Assignment Code: DNHE-1/AST-1/TMA-1 /23

Course Code: DNHE-1

Assignment Name: Nutrition for the Community

Year: 2022-2023

Verification Status: Verified by Professor

Maximum Marks: 100

Assignment-1 consists of two parts and is of 100 marks. The weightage given to each part is indicated in the brackets.

Part A: Descriptive Type Question (60 Marks)

All questions are compulsory.

Q1. a) Define health. Elaborate on the four dimensions of health. (3)

Ans) According to this definition, being healthy is a good state of being. In other words, health goes beyond simply being free of disease to include a condition of whole well-being. Even if a person does not have any diseases, they may not be completely healthy.

Physical Health

The physical dimension of health is familiar to us. When we say a person is healthy,

we are generally referring to this aspect.

Mental Health

Mental health implies:

1. Freedom from internal conflicts

2. No consistent tendency to condemn or pity oneself.

3. A good capacity to adjust to situations and people.

4. Sensitivity to the emotional needs of others

5. Capacity to deal with other individuals with consideration and courtesy.

6. Good control over one’s own emotions without constantly giving in to strong feelings of fear, jealousy, anger or guilt.

Social Health

Describe social health. A person has already taken the first step toward social health if they can identify with a larger community and realise they are a part of a family. A person is said to be socially healthy if they understand their responsibilities to other members of society and can connect with those around them.

Spiritual Health

It's hardest to define spiritual wellbeing. Indians likely have a deeper understanding of spirituality than people from other cultures since moral and religious values are more readily visible in our culture. A healthy person generally abides by these moral principles.

Q1. b) Explain the functions, digestion and absorption of carbohydrates in our body. (3)

Ans) A vital purpose for carbohydrates in the human body. They provide energy, contribute in the metabolism of cholesterol and triglycerides, regulate the metabolism of blood sugar and insulin, and aid in fermentation. Upon intake, the digestive system starts to convert carbs into glucose, which is used as fuel. Large, insoluble food molecules are broken down into smaller ones during digestion so that they can be absorbed into the bloodstream. Numerous digestive enzymes and fluids are utilised during this process, including saliva, mucus, bile, and hydrochloric acid, among others. The process of absorbing or assimilating substances into cells or via tissues and organs via osmosis or diffusion is known as absorption.

Q2. Differentiate between the following terms and give suitable examples for each:

a)    Saturated and Unsaturated fatty acids (2)

Ans) Fatty acids that have hydrogens at every link in their chemical chain are said to be saturated fats. They are linked to the liver producing more LDL cholesterol and total cholesterol. A significant effort has lately been made to re-evaluate whether saturated fat is indeed as harmful as previously believed. Saturated fatty acids, such as palmitic acid or steric acid, appear to affect LDL cholesterol in your blood in various ways.

Monounsaturated and polyunsaturated fats are the two types of unsaturated fats. Compared to saturated or trans fats, monounsaturated and polyunsaturated fats are thought to be healthier. MUFAs, or monounsaturated fatty acids, are fatty acids with one hydrogen pair missing from their chain. They are linked to lower levels of total and LDL cholesterol as well as higher levels of HDL cholesterol, the "good" cholesterol. Typically, these lipids are liquid at normal temperature.

b)   Water soluble and fat soluble vitamins (2)

Ans) Vitamin B complex and vitamin C are both considered water-soluble vitamins since they are easily absorbed, used by bodily tissues, and eliminated by the kidneys through urine. Water-soluble vitamins are not stored by our body for use by future cell processes.

They are soluble in lipids or fatty acids, as their name suggests. Vitamins A, D, E, and K are examples of fat-soluble vitamins since they are not easily absorbed, utilised by bodily tissues, or eliminated by the kidneys through urine. Future biological tasks for fat-soluble vitamins are mostly carried out by the liver and adipose tissues.

c)    Essential and non-essential amino acids (2)

Ans) Essential Amino Acids are those amino acids that cannot be produced by the body and must instead be obtained through a healthy diet or appropriate food. For instance, histidine, isoleucine, and lysine.

