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NCERT Class 12 Home Science Chapter 3 Public Nutrition and Health
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Public Nutrition and Health
Chapter – 3
| PART – Ⅰ HUMAN ECOLOGY AND FAMILY SCIENCES |
| Unit – ⅠⅠ Nutrition, Food Science and Technology |
Review Questions:
1. Explain the terms: Stunting, low birth weight baby, IDD, wasting, ‘double burden of malnutrition’, marasmus, kwashiorkor, Community.
Ans: Stunting: Stunting refers to a condition in which a child’s height or length is significantly below the expected average for their age. It is often used as an indicator of chronic malnutrition and is a reflection of inadequate nutrition and poor overall health during a child’s early years. Stunting can have long-lasting effects on physical and cognitive development, as well as increased vulnerability to various diseases.
Low Birthweight Baby: A low birthweight baby is an infant born with a weight of less than 2,500 grams (5.5 pounds) at birth. Low birthweight can be caused by a variety of factors, including premature birth and maternal malnutrition. Low birthweight babies are at increased risk for various health complications and developmental issues, both in the short term and over the course of their lives.
IDD (Iodine Deficiency Disorders): IDD refers to a group of health conditions that result from a lack of sufficient iodine in a person’s diet. Iodine is an essential mineral required for the production of thyroid hormones, which are crucial for proper growth and development, especially of the brain. Iodine deficiency can lead to disorders such as goiter (enlarged thyroid gland), intellectual disabilities, and other developmental issues. Iodized salt is a common method used to prevent iodine deficiency.
Wasting: Wasting, also known as acute malnutrition, is a condition in which a person’s weight is significantly lower than what is expected for their height and age. It often results from a sudden and severe shortage of food or a sudden illness. Wasting can be life-threatening and is characterized by the rapid loss of muscle and fat tissue, making affected individuals extremely undernourished.
Double Burden of Malnutrition: The “double burden of malnutrition” refers to the coexistence of both undernutrition and overnutrition within a population or even within the same individual. This means that in a given population, you can find individuals who are undernourished and experiencing conditions like stunting and wasting, while others may be overweight or obese. This phenomenon is a growing concern, particularly in low and middle-income countries where malnutrition is transitioning from a focus on undernutrition to the simultaneous presence of undernutrition and overnutrition.
Marasmus: Marasmus is a severe form of protein-energy malnutrition characterized by extreme calorie deficiency. It often results in significant weight loss, muscle wasting, and a shrunken appearance. Marasmus typically occurs in situations of severe and prolonged starvation or when an individual does not receive sufficient calories and nutrients for an extended period. It is more common in children and can be life-threatening if not treated.
Kwashiorkor: Kwashiorkor is another form of severe protein-energy malnutrition, but it differs from marasmus in that it is characterized by edema (swelling) due to the retention of fluids. Individuals with kwashiorkor often have a swollen belly and may experience skin and hair changes. This condition is typically seen in children who have a diet low in protein, even if their calorie intake is not as severely restricted as in marasmus.
Community: A community is a group of people living in a specific geographic area or sharing common interests, characteristics, or goals. Communities can be defined by factors such as location (e.g., a neighborhood, town, or village), cultural or ethnic background, shared activities or hobbies, or a combination of these factors. Communities play a crucial role in social interaction, support networks, and collective decision-making.
2. Discuss the various strategies that can be adopted to combat public nutrition problems.
Ans: Combating public nutrition problems requires a multifaceted approach that involves various strategies aimed at improving the nutritional status of a population. These strategies can address both undernutrition and overnutrition issues and often require collaboration among governments, international organizations, healthcare providers, and communities.
Here are some key strategies to combat public nutrition problems:
(i) Education and Awareness: Promoting nutrition education and awareness is fundamental. This includes educating individuals and communities about the importance of a balanced diet, the risks of malnutrition, and the benefits of breastfeeding, among other topics.
(ii) Promotion of Breastfeeding: Encouraging and supporting breastfeeding is critical for infant nutrition. Breast milk provides essential nutrients and immune support for infants, reducing the risk of malnutrition and illness.
(iii) Micronutrient Supplementation: Providing supplements of essential vitamins and minerals, especially to vulnerable populations like pregnant women, children, and those in areas with known micronutrient deficiencies.
