NUTRITION AND HEALTH (Open Course)

FTL 5D 03 Food & Health (2 Credits)

(Calicut University BSc Food Technology Syllabus)

Prepared by
Department of Food Technology
Christ college (Autonomous) Irinjalakuda

Teachers in Charge
Mrs. Ambily K M (Course Coordinator)
Mr. Binu George (Faculty)
Mrs. Sophia Rachel Kurian (Faculty)
NUTRITION AND HEALTH (Open Course)
FTL 5D 03 Food & Health (2 Credits)
SYLLABUS

Sl No TOPIC COURSE OUTLINE Hrs.

1. Introduction to Definition, Types and classification of 10
Food Food, Junk foods and Functional foods.
Nutritional composition of food-
Carbohydrates, Protein, Fat, Vitamins,
Minerals and Water. Food groups,
Sources of Food- Carbohydrates,
Proteins and fat. Recommended Dietary
Allowances of Nutrients. Types of Work
and energy requirements. Body Mass
Index.
2. Life style and Obesity, Diabetes, Cardio Vascular 8
Food related Diseases, Constipation, Intolerance –
diseases Lactose & Gluten, Chinese Syndrome.
3. Food Additives Definition, Importance in food 6
preparation, Functions of Food Additives
– Anti oxidants, Preservatives, Coloring
Agents, Flavors and Emulsifiers.
4. Food Definition, Common adulterants found in 6
Adulteration Food.

5. Food Allergens Common Food Allergens, Food 6

and Food poison Poisoning, Symptoms and Control,
Botulism, Staphylococcus, E coli and
Salmonella.
 Module 1. INTRODUCTION TO NUTRITION

The word nutrition originates from Latin word nutr – means to nurture or nourish. Nourishment
is essential to sustain life. The body needs energy from conception to death to carry-out vital
function such as breathing. Energy is a constant need of a human body.
“Nutrition is the science of food, the nutrients and other substances therein; their action,
interaction, and balance in relationship to health and disease; the process by which the
organism ingests, digests, absorbs, transports, and utilizes nutrients and disposes of their
end products. In addition, nutrition must be concerned which social, economic, culture and
psychological implication of food and eating”. -(Robinson.)
HEALTH – World Health Organization defines health as the “state of complete physical,
mental, and social well-being and not merely the absence of disease or infirmity.”
NUTRIENTS – Nutrients are the components in food that are essential for the body in
suitable amounts. These include proteins, fats, carbohydrates, vitamins, minerals and
water.
NUTRITIONAL STATUS – Nutritional status is the condition of health of the individual
as influenced by the intake and utilization. This can be determined by the medical and
dietary history, physical examination and through appropriate biochemical investigations.
MALNUTRITION – It is a condition resulting from a deficiency, excess or imbalance of
nutrients. It can be either undernutrition, which refers to a deficiency of calories and / or
one or more essential nutrients, or overnutrition, which refers to an excess of one or more
nutrients especially calories.
FOOD – Food is any edible material that supports growth, repair and maintains of the body.
Any edible substance that we consume to fulfill our daily requirement of nutrition is known
as food.
THE IMPORTANCE OF FOOD IN HEALTH AND DISEASE
The Role of Food
1.Promotes health and prevent diseases, and
2.Treats and controls disease conditions.

CLASSIFICATION OF FOOD
Foods can be classified in various ways
1.Classification based on Functions: -
Broadly speaking the nutrients perform three major functions
• Supplying energy
• Building body tissues
• Protect the body from infections and regulating body processes.

The nutrients that perform these functions in the body are:

➢ Supplying energy-carbohydrates and fats.
➢ Building body tissues-proteins.
➢ Protect the body from infection are regulate body processes-vitamins and minerals.

