IMPORTANCE OF NUTRITION

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IMPORTANCE OF NUTRITION Mother Miracle Project
and Nutrition Education

• Rachel Peters - Dietitian

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My project

• To assess the nutritional adequacy of the diets
  of the children at Mother Miracle and to make
  recommendations that would improve their diets
• Adequate nutrition intake is important for good
  growth and health and also helps children perform
  better and concentrate at school

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Mother Miracle Project

• I have measured the height and weight of the
  children and compared to standard levels
• Most children (82.1) are growing well
• Almost 1 in 5 children show signs of being
  underweight or malnourished (18)
• 3 children appear to be close to being overweight
  for their age
• This is based on updated date of birth records
  and relies on accurate age for the child

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Mother Miracle Project

• I measured the difference in growth in children
  compared to the measurements taken by the
  dietitian in 2011 (53 children)
• Most children are growing well
• Only 1 out of 53 appeared to have only grown
  3.5cm in 2 years

Age Height Difference (cm) Percentage Growth since 2011 Weight Difference (kg) Percentage Growth since 2011
6-9 3.5 - 15.9cm 3.18 -14.65 4 - 10.1kg 22.63 -50.5
10-13 8.3 17.1cm 7.7 - 14.15 3.3 12.4kg 17.67 47
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Mother Miracle Project

• I have taken diet histories from the children to
  find out about their usual diet. I then analysed
  this to look at what nutrients they are low in.
• UGK to 3rd class 3 day diet history
• 5 had missed breakfast once, 15 had missed at
  least one evening meal
• 17.5 did not have vegetables at home in the
  past 3 days
• 42.5 did not have dahl at home in the last 3
  days
• 45 had fruit less than once per week
• 47.5 had milk less than twice per week
• 65 ate nuts once per month or less

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Mother miracle project

• 4th and 5th Class
• Asked about the frequency they eat a list of
  foods
• Analyzed for nutrients that are commonly
  inadequate in Indian diets
• Vitamin A. B12. C, D, iron, iodine, zinc, calcium
  and protein
• Found that most children were not meeting their
  recommended dietary allowance (RDA)

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Mother Miracle Project

• Results 4th and 5th class

Vitamin /Mineral Vit A µg Vit B12 µg Vit D µg Iron Mg Zinc mg Iodine µmol Calcium mmol Vit C mg Protein g
Intake range 81.28 - 723.55 0.14 - 3.53 0.07 -1.63 4.39 19.89 2.71- 12.91 0.17-6.11 104.98-1110.78 13.24- 105.26 16.65-94.82
Intake average 387.17 1.3 0.45 9.68 6.8 2.2 497.6 31.67 45.11
RDA (7-9, 10-12, 13 yrs) 600 0.2- 1 10 16- 32 8 - 11 0.95-1.19 600 - 800 40 29.5-54.3
No. not meeting RDA 32 16 37 36 35 12 36 31 13
Deficient under RDA () 86 43 No 97 95 32 97 84 35
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Recommendations

• Double fortified salt
• increase iron intake
• Consider providing children with a glass of milk
• Vitamin A, B12 and C, calcium, protein, zinc,
  iodine
• Vitamin A fortified oil
• Vitamin A and D
• Change frequency of vegetables
• Vitamin A rich vegetable at least 2/wk
• Vitamin C rich vegetable at least 2/wk
• Include soya bean in subji with vitamin C rich
  vegetable
• Include Nutrela (soya protein) 1/wk

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Mother Miracle Project

• Changes to childrens intake if recommendations
  are implemented

Vitamin /Mineral Vit A µg Vit B12 µg Vit D µg Iron Mg Zinc mg Iodine µmol Calcium mmol Vit C mg Protein g
Increased provision 81.28 - 723.55 0.14 - 3.53 0.07 -1.63 4.39 19.89 2.71- 12.91 0.17-6.11 104.98-1110.78 13.24- 105.26 16.65-94.82
increase meeting RDA 387.17 1.3 0.45 9.68 6.8 2.2 497.6 31.67 45.11
Children meeting RDA 600 0.2- 1 10 16- 32 8 - 11 0.95-1.19 600 - 800 40 29.5-54.3
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Hygiene

• Hygiene is very important to stay healthy and
  prevent disease
• Simple things to help improve hygiene
• Wash hands regularly with soap after toilet,
  before and after eating, before preparing food
• Wash vegetables and fruit thoroughly before
  cutting and eating
• Boil water and milk to kill bacteria
• Keep dairy, meat and fresh vegetables at less
  than 10oC (eg in fridge) where possible
• Filtered water
• Brush your teeth