(iv) Food Fortification: Enriching commonly consumed foods with essential nutrients, such as iodized salt, fortified flour, or fortified milk, can help address specific nutrient deficiencies within a population.
(v) Nutrition Programs for Children: Implementing school feeding programs and interventions like deworming to ensure that children have access to nutritious meals and can attend school regularly.
(vi) Public Health Campaigns: Conducting campaigns to raise awareness about healthy eating habits, balanced diets, and the dangers of excessive consumption of unhealthy foods.
(vii) Agricultural and Food System Improvements: Enhancing agricultural practices to promote the production of diverse and nutrient-rich foods, improving food storage and distribution systems, and reducing food waste can increase access to nutritious foods.
(viii) Food Subsidies and Safety Nets: Implementing food subsidy programs or social safety nets to make nutritious foods more affordable and accessible to low-income populations.
(ix) Promotion of Local and Traditional Diets: Encouraging the consumption of locally available and culturally appropriate foods can help improve nutrition and support sustainable food systems.
(x) Monitoring and Surveillance: Establishing effective data collection and surveillance systems to track nutrition-related trends and identify at-risk populations, which can inform targeted interventions.
3. What is public health nutrition?
Ans: Public health nutrition is the field of study that is concerned with promotion of good health through prevention of nutrition–related illnesses / problems in the population, and the government policies and programmes that are aimed at solving these problems. Public health nutritionists / professionals use large scale, organised and multidisciplinary approaches to solve the problems that affect the population i.e., large number of people for whom group action is necessary. Therefore, this field is multidisciplinary in nature and is built on the foundations of biological and social sciences. It differs from other fields of nutrition e.g. clinical nutrition and dietetics, because the professionals are required to address problems of the community / public specially the vulnerable groups. Public Nutrition is a special body of knowledge derived from the nutritional, biological, behavioural, social and managerial sciences. It can also be described as the art and science of promoting health and preventing diseases, prolonging life, through the organised efforts/action of society.
4. What are the common nutritional problems facing India?
Ans: India faces several common nutritional problems that affect various segments of its population.
Some of the most prevalent nutritional challenges in India include:
(i) Malnutrition: India has a significant burden of both undernutrition and overnutrition. Undernutrition encompasses problems like stunting (low height-for-age), wasting (low weight-for-height), and underweight (low weight-for-age), particularly among children. Overnutrition includes issues like obesity and diet-related non-communicable diseases, such as diabetes and cardiovascular diseases.
(ii) Child Malnutrition: A substantial number of Indian children suffer from stunting, wasting, and underweight due to inadequate nutrition, poor maternal nutrition, and limited access to essential healthcare services. Malnutrition during childhood can have lifelong consequences for physical and cognitive development.
(iii) Iron-deficiency anemia (IDA): It is the most common nutritional disorder in the world and is prevalent in both developed and developing countries. The vulnerable groups are women in child–bearing age, adolescent girls, pregnant women and school age children. IDA occurs when hemoglobin production is considerably reduced and it results in low levels of hemoglobin in blood. Symptoms depend on the rate of fall in hemoglobin. Since hemoglobin is required for carrying oxygen in the body, any physical exertion leads to shortness of breath (breathlessness on slight exertion) and the person complains of fatigue and may feel lethargic. Manifestations of IDA include general pallor, paleness of conjunctiva of eyes, tongue and nail beds and soft palate. In children, cognitive functions (attention span, memory, concentration) are adversely affected.
(iv) Vitamin A deficiency (VAD): Vitamin A is necessary for maintenance of healthy epithelium, normal vision, growth and immunity. Deficiency of vitamin A results in night blindness which progresses to complete blindness if corrective measures are not taken. Also, there is less resistance to infection and growth may be adversely affected. There is a vicious cycle between vitamin A deficiency and infection. Vitamin A deficiency is the most common cause of childhood blindness.
(v) Low Birthweight: Many infants in India are born with low birthweights due to factors such as poor maternal nutrition, limited access to prenatal care, and high rates of adolescent pregnancies. Low birthweight increases the risk of neonatal mortality and long-term health issues.
