HUMAN NUTRITION

Course Code: PubH2061

Course Credit Hour:2

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Kidanemaryam Berhe (BSC, MPH/N)
Email: smichale@yahoo.com
Phone: +251920049517
Adigrat university
College of health science
Department of public health

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Mode of course delivery

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 Student evaluation

Continuous assessment (60%)

Tests
Quiz
Individual assignment
Group assignment
Attendance
Final exam (40%)

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 COURSE OBJECTIVES

After successful completion of this course, students are

supposed to know
Importance of Nutrition in Health Promotion and Disease
Prevention.
Identify the food sources and difference between the basic
nutrients.
Identify the nutritional needs at various life stages.
Explain the links between diet and disease.
Analyze current issues in nutritional conditions of Ethiopia.
Correctly measure & interpret anthropometric indices.
Assess, identify problems and counsel the mothers on child
feeding
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 COURSE OBJ..

Identify socio-cultural and other factors which affecting

food choice, food preference and food intake.
Understand Food self-sufficiency, food security,
alleviation of malnutrition .
Understand the influence of nutrition policy and
strategies on nutrition
etc.

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 Contents

Unit 1: Introduction to Human Nutrition

Unit 2: Carbohydrates
Unit 3: Proteins
Unit 4: Lipids
Unit 5: Vitamins, Minerals, water & electrolyte
Unit 6: Nutritional requirement
Unit 7: Malnutrition
Unit 8: Food quality measure
Unit 9: Food and nutrition policies
Unit 10: Nutrition assessment
Unit 11: Nutritional surveillance
Unit 12: Nutritional intervention approaches
Unit13: Nutritional Anthropology
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 References

1.Tefera B. Lecture notes on Human Nutrition for Ethiopian Health

science students. 2002
2.Michael C. Latham (1997). Human Nutrition in the Developing
World. Food and Agriculture Organization of the United Nations
(FAO), ISSN
3.Robert E.C. Wildman, Denis M. Medeiros (2000). Advanced Human
Nutrition; CRC PRESS LLC.
4.Rosalind S Gibson (2005). Principles of nutritional assessment. 2nd
ed. Oxford University Press, New York.
5.Federal MOH, National Strategy for infant and young child feeding ,
April 2004 Addis Ababa
6.Federal MOH, National guideline for the Control and Prevention of
Micronutrient deficiencies June, 2004.
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 Unit 1: Introduction to Human Nutrition

Objectives
At the end of the chapter students are expected to know:
Definition of terms
Origin & development of Nutrition
Significance of Nutrition in general
Why nutrition matters in Ethiopia?
Nutrition & sustainable Development goals

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1. Definitions of terms

Nutrition: is the science of nutrients and their

action, interaction and balance in relation to health
and disease, and the process by w/c the organism
ingests, digests, absorbs, transports, utilizes and
excretes food substances.
Deals with the nutrients; their characteristics,
functions, bodys quantitative need for them, and
their food sources.
Food: anything edible as defined based on specific
culture, religion, etc. Includes all foods and drinks
acceptable to be ingested by certain society.
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 Definition ..

Nutrient: is an active chemical component in the food that play

specific structural or functional role in the bodys lively activity.
Diet: is the sequence/pattern of meals in a day for individual or
groups.
Balanced diet: is diet that contains all essential nutrients in the
proportion that is optimal for longer term health and survival.
Macronutrients: required by our body in larger quantity on a
daily basis. Includes CHO, proteins and lipids. Upon oxidation all
give energy.
Alcohol also give energy. But not considered as macronutrients.
B/s we do not need it for survival.

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 Definition.

Micronutrients: required in smaller quantities by the

body. They perform essential physiological
and structural functions (vitamins and
minerals).
Nutritional assessment: is an interpretation of
anthropometric, biochemical, clinical and dietary
survey data in order to determine whether a person is
well nourished or malnourished (over or under
nourished).

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 Definition

Essential nutrients:
Absolutely necessary for growth, development, and
health. E.g..Histidine, Isoleucine, Lucien
Can not be made in the body to meet physiological
needs.
Non-essential nutrients:
Those substances that are synthesized in the body in
adequate quantity E,g. Alanine, Arginine, Aspargine

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 Definition.

