Page 1
70
Learning Objectives
After completing this chapter the learner will be able to:
z z understand the significance of public nutrition
z z have knowledge about the nutritional problems of public health
significance
z z understand the factors that are linked to nutritional problems
z z describe strategies that can be used to tackle nutritional problems
z z be acquainted with the programmes that are in operation to tackle
important nutritional problems.
Introduction
In Class XI you studied the basic concepts of nutrition and health, physical
fitness and wellness. You must be aware of the importance of good
nutrition as the foundation and cornerstone of health. So what is significant
about the introduction of the word ‘public’ in this context? Let us find out.
You are already familiar with the definition of health given by the World
Health Organisation. The concept of public health refers to the collective
action taken by society to protect and promote the health of the whole
populations.
Public Nutrition
And Health
Chapter
3
Page 2
70
Learning Objectives
After completing this chapter the learner will be able to:
z z understand the significance of public nutrition
z z have knowledge about the nutritional problems of public health
significance
z z understand the factors that are linked to nutritional problems
z z describe strategies that can be used to tackle nutritional problems
z z be acquainted with the programmes that are in operation to tackle
important nutritional problems.
Introduction
In Class XI you studied the basic concepts of nutrition and health, physical
fitness and wellness. You must be aware of the importance of good
nutrition as the foundation and cornerstone of health. So what is significant
about the introduction of the word ‘public’ in this context? Let us find out.
You are already familiar with the definition of health given by the World
Health Organisation. The concept of public health refers to the collective
action taken by society to protect and promote the health of the whole
populations.
Public Nutrition
And Health
Chapter
3
Unit II - Nutrition, Food Science
And Technology
71
In Class XI, you were introduced to the terms undernutrition and
overnutrition. The mission in public health nutrition is to prevent both
undernutrition and overnutrition and to maintain optimal nutritional
status of the population.
Significance
Why do we need to focus on this specific aspect in the field of nutrition?
Malnutrition is the underlying cause of at least 50 per cent of deaths
of children under five years of age. The statistics for nutrition-related
problems in our country reveal an alarming situation:
z z Almost one-third of the infants born in India are low birth weight
babies i.e., they weigh less than 2500g or 2.5kg. These infants start
life with a handicap, which continues to plague them throughout
their growing years and may have tremendous adverse implications
even in adult life.
z z There is widespread prevalence of growth retardation among pre-
schoolers (from socio-economically disadvantaged families) and almost
half the children suffer from mild and moderate under nutrition.
z z A large proportion of children (and adults) suffers from micronutrient
deficiencies in varying degrees of severity. The micronutrients of most
concern are iron, zinc, vitamin A, iodine, folic acid, B12.
If these problems are not controlled in time, they will not only affect
physical growth which may lead to smaller body stature in adulthood, but
may also affect mental and cognitive development. All of these, in turn,
can have negative impact on productivity and quality of life. The costs of
malnutrition are very high. Experts have estimated that productivity losses
are more than 10 per cent of lifetime earnings for individuals and 2-3
percent of gross domestic product for the nation. This clearly indicates that
if we tackle malnutrition, we can help India to develop, grow economically
and become a powerful nation.
India mostly faces the problem of under nutrition; however, the problem
of over nutrition is also on the rise. Gradually, over the years, large
numbers of persons have altered their dietary patterns and lifestyles. With
respect to lifestyle, people have become more sedentary, relying on faster
means of transportation, walking less and doing less amount of outdoor or
physical activity. In large cities, even children do not play enough outdoor
games. Simultaneously dietary patterns have become less ‘healthful’
with over indulgence in food per se. Also food choices have become less
“healthy” because processed foods, fast foods, snacks, western type foods
Page 3
70
Learning Objectives
After completing this chapter the learner will be able to:
z z understand the significance of public nutrition
z z have knowledge about the nutritional problems of public health
significance
z z understand the factors that are linked to nutritional problems
z z describe strategies that can be used to tackle nutritional problems
z z be acquainted with the programmes that are in operation to tackle
important nutritional problems.
Introduction
In Class XI you studied the basic concepts of nutrition and health, physical
fitness and wellness. You must be aware of the importance of good
nutrition as the foundation and cornerstone of health. So what is significant
about the introduction of the word ‘public’ in this context? Let us find out.
