How to Assess the Nutritional Status | Nutrition Articles
To assess the Status of Nutrition is to map out the magnitude and geographical distribution of malnutrition as a public health problem. Nutrition and its assessment can be done by direct and indirect methods. The direct method includes clinical signs, nutritional anthropometry, and biochemical tests. Indirectly, it can be assessed by the use of vital statistics, mortality and morbidity rates and studying the ecological factors. Field investigations (surveys) also form a direct measure of nutritional status.
It remains an important method for assessing the nutritional status of a community. It is important to keep in mind that all physical signs of nutritional deficiency syndromes are not pathognomonic.
This is concerned with the measurement of the gross composition of the human body at different age levels and degrees of nutrition. For measurements are weight, height, and circumferences of the head and chest. Skin fold thickness of the triceps and of subscapular areas are also employed.
Tests, particularly of the serum/blood and urine, are done to determine the level of nutrients in the body.
The nutritional status of a community can be assessed directly by two types of field investigation: (a) Longitudinal incidence surveys, and (b) cross-sectional prevalence studies. Each type has its own advantages and disadvantages. The types of information collected may include anthropometric measurements, clinical findings, biochemical data, parasitological data, immunization history, dietary history, etc.
For accurate dietary data, some type of food consumption study is indicated. (a) Assessment of food consumption: Dietary survey teams visit household and record the quantities of all foods eaten during a set period by weighing and measuring them in their raw state and also by weighing cooked food portions; 24-hour recall methods is frequently used.
Nutritive value of food
The data of food consumption is converted into uniform terms of weight and cost and then their nutritive values calculated, by means of appropriate food composition tables. (c) Comparison with nutritional requirements: The last stage of the analysis is to compare the nutritive values of the diets consumed with that of the standard requirements corrected for age, sex, pregnancy, etc.
A balanced diet is mixed of all the proximate principles (protein, fat, and carbohydrate), minerals and vitamins. Its requirements for maintaining health. vitality and well-being of a person. Lack of balanced diet may lead to malnutrition.
Food additives are defined as non-nutritious substances which are added intentionally to food generally in small quantity, to improve its appearance, flavor. texture or storage properties. These are coloring agents (e.g., saffron, turmeric), flavoring agents (e.g. vanilla essence). Preservatives bleaching agents (e.g..chlorine). Use of food additives may pose health hazards, and as such, the use of food additives is subjected to government regulation.
Adulteration of Food
Adulteration of food consists of mixing. substitution, abstraction, concealing the quality, putting up decomposed food for sale and misbranding or giving false labels. The foodstuffs which are commonly adulterated are milk, ghee, edible oils. cereals, flours, pulses, honey, tea and coffee.
Legal provisions exist against the sale of adulterated food, for ensuring sanitation and regulating the use of food additives and preservatives. Sanitary Inspectors have the authority to initiate actions in this direction.
Major Food items and Their Nutritional Properties
Hereunder we propose to discuss food items generally included in our daily diet, their origin, function and nutritional values.
Milk and its Nutritional Value
What sets a mammal apart from all other animals is the fact that a mammal does produce milk and suckle its young. During pregnancy, under the influence of both pituitary and placental hormones, the ability to produce milk develops. For the first few days, only colostrums are formed. Colostrums is a high protein substance containing mainly immunoglobulins. In the human. where IgA is not transported through the placenta, it is present in the milk. IgG in the human is transported through the placenta and is not present in the milk. Colostrums also contain macrophages.
Milk is an almost complete and ideal food and contains all the food factors of a well-balanced diet required for the human body. The protein of human milk is different qualitatively from the protein of cow’s milk. Human milk protein is about 70% lactalbumin and about 30% casein; in cow’s milk about 80% is casein and about 20% is lactalbumin. Human milk contains more cystein. Conversion of methionine to cystein is rather limited in very young infants and as such cystein becomes essential. When we consider fat. cow’s milk is more saturated than human milk. The calcium: phosphorus ratio is higher in human milk than in cow’s milk and will promote better calcium absorption. There is no question that, from a nutritional stand-point, breast feeding is the optimal way to feed a baby.
Milk is an ideal food but it is also an efficient vehicle for a great variety of disease producing micro-organisms. The diseases which are commonly transmitted to man through ingestion of contaminated milk are tuberculosis, typhoid and paratyphoid fevers, streptococcal infections, staphylococcal food poisoning, diphtheria, viral hepatitis, etc.
The characteristics of milk-borne epidemics are:
- The onset is sudden with an explosive outburst;
- The cases occur only in those houses receiving milk from a common source; (3) All the cases occur simultaneously; (4) Children, fed on cow’s milk, are more frequently attacked than adults.
