Dr.
Marzia Zaman Sultana
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Access to sufficient amounts of safe and nutritious
food is key to sustaining life and promoting good
health.
Unsafe food containing harmful bacteria, viruses,
parasites or chemical substances, causes more than
200 diseases – ranging from diarrhoea to cancers.
An estimated 600 million – almost 1 in 10 people in the
world – fall ill after eating contaminated food and
420 000 die every year, resulting in the loss of 33
million healthy life years (DALYs).
Children under 5 years of age carry 40% of the
foodborne disease burden, with 125 000 deaths every
year.
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Diarrhoeal diseases are the most common illnesses resulting from
the consumption of contaminated food, causing 550 million
people to fall ill and 230 000 deaths every year.
Food safety, nutrition and food security are inextricably linked.
Unsafe food creates a vicious cycle of disease and malnutrition,
particularly affecting infants, young children, elderly and the sick.
Foodborne diseases impede socioeconomic development by
straining health care systems, and harming national economies,
tourism and trade.
Food supply chains now cross multiple national borders. Good
collaboration between governments, producers and consumers
helps ensure food safety.
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Nutrition may be defined as the science of food
and its relationship to health.
Nutrient or food factor is specific dietary
constituents such as protein, vitamin and mineral.
Macro nutrients – proteins, fat, carbohydrate
Micro nutrients – vitamins, mineral
Others – water, fiber
Dietetics is the practical application of the
principles of nutrition which includes planning of
meals for the well and sick.
Good nutrition means maintaining a nutritional
status that enables us to grow well and enjoy good
health.
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Nutrition – what people eat – is known to be one of
the key factors influencing health.
If people eat healthily, they can avoid many
preventable diseases and can live longer lives
more free of illness.
Whereas health professionals can see clearly the
relationship between diet and health, most
people’s diet and food preferences are determined
more by –
• social, economic, climatic, geographical factors and by
religion and customs than by a concern for health.
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Many people do not have enough money to provide
themselves and their families with a healthy diet.
People can follow a balanced diet in many different
social and cultural contexts, even though they may eat
very different foods.
A healthy diet means that the amount and variety of
foods is adequate to provide the body with all the
nutrients required in adequate proportions.
Nutrition education, therefore, needs to consider all
these issues.
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No single nutrient is inherently good or bad, but the
proportion in which it is provided by the diet is
important.
In other words, no single food is enough – except
for breast milk for newborns – and a variety of
foods are needed in the diet.
The frequency with which they are part of the diet
is what makes the diet healthy or unhealthy.
Nutrition is important; the enjoyment of food is
essential.
Food and eating are important and powerful
expressions of cultural and social identity.
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A diet may be defined as the kinds of food on which a
person or a group lives.
A balanced diet is defined as one which contains a
variety of foods in such quantities and proportions that
the need of energy, amino acids, vitamins, minerals, fats,
carbohydrate and other nutrients is adequately met for
maintaining health, vitality and general well being and
also makes a small provision for extra nutrients to
withstand short duration of leanness.
Principles for constructing a balanced diet:
• Daily requirement for protein should be met, 15-20% of daily energy
intake
• Fat should be limited to 20-30% of daily energy intake
• Remaining 60-65% should be carbohydrate rich in natural fiber
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Nutrition is a major environmental influence in physical
and mental growth and development in early life.
Food provides the nutrients needed to –
• form and maintain body tissues (protein, iron and calcium),
• energy for physical activity and metabolism (fat and carbohydrate)
and
• nutrients for regulating body processes and immunity (vitamins and
minerals).
Studies support the theory that good nutrition contributes
to improving the wellbeing of children and their potential
learning ability, therefore contributing to better school
performance.
Good nutrition enables adequate growth and prevents
deficiency disorders.
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People’s food choices are influenced by:
• psychological factors;
• food preferences and dislikes;
• Uses and traditions;
• culture, social values, food symbolism,
• beliefs and religion;
• education; economic factors;
• aesthetic factors; age; physiology;
• mass communication and advertising;
• and family and friends
The family plays a major role in modelling children’s food
habits during the first years of life .
Most very young children cannot make their own food
choices. Their parents decide for them and prepare their
food.
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When children start school, they spend many hours at school
with friends and peers and often have a meal there.
At this stage, school becomes a major factor influencing
children’s eating behavior.
But young people also spend a lot of time watching television,
films and commercial spots, which often send out messages
related to food and nutrition or what an ideal body shape
should be.
Friends and peers become very important for adolescents
when they are looking for their own personal identity and
independence from the family.
The young adolescent needs to be accepted by the group.
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Diet and inadequate physical activity are related to the
development of chronic diseases like obesity,
cardiovascular disease, cancer etc.
Various studies show that the risk factors for these
processes, such as overweight or high levels of serum
cholesterol, start in early youth .