You are already familiar with the definition of health given by the World
Health Organisation. The concept of public health refers to the collective
action taken by society to protect and promote the health of the whole
populations.
Public Nutrition
And Health
Chapter
3
Unit II - Nutrition, Food Science
And Technology
71
In Class XI, you were introduced to the terms undernutrition and
overnutrition. The mission in public health nutrition is to prevent both
undernutrition and overnutrition and to maintain optimal nutritional
status of the population.
Significance
Why do we need to focus on this specific aspect in the field of nutrition?
Malnutrition is the underlying cause of at least 50 per cent of deaths
of children under five years of age. The statistics for nutrition-related
problems in our country reveal an alarming situation:
z z Almost one-third of the infants born in India are low birth weight
babies i.e., they weigh less than 2500g or 2.5kg. These infants start
life with a handicap, which continues to plague them throughout
their growing years and may have tremendous adverse implications
even in adult life.
z z There is widespread prevalence of growth retardation among pre-
schoolers (from socio-economically disadvantaged families) and almost
half the children suffer from mild and moderate under nutrition.
z z A large proportion of children (and adults) suffers from micronutrient
deficiencies in varying degrees of severity. The micronutrients of most
concern are iron, zinc, vitamin A, iodine, folic acid, B12.
If these problems are not controlled in time, they will not only affect
physical growth which may lead to smaller body stature in adulthood, but
may also affect mental and cognitive development. All of these, in turn,
can have negative impact on productivity and quality of life. The costs of
malnutrition are very high. Experts have estimated that productivity losses
are more than 10 per cent of lifetime earnings for individuals and 2-3
percent of gross domestic product for the nation. This clearly indicates that
if we tackle malnutrition, we can help India to develop, grow economically
and become a powerful nation.
India mostly faces the problem of under nutrition; however, the problem
of over nutrition is also on the rise. Gradually, over the years, large
numbers of persons have altered their dietary patterns and lifestyles. With
respect to lifestyle, people have become more sedentary, relying on faster
means of transportation, walking less and doing less amount of outdoor or
physical activity. In large cities, even children do not play enough outdoor
games. Simultaneously dietary patterns have become less ‘healthful’
with over indulgence in food per se. Also food choices have become less
“healthy” because processed foods, fast foods, snacks, western type foods
72
Human Ecology and Family Sciences – Part 1
e.g., burgers, pizzas, biscuits, chocolates, cakes and pastries, soft drinks,
even Indian mithais, samosas, etc. (that are high in energy, sugar, fat, salt
and low in other nutrients and fibre) are increasingly becoming part of
the daily diet. At the same time, intake of whole grains, pulses, vegetables
and fruits has reduced. All these lead to undesirable/inappropriate weight
gain, overweight and obesity and ultimately lead to diseases such as
hypertension, heart disease, diabetes, cancer, arthritis, among others.
These diseases are non-communicable and take their toll not only on the
physical health but also on quality of life, adding to the financial burden.
Thus India is said to face “the double burden of malnutrition” i.e.,
coexistence of both undernutrition and overnutrition. Further, although
communicable diseases like smallpox have been controlled, newer ones like
HIV/AIDS and old ones like tuberculosis, hepatitis, malaria, are increasing
in prevalence. The ultimate consequences of these communicable diseases
are far worse for those who are not optimally nourished i.e., those who are
undernourished and those who have compromised and lower immunity
due to obesity, diabetes, HIV/AIDS etc. This poses challenges for doctors,
nutritionists and the government in terms of treatment, control and
prevention.
There is a tremendous need for a trained cadre of public health
professionals including public health nutritionists, to address and solve
these problems. Let us first acquaint ourselves with what is public health
nutrition.
Basic Concepts
What is public health nutrition?
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
Page 4
70
Learning Objectives
After completing this chapter the learner will be able to:
z z understand the significance of public nutrition
z z have knowledge about the nutritional problems of public health
significance
z z understand the factors that are linked to nutritional problems
z z describe strategies that can be used to tackle nutritional problems
z z be acquainted with the programmes that are in operation to tackle
important nutritional problems.
