enamel of teeth and
(b) skeletal fluorosis
i.e.,
dense
bone
formation,
severe
spondylitis and even
calcifications
of
ligaments of spine and
tendinous inflamation
of other muscles in
severe cases.
Food allergies
Some people have allergies or sensitivities to
foods which are not problematic to most people.
This occurs when a person's immune system
mistakes a certain food protein for a harmful foreign
agent and attacks it. About 2% of adults and 8% of
children have a food allergy.
Commonly food allergens are gluten, corn, shellfish
(mollusks), peanuts, and soy. Most patients present with
diarrhea after ingesting certain foodstuffs, skin
symptoms (rashes), bloating, vomiting and regurgitation.
The digestive complaints usually develop within half an
hour of ingesting the allergen.
Rarely, the food allergy chelce can lead to
anaphylactic shock: hypotension (low blood pressure)
and loss of consciousness. This is a medical emergency.
An allergen associated with this type of reaction is
peanut, although latex products can induce similar
reactions.
Diet and Disease
Nutrition and Cancer Protection
These days there is great interest in the effect of diet on cancer
risk. Much research is under way to evaluate and clarify the role
that diet and nutrition play in the development of cancer.
Although no direct cause-and-effect relationship has been
proved, statistics do show that some foods may increase or
decrease the risk for certain types of cancer.
-Keep a Normal Body Weight. Obesity is linked to increased death
rates from some cancers in humans, particularly those of the
prostate, pancreas, breast, ovary, colon, gallbladder, and
uterus.
-Avoid Too Much Fat in Your Diet, Both Saturated and Unsaturated.
Evidence from epidemiologic studies suggests a relationship
between dietary fat levels and the occurrence of prostate,
colorectal, and other cancers. Currently, the reasons for such
correlations are unclear.
 -Eat Foods Rich in Fiber. The National Cancer Institute recommends
a fiber intake of 25 to 35 grams each day. Dietary fiber appears to
protect the body against some forms of cancer, particularly
colorectal. The manner in which specific types of fiber work is
unclear. Therefore, eat fiber daily from various dietary sources such
as fresh fruits, vegetables, and whole-grain products.
 -Eat Foods Rich in Vitamins A and C Daily. Examples of these foods
include dark green and deep yellow fresh vegetables and fruits, such
as carrots, spinach, sweet potatoes, cantaloupe, and apricots, as
sources of vitamin A. Oranges, grapefruit, strawberries, and green
and red peppers supply vitamin C. Vitamin A may help decrease the
incidence of several cancers, including those of the oral cavity,
pharynx, larynx, and lung.
 -Include Vegetables as Part of Your Regular Diet. Broccoli, cabbage,
Brusselssprouts, kale, cauliflower, kohlrabi, mustard greens, and
Swiss chard are a few recommended examples. Research shows that
these foods seem to offer protection from the development of
colorectal, stomach, and lung cancers.
-Eat• Only Moderate Amounts of Salt-Cured, Smoked, and
Nitrite-Cured Foods. This group of foods includes smoked and
cured meats such as bacon, sausage, ham, and others. The
incidence of cancers of the esophagus and of the stomach is
higher among populations in which large quantities of these
foods are eaten.
Some cooking methods, such as barbecuing or smoking,
can produce substances that might cause cancer thus, be
moderate in using these methods.
-If You Drink Alcohol, Do So in Moderation. Drinking large
quantities of alcohol over a long period of time increases your
risk of liver cancer. Combining alcohol consumption with
smoking or chewing tobacco increases your risk of cancer of
the mouth, larynx, throat, and esophagus. A limit of two or fewer
drinks per day is recommended.
Salt and Hypertension
Too much salt (sodium chloride) in the human’s diet has been the
focus of much study and has been given much attention by the media in
recent years.
•
•
•
•
•
•
If you need to limit your salt intake, begin with the food you prepare.
Do not use salt when you cook, or use it only in very small amounts.
Avoid salty foods such as chips and pickled foods.
Switch from salted butter and margarine to unsalted.
Be aware that many processed foods contain large amounts of salt. Get
in the habit of scrutinizing food labels.
Condiments such as ketchup, prepared mustard, and soy sauce are all
high in sodium.
Prepared foods such as canned soups, stews, and broths and cured
foods such as ham, bacon, cold cuts, and hot dogs also are high in salt
content.
As a part of the treatment of hypertension, restriction of sodium to
less than 2 or 2.5 grams daily is commonly recommended. This
restriction can usually be achieved without great inconvenience. Greater
degrees of restriction are used for treatment of persons who have certain
forms of kidney disease.
Diabetes Diet
Other recent changes in diabetic management include:
-Reasonable Weight Goals. Being overweight can make it more difficult to
control blood sugar.
-Flexible Fat Levels. If you're at a healthful weight and have a normal blood
cholesterol level, new guidelines encourage you to keep fat to no more
than 30 percent of total calories.
-Calculated Use of Sugar. Sugar is no longer forbidden. People with diabetes
have long been told that simple carbohydrates — sweets such as table
sugar, honey, jelly, fruit juice, and candy—cause a rapid rise in blood
sugar. Complex carbohydrates—starches such as breads, cereals, and
potatoes — were believed to cause a moderate increase in blood sugar.
But new information shows that table sugar affects blood sugar about the
same as bread, rice, and potatoes. It's the total amount of carbohydrate in
the diet, rather than the source, that is the critical factor affecting blood
sugar levels after meals. Using modest amounts of sugar may not
interfere with blood sugar control—as long as you substitute a sugary
food for a starchy food that contains an equal amount of carbohydrate.
Meal planning for people with diabetes continues to be a nutritionally
balanced, flexible style of eating.
Avoiding Heart Disease
Some factors that put you at
high risk for heart disease are
beyond your control (for example,
your heredity). But one risk factor, a
high blood cholesterol
concentration, may be affected by
what you eat. In short, reduce the
amount of fat and cholesterol you
consume, particularly if you are
susceptible to having a high
cholesterol value. For most people,
this need not involve a revolution in
eating patterns. Moderation is the
key. Small changes, consistently
followed, can have a significant
impact.
Control questions:
• What are the main function of nutrition?
• What are main principles of nutrition
for cancer protection?
Thank you
for your attention!