Dietetics
"The integration and application of principles derived
from several disciplinesincluding:
Nutrition, biochemistry, physiology, food science, food
service, behavioral and social sciencesto achieve and
optimize human health.
Dietetic professionals translate the scientific evidence
regarding human nutrition and use that information to
help shape the food intake or choices of the public.
(American Dietetic Association, 2002)

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 Definition.

Food science
Study of the nature of foods and the changes that occur
in them naturally and as a result of handling and
processing.
Branches of nutrition
Molecular nutrition
Genetics, DNA
Clinical Nutrition
Use of nutrition as a means of treating illnesses
Public Health/community Nutrition
Promotion of good health with the primary prevention of
nutrition related diseases
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 Definition.

Malnutrition means bad nourishment

Which generally refers both to under nutrition and over
nutrition.
Malnutrition is characterized by inadequate or excess
intake of protein, energy, and micronutrients such as
vitamins, and the frequent infections and disorders that result
in chronic diseases.
Malnutrition is a process, with consequences that may
extend not only into later life, but also into future
generations.

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 Definition.

The process of becoming malnourished often starts in

utero and may last, particularly for girls and women,
throughout the life cycle (intergenerational cycle of
malnutrition).
Women and young children are the ones bearing the
burden of malnutrition.
In Africa and south Asia, 27%51% of women of
reproductive age are under weight (ACC/SCN, 2000).

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 2. Origin and development of Nutrition

The Idea of nutrition started in ancient times, prior to

476 B.C.
Hippocrates (460-359 B.C): persons who are very fat
are about to die earlier than those who are slender.
Leonardo DaVinci (1452-1519): if you dont supply
nourishment equal to the nourishment departed, life will
fail in vigor (physical or mental strength and energy).
Antoine Laurent Lavoisier(1743-1794):brought
together the findings of his predecessors (the beginners)
to explain the phenomenon of respiration. Known as the
father of nutrition.
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 Origin and development

Notable discoveries in 19th C in nutrition

1857: Claude Bernard isolated glycogen.
1864: chemical methods for analysis of foodstuffs were
developed.
A number of amino-acids were isolated.
Efforts to use nutrition findings in solving the needs of people were
made.
1870-71: French scientist Dumas prepared artificial milk.
1883/87: energy studies in small animals and farm animals
were initiated.
1899: Emil fisher began classic studies of protein
composition.
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 Origin and development

Impressive advances have been made in the 20th

century
Vitamins were discovered, essential amino acids were
identified.
Certain minerals found to be essential.
The electron microscope (1933), made possible the
study of nutrition at cellular level.
Hunger anywhere in the world is of concern to us.
The importance of nutrition education was recognized
in this era with the founding of the Nutrition
Education Society in 1971.
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 Significant of nutrition in General

Human nutrition is a complex, multifaceted scientific domain

indicating how substances in foods provide essential
nourishment for the maintenance of life.
To understand, study, and practice nutrition a holistic
integrated approach from molecular to societal level is
needed.
Optimal, balanced nutrition is a major determinant of health. It
can be used to promote health and well-being, to prevent ill
health and to treat disease.
The study of the structure, chemical and physical characteristics
and physiological and biochemical effects of the more than 50
nutrients found in foods which helps to strengthen the
understanding of nutrition. 21
Significant of nutrition..

The hundreds of millions of food and nutrition

insecure people globally, the coexistence of under
nutrition and over nutrition, and inappropriate
nutritional behaviors are challenges that face the
nutritionist of today.
More information is needed to solve global, regional,
communal and individual nutrition problems.
The development of ethical norms, standards and
values in nutrition research and practice is needed.

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 Why nutrition matters in Ethiopia?

Some myth-information on nutrition

Increasing food production will reduce malnutrition.
Protein deficiency is the only cause of malnutrition.
Children in developing countries are genetically short.
Malnutrition should be left in the hands of
nutritionists.

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 Why nutrition matters in Ethiopia..