Introduction
In Class XI you studied the basic concepts of nutrition and health, physical
fitness and wellness. You must be aware of the importance of good
nutrition as the foundation and cornerstone of health. So what is significant
about the introduction of the word ‘public’ in this context? Let us find out.
You are already familiar with the definition of health given by the World
Health Organisation. The concept of public health refers to the collective
action taken by society to protect and promote the health of the whole
populations.
Public Nutrition
And Health
Chapter
3
Unit II - Nutrition, Food Science
And Technology
71
In Class XI, you were introduced to the terms undernutrition and
overnutrition. The mission in public health nutrition is to prevent both
undernutrition and overnutrition and to maintain optimal nutritional
status of the population.
Significance
Why do we need to focus on this specific aspect in the field of nutrition?
Malnutrition is the underlying cause of at least 50 per cent of deaths
of children under five years of age. The statistics for nutrition-related
problems in our country reveal an alarming situation:
z z Almost one-third of the infants born in India are low birth weight
babies i.e., they weigh less than 2500g or 2.5kg. These infants start
life with a handicap, which continues to plague them throughout
their growing years and may have tremendous adverse implications
even in adult life.
z z There is widespread prevalence of growth retardation among pre-
schoolers (from socio-economically disadvantaged families) and almost
half the children suffer from mild and moderate under nutrition.
z z A large proportion of children (and adults) suffers from micronutrient
deficiencies in varying degrees of severity. The micronutrients of most
concern are iron, zinc, vitamin A, iodine, folic acid, B12.
If these problems are not controlled in time, they will not only affect
physical growth which may lead to smaller body stature in adulthood, but
may also affect mental and cognitive development. All of these, in turn,
can have negative impact on productivity and quality of life. The costs of
malnutrition are very high. Experts have estimated that productivity losses
are more than 10 per cent of lifetime earnings for individuals and 2-3
percent of gross domestic product for the nation. This clearly indicates that
if we tackle malnutrition, we can help India to develop, grow economically
and become a powerful nation.
India mostly faces the problem of under nutrition; however, the problem
of over nutrition is also on the rise. Gradually, over the years, large
numbers of persons have altered their dietary patterns and lifestyles. With
respect to lifestyle, people have become more sedentary, relying on faster
means of transportation, walking less and doing less amount of outdoor or
physical activity. In large cities, even children do not play enough outdoor
games. Simultaneously dietary patterns have become less ‘healthful’
with over indulgence in food per se. Also food choices have become less
“healthy” because processed foods, fast foods, snacks, western type foods
72
Human Ecology and Family Sciences – Part 1
e.g., burgers, pizzas, biscuits, chocolates, cakes and pastries, soft drinks,
even Indian mithais, samosas, etc. (that are high in energy, sugar, fat, salt
and low in other nutrients and fibre) are increasingly becoming part of
the daily diet. At the same time, intake of whole grains, pulses, vegetables
and fruits has reduced. All these lead to undesirable/inappropriate weight
gain, overweight and obesity and ultimately lead to diseases such as
hypertension, heart disease, diabetes, cancer, arthritis, among others.
These diseases are non-communicable and take their toll not only on the
physical health but also on quality of life, adding to the financial burden.
Thus India is said to face “the double burden of malnutrition” i.e.,
coexistence of both undernutrition and overnutrition. Further, although
communicable diseases like smallpox have been controlled, newer ones like
HIV/AIDS and old ones like tuberculosis, hepatitis, malaria, are increasing
in prevalence. The ultimate consequences of these communicable diseases
are far worse for those who are not optimally nourished i.e., those who are
undernourished and those who have compromised and lower immunity
due to obesity, diabetes, HIV/AIDS etc. This poses challenges for doctors,
nutritionists and the government in terms of treatment, control and
prevention.
There is a tremendous need for a trained cadre of public health
professionals including public health nutritionists, to address and solve
these problems. Let us first acquaint ourselves with what is public health
nutrition.
Basic Concepts
What is public health nutrition?
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
Unit II - Nutrition, Food Science
And Technology
73
and managerial sciences. It can also be described as the art and science
of promoting health and preventing conditions / diseases, prolonging life,
through the organised efforts/ action of society.
A community is a specific group of people who share common
characteristics, e.g. a common language, the same government (a
nation, a state, a city) or the same health problem.