Non-essential amino acids are those that our bodies are capable of producing. Alanine, arginine, asparagine, and aspartic acid are some examples. For instance, histidine, isoleucine, and lysine.

Q3. a) Give the functions, food sources and deficiency of iron. (3)

Ans)

Functions:

1. Boosts the system's innate immune activity.

2. Helps cells meet energy requirements, to carry out routine biochemical roles.

3. Regulates body temperature, keeping it at the normal range of 37 to 38 Celsius.

4. Promotes digestion and gut health.

5. Enhances brain function, memory and concentration.

Typical food sources:

1. Green beans and peas

2. Lentils such as moong dal, urad dal, toor dal, channa

3. Whole grains like ragi, oats, quinoa

4. Dark green vegetables such as spinach, broccoli, kale, moringa leaves

5. Tofu

6. Potatoes

7. Cashew nuts

Deficiency:

Low levels of healthy red blood cells are caused by an iron shortage in the body. In turn, this leads to serious consequences such a lack of haemoglobin, which prevents the muscles and other tissues from getting the oxygen they need to perform their regular tasks. This is a disorder known as iron deficiency anaemia, and its typical symptoms include exhaustion, light-headedness, and breathing difficulties.

Q3.b) “Foods can be classified based on their functions”. Explain briefly. (3)

Ans) Man must eat to survive, and the food he consumes has a significant impact on how healthy, productive, and long-lived he is. Food serves a variety of important roles in the body.

Energy Yielding Foods

Foods high in protein, fat, and carbohydrates are included in this category. They might be split roughly into two groups. grains, beans, roots, and tubers Large amounts of proteins, minerals, and vitamins are also provided by cereals in the diet in addition to energy. In addition to providing the body with energy, pulses also include protein and B vitamins.

Body Building Foods

Protein-rich foods are referred to as "body building foods." They are divided into two categories. fish, meat, milk, and eggs. They include a lot of highly biologically valuable proteins. These proteins are properly proportioned with all the essential amino acids needed for the creation of bodily tissues.

Protective Foods

Protein-rich foods are referred to as "body building foods." They are divided into two categories. fish, meat, milk, and eggs. They include a lot of highly biologically valuable proteins. These proteins are properly proportioned with all the essential amino acids needed for the creation of bodily tissues.

Q4. a) What is food budgeting? List the factors that influence food  expenditure. (3)

Ans) A budget is a written plan that outlines how the family's needs will be met with the money that is available to you. For instance, a budget would outline the best way to spend, say, Rs. 1500 per month, to cover your monthly expenses. Budgeting is the process of creating a financial plan.

The income of the family

When discussing expenditures of any kind, we discuss the actual dollar amount spent as well as how much of our overall income goes toward these expenditures. Since you must consume a minimum amount of food to be able to live and work, the actual amount of money spent on food increases when income declines.

The size of the family

It goes without saying that families with larger numbers of members will spend more on food. However, as the population grows, the cost per person decreases.

Current food prices

The market's trend in food costs directly affects the household's food budget. You spend less money on food when the price is low. Your food expenses increase along with an increase in food prices.

Q4. b) Enlist the steps in the preparation of a short -term monthly budget. (3)

Ans)

Step 1: Set Realistic Goals

Setting financial goals will assist you in making wise purchases. What do you want your financial situation to be like in a year? Start by deciding what's important to you.

Step 2: Identify your Income and Expenses

You most likely are aware of your monthly income, but do you also understand where it all goes? By keeping track of your spending, you can find out. Spend like you normally would but record each dollar for a few weeks. It's simple, and you might be surprised by what you learn.

Step3: Separate Needs and Wants

Consider if you need or want the item in question. Will using this money move me in the direction of or away from my financial objectives? Could I survive without it? Decide what your priorities are, and making decisions will become simpler.