2.Classificassion based on Nutrients

Food can be classified on the basis of nutrients in two broad categories:
❖ Macronutrients
❖ Micronutrients
Macronutrients- are those nutrients required by the human body in larger amounts, such as
carbohydrates, proteins and fats.
 Micronutrients- are those nutrients required by the body in smaller amounts, such as vitamins
and minerals. The nutrients are the elements of nutrition. The functions of these nutrients are
discussed here briefly.
1.MACRONUTRIENTS
a. Carbohydrates
• It provides energy for performing work and sustaining body processes.
• Carbohydrates have a protein-sparing action so the proteins are used for their
principal action rather than for providing energy.
• Carbohydrate is also essential for proper breakdown of fat.
Carbohydrates provide starches and sugars and are the primary and preferred source of
energy. They are also stored in the body as glycogen or are stored in muscle tissues ana
liver. Carbohydrates should provide approximately 45 to 65 percent of the total kilocalories.
b. Fats
• Fats are concentrated source of energy. They provide more than double the energy
supplied by carbohydrates, i.e. 9 kcal per gram.
• Fats is present around the vital organs which protects them from damage and injury.
• Fats present under the skin prevents excessive loss of heat and keep the body warm.
• Dietary fat provides the satiety and increases the palatability of foods.
• Dietary fat supplies essential fatty acid to the body
• It plays an important role as a carrier of fat-soluble vitamin and aids in their
absorption
In a well-balanced diet, fat should provide not more than 20 percent of the total
kilocalories. Out of this approximately two thirds of this should come from unsaturated
fats (plant sources).

c. Protein
• The principal function of protein is sustaining growth and repair of body tissues.
 • As digestive enzymes, they help in digestion process
• As metabolic enzymes, they regulate chemical reaction in the body.
• Protein serves as carriers in transporting many substances from one part of the body
to another through blood.
• Antibodies are protein by natural and are a crucial link in a immune system.

The body is forced to draw the necessary energy from tissue protein if the supply of
fuel from carbohydrates and fats is insufficient. In a well-balanced diet, protein
should provide approximately 10 to 30 percent of the total kilocalories.

2. MICRONUTRIENTS

a) Vitamins

• B complex vitamins plays a crucial role in the metabolism of carbohydrates,

fats and proteins.
• Folic acid and vitamin B12 are indispensable in the formation of normal red
blood cells in the bone marrow.
• Sufficient amount of vitamin B12 and B6 are required for the proper
functioning of the tract and nervous system.
• Vitamin C plays a role in collagen formation.
• Vitamin C helps in the absorption of iron.
• Vitamin C is essential for wound healing.
• Vitamin C helps a person in stressful conditions.
• Vitamin C is an antioxidant.
• Vitamin A is needed for proper vision.
• Vitamin D is essential for bones.
• Vitamin D helps in the absorption of calcium.
• Vitamin D is essential for the deposition of calcium and phosphorous in
bones.
• Vitamin E is an antioxidant,
• Vitamin K helps in the blood coagulation.
Several vitamins function as coenzyme factors in governing chemical reactions in metabolism,
for eg, most of the B complex vitamins.
b) Minerals

• Calcium and phosphorous are closely associated. They are essential for the
development of bones and teeth.
• Calcium regulates the contraction and relaxation of muscles.
• Calcium plays a role in blood clotting.
• Phosphorous plays a role in phospholipids.
• Phosphorous helps in the formation of basic genetic material such as DNA
and RNA.
• Iron is involved in oxygen transfer.
• Iodine essential for thyroxine hormone.
• Sodium is essential fluid balance between extracellular and intracellular
fluids.
• Sodium regulates the PH of the body fluids.
• Sodium regulates muscle contraction.

c) Water and Fiber

Water and fiber are also considered as regulatory agents. In fact, water is the fundamental agent
to sustain life. It provides base for all metabolic processes. Similarly, dietary fiber helps regulate the
passage of waste from the body and influences the absorption of several nutrients.
Food Sources: -
Carbohydrates – Cereals like rice, wheat, ragi, bajra etc. Roots and tubers like tapioca, yam, potato
etc.
Proteins – Animal sources like meat, fish, egg, poultry and milk, curd etc.
Vegetable sources like soybean, peanuts, almonds, green gram, dal etc.
Fats – Visible fats like butter, ghee and vanaspati. Invisible fats like Cereals pulses, milk,
egg,
oilseeds etc. Animal sources – beef, pork, egg, milk, and lamb etc. Plant sources – Coconut oil,
rice bran oil, corn oil and sunflower oil.
Vitamins - Fruits and Vegetables.
Minerals -Fruits and Vegetables

FOOD GROUPS

According to Dietary guidelines for Indians by National Institute of Nutrition food are
conventionally grouped as:
1. Cereals, millets and pulses
2. Vegetables and fruits
3. Milk and milk products, egg, meat and fish
4. Oils & fats and nuts & oilseeds and sugars.