Any professional in the field of public nutrition has to promote good
nutrition and /or to prevent nutritional problems, for which it is important
to identify the problem and its magnitude , understand how and why these
problems occur and then plan strategies and actions to implement them
and evaluate their impact.
In any society, nutritional problems are not just linked to food but
there are a variety of interacting/interrelated factors at various levels that
have their roots in poverty, which have been summarised in Figure 2.
The situation becomes worse when a substantial proportion of families do
not have access to basic amenities. Rural households have less access to
toilets. Poor sanitation results in loss of work days and further economic
loss. Further, considerable proportion of the population does not have
safe drinking water. Working days are lost each year due to water borne
diseases.
As shown in Figure 2, the factors related to nutritional problems range
from economic factors (availability of financial resources), agricultural
policy (production, price of various food stuffs), health care facilities/
services, their availability and access, government policies, political will
and socio-cultural factors.
Nutritional Problems in India: It is important to know about the nutritional
problems in our country.
Let us discuss these in brief:
a) Protein- Energy Malnutrition(PEM) : Can be found in every society, even
in developed and industrialised countries, although the numbers are
fewer in the latter as compared to developing countries. It is caused
by inadequate food intake vis–a–vis the requirements, i.e., insufficient
intake of the macronutrients (energy and protein). Children are at
greatest risk although PEM can occur in adults especially the elderly,
as well as in some diseases e.g. T.B., AIDS. It is assessed by evaluating
the anthropometric measurements (weight and / or height).
Page 5
70
Learning Objectives
After completing this chapter the learner will be able to:
z z understand the significance of public nutrition
z z have knowledge about the nutritional problems of public health
significance
z z understand the factors that are linked to nutritional problems
z z describe strategies that can be used to tackle nutritional problems
z z be acquainted with the programmes that are in operation to tackle
important nutritional problems.
Introduction
In Class XI you studied the basic concepts of nutrition and health, physical
fitness and wellness. You must be aware of the importance of good
nutrition as the foundation and cornerstone of health. So what is significant
about the introduction of the word ‘public’ in this context? Let us find out.
You are already familiar with the definition of health given by the World
Health Organisation. The concept of public health refers to the collective
action taken by society to protect and promote the health of the whole
populations.
Public Nutrition
And Health
Chapter
3
Unit II - Nutrition, Food Science
And Technology
71
In Class XI, you were introduced to the terms undernutrition and
overnutrition. The mission in public health nutrition is to prevent both
undernutrition and overnutrition and to maintain optimal nutritional
status of the population.
Significance
Why do we need to focus on this specific aspect in the field of nutrition?
Malnutrition is the underlying cause of at least 50 per cent of deaths
of children under five years of age. The statistics for nutrition-related
problems in our country reveal an alarming situation:
z z Almost one-third of the infants born in India are low birth weight
babies i.e., they weigh less than 2500g or 2.5kg. These infants start
life with a handicap, which continues to plague them throughout
their growing years and may have tremendous adverse implications
even in adult life.
z z There is widespread prevalence of growth retardation among pre-
schoolers (from socio-economically disadvantaged families) and almost
half the children suffer from mild and moderate under nutrition.
z z A large proportion of children (and adults) suffers from micronutrient
deficiencies in varying degrees of severity. The micronutrients of most
concern are iron, zinc, vitamin A, iodine, folic acid, B12.
If these problems are not controlled in time, they will not only affect
physical growth which may lead to smaller body stature in adulthood, but
may also affect mental and cognitive development. All of these, in turn,
can have negative impact on productivity and quality of life. The costs of
malnutrition are very high. Experts have estimated that productivity losses
are more than 10 per cent of lifetime earnings for individuals and 2-3
percent of gross domestic product for the nation. This clearly indicates that
if we tackle malnutrition, we can help India to develop, grow economically
and become a powerful nation.