Step 4: Design Your Budget

Ensure that your expenditure does not exceed your income. In order to cover all you need to spend money on, balance your budget. Our free, user-friendly budget calculator spreadsheet and worksheet, designed for Canadians, is one simple way to accomplish this.

Q5. Enumerate any 3 criteria for selection of each of the following foods:

a)    Cereals and millets (2)

Ans) Semi-perishable foods include all cereal and pulse products such as wheat flour, semolina, vermicelli, broken wheat, Bengal gramme flour, as well as some fruits and vegetables such as citrus fruits, aonla, apples, pumpkin, roots and tubers, yams, potatoes, onions, and garlic. Foods that are preserved (canned, dried, pickled, etc.), whole grains, pulse and millet grains, oilseeds, nuts, fats and oils, honey, sugar, jaggery, salt, whole spices, and essence are examples of non-perishable foods.

b)   Fats and Oils (2)

Ans) When choosing foods, especially fats and oils, use the Nutrition Facts label. The fat, saturated fat, and trans-fat content of your options should be compared. Replace oils high in saturated fat, such as coconut* and palm oil, with oils high in monounsaturated fat, such as olive, canola, peanut, and sesame oil.

c)    Milk and milk products (2)

Ans) A dairy or dairy factory is a facility used to produce dairy products. Food items made from milk are often referred to as dairy products. They are abundant energy sources. Dairy items include ice cream, yoghurt, Swiss cheese, cheddar cheese, and milk of all kinds (including whole milk, skim milk, and buttermilk). The finest dairy products for calcium are milk, yoghurt, and cheese.

Q6. a) Foods can be classified based on perishability. Comment on the statement giving suitable examples. (3)

Ans) Unconsciously or not, the majority of us take both perishable and non-perishable goods into account when creating our grocery lists and meal plans. Most household kitchens are stocked with both kinds of food to strike a balance between convenience, flavour, and health. Perishable goods must be frozen at 0°F (-17°C) or refrigerated at 40°F (4°C) in order to prevent spoilage, decay, or harmful eating conditions, according to the United States Department of Agriculture (USDA). Meat, poultry, fish, eggs, and dairy products are a few examples of perishable food items. Few fresh fruits and vegetables can be kept at room temperature for extended periods of time; therefore they are also regarded as perishable.

Q6. b) Elaborate on any 3 techniques used for preservation of food by bacteriostatic method (3)

Ans) Heat, filtration, radiation, and chemical exposure are all examples of bactericidal techniques. In a microbiology lab, the use of heat is a highly common sterilising technique. Bacteria, fungus, and yeast are all incinerated by the dry heat of an open flame. In addition to causing the microbial membranes to liquefy, the wet heat of a device like an autoclave can deform the protein components of the organism. Heat's effects are influenced by the length of exposure as well as the type of heat applied. For instance, 15 minutes of exposure time is enough to kill the so-called vegetative form of bacteria in an autoclave that maintains a temperature of 121° F (49.4° C). A bacterial spore can, however, endure this heat treatment. In order to prevent the spore from growing into a living bacteria after autoclaving, more time must be spent in the heat. Mathematical computations can be used to determine the link between temperature and exposure time.

Q7. a) What is food adulteration? Explain with examples. (3)

Ans) Food is considered adulterated when it does not adhere to the government's legal criteria, which is considered a criminal offence. One type of food adulteration is the addition of a different substance to a food item in order to increase its quantity in raw or prepared form, which degrades the food item's true quality. These ingredients could be readily available foods or non-food objects. Water, ice, carcasses, or carcasses of animals other than the one intended for consumption are some of the substances used to adulterate meat and meat products. Adulteration in the context of seafood can refer to species substitution (mislabelling), in which a different species is used in place of the one identified on the product label, or undisclosed processing techniques, in which consumer-unaware treatments like additives, excessive glazing, or short-weighting are used.