1.Food Groups Cereals and millets

• A staple food (rice, wheat, puffed cereals, ragi)

• 70%-80% of diet of the low-income groups (6K to 10K monthly income) in India
• Contain 6-12% of proteins
 • Source of B vitamins (thiamine, niacin, pantothenic acid and Vit B6)
• Contains mineral such as P and Fe
• Ragi is an exception - rich source of calcium (0.4%)
• Deficient in Vit A, D, B12 and C (exception: yellow maize - carotene/Provitamin A)

Food Groups Pulses

• Rich in proteins and supplement cereals effectively

• Contain 19-24% of proteins
• Source of B vitamins (thiamine, niacin, pantothenic acid and Vit B6) and minerals
• Deficient in Vit A, D, B12 and C
• Puffed pulses: puffed Bengal gram (chickpea)
• Tener pulses: green Bengal gram, green beans (contain fair amount of vit C)

Food Groups Nuts and oilseeds

• Rich in proteins and fat (Soybean)
• Contain 18-40% of proteins
• Source of Vit B, Vit E and minerals like P and Fe
• Sesame seeds are rich in calcium
• Used as a milk substitute for infants over 6 months
• Deficient in Vit A, D, B12 and C

2.Food Groups Vegetables

• Broadly divided into 3 groups

1. Green leafy vegetables 2. Roots and tubers 3. Other vegetables

. Food Groups Vegetables: Green leafy vegetables

• Rich in sources of carotene (pro vit A)
• Source of calcium, riboflavin, folic acid and vitamin C
• 100g for adults and 50g for children – for optimum carotene, folic acid and vit C
• Cheapest and easily available among protective foods
 Food Groups Vegetables: Roots and tubers
• Potato, sweet potato, tapioca, carrot, elephant yam and Colocasia
• Good source of carbohydrate
• Poor source of proteins (exception: Potato)
• Carrot and yellow sweet potato are good source of carotene
• They should not be used to substitute cereals since they lack protein

Food Groups Fruits

• Good source of Vit C

• May also contain carotene (Mango and papaya)
• Amla and guava are rich in vit C
• tomato, citrus fruits, cashew fruit, pine apple are sources of carotene
• Apple, banana and grapes are poor sources of Vit C

3. Food Groups Milk, Meat, Fish, Egg

• Rich in proteins • 1 liter cow milk: 35g protein, 35g fat, 1g calcium, 1.5mg riboflavin, 1500
I.U of Vit A and Vit B and other minerals • Buffalo milk had higher fat content than cow’s
milk • Deficient of iron, Vit C and D Full fat milk powder Skimmed milk powder • 8 times rich
than milk from cows milk containing 26% proteins and 26% fat • Used in place of fresh milk •
prepared from fat free milk, no fat and no vit A • 35% proteins • 10 times rich than skimmed
milk • Can supplement diet of children (not for infants)

Food Groups Eggs • Hens Egg: 13% protein and 13% fat • Rich in Vit A • Source of Vit D (no
vit C) • Duck: 12% protein, devoid of fat and Vit A • Egg Yolk: 15% proteins, 27% fat, Vit A
• Used as a supplement to diets of infants

Food Groups Meat, Fish and other animal foods Meat • Protein rich: 18-22% • Vit B, (No vit A,
C, or D) Fish • Rich in protein • Vit B, Vit A and D • Large fishes: Phosphorus, deficient in
calcium • Small Fishes: Rich in calcium Liver • Rich in proteins • Vit D, A, B complex • Richest
source of Vit B12
4. Food Groups Fats and oils and Sugars

• Contains essential fatty acids • Vit A and Vit E Sugar and other carbohydrates foods •
Cane sugar, Jaggery, honey, syrup • Primary sources of energy Condiments and spices •
They are not essential part of nutrition • Spices like turmeric, ginger, garlic, cumin and
cloves are rich in antioxidants.

BALANCED DIETS

What is Balanced Diet

• A balanced diet is one which provides all the nutrients in required amounts and proper
proportions It can easily be achieved through a blend of the four basic food groups.
The quantities of foods needed to meet the nutrient requirements vary with age,
gender, physiological status and physical activity.

• Should provide around 50-60% of total calories from carbohydrates, preferably from
complex carbohydrates • about 10-15% from proteins and 20-30% from fat. • should
provide other non-nutrients such as dietary fiber, antioxidants and phytochemicals •
Antioxidants such as vitamins C and E, beta-carotene, riboflavin and selenium protect
the human body from free radical damage. • Other phytochemicals such as
polyphenols, flavones, etc., also afford protection against oxidant damage.