India mostly faces the problem of under nutrition; however, the problem
of over nutrition is also on the rise. Gradually, over the years, large
numbers of persons have altered their dietary patterns and lifestyles. With
respect to lifestyle, people have become more sedentary, relying on faster
means of transportation, walking less and doing less amount of outdoor or
physical activity. In large cities, even children do not play enough outdoor
games. Simultaneously dietary patterns have become less ‘healthful’
with over indulgence in food per se. Also food choices have become less
“healthy” because processed foods, fast foods, snacks, western type foods
72
Human Ecology and Family Sciences – Part 1
e.g., burgers, pizzas, biscuits, chocolates, cakes and pastries, soft drinks,
even Indian mithais, samosas, etc. (that are high in energy, sugar, fat, salt
and low in other nutrients and fibre) are increasingly becoming part of
the daily diet. At the same time, intake of whole grains, pulses, vegetables
and fruits has reduced. All these lead to undesirable/inappropriate weight
gain, overweight and obesity and ultimately lead to diseases such as
hypertension, heart disease, diabetes, cancer, arthritis, among others.
These diseases are non-communicable and take their toll not only on the
physical health but also on quality of life, adding to the financial burden.
Thus India is said to face “the double burden of malnutrition” i.e.,
coexistence of both undernutrition and overnutrition. Further, although
communicable diseases like smallpox have been controlled, newer ones like
HIV/AIDS and old ones like tuberculosis, hepatitis, malaria, are increasing
in prevalence. The ultimate consequences of these communicable diseases
are far worse for those who are not optimally nourished i.e., those who are
undernourished and those who have compromised and lower immunity
due to obesity, diabetes, HIV/AIDS etc. This poses challenges for doctors,
nutritionists and the government in terms of treatment, control and
prevention.
There is a tremendous need for a trained cadre of public health
professionals including public health nutritionists, to address and solve
these problems. Let us first acquaint ourselves with what is public health
nutrition.
Basic Concepts
What is public health nutrition?
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
Unit II - Nutrition, Food Science
And Technology
73
and managerial sciences. It can also be described as the art and science
of promoting health and preventing conditions / diseases, prolonging life,
through the organised efforts/ action of society.
A community is a specific group of people who share common
characteristics, e.g. a common language, the same government (a
nation, a state, a city) or the same health problem.
Any professional in the field of public nutrition has to promote good
nutrition and /or to prevent nutritional problems, for which it is important
to identify the problem and its magnitude , understand how and why these
problems occur and then plan strategies and actions to implement them
and evaluate their impact.
In any society, nutritional problems are not just linked to food but
there are a variety of interacting/interrelated factors at various levels that
have their roots in poverty, which have been summarised in Figure 2.
The situation becomes worse when a substantial proportion of families do
not have access to basic amenities. Rural households have less access to
toilets. Poor sanitation results in loss of work days and further economic
loss. Further, considerable proportion of the population does not have
safe drinking water. Working days are lost each year due to water borne
diseases.
As shown in Figure 2, the factors related to nutritional problems range
from economic factors (availability of financial resources), agricultural
policy (production, price of various food stuffs), health care facilities/
services, their availability and access, government policies, political will
and socio-cultural factors.
Nutritional Problems in India: It is important to know about the nutritional
problems in our country.
Let us discuss these in brief:
a) Protein- Energy Malnutrition(PEM) : Can be found in every society, even
in developed and industrialised countries, although the numbers are
fewer in the latter as compared to developing countries. It is caused
by inadequate food intake vis–a–vis the requirements, i.e., insufficient
intake of the macronutrients (energy and protein). Children are at
greatest risk although PEM can occur in adults especially the elderly,
as well as in some diseases e.g. T.B., AIDS. It is assessed by evaluating
the anthropometric measurements (weight and / or height).
74
Human Ecology and Family Sciences – Part 1
1. Quantity and quality of actual resources viz.
manpower (human resources), financial and
organisational (existence of services and the
way they are operated and controlled).
2. Political, cultural, religious, economic and
social systems. This includes status of women,
allocation of funds for programmes to solve
the problems, environmental degradation and
biodiversity.
3. Potential resources: environment, technology
and people.
Basic
Causes
1. Insufficient access to food
2. Inadequate maternal and child care practices
3. Poor water / sanitation and hygiene
4. Inadequate health services and insufficient
access to health services
5. Inadequate and/or in appropriate knowledge
and discrimination against women, elderly
and girl child.
6. Inadequate education.
Underlying
causes at
Household
/ Family
level
1. Inadequate dietary intake
2. Disease
Immediate
causes at
individual
level
Outcomes Malnutrition, disability and death
Fig. 3.1: Factors Related to Undernutrition
Read More