Nutrition | Hasnat Hussain (Reus-11)

Nutrition
Q.1) Malnutrition is one of the major nutritional public health problems in
developing countries. It is responsible for the high mortality and morbidity in
children under 5.
(a) What are the commonly used classifications of malnutrition?
(b) How will you assess malnutrition in under 5 children?
ANS:
Commonly used classifications of malnutrition:
1.
2.
3.
4.
5.
6.
7.
8.

Gomez
Welcome
Waterlow
Jeliffe
WHO
CDC
McLaren/Read
NCHS

Q.2) During a visit to a village, you encountered small children with retarded
growth, muscle wasting, thin hair, loose motion and pot belly.
(a) What factors are responsible for this malnutrition problem?
(b) What preventive measures will you take?
ANS:
Factors responsible of this malnutrition:
1.
2.
3.
4.
5.
6.
7.
8.

Inadequate intake of food both qualitatively and quantitatively.

Infections e.g. diarrhea, measles
Poor environment
Overcrowding
Poor maternal health
Failure of lactation
Early weaning
Ingestion of dilute cows milk

Nutrition | Hasnat Hussain (Reus-11)

Prevention:
1.
2.
3.
4.

Protein rich diet

Immunization to prevent infections
Promotion of breast feeding
Education of mothers about the importance of breast feeding and nutrition of the
child
5. Improvement of environmental conditions
6. Reduction of poverty
7. Provision of low cost weaning foods and supplements
8. Supplement feeding programs
9. Family planning to reduce family size
10.Surveillance
11.Early diagnosis and treatment
12.Rehabilitation

Q.3) Note on PEM.

ANS:
PEM:
Malnutrition due to deficiency of protein and calories, and commonly associated with
infections.
Occurs in infants and children more frequently.
Consists of 2 conditions
(i)
Marasmus
(ii)
Kwashiorkor
Age groups affected; Marasmus children below 15 months of age
Kwashiorkor children more than 15 months of age
Etiological factors and prevention have already been described.

Q.4) A child of age 2 belonging to a poor family is brought to paeds OPD. The
father is complaining of difficulty to see things at night and occurrence of
repeated chest infections. On examination of the eyes, conjunctival xerosis
was present.
(a) Diagnosis?
2

Nutrition | Hasnat Hussain (Reus-11)

(b) Signs and symptoms?

(c) Function of the deficient thing?
ANS:
Dx: Vitamin A deficiency
Signs and symptoms:
1. Night blindness
Inability to see in dim light.
Late dark adaptation.
2. Conjunctival xerosis
Dry conjunctiva.
Muddy and wrinkled. Not shiny.
3. Corneal xerosis
Dry cornea.
Ulceration and scarring may also occur.
4. Bitots spots
Triangular, white or yellowish foamy spots on the bulbar conjunctiva beside
the cornea.
5. Keratomalacia
Liquefaction of cornea.
Cornea may rupture.
Its an emergency and urgent intervention is required.
6. Anorexia
7. Growth retardation
8. Recurrent respiratory and intestinal infections

Function of the deficient thing:

1. It is involved in the production of rods in retina, which are required for night vision.
2. Maintains integrity and functioning of glandular and epithelial tissue of respiratory,
intestinal and urinary tract.
3. Skeletal growth.
4. Anti-infective.
5. Protects against some epithelial cancers.

Nutrition | Hasnat Hussain (Reus-11)

Q.5) Among macronutrients, proteins are of the greatest importance in human

nutrition and constitute about 20% of body weight in an adult.
(a) What is biological complete and incomplete protein?
(b) Describe the complementary action of proteins with examples.
(c) How PEM is classified according to Waterlows classification?
ANS:
Biological complete protein:
Protein that contains all the EAA in sufficient amounts required by human beings.
E.g. meat, fish, eggs
Biological incomplete protein:
Protein which lacks one or more EAA.
E.g. nuts, seeds, legumes

Q.6) Explain pasteurization process to render milk safe for human

consumption and give the definition, causes and common types of
micronutrients deficiency.
ANS:
Pasteurization of milk:
Heating of milk to a specific temperature for a specific period of time, to destroy all the
pathogens that may be present in the milk while causing minimum changes to milks
composition, taste and nutritive value.
Pasteurization is a very important preventive measure. It makes the milk safe and healthy
to drink. It kills 90% of bacteria present in the milk.
Methods;
1. Holder method
Milk is kept at 63-66 deg C for 30 minutes and then quickly cooled to 5 deg C
2. HTST method
Milk is rapidly heated to 72 deg C for less than 15 seconds and then rapidly
cooled back to 4 deg C
3. UHT method

Nutrition | Hasnat Hussain (Reus-11)

Milk is rapidly heated to 125 deg C for a few seconds and then rapidly cooled
and bottled

Micronutrients deficiency:
Lack of essential vitamins and minerals required in small amounts by the body for proper
growth and development.
Causes;
1.
2.
3.
4.
5.
6.
7.
8.
9.

Poverty
Lack of education about nutrition
Poor maternal and paternal care
Inadequate or no breastfeeding
Consumption of formulated or diluted cow milk
Parasitic diseases
Lack of consumption of fresh vegetables and fruits
Lack of consumption of fortified food
Consumption of ready-made food or fast food

Types;
1.
2.
3.
4.
5.
6.
7.
8.

Vitamin A deficiency
Vitamin B deficiency
Scurvy
Vitamin D deficiency
Iodine deficiency
Iron deficiency
Folate deficiency
Calcium deficiency

Q.7) Name five nutritional disorders of public health importance in the context
of our country. What measures would you take to control PEM?
ANS:
Nutritional disorders of Public Health importance in our country:
1.
2.
3.
4.

Low birth weight

PEM
Xerophthalmia
Anemia
5

Nutrition | Hasnat Hussain (Reus-11)

5. Goiter
6. Obesity
7. Rickets

Measures to control PEM:

Described previously.

Prepared By: Hasnat Hussain (Reus-11)