Examples

1. Mixing of pulses with sand particles, pebbles.

2. Mixing oil with chemical derivatives or cheaper oils.

3. Packing low-quality food products with fresh and high-quality ones.

4. Mixing of milk with water.

Q7. b) Enumerate any simple test by which adulteration can be detected in : (1.5+1.5)

a)    Sand or dirt in jaggery

Ans)

Chalk Powder

Jaggery, often referred to as Panela, is a fantastic source of vitamins, minerals, and proteins. These nutrients are the fundamental elements of a balanced diet. Jaggery includes a significant amount of iron and copper proportion compared to white sugar.

Washing Soda

Add a few drops of solution HCL. Effervescence shows presence of washing soda.

b)   Papaya seeds in black pepper

Ans)

Papaya Seeds

Papaya seeds can be distinguished from pepper seeds by their shrunken, oval form, greenish brown or brownish black colour, and their different size and shape.

Q8. Enlist the clinical manifestations, causes and treatment of the following nutrition related disorders:

a)    A 7 year child suffering from Xerophthalmia (3)

Ans) A lack of vitamin A can result in xerophthalmia, a degenerative eye condition. Your tear ducts and eyes may become dry from a lack of vitamin A. Xerophthalmia can progress to night blindness or more severe injury to the cornea, the surface of the eye. White patches on your eyes and corneal ulcers could result from this injury. With vitamin A therapy, xerophthalmia is typically reversible. A deficiency in vitamin A leads to xerophthalmia. Vitamin A is not something your body can make on its own. As an alternative, you must obtain vitamin A through your diet. Due to its role in the protein that absorbs light in the receptors in your retina, vitamin A is crucial for eyesight. Your heart, lungs, kidneys, and other organs depend on vitamin A for proper operation and maintenance. Vitamin A supplementation or therapy is the primary treatment for xerophthalmia. It may be administered orally or intravenously. In order to avoid eye infections, your doctor could also prescribe you other drugs, such as antibiotics. Both adults and kids who have xerophthalmia can benefit from vitamin A therapy.

b)   A 5 year girl suffering from Vitamin D deficiency (3)

Ans) One of the numerous vitamins your body requires to keep healthy is vitamin D. It is essential for preserving the equilibrium of calcium in your blood and bones as well as for the formation and upkeep of bones. You need vitamin D especially so that your body can utilise calcium and phosphorus to promote healthy tissues and create bones.

In general, the two main causes of vitamin D deficiency are:

1. Not getting enough vitamin D in your diet and/or through sunlight.

2. Your body isn’t properly absorbing or using vitamin D.

Reaching and then maintaining a sufficient amount of vitamin D in your body are the objectives of both treatment and prevention for vitamin D deficiency. Your doctor would probably advise taking vitamin D pills even if you might think about increasing your intake of foods rich in vitamin D and receiving more sunlight. There are two types of vitamin D: D2 and D3. Plants provide ergocalciferol, or vitamin D2. Animals provide cholecalciferol, or vitamin D3. To purchase D2, you need a prescription. However, D3 can be purchased over the counter. D3 is easier for your body to absorb than D2.

Q9. Explain briefly:

a)    Dietary management of Diarrhoea (3)

Ans)

1. A vital component for your body is potassium. Large amounts of it could be lost through diarrhoea. You could experience weakness if your potassium levels are low. Eat foods high in potassium, such as ripe bananas, apricot or peach nectar, potatoes, fish, and meat, when you have diarrhoea.

2. Drink fluids between meals.

3. Eat small amounts of food frequently.

b)   Dietary management of Coronary Heart Disease (3)

Ans)

1. Start your day out right. Have some kind of grain (like whole-grain bread or whole-grain cereal) and fruit for breakfast.

2. Think of grains and vegetables as your main dish in lunches and dinners. If you are serving meat or poultry as a main dish, add a tossed salad or a vegetable to your plate.

3. Add beans to leafy green salads, pasta salads, and stews—chick peas, kidney beans, and navy beans have been shown to reduce LDL cholesterol levels.