FOOD GUIDE PYRAMID

A food pyramid or diet pyramid is a triangular diagram representing the optimal

number of servings to be eaten each day from each of the basic food groups. The first
pyramid was published in Sweden in 1974. WHO and FAO, published guidelines that
can effectively be represented in a food pyramid relating to objectives to prevent
obesity, chronic diseases and dental caries based on meta-analysis though they
represent it as a table rather than a "pyramid”
RECOMMENDED DIETARY ALLOWANCES (RDA)
In order to maintain good health and physical efficiency, adequate amount of all nutrients must be
provided daily to the body. The recommended dietary allowance that exists today is a result of
thousands of investigations in research laboratories. The knowledge of daily requirement is essential
for planning balanced diets. The RDAs for Indians were developed by Indian council of medical
research (ICMR). It was set-up in India in 1944 for the first time. Since then, it has been revised
number of times and published by “National Institute of Nutrition”, ICMR, Hyderabad, as new
research data have become available.
RDA is defined as the average daily dietary intake level that is sufficient to meet the nutrient
requirement of hearty all health individuals in a particular life stage and gender group.
Uses of RDA
1.It is a useful tool to evaluate the adequacy of the national food supply and to set goal for food
production.
2.It can be used for setting standards for menu planning for government aided nutrition programs
3.It is used to interpret the adequacy of diet in experiments where food consumption is involved.
4.It is used for developing nutrition education material such as food guides etc.
5.It is used to set the dietary pattern in the hospital which may be normal diet or modified diet.
6.It is used in labeling foods by the manufacturers to give nutrition facts of their products.
7.It is used for setting guidelines for the formulation of new products or the fortification of specific
foods.
Factors Affecting Recommended Dietary Allowances
1. Age – An infant requires more protein and energy per kg of body weight and as he/she grows
the requirement slightly decreases. This is due to the higher BMR in infants as compared to
older adults.
2. Sex – During adolescent years, girls require more iron than boys due to menstruation.
3. Physiological Condition – Nutritional requirements during pregnancy and lactation are
increased because the mother has to meet the nutritional demands of the growing fetus.
4. Activity level – A person leading a sedentary lifestyle requires less calories than the person
who is a moderate or heavy worker.
5. Body size – A person who has a larger surface area needs more calories than and a thin and
small frame.

BODY MASS INDEX (BMI)

Body mass index is a simple index of weight-for-height which is frequently used to indicate
obesity overweight in adult.
BMI = weight (kg) / height (meters)2

Classification of overweight and obesity

 JUNK FOOD
Junk food is an informal term applied to some foods that are perceived to have little or no
nutritional value (containing "empty calories"), or to products with nutritional value but which
also have ingredients considered unhealthy when regularly eaten, or to those considered
unhealthy to consume at all.

FAST FOOD, JUNK FOOD, STREET FOOD

. FAST FOOD -Term given to food that is prepared and served very quickly. -Typically, the
term refers to food sold in chain of fast-food restaurants

STREET FOOD -Obtained from a cart, truck parked on a street, temporary stands at market
places/ fairs -Strong cultural ties. -At times it can be fresher and healthier. -Made from local
ingredients. Like samosas, mommos, chats etc.

WHAT JUNK FOOD CONTAINS?

Saturated fat, sugar & salt.
Little or no fruit, vegetables, or dietary fiber.
Little proteins, vitamins and minerals
Includes highly processed food items.
 Common junk foods include salted snack foods (chips, crisps), candy, gum, most sweet
desserts, fried fast food and carbonated beverages (sodas) as well as alcoholic beverages,
popcorns, pizzas, burgers, hamburgers.
Depends on ingredients and preparation method

WHY JUNK FOOD IS LIKED?

Time factor-easy to prepare/ being served at door hot and ready to eat/ when in hurry. Taste
factor-influences one to opt it. Great taste it has owing to lavish use of oils, salt, sugar.
More appealing /attractive to children
A lot is spent by companies in advertising
For companies/restaurants they are cheap to make, easy to handle, easy to store, stock and
sell, has extended shelf life.
EFFECT OF JUNK FOOD ON HEALTH

• LACK OF ENERGY AND FATIGUE-This is known as a short-term adverse effect

resulting from eating junk foods. As it doesn't provide you with essential nutrients, even
though they can be very much sufficing, you feel weakened.
• LACK OF CONCENTRATION- These are traced to affect in immediate and medium-
term periods. When you have a junk meal rich in oil you feel drowsy and fail to concentrate.
Over due course of time, blood circulation drops due to fat accumulation. Lack of vital
oxygen, nutrients and proteins particularly can stale your brain cells temporarily.
• HEART PROBLEMS- Junk food is a major cause of heart diseases. - Myocardial
infarction -Hypertension -Atherosclerosis -Peripheral vascular diseases -ischemic heart
diseases
• HIGH CHOLESTEROL LEVEL- Apart from forming plaques and constricting arteries,
cholesterol also affects liver where it is metabolized. High cholesterol from junk food and
diet strains liver damaging it eventually. This is a long-term effect.