(vi) Dietary Imbalance: The typical Indian diet is often imbalanced, with an overreliance on carbohydrate-rich foods and insufficient consumption of fruits, vegetables, protein, and essential fats. This imbalance can contribute to both undernutrition and overnutrition.
(vii) Obesity and Non-Communicable Diseases: India is experiencing a rising prevalence of obesity, especially in urban areas. This increase is associated with an increased risk of non-communicable diseases, including type 2 diabetes, cardiovascular diseases, and hypertension.
(viii) Poor Sanitation and Hygiene: Inadequate access to clean drinking water and sanitation facilities can lead to waterborne diseases and impact nutritional status. Diarrheal diseases, for example, can cause malnutrition in children.
(ix) Food Security: Issues related to food security, including access to nutritious and affordable food, can contribute to malnutrition, especially among marginalized and economically disadvantaged populations.
(x) Lack of Awareness: Limited awareness of proper nutrition and healthy dietary practices is a challenge in India. This lack of awareness can hinder efforts to combat nutritional problems.
5. What are the consequences of IDA and IDD?
Ans: Iron-deficiency anemia (IDA): It is the most common nutritional disorder in the world and is prevalent in both developed and developing countries. The vulnerable groups are women in child–bearing age, adolescent girls, pregnant women and school age children. IDA occurs when hemoglobin production is considerably reduced and it results in low levels of hemoglobin in blood. Symptoms depend on the rate of fall in hemoglobin. Since hemoglobin is required for carrying oxygen in the body, any physical exertion leads to shortness of breath (breathlessness on slight exertion) and the person complains of fatigue and may feel lethargic. Manifestations of IDA include general pallor, paleness of conjunctiva of eyes, tongue and nail beds and soft palate. In children, cognitive functions (attention span, memory, concentration) are adversely affected.
Iodine deficiency disorders (IDD): Iodine is required for normal mental and physical growth and development. IDD is an ecological phenomenon, largely due to deficiency of iodine in the soil. Some of the states in India where IDD is common are– Jammu and Kashmir to Arunachal Pradesh in the Himalayan belt, Andhra Pradesh, Karnataka, Kerala, Maharashtra and Madhya Pradesh. The term ‘Iodine Deficiency Disorders’ refers to a spectrum of disabling conditions that affect the health of humans, from fetal life through adulthood due to inadequate dietary intake of iodine. Deficiency of iodine results in insufficient amount of thyroid hormone which is synthesised by the thyroid gland. Enlarged thyroid known as ‘goitre’ is the most common manifestation of iodine deficiency in adults. In children it manifests as cretinism. Iodine deficiency in adults during pregnancy has several adverse effects specially resulting in mental retardation and congenital abnormalities of the fetus. Unfortunately this effect is irreversible. IDD is estimated to affect about 13 percent of the world’s population and about 30 per cent are at risk.
6. What is the scope of public health nutrition? List some of the career choices in this area.
Ans: The scope of public health nutrition is the role of public nutrition is an important determinant of health. The changing health scenario globally has increased the challenges for public nutritionists. The public nutritionist (also called community nutritionist), who is well trained and equipped in key areas, is eminently suited to participate in all the strategies of health promotion and prevention. The key areas include nutritional science, nutritional needs throughout the life cycle, nutritional assessment, nutritional care, food science, educational methods, mass media and communication and programme management. A community nutritionist can work in the following areas/situations.
Some of the career choices in this area are:
(a) As a part of outreach programmes undertaken by hospitals for prevention and promotion and education.
(b) As a part of the national Integrated Child Development Services, at different levels based on qualifications and expertise.
(c) At the government level as consultants, advisors, or in policy making committees.
(d) In all developmental programmes of government, voluntary organisations, NGOs and international organisations like UNICEF, USAID, GAIN, Nutrition International, TATA Trust, IFPRI and others are numerous other national and regional organisations.
(e) They can be involved with organisations who undertake large scale feeding programmes for various target groups such as young children, school children, adolescents, pregnant and lactating mothers, elderly, challenged individuals.
(f) Nutritionists or school health counsellors in school health Programmes.
(g) They can be involved with corporate CSR programmes dealing with food and nutrition security to vulnerable groups.
