Definition of Nutrition by WHO

Nutrition is the intake of food, considered in relation to the bodys dietary needs. Good nutrition an adequate, well balanced diet combined with regular physical activity is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity. Good nutrition can be achieved by consuming balanced diet which provides us with all the elements in the required quantities.

Food Groups
Foods are grouped together when they share similar nutritional properties. There are 5 main food groups. Dairy, also called milk products and sometimes categorized with milk alternatives or meat, is typically a smaller category in nutrition guides. Examples of dairy products include milk, yogurt and cheese. Though they are also dairy products, ice cream is typically categorized with sweets and butter is typically classified with fats and oils in nutrition guides. Fats and oils, sometimes categorized with sweets, is typically a very small category in nutrition guides, if present at all, and is sometimes listed apart from other food groups Examples include cooking oil, butter, margarine and shortening. Fruit, sometimes categorized with vegetables, is typically a medium-sized category in nutrition guides, though occasionally a small one. Examples include apples, oranges, bananas, berries and melons. Grains, also called cereals and sometimes inclusive of potatoes and other starches, is often the largest category in nutrition guides. Examples include wheat, rice, oats, barley, bread and pasta. Meat, sometimes labeled protein and occasionally inclusive of legumes, eggs, meat analogues and/or dairy, is typically a medium- to smaller-sized category in nutrition guides.Examples include chicken, fish, turkey, pork and beef. Sweets, also called sugary foods and sometimes categorized with fats and oils, are typically a very small category in nutrition guides, if present at all, and is sometimes listed apart from other food groups. Examples include candy, soft drinks, cake, pie and ice cream. Vegetables, sometimes categorized with fruit and occasionally inclusive of legumes, is typically a large category second only to grains, or sometimes equal to grains, in nutrition guides.[1][2][3] Examples include spinach, carrots, onions, peppers, and broccoli. Water is treated in very different ways by different food guides. Some exclude the category, others list it separately from other food groups, and yet others make it the center or foundation of the guide. Water is sometimes categorized with tea, fruit juice, vegetable juice and even soup, and is typically recommended in plentiful amounts.

Benefits of Healthy Eating

Healthy eating contributes to overall healthy growth and development, including healthy bones, skin, and energy levels; and a lowered risk of dental caries, eating disorders, constipation, malnutrition, and iron deficiency anemia.1

Diet and Disease

Early indicators of atherosclerosis, the most common cause of heart disease, begin as early as childhood and adolescence. Atherosclerosis is related to high blood cholesterol levels, which are associated with poor dietary habits.2 Osteoporosis, a disease where bones become fragile and can break easily, is associated with inadequate intake of calcium.3 Type 2 diabetes, formerly known as adult onset diabetes, has become increasingly prevalent among children and adolescents as rates of overweight and obesity rise.4 A CDC study estimated that one in three American children born in 2000 will develop diabetes in their lifetime.5 Overweight and obesity, influenced by poor diet and inactivity, are significantly associated with an increased risk of diabetes, high blood pressure, high cholesterol, asthma, joint problems, and poor health status.6

Obesity Among Youth

The prevalence of overweight among children aged 6-11 years has more than doubled in the past 20 years and among adolescents aged 12-19 has more than tripled.7,8 Overweight children and adolescents are more likely to become overweight or obese adults;9 one study showed that children who became obese by age 8 were more severely obese as adults.10

Eating Behaviors of Young People

Less than 40% of children and adolescents in the United States meet the U.S. dietary guidelines for saturated fat.11 In 2009, only 22.3% of high school students reported eating fruits and vegetables five or more times daily (when fried potatoes and potato chips are excluded) during the past 7 days.12 Only 39% of children ages 2-17 meet the USDAs dietary recommendation for fiber (found primarily in dried beans and peas, fruits, vegetables, and whole grains).13 Eighty-five percent of adolescent females do not consume enough calcium.3 During the last 25 years, consumption of milk, the largest source of calcium, has decreased 36% among adolescent

females.14 Additionally, from 1978 to 1998, average daily soft drink consumption almost doubled among adolescent females, increasing from 6 ounces to 11 ounces, and almost tripled among adolescent males, from 7 ounces to 19 ounces.11, 15

A large number of high school students use unhealthy methods to lose or maintain weight. A nationwide survey found that during the 30 days before the survey, 10.6% of students went without eating for 24 hours or more; 4.0% had vomited or taken laxatives in order to lose weight; and 5.0% had taken diet pills, powders, or liquids without a doctor's advice.12