Q10. a) Write about the objectives and components of MDM Programme. (3)

Ans)

Objectives

The programme has both health and educational objectives. There are :

1. To improve the nutritional status and the attentiveness of school children attending primary sections (I to V classes).

2. To improve school enrolment and attendance on one hand and to reduce dropout rates on the other.

Components

The food options offered in this programme are diverse. International agencies provide raw food materials such as corn soy meal (CSM), wheat soy mix, bulgar wheat fortified with soy (SFB), and salad oil. The uncooked ingredients are prepared into upma, khichri, or other dishes that are simple to eat. Along with flavourings and toppings, they are also included in prepared foods. In certain regions, supplies even include milk powder.

Q10.b) Enumerate the 4 major methods used to assess nutritional status of individuals. Discuss one in brief. (2+1)

Ans) The five domains of nutrition assessment outlined in the NCP include 1) food or nutrition-related history, 2) biochemical data, medical tests, and procedures, 3) anthropometric measurements, 4) nutrition-focused physical findings, and 5) client history.

Anthropometric assessment: In order to evaluate growth and body composition, measurements of the body are taken, such as height, weight, and waist circumference. The results of these measurements can be used to assess if a person is underweight, overweight, or at a healthy weight.

Biochemical assessment: It entails determining the nutritional concentrations in the blood, urine, or other body fluids. This can assist identify whether a person has excess or insufficient amounts of specific nutrients like calcium, iron, or vitamin D.

Clinical assessment: This entails assessing malnutrition's outward manifestations, such as changes to the skin and hair, dental issues, and limb swelling. In order to discover any illnesses or prescription drugs that might have an impact on nutritional status, it may also require reviewing medical history.

Section B – Application Question (AQ) (40 marks)

1. Based on the steps involved in planning balanced diet, prepare a diet for a pregnant woman belonging to low socio-economic group. (Refer to DNHE 1, Vol 2, Practical Manual -Part 1, Section 6) (10)

Ans) The steps involved in planning a balanced diet for a pregnant woman belonging to a low socio-economic group are:

1. Determine the nutrient needs: Pregnant women have different nutritional needs than non-pregnant women. To ascertain the precise nutrient needs, speak with a qualified nutritionist or see the pregnancy diet recommendations.

2. Identify locally available and affordable foods: Find cheap and readily available foods in your area that can satisfy the pregnant woman's nutrient requirements. This can make the diet plan feasible and affordable for a low socioeconomic group's budget.

3. Plan meals: Create a range of dietary groups for your meals, including fruits, vegetables, whole grains, dairy, protein, and proteins. Include foods high in the vitamins and minerals a pregnant woman needs, such as folate, iron, calcium, and protein.

4. Monitor portion sizes: Pregnant women require additional calories, but excessive weight gain should be avoided. Monitor portion sizes and ensure that the pregnant woman is consuming an appropriate number of calories.

5. Consider food safety: Ensure that the food is prepared and stored safely to reduce the risk of foodborne illnesses. Pregnant women are more susceptible to foodborne illnesses that can harm the developing foetus. Example diet plan for a pregnant woman belonging to a low socio-economic group:

6. Breakfast: A bowl of oatmeal with banana, milk, and nuts

7. Mid-morning snack: Apple slices with peanut butter

8. Lunch: Whole-grain bread with canned salmon, mixed greens, and a side of sweet potato wedges

9. Afternoon snack: Greek yogurt with honey and berries

10. Dinner: Brown rice, mixed vegetables, and grilled chicken breast

11. Evening snack: A small serving of nuts and raisins

This is merely an illustration; the actual diet plan should be tailored to the pregnant woman's unique dietary requirements and food accessibility. It is advised that a certified dietician or other healthcare provider examines and approves the diet plan.

