Public Nutrition and Health Notes in English Class 12 Home Science Chapter-3 Book-Human Ecology and Family Sciences Part-I

 

Public nutrition and health

• Public nutrition means providing nutritious and balanced diet to all people

• Health means being physically, mentally and socially healthy.

Why are both of these important?

• Because only a healthy citizen can contribute to the development of the country.

• The purpose of mass nutrition

• "The main goal of public nutrition is to prevent both undernutrition and overnutrition, and to provide every individual with the nutrition he or she needs."

Malnutrition

When a person does not get the required amount of nutrients (such as proteins, vitamins, minerals, etc.), that condition is called malnutrition.

Types of malnutrition:

1. Undernutrition: The body gets less nutrition than it needs

Weight loss, tiredness, weakness, stunted growth

2. Overnutrition: Excessive calorie and fat intake

Obesity, diabetes, heart disease

3 important aspects to fight malnutrition:

low birth weight newborn

Every 5th child in India is born with a weight less than 2.5 kg which hampers their physical and mental development.

socio-economic weakness

Children from poor and backward families have slow growth. Children and adolescents are often found to be deficient in these nutrients:

Micronutrient Deficiency

• Iron

• Vitamins A, C, D, B12

• Zinc, Iodine, Folic Acid

side effects of malnutrition 

The double threat crisis

The problems of both undernutrition and overnutrition exist simultaneously in India. 

If it isn't stopped:

• Physical development slows down.

• Mental ability is affected.

• Cognitive (thinking) power becomes weak.

• Quality of life and productivity decrease.

What is the solution?

If we can control malnutrition, it can make a big contribution to the overall development and economic progress of India.

Main causes of overnutrition in India

• Changes in diet and lifestyle: People are now eating more fried and fast food than before.

• Reduction in physical exertion: People walk less and work less.

• The effect of convenience in traffic, going everywhere by vehicle – the habit of walking is over!

• Children's interest in sports is decreasing. Instead of playing in the field, children are spending time on screens.

• Addiction to fast food and snacks: Excessive consumption of high-calorie foods like burgers, pizza, chips etc.

• Distance from healthy food: Nowadays people have started eating less whole grains, pulses, vegetables and fruits, due to which the body is not able to get the necessary nutrients.

side effects of overnutrition

When the body gets more than required and unbalanced nutrition, these problems may arise:-

• Unwanted weight gain – Obesity and unwanted weight gain

• High Blood Pressure (High BP) – Pressure on the heart

• Diabetes - an imbalance of sugar in the blood

• Cancer – may increase the risk of certain types of cancer

• Arthritis – swelling and pain in the joints

• Decreased quality of life – less energy, confidence and activity

• Financial burden – increased expenditure on treatment and medicines

Causes of nutritional problems 

• Due to poverty people are not able to eat nutritious food.

• Diseases increase due to dirt and uncleanliness.

• Malnutrition persists due to improper implementation of government schemes.

• Due to lack of health services, timely treatment is not possible.

• Focusing on cash crops leads to neglect of nutritious grains.

• Due to unemployment and low income, people are not able to spend on nutrition.

• Drinking dirty water causes water borne diseases.

• Traditional thinking gives less food to women and girls.

• Due to lack of education, people do not understand the importance of balanced diet.

Effects and causes of nutritional problems

1. Effect:

Risk of malnutrition, weakness, and death.

2. Reasons at the individual level:

• Not getting enough food.

• Frequent illnesses (such as diarrhoea, fever).

3. Reasons at the household/family level:

• Lack of nutrients in food.

• Lack of care for mother and child.

• Lack of clean water and sanitation.

• Difficult access to health services.

• Lack of information among women and girls.

• Lack of education.

4. Main/Deep Social Causes:

• Lack of resources or their wrong distribution.

• Discrimination on the basis of caste, gender, poverty.

• Inequality in education, employment and health.

• Poor access to government policies and services.

• Ignoring the voices of the poor and the deprived.

Nutritional problems in India

(a) Protein–energy malnutrition (PEM) 

• This problem occurs when the body does not get enough protein and energy (calories).

• This happens especially in children, elderly and weak people.

• Due to this, there is weakness in the body, weight loss occurs and the power to fight diseases decreases.

There are two main types of protein-energy malnutrition: -

1. Marasmus:

• This occurs when the body is severely deficient in both total energy and protein in food.

• The body starts to look like bones, the muscles melt away.

2. Kwashiorkor:

• This happens when the body is severely deficient in proteins.