Diet and Academic Performance

Research suggests that not having breakfast can affect children's intellectual performance.16 The percentage of young people who eat breakfast decreases with age; while 92% of children ages 611 eat breakfast, only 77% of adolescents ages 1219 eat breakfast.11 Hunger and food insufficiency in children are associated with poor behavioral and academic functioning.17,18

Anemia
Anemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which vary by age, sex, altitude, smoking, and pregnancy status. Iron deficiency is thought to be the most common cause of anaemia globally, although other conditions, such as folate, vitamin B12 and vitamin A deficiencies, chronic inflammation, parasitic infections, and inherited disorders can all cause anaemia. In its severe form, it is associated with fatigue, weakness, dizziness and drowsiness. Pregnant women and children are particularly vulnerable. Early detection of anaemia in pregnant women is reflected in the vision of the Making Pregnancy Safer initiative. HIV/AIDS guid elines state that a haemoglobin estimation and HIV test are the absolute minimum before anti-retroviral therapy, meaning that simple, reliable and affordable screening tools must be widely available if 3 million people are to receive ARVs by 2005. One such tool is the Haemoglobin Colour Scale, now commercially available to assist remote settings in the detection and management of anaemia.

Beriberi
Beriberi is a disease in which the body does not have enough thiamine (vitamin B1). There are two major types of beriberi: Wet beriberi affects the cardiovascular system. Dry beriberi and Wernicke-Korsakoff syndrome affect the nervous system. Beriberi is rare in the United States because most foods are now vitamin enriched. If you eat a normal, healthy diet, you should get enough thiamine. Today, beriberi occurs mostly in patients

who abuse alcohol. Drinking heavily can lead to poor nutrition, and excess alcohol makes it harder for the body to absorb and store thiamine. A rare condition known as genetic beriberi is inherited (passed down through families). People with genetic beriberi lose the ability to absorb thiamine from foods. This can happen slowly over time and symptoms occur when the person is an adult. However, because doctors may not consider beriberi in nonalcoholics, this diagnosis is often missed. Beriberi can occur in breast-fed infants when the mother's body is lacking in thiamine. The condition can also affect infants who are fed unusual formulas that don't have enough thiamine. Getting dialysis and taking high doses of diuretics raise your risk of beriberi. Symptoms of dry beriberi include: Difficulty walking Loss of feeling (sensation) in hands and feet Loss of muscle function or paralysis of the lower legs Mental confusion/speech difficulties Pain Strange eye movements (nystagmus) Tingling Vomiting Symptoms of wet beriberi include: Awakening at night short of breath Increased heart rate Shortness of breath with activity Swelling of the lower legs Treatment The goal of treatment is to replace the thiamine your body is lacking. This is done with thiamine supplements. Thiamine supplements are given through a shot (injection) or taken by mouth.

Protein-Energy Malnutrition
Protein-energy malnutrition (PEM) is a potentially fatal body-depletion disorder. It is the leading cause of death in children in developing countries. PEM is also referred to as protein-calorie malnutrition. It develops in children and adults whose consumption of protein and energy (measured by calories) is insufficient to satisfy the body's nutritional needs. While pure protein deficiency can occur when a person's diet provides enough energy but lacks the protein minimum, in most cases the deficiency will be dual. PEM may also occur in persons who are unable to absorb vital nutrients or convert them to energy essential for healthy tissue formation and organ function. Although PEM is not prevalent among the general population of the United States, it is often seen in elderly people who live in nursing homes and in children whose parents are poor. PEM occurs in one of every two surgical patients and in 48% of all other hospital patients.