Obese children and adolescents tend to become obese
adults .
A healthy diet and physical fitness from early life will
probably positively affect health in adulthood by
potentially reducing chronic disease.
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Young age is a unique opportunity to develop dense,
strong bones, thus decreasing the risk of osteoporosis
by means of an adequate diet, especially a diet rich in
calcium, and physical activity.
In contrast, a diet rich in protein and salt increases the
chances of losing bone density in later life .
Osteoporosis is an important cause of disability in older
age.
Life expectancy for women than for men is increasing
and it should be strongly emphasized that this longer life
expectancy is healthy and free of disability.
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Iron deficiency anaemia is the most common
deficiency disorder, especially among children and
young girls, even in affluent societies.
Iodine deficiency and vitamin A deficiency are also
frequent in some regions. Vitamin D deficiency causes
rickets.
Malnutrition (Protein energy malnutrition)impairs
growth and mental development.
The promotion of a healthy diet and physical activity
during childhood contributes to –
• better mental, social and physical health during this stage of life,
• providing increased capacity to perform daily activities,
• also sets the basis for better health throughout the life course
• and therefore contributes to a longer life with a better quality.
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The prevalence of obesity in adults is 10–25% in most
countries in western Europe, but up to 40%in some
countries in the eastern part of the WHO European
Region .
Obesity rates are rising in many countries.
Obesity is related to a higher risk for the development
of chronic disorders such as
• cardiovascular diseases,
• high blood pressure,
• diabetes and
• some forms of cancer.
Reducing caloric intake and increasing physical activity
contributes to reducing the risk of obesity.
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A low-fat diet (especially low in animal fat) that is rich in
vegetables and fiber together with physical exercise can
decrease the risk of cardiovascular disease.
Cancer
The global effect of diet on cancer rates is evident.
In industrialized countries, cancer accounts for 25% of total
mortality. It has been suggested that 30–40% of tumours
among males and 60% among females are attributable to diet
.
As suggested by the European Code against Cancer , eating
plenty of fruit and vegetables can significantly reduce the risk
of cancer and probably also cardiovascular disease.
Physical activity contributes to avoiding overweight.
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Achieving and maintaining desired body weight and shape can
be very important for young people.
Unsafe weight-loss methods have been reported among girls as
young as 9 years in Europe.
Young people involved in certain competitive sports and dancing
are especially at risk for harmful weight-control practices.
Eating disorders are behavioral disorders characterized by
severe disturbances in eating behavior.
• Less eating – anorexia nervosa
• More eating – bulimia
• Abnormal eating – pica
These practices may lead to nutritional disorders and health
problems and even to death.
Enabling children to develop personal skills, a positive body
image and increased self-esteem can help to prevent eating
disorders. 7/15/2020
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Food is a potential source of infection and is liable to
contamination by microorganisms, at any point during
its journey from the producer to the consumer.
Food hygiene implies hygiene in the production,
handling, distribution and serving of all types of food.
The primary aim of food hygiene is to prevent food
poisoning and other food born illness.
Food born infections like typhoid, paratyphoid, food
poisoning, diarrhea, cholera, viral hepatitis, ascariasis,
amoebiasis, brucellosis etc.
Food born intoxication like lathyrism (khesari dhal),
botulism, aflatoxin, lead poisoning, pesticide residues
(DDT)
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Foodborne illnesses are usually infectious or toxic in
nature and caused by bacteria, viruses, parasites or
chemical substances entering the body through
contaminated food or water.
Foodborne pathogens can cause severe diarrhoea or
debilitating infections including meningitis.
Chemical contamination can lead to acute poisoning
or long-term diseases, such as cancer.
Foodborne diseases may lead to long-lasting disability
and death.
Examples of unsafe food include uncooked foods of
animal origin, fruits and vegetables contaminated with
faeces, and raw shellfish containing marine biotoxins.
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Salmonella, Campylobacter, and Enterohaemorrhagic
Escherichia coli are among the most common foodborne
pathogens that affect millions of people annually – sometimes
with severe and fatal outcomes.
Symptoms are fever, headache, nausea, vomiting, abdominal
pain and diarrhoea.
Examples of foods involved in outbreaks of salmonellosis are
eggs, poultry and other products of animal origin.
Foodborne cases with Campylobacter are mainly caused by
raw milk, raw or undercooked poultry and drinking water.
Enterohaemorrhagic Escherichia coli is associated with
unpasteurized milk, undercooked meat and fresh fruits and
vegetables.
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Listeria infection leads to unplanned abortions in
pregnant women or death of newborn babies.
Although disease occurrence is relatively low, listeria’s
severe and sometimes fatal health consequences
Particularly among infants, children and the elderly,
count them among the most serious foodborne
infections.