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Water

• Many children reported having headaches often
• Some only had 2-3 glasses of water per day
• It is recommended to have at least 8 cups of
  water per day and more when it is summer time.
• Encourage the children to have regular intake of
  water during the day

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Nutrients studied

• Protein
• Vitamin A
• Vitamin B12
• Vitamin D
• Iron
• Zinc
• Iodine
• Calcium
• Vitamin C

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Protein

• Function
• Growth and repair, make new cells and hormones
• Sources
• Meat, dahl and beans, dairy, eggs, nuts and
  seeds, soya beans, wheat (eg roti)
• Important to have a variety
• Deficiency
• poor growth in children, poor immune system,
  weakness in strength, anaemia
• Higher risk in vegetarian and poorer communities

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Vitamin A

• Function
• Important for normal vision, particularly at
  night, helps strengthen immunity and important
  for health skin and gut lining
• Sources
• Cheese, eggs, milk,
• Deficiency
• Night blindness, bitot spots

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Vitamin B

• Group of 8 vitamins found in various foods
• B1, B2, B3, B5, B7 folate, B12
• B12 is common deficiency found in India
• Vitamin B12
• Function
• helps protects nerves, maintain mental ability,
  make red blood cells, make energy for the body
• Sources
• meat, liver, milk, cheese, eggs
• only found in animal based foods
• Deficiency
• fatigue, nerve damage, depression, weight loss

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Vitamin C

• Function
• Immune system, wound healing, important to keep
  organs and cells healthy and strong
• Sources
• Tomato, cauliflower, cabbage, potato, giant
  chilli/capsicum, citrus fruit (orange, lemon,
  lime, grapefruit), alma, guava, coriander leaves,
  agathi,
• Deficiency
• Poor immune system,
• Scurvy bleeding and swollen gums, red dots on
  skin, tiredness, muscle and joint pain

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Vitamin D

• Function
• Sources
• Eggs, powdered milk, fortified oil, oily fish
• The Sun!! The body creates Vitamin D when the
  skin is exposed to the sun.
• Deficiency
• Weak bones and decreased bone density, increased
  risk of osteoporosis in adulthood
• Increased risk in those who do not go outside
  often. Also, if the skin is covered up then you
  cannot produce Vitamin D

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Iron

• Function
• Creating heamglobin (blood), mental function,
  improve immune system
• Sources
• Red meat, legumes, soya beans, green leafy
  vegetables - Amaranth, bengalgram leaves,
  cauliflower greens and radish leaves
• Deficiency
• Anaemia 50-70 of the Indian population have
  anaemia and most is related to poor iron intake
• Feeling very tired, no energy, poor immune system

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Ways to improve Iron intake

• Eat foods high in Vitamin C at the same time to
  improve absorption
• Tomato, cauliflower (gaubi), cabbage (patta
  gaubi), fruit citrus, alma, guava
• Some foods reduce iron absorption and should be
  limited at meal time with iron rich foods
• Tea, coffee, chocolate, eggs, peppermint and
  chamomile
• Sprouting beans will help improve iron (and zinc)
  content

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Calcium

• Function
• Important for strong bones, muscle contraction,
  heartbeat
• Sources
• Dairy foods milk, cheese (paneer),
  yoghurt/curd, green leafy vegetables, soya bean,
  almonds (badam), fish eaten with bones
• Deficiency
• Poor growth, weak and soft bones that can break
  easily, bone pain, bone deformaties bowed legs,
  dental cavities

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Iodine

• Function
• Helps to make hormones that are important for
  metabolism and keeping cells healthy
• Sources
• Sea fish, milk, eggs, iodized salt, legumes,
  seaweed
• Important not to have too much salt as this will
  increase blood pressure
• Deficiency
• In children stunted growth, decreased
  intelligence, retardation
• Goitre enlarged thyroid, dry skin, hair loss,
  fatigue and slowed reflexes.

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Zinc

• Function
• Helps make new cells and enzymes, helps digest
  protein, fat and carbohydrate, wound healing
• Sources
• Dairy - milk, paneer, curd, cereal product
  (wheat) eg bread/chapati, meat, shellfish,
  legumes, nuts, tofu
• Deficiency
• Decreased immune system, diarrhea, decreased
  eyesight, taste, smell, poor memory

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Thank you!!!