Human and Economic Costs vs. malnutrition

Malnutrition & Child Survival
Underweight and Mortality
majority of child deaths are associated with mild
and moderate malnutrition
invisible to see as nearly all Ethiopian children
are malnourished
Sub optimal breastfeeding Practices in Ethiopia

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 Why nutrition matters in Ethiopia..

Ethically necessary
nutrition is a human right
Negative functional consequences
Illness & Mortality
Intelligence loss
Reduced productivity

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 What nutrition matters in Ethiopia

Malnutrition and Education

Reduces:
Intellectual development
Iron deficiency anemia lowers IQ by about 10 points
Iodine deficiencies lowers IQ by about 13 points
Severe stunting associated with IQ loss of 5-10
points
Low birth weight babies have IQ 5 points lower
School performance
Economic productivity
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Why nutrition matters in Ethiopia..

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 Why nutrition matters in Ethiopia

Planners from each sector need to address:

Impact of nutrition on their sector
Impact of their sector on nutrition
In Ethiopia we can focus on multi sector to tackle
malnutrition
1. Macroeconomic Policies
2. Sector Policies
3. Direct Nutrition Interventions

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 Why nutrition matters in Ethiopia..cont

Macroeconomic Policies
Trade and exchange rate policies: import, export, expired
date
Price policy (real income): market price
Social safety nets (subsidies, public works & feeding
programs)
Sector Policies
Agriculture: availability, access, and stability of food
Health (especially primary prevention)
Education (especially primary school)
Environment etc 29
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 Causes of malnutrition

Malnutrition is multifactorial in nature caused by multiple factors at

different levels
Nutritional status is clearly compromised by diseases, inadequate nutrient
intake (immediate causes)
These are in turn caused by underlying causes (household food security,
care practices, health service and environment)
Basic causes ( e.g. use of potential resources, socio economic status,
Poverty, drought, conflicts, war, Topographical differences etc.)
Exploited land due to planting the same type of food crop for many
years,
Erosion because of overgrazing and moreover the farmers could not
use the fertilizers due to many reasons.
Malnutrition is a subject for political debate and an issue of immediate
concern to any national development strategies
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Harmful traditional practices with regard to nutrition

During period of fasting important nutrients are not

eaten, such as milk, eggs, butter, meat, fish, meal
pattern, etc.
Pork is forbidden for religious and cultural reasons.
Lack of sun light (lack of Vitamin D) during infancy
to protect the child from the evil eyes.
Discrimination in feeding among family members,
adults before children, adult males over adult females.

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 Harmful traditional practices

Giving butter to neonate to swallow, hoping to keep

the intestine smooth.
Delay to start complementary food.
Refusing to give the child meat for fear of infection.
Feeding children with diluted milk.
Feed children with left over and may be contaminated
food.

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 Best practices which favor nutrition

Breast feeding
Mixing of foods E.g. Injera with wet prepared from
Cereals, Legumes and Vegetable.
Eating cereals in the form of kolo (roasted) and nefro
(cooked).
Additional high calories and high protein diet for
pregnant and lactating mothers.
After the 7th day of delivery the mother and the child
warm in the sun every morning.

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 Best practices which favor nutrition.cont

Special care for children, pregnant and lactating

mothers.
Eating wild fruits from the forest.
Honey mixed with butter is eaten in the morning.
Eating of raw vegetables and cereals.
Taking care of elders.

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 Group presentation (assignment)

Group1:carbohydrate(Composition, Classification, Digestion, Absorption,

Function, Food source, Requirement of CHO, Diseases related to CHO)
Group2:proteins(Compositions, Classification ,Digestion, Absorption,
Function, Food source, Requirement of proteins, Diseases related to protein)
Group3:lipids(Compositions, Classification, Digestion, Absorption,
Function, Food source, Requirement of lipid, Diseases related to lipids)
Group4:vitamins(Characteristics, Classification , Functions, Food Sources,
deficiency syndrome & treatment)
Group5:minerals(Classification, Functions, Food Sources, Deficiency
syndrome & treatment)
Group6:water and electrolytes
Group7: nutrition and sustainable development goals

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 Thank You !!!
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