Listeria is found in un-pasteurised dairy products and
various ready-to-eat foods and can grow at
refrigeration temperatures.
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Vibrio cholerae infects people through contaminated water or food.
Symptoms include abdominal pain, vomiting and profuse watery
diarrhoea, which may lead to severe dehydration and possibly death.
Rice, vegetables, millet gruel and various types of seafood have
been implicated in cholera outbreaks.
Antimicrobials, such as antibiotics, are essential to treat infections
caused by bacteria.
However, their overuse and misuse in veterinary and human
medicine has been linked to the emergence and spread of resistant
bacteria, rendering the treatment of infectious diseases ineffective in
animals and humans.
Resistant bacteria enter the food chain through the animals
(e.g. Salmonella through chickens). Antimicrobial resistance is one of
the main threats to modern medicine.
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Norovirus infections are characterized by nausea, explosive
vomiting, watery diarrhoea and abdominal pain.
Hepatitis A virus can cause long-lasting liver disease and spreads
typically through raw or undercooked seafood or contaminated raw
produce.
Infected food handlers are often the source of food contamination.
Parasites:
Some parasites, such as fish-borne trematodes, are only
transmitted through food.
Others, for example tapeworms like Echinococcus spp, or Taenia
solium, may infect people through food or direct contact with
animals.
Other parasites, such as Ascaris, Cryptosporidium, Entamoeba
histolytica or Giardia, enter the food chain via water or soil and can
contaminate fresh produce.
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Prions, infectious agents composed of protein, are
unique in that they are associated with specific forms of
neurodegenerative disease.
Bovine spongiform encephalopathy (BSE, or "mad cow
disease") is a prion disease in cattle, associated with the
variant Creutzfeldt-Jakob Disease (vCJD) in humans.
Consuming bovine products containing specified risk
material, e.g. brain tissue, is the most likely route of
transmission of the prion agent to humans.
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Of most concern for health are naturally occurring toxins
and environmental pollutants.
Naturally occurring toxins include mycotoxins,
marine biotoxins, cyanogenic glycosides and toxins
occurring in poisonous mushrooms.
Staple foods like corn or cereals can contain high levels
of mycotoxins, such as aflatoxin and ochratoxin,
produced by mould on grain.
A long-term exposure can affect the immune system
and normal development, or cause cancer.
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Persistent organic pollutants (POPs) are compounds that
accumulate in the environment and human body.
Known examples are dioxins and polychlorinated biphenyls
(PCBs), which are unwanted by-products of industrial
processes and waste incineration.
They are found worldwide in the environment and accumulate
in animal food chains.
Dioxins are highly toxic and can cause reproductive and
developmental problems, damage the immune system,
interfere with hormones and cause cancer.
Heavy metals such as lead, cadmium and mercury cause
neurological and kidney damage.
Contamination by heavy metal in food occurs mainly through
pollution of air, water and soil. 7/15/2020
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A variety of terms have been used to define
the amount of nutrients needed by the body,
such as: optimum requirements, minimum
requirements, recommended intake,
recommended allowance, safe level of intake.
Among these the ‘recommended daily
allowance (RDA)’ has been widely accepted.
The recommended daily allowance is defined
as the amounts of nutrient sufficient for the
maintenance of health in nearly all people.
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BMI or body mass index is calculated by
measuring a person’s weight in kg and then
dividing by that person’s height in meter
squared (kg/m2)
BMI=weight in kg/height in m2
It is a tool to measure the nutritional status of
a person.
BMI range:
• <18.5 = under weight
• 18.5-24.9 = normal
• 25-29.9 = overweight
• 30-39.9 = obese
• >40 = extremely obese
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Jahid, weight=74 kg
Height = 5 feet 7 inch = (5X12+7)=67 inch=
(67X0.0254) M=1.7018 M= (1.7018)2 M2=2.896 M2
BMI=weight in kg/height in m2=74/2.896 =25.55
kg/m2
He is overweight.
He needs balanced diet with less calorie and regular
physical activity double amount.
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Policy-makers can:
Build and maintain adequate food systems and
infrastructures (e.g. laboratories) to respond to and
manage food safety risks along the entire food chain,
including during emergencies;
Foster multi-sectoral collaboration among public
health, animal health, agriculture and other sectors for
better communication and joint action;
Integrate food safety into broader food policies and
programmes (e.g. nutrition and food security);
Think globally and act locally to ensure the food
produce domestically be safe internationally.
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Food handlers and consumers can:
Know the food they use
• read labels on food package,
• make an informed choice,
• become familiar with common food hazards;
Handle and prepare food safely, practicing the WHO
Five Keys to Safer Food at home, or when selling at
restaurants or at local markets;
Grow fruits and vegetables using the WHO Five Keys
to Growing Safer Fruits and Vegetables to decrease
microbial contamination.
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