Pasteurization of milk. Pasteurization of milk may be defined as the heating of milk to such temperatures for periods . It pathogens that may be present while causing minimal changes in the composition, flavor, and nutritive value. Three widely used methods are used for the purpose: (1) Holder (Vat) method: Milk is heated and kept at 6366°C for at least 30 minutes, and then quickly cooled to 5°C. This method is recommended for rural and small communities. (2) High
Method: Milk is rapidly heated under pressure to 125°C, for a few seconds only and then rapidly cooled and bottled as quickly as possible.
Pasteurization kills nearly 90% of the bacteria in milk including TB bacillus, but will not destroy bacterial spores. The pasteurized milk should be kept cold until it reaches the consumers to prevent multiplication of bacteria.
Meat and its Nutritional Value
Meat protein is a very rich source of essential amino acids, though protein content of meat (15-20 percent) is lesser than that in pulses. Meat is also a good source of iron (2-4 mg per 100g, zinc and B Vitamins.
Criteria of good meat are: (1) should be firm and elastic to touch; (2) should be neither pale pink nor have a deep purple tint; (3) should have an agreeable odor; (4) should not be slimy.
Meat-borne diseases: (1) Tape worm infestations: Taenia sodium infection; Trichinella spiralis infection; Fasciola hepatic infection; (2) Bacterial infection: Anthracis; Brucellosis; Tuberculosis; Food poisoning; (3) Fungal infection; Actinomycosis; (4) Allergy to particular meat.
Egg and its Nutritional Value
Egg contains a diverse range of nutrients excepting carbohydrate and provides almost all the essential amino acids, all the fat, and water soluble vitamins excepting vitamin C and important minerals . It is a rich source of protein, fat, calcium and iron; an egg weighing about 60g contains 6g of protein, 5g of fat, 30mg of calcium and 1.5mg of iron and supplies about 70 kcal of energy. Boiled egg is nutritionally better than raw egg, as the raw egg is not assimilated by intestinal mucosa while boiling destroys ‘avidin’ which hinders absorption of the biotin component of vitamin B-complex.
A few persons are allergic to egg and egg-borne diseases include salmonellosis and consequent food poisoning. Features of the fresh egg are: They are translucent against light; while light passes through the yolk part, it is seen to be floating on the white part. Spoiled egg with gas is transparent against light and light can easily pass through it. On the other hand, spoiled egg with no gas is opaque against light and light cannot pass through it. This test for determining the freshness is known as ‘candling test’. ‘Floating test’ is sometimes applied to find out the freshness of an egg. The spoiled egg will float on saline water due to gas accumulating inside the egg.
Preservation of eggs. So as to keep them unspoiled preservation may be done by very many ways: (1) freezing: (2) blocking the pores of the shell by smearing the egg with oil or grease; (3) by immersing egg in solutions of sodium silicate: (4) by immersing egg in lime water, (5) by covering the shell with excreta of poultry birds or that of babies; (6) cooking process may also help to preserve eggs.
Fish and its Nutritional Value
Fish is a very common food item in riverine Bangladesh. This nutritious food -contains 15-25 percent protein yielding balanced amino acids and is rich in unsaturated fatty acids and vitamins A and D. Fishbone is an excellent source of calcium, phosphorus and fluorides and small fish bones can be eaten after the ordinary cooking process. The iron content of fish is good (0.7-3ing per 100g) but not so rich as in meat. Sea fish contains iodine; oysters and lobsters being the richest source of this goiter preventing element.
Features of fresh fish are: (i) state of stiffness is maintained: (2) no pittangoetiorgoottiokte1.(61)
look bright red: (41 eyes look prominent, clear and lustrous: (5) emits no bad smell.
Preservation °Trish can be carried out by the following processes: (1) salting; (2) drying;(3) smoking; (4) refrigeration;(5) scanning and (6) by an addition of chemicals.
Fish, so nutritious a food item may occasionally be a source of disease. The fish-borne disease is: (1) fish tapeworm, e.g., dibothriocephalus late.s infection: (2) viral hepatitis A: (3) water-borne diseases, e.g., vibrio para hemolytic us infection. (4) Salmonellosis and clostridium botulinum type E infection.
Cereals and its nutritional value
Cereals like rice, wheat, and maize form the bulk of the human diet. They are the principal sources of carbohydrate and so of energy. They also contribute the significant amount of proteins; 100 g of rice contains 6.8g of protein while the protein content of the same quantity of wheat and maize are 11.8g and 11.1g respectively. Cereal proteins are incomplete as they do not provide all of the amino acids the body need. Rice is very much deficient in lysine, but if rice is eaten with pulses it provides the intake of ‘complete protein’ as amino acids in each of the two food items compensate for each other. Polished rice as a result of milling loses important vitamins—thiamine, riboflavin and most of the protein content of rice as the outer aleurone layer are lost. Nutritionally parboiled rice, which is obtained from partial cooking or steaming of paddy, is superior to polished rice. Vitamins are not lost in the process as they are driven into the inner endospore. The practice of cooking rice in larger than the needed quantity of water and draining way the excess water at the end of cooking causes loss of vitamins and should be discouraged.
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