Types of PEM
Kwashiorkor Kwashiorkor, also called wet protein-energy malnutrition, is a form of PEM characterized primarily by protein deficiency. This condition usually appears at the age of about 12 months when breastfeeding is discontinued, but it can develop at any time during a child's formative years. It causes fluid retention (edema); dry, peeling skin; and hair discoloration. Marasmus Primarily caused by energy deficiency, marasmus is characterized by stunted growth and wasting of muscle and tissue. Marasmus usually develops between the ages of six months and one year in children who have been weaned from breast milk or who suffer from weakening conditions like chronic diarrhea. Causes and symptoms Secondary PEM symptoms range from mild to severe, and can alter the form or function of almost every organ in the body. The type and intensity of symptoms depend on the patient's prior nutritional status and on the nature of the underlying disease and the speed at which it is progressing. Mild, moderate, and severe classifications have not been precisely defined, but patients who lose 10-20% of their body weight without trying are usually said to have moderate PEM. This condition is also characterized by a weakened grip and inability to perform high-energy tasks. Losing 20% of body weight or more is generally classified as severe PEM. People with this condition can't eat normal-sized meals. They have slow heart rates and low blood pressure and body temperatures. Other symptoms of severe secondary PEM include baggy, wrinkled skin; constipation; dry, thin, brittle hair; lethargy; pressure sores and other skin lesions. Kwashiorkor People who have kwashiorkor often have extremely thin arms and legs, but liver enlargement and ascites (abnormal accumulation of fluid) can distend the abdomen and disguise weight loss. Hair may turn red or yellow. Anemia, diarrhea, and fluid and electrolyte disorders are common. The body's immune system is often weakened, behavioral development is slow, and mental retardation may occur. Children may grow to normal height but are abnormally thin. Kwashiorkor-like secondary PEM usually develops in patients who have been severely burned, suffered trauma, or had sepsis (tissue-destroying infection) or another life-threatening illness. The condition's onset is so sudden that body fat and muscle mass of normal-weight people may not change. Some obese patients even gain weight. Marasmus Profound weakness accompanies severe marasmus. Since the body breaks down its own tissue to use as calories, people with this condition lose all their body fat and muscle strength, and acquire a skeletal appearance most noticeable in the hands and in the temporal muscle in front of and above each ear. Children with marasmus are small for their age. Since their immune systems are weakened, they suffer from frequent infections. Other symptoms include loss of appetite, diarrhea, skin that is dry and baggy, sparse hair that is dull brown or reddish yellow, mental retardation, behavioral retardation, low body temperature (hypothermia), and slow pulse and breathing rates. The absence of edema distinguishes marasmuslike secondary PEM, a gradual wasting process that begins with weight loss and progresses to mild, moderate, or severe malnutrition (cachexia). It is usually associated with cancer, chronic obstructive pulmonary disease (COPD), or another chronic disease that is inactive or progressing very slowly. Some individuals have both kwashiorkor and marasmus at the same time. This most often occurs when a person who has a chronic, inactive condition develops symptoms of an acute illness.

Treatment Treatment is designed to provide adequate nutrition, restore normal body composition, and cure the condition that caused the deficiency. Tube feeding or intravenous feeding is used to supply nutrients to patients who can't or won't eat protein-rich foods. In patients with severe PEM, the first stage of treatment consists of correcting fluid and electrolyte imbalances, treating infection with antibiotics that don't affect protein synthesis, and addressing related medical problems. The second phase involves replenishing essential nutrients slowly to prevent taxing the patient's weakened system with more food than it can handle. Physical therapy may be beneficial to patients whose muscles have deteriorated significantly. Prevention Breastfeeding a baby for at least six months is considered the best way to prevent early-childhood malnutrition. Preventing malnutrition in developing countries is a complicated and challenging problem. Providing food directly during famine can help in the short-term, but more long-term solutions are needed, including agricultural development, public health programs (especially programs that monitor growth and development, as well as programs that provide nutritional information and supplements), and improved food distribution systems. Programs that distribute infant formula and discourage breastfeeding should be discontinued, except in areas where many mothers are infected with HIV. Every patient being admitted to a hospital should be screened for the presence of illnesses and conditions that could lead to PEM. The nutritional status of patients at higher-than-average risk should be more thoroughly assessed and periodically reevaluated during extended hospital stays or nursing home residence.

Pellagra
Pellagra is a disease that occurs when a person does not get enough niacin (one of the B complex vitamins) or tryptophan (an amino acid).Pellagra is caused by having too little niacin or tryptophan in the diet. It can also occur if the body fails to absorb these nutrients. It may develop after gastrointestinal diseases or with alcoholism.The disease is common in parts of the world where people have a lot of corn in their diet. Symptoms of pellagra include: Delusions Diarrhea Inflamed mucus membranes Mental confusion Scaly skin sores

Iron deficiency anemia

Anemia is a condition in which the body does not have enough healthy red blood cells. Iron is an important building block for red blood cells. When your body does not have enough iron, it will make fewer red blood cells or red blood cells that are too small. This is called iron deficiency anemia. Iron deficiency anemia is the most common form of anemia. Red blood cells bring oxygen to the body's tissues. Healthy red blood cells are made in your bone marrow. Red blood cells move through your body for 3 to 4 months

Symptoms

Feeling grumpy

Feeling weak or tired more often than usual, or with exercise Headaches Problems concentrating or thinking As the anemia gets worse, symptoms may include: Blue color to the whites of the eyes Brittle nails Light-headedness when you stand up Pale skin color Shortness of breath Sore tongue