2. Record height and weight of 10 (ten) adults in your locality and determine their body mass index (BMI). Classify them to identify their health status based on WHO classification (Refer to DNHE 1 Vol 2, Unit 21, Table 21.1) (10)

Ans)

Based on the WHO classification, the health status of an individual can be classified according to their body mass index (BMI). The classifications are as follows:

1. Underweight: BMI less than 18.5 kg/m²

2. Normal weight: BMI between 18.5 and 24.9 kg/m²

3. Overweight: BMI between 25 and 29.9 kg/m²

4. Obese: BMI of 30 kg/m² or higher

It's critical to remember that BMI is only one indicator of health condition; additional elements like age, gender, and muscle mass should also be taken into account. Furthermore, because body composition is not taken into account when calculating BMI, a person with a lot of muscle mass may have a high BMI while still being in good health. For a thorough assessment of a person's health situation, it is always advised to consult with a healthcare professional.

3. Visit your locality and identify 10 individuals who are suffering from diabetes mellitus. In a table record their name, age, gender and the food restrictions made by them in their diet. Analyse whether their diet is in accordance to dietary modifications suggested for diabetes.. (Refer to DNHE 1 Vol 2, Unit 21) (10)

Ans)

Simple dietary guidelines for diabetes include eating the healthiest foods in reasonable portions and maintaining regular mealtimes.

A healthy eating regimen that is naturally high in nutrients and low in fat and calories is known as a diabetes diet. Whole grains, fruits, and vegetables are essential components. Actually, the greatest eating strategy for the majority of people is a diabetes diet. The programme aids in controlling your blood sugar (glucose), weight, and risk factors for heart disease such high blood pressure and high blood fats.

Your body produces an unfavourable increase in blood glucose when you consume too many calories and fat. If blood glucose levels are not controlled, it can result in major issues, such as hyperglycaemia, which can cause long-term difficulties like damage to the heart, kidneys, and nerves if it persists.

Making smart meal selections and keeping track of your eating patterns will help you maintain a safe blood glucose level.

Losing weight has a variety of positive health effects and can help most persons with type 2 diabetes better control their blood glucose levels. A diabetes diet offers an organised, nourishing strategy to safely attain your weight loss goal if you need to do so.

4. Visit an Anganwadi functioning under ICDS programme in your neighbourhood. Write the name/age/gender of the beneficiary who came to the Anganwadi that day and services provided to them in that centre. Comment on the services followed, and not being provided. (Refer to DNHE 1 Vol 2, Unit 24) (10)

Ans)

These services are provided from Anganwadi centres established mainly in rural areas and staffed with frontline workers.

Supplementary Nutrition Programme (SNP)

In this section of the ICDS, mothers who are pregnant or nursing and children under the age of six are identified in the neighbourhood and given additional feeding and growth monitoring services. The recipients receive supplemental nourishment for 300 days. The programme aims to close the caloric gap between children and women in low-income categories and the average calorie intake by providing extra feeding.

Health & Nutrition Check-Up

This covers antenatal care for expectant women, postnatal care for nursing mothers, and healthcare for children under the age of six. Regular health examinations, deworming, weight monitoring, vaccines, and the provision of basic medications are among the services provided.

Immunization

The following preventable diseases are vaccinated against in children: diphtheria, polio, pertussis, measles, TB, and tetanus. Tetanus immunizations are provided to expectant mothers, which has decreased neonatal and maternal mortality.

Non-Formal Education for Children in Pre-School (PSE)

The ICDS scheme's foundation might be considered to be this section. The Anganwadi centres in rural and urban slums and villages house all of the scheme's services. This preschool education programme, which primarily serves children from disadvantaged backgrounds, aims to create and maintain a natural, happy, and stimulating environment with a focus on the essential elements for healthy growth and development. A key component of creating a solid foundation for cumulative lifelong learning and development is the ICDS' early learning component. It gives the kid the essential preparation for elementary schools and also relieves older siblings (especially girls) of the responsibility of caring for younger family members, allowing them to go to school.

Health and Nutrition Education

Women between the ages of 15 and 45 are covered for providing nutrition and health education under this component. The BCC (Behavior Change Communication) technique includes this. The long-term objective is to increase women's capacities so they can take care of their own health, nutrition, and development requirements as well as those of their families and children.