Nutritional problems
Dr K N Prasad
Community Medicine
Xeropthalmia
Common cause for blindness in
SEA
 Commonly affected are children
below the age of 3 years
 Risk factors are – low SES,
Ignorance, faulty feeding practices,
Acute diarrhoea, Measles, bottle
feeding
 Common in rice eating population
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Prevention and control
 Short
term action:
Large dose of Vitamin A orally on
periodic basis to vulnerable group.
 Two lakhs IU Retinol Palmitate in
oil for children less than 6 years of
age once in 6 months.
 Children less than 1 year will get
one Lakh IU of RP
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Prevention and control
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Medium term action:
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Regular and adequate intake of
Vitamin A rich foods, Food
fortification with Vitamin A
ex. Vanaspathi, Margarine oil, dried
mild powder, sugar.
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Prevention and control
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Long term action:
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Education opportunities:
General population, pregnant and
lactating mothers about
consumption of dark GLV,
Promotion of breast feeding,
improvement in environment health,
immunisation against measles,
improved health services for MCH
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Nutritional Anemia
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A disease syndrome caused by
malnutrition
Commonly called as Iron deficiency
WHO standard – Hb level estimation
Adult male – 13 gm%
Adult Female non pregnant- 12gm%
Pregnant woman- 11gm%
Children < 6 years- 11gm%
Children 6-14 years- 12gm%
Global problem of Anemia
Prevalence is highest in developing
countries
 Child bearing age group is highest
burden other than children
 Two third of pregnant women and
half of non pregnant women are
anemic in developing countries
 4-12% of child bearing women are
anemic in developed countries
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India
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Many have iron deficiency other than
anemia
Rural population both Male and female
are susceptible
Common cause is inadequate intake ,
poor bioavailability and excess loss of
iron
Infections – Malaria, Hook worm, etc.
Short interval between pregnancies
Folic acid deficiency is accounting for
50-70% of population
Detrimental effect of Anemia
 Pregnancy-
increased risk of
Mortality and morbidity ( 40% )
 Aggravate by infections and
susceptible to infections
 Decreased working capacity
 Decreased economy of the
country
Interventions
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Iron & Folic acid supply: under National Program
for Nutritional anemia daily supplementation of
IFA to prevent mild and moderate anemia.
Beneficiaries : Pregnant & Lactating mothers ,
children below 12 year sof age
Eligibility : Hb< 12gm% , refer to Hospital if
Hb<10gm%
Dose: Each Tab contains 80 mg of elemental
iron
( 200mg Fe sulphate ) and 0.5mg of Folic
acid
Duration: 2-3 months Hb returns to normal
Follow up: estimate Hb after 3 months
Children: if anemia supplement 20mg of
elemental iron ( 100mg Fe Sulphate)
Iron Fortification
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Fortification to salt is tried
Recommended for high risk group in the
endemic area
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Other measures
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Changing dietary habits
 Control of parasitic infections
 Nutrition education
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Iodine deficiency disorders (IDD)
Equivalent to Goitre
 Major nutritional problem in India
 Deficiency leads to wide range of
disorders commencing from Intra
uterine life to childhood , adult life
with serious health and social
implications.
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Public health problem of IDD
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Major problem in SEA
Common In Himalayan region known as
Goitre belt
IDD is common everywhere in India
No state is free from IDD
1960- 9 million
Present- 130 million have IDD
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Clinical manifestations are wide.
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Control of IDD
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Iodised salt and Oil
Monitoring and surveillance
Manpower training
Mass campaign
Iodised salt and Oil
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Iodised salt is widely used in India
Recommended concentration is
not less than 30 PPM at production level
Not less than 15 PPM at consumer level
Non iodised salt is completely banned for
sale
IM injection of Iodised oil 1 ml for high
risk group individuals
Iodised oil
Protection for 4 years
Replace salt with iodised salt
Monitoring
Neonatal hypothyroidism is a
sensitive indicator for community
IDD
 Laboratory test for iodine excretion
determination
 Determination of iodine in drinking
water , soil and food
 Determination of iodine in salt for
quality assessment.
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Mass campaign
 Public
awareness about IDD
 Use of only iodised salt for
regular consumption
Thought for the day
Asking for help is a strength
not weakness
Thank you