Treatment
Taking supplements and eating iron-rich foods are important parts of treating iron deficiency anemia. However, you and your health care provider must first search for the cause of your anemia. Iron supplements (most often ferrous sulfate) are needed to build up the iron stores in your body. Patients who cannot take iron by mouth can take it through a vein (intravenous) or by an injection into the muscle. Pregnant and breastfeeding women will need to take extra iron because their normal diet usually will not provide the amount they need. The hematocrit should return to normal after 2 months of iron therapy. However, keep taking iron for another 6 - 12 months to replace the body's iron stores in the bone marrow. Iron-rich foods include: Chicken and turkey Dried lentils, peas, and beans Eggs (yolk) Fish Meats (liver is the highest source) Peanut butter Soybeans Whole-grain bread Other sources include: Oatmeal Raisins, prunes, and apricots Spinach, kale, and other greens

Goiter Disease
Goiter can be described as the enlargement of the thyroid gland in a person, which could prevent it from functioning in the right manner. At times, the thyroid gland could swell to such an extent that it can be seen in the neck. Though there are different kinds of goitre that have been known to affect people, they can be broadly divided into two categories, mainly, diffuse goitre and nodular goitre. Most people refer to the iodine nutrient deficiency disease as goitre, because iodine deficiency is one of the prime causes of the condition. When the levels of iodine in the body fall, the glands swell up and become larger in an effort to produce hormones, which in turn leads to a swelling around the neck, often referred to, as goitre.

Symptoms
Goitre, (also often spelled as goiter) can be described as a condition that causes the thyroid gland, located in the neck to swell up. The presence of goitre could mean that all the thyroid glands are enlarged or swollen. It could also mean that lumps or swelling have developed in one part or a few parts of the thyroid gland. Studies indicate that thyroid goitre symptoms are more commonly seen in women, as compared to men. There are different types of goitre and the thyroid goitre symptoms could vary, based on the types that affect a person. However, the main and the common thyroid goitre symptoms seen in people include swelling in the thyroid gland, just below the neck, which could lead to a lump in the throat. People suffering from goitre disease symptoms claim that they can feel the throat lump moving up and down, when they swallow. .

Scurvy
Scurvy is a condition where an individual has a vitamin C (ascorbic acid) deficiency. The name scurvy comes from the Latin scorbutus, and humans have known about the disease since ancient Greek and Egyptian times. Scurvy commonly is associated with sailors in the 16th to 18th centuries who navigated long voyages without enough vitamin C and frequently perished from the condition. Modern cases of scurvy are very rare. Humans are unable to synthesize vitamin C - which is necessary for collagen production and iron absorption - and so they must obtain it from external sources (such as citrus fruits). Therefore, people must consume fruits and vegetables that contain or are fortified with vitamin C in order to avoid the vitamin C deficiency known as scurvy. The primary cause of scurvy is insufficient intake of vitamin C (ascorbic acid). This may be due to ignorance, famine, anorexia, restrictive diets (due to allergies, food fads, etc.), or difficulty orally ingesting foods. Historically, scurvy was the result of long sea voyages where sailors did not bring along enough foods with vitamin C. Scurvy symptoms may begin with appetite loss, poor weight gain, diarrhea, rapid breathing, fever, irritability, tenderness and discomfort in legs, swelling over long bones, bleeding (hemorrhaging), and feelings of paralysis. As the disease progresses, a scurvy victim may present bleeding of the gums, loosened teeth, petechial hemorrhage of the skin and mucous membranes (a tiny pinpoint red mark), bleeding in the eye, proptopsis of the eyeball (protruding eye), constochondral beading (beading of the cartilage between joints), hyperkeratosis (a skin disorder), corkscrew hair, and sicca syndrome (an automimmune disease affecting connective tissue). Infants with scurvy will become apprehensive, anxious, and progressively irritable. They often will assume the frog leg posture for comfort when struck with pseudoparalysis. It is common for infants with scurvy to present subperiosteal hemorrhage, a specific bleeding that occurs at the lower ends of the long bones. Prevention- Scurvy can be prevented by consuming enough vitamin C, either in the diet or as a supplement. Foods that contain vitamin C include: Oranges Lemons Blackcurrants Guava Kiwifruit Papaya Tomatoes Strawberries Carrots Bell peppers Broccoli Potatoes Cabbage Spinach Paprika Liver Oysters