• The stomach gets bloated, the skin gets swollen, the hair falls out.

(b) Micronutrient Deficiency:

(i) Iron Deficiency Anaemia (IDA)

It is a common nutritional disorder, especially in developing countries.

The most affected categories:

• Younger women (who lose iron during menstruation)

• teenage girls

• Pregnant women

• school going children

• Why does inactivity occur?

• There is a deficiency of hemoglobin in the body.

• Oxygen does not reach body parts properly.

Symptoms of Aphasia:

• pale face and skin

• Yellowing of nails, lips and whites of eyes

• weakness and fatigue

• inability to concentrate

• Decline in memory

• Lack of interest in studies and work

• General jaundice

• whitening of the eye mucosa

(ii) Vitamin A deficiency (VAD)

Functions of Vitamin A:

• Maintains healthy skin

• Maintains normal vision (the ability to see)

• Helps in physical growth

• Strengthens immunity

Consequences of Vitamin A deficiency:

• Night blindness (inability to see well at night), especially in children

• Complete blindness (in extreme cases)

• the ability to fight infection decreases

• Physical growth is hampered

(iii) iodine deficiency disorder (IDD)

Iodine is necessary for normal mental and physical growth.

Affected States in India:

• Himalayan region - from Jammu & Kashmir to Arunachal Pradesh

• Andhra Pradesh

• Karnataka

• Kerala

• Maharashtra

Problems caused by iodine deficiency:

• Lack of iodine in the diet decreases the production of thyroid hormones.

• Due to this the throat starts swelling, which is called Goiter.

• Children may suffer from mental retardation, hindrance in development, and problems in speaking and hearing.

• Deficiency during pregnancy may result in congenital malformation and intellectual impairment in the baby.

Efforts to tackle nutrition problems

Nutrition Campaign:

Launched: March 2018, Location: Jhunjhunu (Rajasthan) by Prime Minister

1. Objective:

• Reducing problems of malnutrition, anemia, low weight and short height

• Improving the overall nutrition of women and children

2. Ministry: Ministry of Women and Child Development (MWCD)

3. Method: Technology, People's Participation and Multi-Sectoral

Two main components of Poshan Abhiyaan

(i) Key Interventions

• ICDS (Integrated Child Development Services): Nutrition, immunization, and care services for children aged 0–6 years, pregnant women, and adolescent girls 

• Food supplementation by FSSAI (e.g. iron, vitamin enriched food items)

• Providing nutritious food from local and affordable sources

• Focus on vulnerable groups (children, women, especially pregnant and lactating mothers)

• Health and nutrition education (to change people's behavior)

• Multi-sectoral collaboration (education, health, sanitation, women empowerment – ​​connecting all)

(ii) Long-Term Interventions

1. Increasing the quality and availability of food

2. Increasing the use of nutritious foods

3. Reducing poverty, especially:

• through employment schemes

• From Public Distribution System (PDS)

• by land reforms

• Expanding and improving health services

• control of food adulteration

• Spreading awareness through the media

• Better monitoring and implementation of nutrition programmes

• Promoting women's education

• Ensuring solutions through social participation

Work Policies

(i) Diet or food based activities   

• Policies: This policy focuses on improving nutrition by improving people's eating habits and quality of food.

• Benefits :

• Long term: It provides a permanent solution and does not go away quickly.

• Low cost effectiveness: Costs less and is effective.

• There are no side effects: There is no harm even if overdose is taken.

• According to local culture: It can be adopted according to the food traditions of each region.

(ii) Nutrition based or medicinal approach

This policy focuses on providing special nutritional supplements to vulnerable populations (e.g. pregnant women, children, etc.).

features:

• Short-term solutions: These provide immediate help but not a permanent solution.

• Expensive: Supplements, medications, specialty foods are expensive.

• Targeted: There are different groups for different nutrients (e.g. iron tablets for teens, vitamin A for kids, etc.).

Measures to reduce undernutrition (interventions)

Medical or nutrition-based interventions (i.e., prescription treatment)

1. Nutritional Supplementation

• Such as - vitamin tablets, iron syrup, etc.

• For whom? : Children, teenagers, pregnant women etc.

