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Nutritional problems

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

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Nutritional problems

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  1. Nutritional problems Dr K N Prasad Community Medicine

  2. 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

  3. 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

  4. Prevention and control • Medium term action: • Regular and adequate intake of Vitamin A rich foods, Food fortification with Vitamin A • ex. Vanaspathi, Margarine oil, dried mild powder, sugar.

  5. Prevention and control • Long term action: • 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

  6. Nutritional Anemia • 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%

  7. 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

  8. India • 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

  9. 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

  10. Interventions • 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)

  11. Iron Fortification • Fortification to salt is tried • Recommended for high risk group in the endemic area • Other measures • Changing dietary habits • Control of parasitic infections • Nutrition education

  12. 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.

  13. Public health problem of IDD • 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 • Clinical manifestations are wide.

  14. Control of IDD • Iodised salt and Oil • Monitoring and surveillance • Manpower training • Mass campaign

  15. Iodised salt and Oil • 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 • Toxicity risk is low

  16. 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.

  17. Mass campaign • Public awareness about IDD • Use of only iodised salt for regular consumption

  18. Thought for the day Asking for help is a strength not weakness

  19. Thank you

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