Module 4

Maternal and Child Care Nutrition

Basic Concepts of Food and Nutrition

Session 1

Definitions

• Nutrition– Study of food and how the body uses it to be

healthy, socially active and economically productive

• Nutrients– Chemical substances present in food that

keep the body healthy, supply materials for growth and repair tissues and provoide energy for work and physical activities

Nutrients• Macronutrients

– Proteins, for growth and repair of body tissues– carbohydrates, main sources of energy (starch, sugar,

fiber)– Fats, essential nutrients and concentrated source of

energy; absorb, transport and store A,D,E,K• Micronutrients

– Vitamins: ADEK, B complex, vitamin C– Minerals: calcium, iron, iodine, zinc, fluoride– water

Three food groups

• Energy food (Go)– Rice and starchy food– Fat-rich food

• Body-building food (Grow)– Meat, fish, dairy, dried beans

• Regulating food (Glow)– Green and yellow leafy vegetables– Vitamin C rich food– Other fruits and vegetables

Balanced diet

Forms, causes and consequence of malnutrition

Session 2

Malnutrition

• Malnutrition is an abnormal condition of the body due to lack or too much intake of one or more nutrients

• Overnutrition results from an excessive food intake and lack of physical activity

• Undernutrition results from lack of one or more nutrients in the body

Evidence Based DirectInterventions to Prevent and Treat

Undernutrition

Promoting good nutritional practices

❑ breastfeeding ❑ complementary feeding for infants after the age of six months ❑ improved hygiene practices including

handwashing

Increasing intake of vitamins and mineralsProvision of micronutrients for young children

and their mothers

❑ periodic Vitamin A supplements ❑ therapeutic zinc supplements for diarrhea

management ❑ multiple micronutrient powders ❑ de-worming drugs for children (to reduce

losses of nutrients) ❑ iron-folic acid supplements for pregnant

women to prevent and treat anaemia ❑ iodized oil capsules where iodized salt is

unavailable

Provision of micronutrients through foodfortification for all:

❑ salt iodization ❑ iron fortification of staple foods

Therapeutic feeding for malnourished children with special foods

❑ prevention or treatment for moderate undernutrition ❑ treatment of severe undernutrition (“severe acute malnutrition”) with ready-to-use therapeutic foods (RUTF).

• Reference: Scaling Up Nutrition: What Will it Cost? Horton, et al 2009

MicronutrientDeficiencies

Session 3

Micronutrient Programs:

MicronutrientSupplementation

and Food Fortification

VADD Vitamin A Deficiency Disorder

IDD Iodine Deficiency Disorders

Micronutrient Malnutrition in the Philippines

IDA Iron Deficiency Anemia

Vitamin and Mineral Deficiency:Estimated Damage

• Approx. 40% to 60% of the nation’s 6-24 mo. old children at risk of disrupted brain development (iron deficiency)

• An est. 300,000 Filipino babies born each year w/ intellectual impairment caused by iodine def. in pregnancy.

• In countries where goiter rate is 10% or more (Phils. almost 15%), ave. national IQ lowered by as much as 10-15% points

•

Vitamin and Mineral Deficiency:Estimated Damage

• The deaths of >4,000 children each yr. from increased susceptibility to infection (VAD)

• Approx. 20% of children with lowered immunity leading to frequent ill health and poor growth (VAD)

• The deaths of est. 500 young Filipina women every year in pregnancy and childbirth (severe IDA)

• Approx. 10,000 Filipino infants a year at risk of death in the period immediately before or after birth (severe anemia in mothers)

Vitamin and Mineral Deficiency:Estimated Damage

• Approx. 4,000 severe birth defects annually, including infantile paralysis (folate deficiency)

• Suspected increase in deaths from heart disease and stroke (folate deficiency)

Strategies to Sustain Micronutrient Malnutrition

Elimination

2Improving Diet/Dietary Diversification The adoption of proper food & nutrition practices thru nutrition education & food production

Food FortificationFood Fortification The addition of essential micronutrients to widely consumed food product at levels above its natural state

3

1Micronutrient Supplementation The provision of pharmaceutically prepared vitamins & minerals for treatment or prevention of specific micronutrient deficiency

Our expectation is that…Su

pplem

enta

tion

Fortification

Diet Change

C

O

V

E

R

A

G

ETIME

Meals for the Sick and those with special needs in the Family

Session 5

If a person is sick…

• Poor appetite• Special foods required• Important for the person to meet increased

nutrient requirement• May be dehydrated• May be nauseated or may vomit

General rules on feeding when sick

• Increased fluid intake• Continued feeding• Vitamin C rich foods• Give small frequent feeding• Give easily digestible food