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
Common in rice eating population

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

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.

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

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%

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

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 5070% of population

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

Interventions

Iron & Folic acid supply:

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:
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:
up estimate Hb after 3 months
Children:
Children if anemia supplement 20mg of elemental
iron ( 100mg Fe Sulphate)

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

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.

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.

Control of IDD

Iodised salt and Oil

Monitoring and surveillance
Manpower training
Mass campaign

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

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.

Mass campaign
Public

awareness about IDD

Use of only iodised salt for
regular consumption

Thought for the day

Asking for help is a strength
not weakness

Thank you