• Advantages:

• The effect is visible immediately

• Provides long term benefits

• Problems:

• it is costly

• Not everyone gets it, it is limited to only a few people

• Food-based/dietary policy-based interventions (i.e., improving nutrition by improving food intake)

1. Fortification

• Adding nutrients to food (such as adding iodine to salt)

• For all people

• Advantages:

• Benefit to the whole society

• More impact at lower cost

• Problems:

• Food industry needs help

• People don't even know what they got

• can't mix with everything

• People don't change their habits

2. Dietary Diversity

• Include a variety of foods (eg, pulses, fruits, vegetables, grains)

• For all people

• Advantages:

• Provides all essential nutrients

• The food is safe too

• There is a permanent (long-term) solution

• Problems:

• Difficult to change eating habits

• Depends on farming and money

• Social thinking and traditions need to be changed

Major schemes and programs related to nutrition in India 

(i) Integrated Child Development Services (ICDS)

The program provides services such as nutrition, immunization, and primary education to young children (0-6 years), pregnant women, and lactating mothers.

(ii) Malnutrition Control Programme: Its aim is to remove nutritional deficiency in the body.

Main events:

• National disease prevention program to prevent blindness due to vitamin A deficiency

• National Nutrition Anaemia Prevention Programme To prevent anemia

• National Iodized Salt Programme for brain development and prevention of thyroid disease

(iii) Food Security Programme: Its objective is to provide food grains to the poor at cheap prices.

Main schemes:

• Public Distribution System (PDS)

• Antyodaya Anna Yojana – For very poor families

• Annapurna Yojana – For Old Age People

• Food for work scheme – grain in lieu of wages

(iv) Food supplement programme : 

Under this scheme, children are provided free nutritious food under the Mid-Day Meal programme in schools and Anganwadi centres.

(v) Self-Reliance and Alternate Employment Schemes:

These schemes provide people with an opportunity to work and earn money, so that they can buy food for themselves and improve the nutrition of their families.

3 Levels of Health Care in India 

Primary Level

• This is the first and basic level.

• When an individual, family or community needs health care, they first go to a Primary Health Centre (PHC) or Sub-Health Centre.

• Example: Cold, cough, fever, vaccination, pregnancy check up, etc.

Secondary Level

• When the disease becomes a little more serious, the person is referred to the district hospital or Community Health Centre (CHC) for treatment.

• Example: Injury, need for surgery, delivery case, initial check-up of major illness etc.

Tertiary Level

• This is the most advanced and specialized level of services.

• Here treatment is done for major and complex diseases.

• The following services are available:

• AIIMS, Medical College Hospitals, Regional/Specialty Hospitals, Cancer Hospitals, Super-Specialty Hospitals etc.

Where can a nutritionist work?

• In hospitals: Can participate in programs related to disease prevention, treatment and nutrition education.

• In Children and Women Programmes: Based on their understanding and competency in nutrition, they can join Anganwadi/Integrated Child Development Services (ICDS).

• Contribution in policy making: Can work as a consultant in the government or any organization, where they help in formulating nutrition policy and planning.

• Volunteer and work with international organizations: You can work on nutrition-related projects with organizations like UNICEF, WHO, etc.

• In large institutions: Can work where special nutrition programs are run for a specific target (e.g. school children, pregnant women).

• At school or college: Schools can participate in health programs or nutrition education programs.

• In education, sports and industry sectors: They can get involved in wellness programs in these sectors - like making diet charts for sportspersons, health schemes for employees, etc.

Major voluntary and international organizations involved in community nutrition 

• UNICEF: An organization of the United Nations that works for the health, nutrition, education and protection of children.

• Oxfam: This organization works worldwide to eliminate poverty, hunger and social inequality.

• DFID: A UK organization that provides aid to developing countries in the field of health and nutrition.

• FAO: Food and Agriculture Organization, which works to provide people with a balanced and adequate diet.

• WHO: The World Health Organization, which sets and monitors standards of health and nutrition around the world.

• USAID: An American organization that helps other countries with health, education, and nutrition projects.

• GAIN: This organization helps in the work of adding nutrients to food (fortification).

• Micronutrient Initiative: This organization works to eliminate micronutrient deficiencies (e.g., iron, vitamin A).

• IFPRI: International Food Policy Research Institute, which conducts research on food and nutrition policies.

What do public nutrition professionals do?

• Identifying the problem: understanding what the problem is (such as malnutrition) and how many people it affects.

• Getting to the root of the problem: It tries to understand how and why these problems are arising.

• Impact assessment: This looks at the impact of these nutrition problems on people, such as on health, education, development, etc.

• Policy and planning: Formulates policies and programs to find solutions, and determines the process for implementing them.