• OBESITY- -Occurs as more fat, carbohydrate, processed sugar, and less fiber is
consumed. Also, extra calories per day, leading to extra pounds additional gain in wt. /year
-Increases risk of other diseases.

• DIABETES- -Increases insulin levels -Chronically insulin resistance develops and type 2
diabetes sets in. -Increasing incidence in teenagers.

• NUTRIENT DEFICIENCIES- Vitamin deficiencies -Anemia -Osteoporosis

• DEPRESSION- -Hormonal changes at puberty make teens susceptible to mood swings and
behavioral changes. A healthy diet keeps the hormonal level on an even whereas junk food
fails.

• GASTROINTESTINAL EFFECTS- -Nausea, vomiting, diarrhea, constipation, bloating

of stomach, Lack of appetite, stomach ache and peptic ulcers
 FUNCTIONAL FOOD

The term 'functional food' was born in Japan. Functional foods are actually products
formulated with naturally occurring chemicals or a combination of these. They are found
in many fruits, vegetables, grains, herbs and spices to provide a health benefit, lower the
risk of certain diseases or affect a particular body process. To be precise, these are the food
substances, beyond basic nutrients that are designed to lower the risk or delay the onset of
certain diseases.
The Japanese were the first to observe that food could have a role beyond nutrient supply.
Thus, a functional food must be a food and not a drug.
‘Functional foods are:
• conventional foods- everyday foods consumed as a part of the normal diet;
• composed of naturally-occurring components, sometimes in increased
concentration or present in foods that would not normally supply them;
• scientifically demonstrated to promote positive effects on target functions beyond
basic nutrition;
• thought to provide enhancement of the state of well-being and health in order to
improve the quality of life and reduce the risk of disease;
• They are food (not capsules, pills (powder) on the basis of naturally occurring food
components.

They have a defined function on the human organism to: -

• improve immune function, -
• prevent specific disease, -
• support recovery from specific diseases, -
• control physical and psychic complaints, and –
• slow down the ageing process.
 Functional Food is a Natural or processed food that contains
known biologically-active compounds which when in defined quantitative and
qualitative amounts provides a clinically proven and documented health benefit.

Functional foods as nutraceuticals Nutraceuticals are

functional foods which not only provide mere health benefits but helps in effective
prevention and treatment of different diseases.
Nutraceuticals have been claimed to have a physiological benefit or provide protection
against the following diseases: -
 Cardiovascular agents
 Anti obese agents
 Antidiabetics
 Anticancer agents
 Immune boosters
 Chronic inflammatory disorders
 Degenerative diseases

Examples of functional foods and nutraceuticals: wheat, barley, buckwheat, oat, brown
rice, lycopene (tomato), allicin (garlic), curd, yogurt
 MODULE.2. LIFESTYLE AND FOOD RELATED DISEASES

DIABETES-MELLITUS
Diabetes-Mellitus is a chronic metabolic disorder that prevents the body to utilize glucose
completely or partially. It is characterized by elevated blood glucose levels caused by defective
insulin secretion, insulin action or both. Metabolism of carbohydrates, proteins and fats are also
altered. A person with diabetes does not produce or respond to insulin. Insulin is a hormone
produced by beta cells of the pancreas. It is essential for the use or storage of body fuels.
Ineffective insulin causes hyperglycemia (elevated blood glucose). This condition can lead to
both the short term and long-term complications of diabetes mellitus. Uncontrolled diabetes can
damage the heart, blood vessels, kidneys (nephropathy), eyes(retinopathy), and
nerves(neuropathy). Along with other modes of treatment, diet control plays an important role
and can make it possible to lead a normal life in spite of having diabetes. The diabetic diet must
be as close to the normal diet as possible so it meets the nutritional requirements. Diabetes can
be controlled by diet and the exercise alone or by diet, exercise and medication.

SYMPTOMS
Early Symptoms:
Polyuria (Increased urination)
Polydipsia (Increased thirst)
Polyphagia (Increased hunger)
Weight loses in IDDM and obesity in NIDDM

Advanced symptoms:
Hyperglycemia (elevated blood sugar)
Glycosuria (sugar in the urine),

CLASSIFICATION
Type 1(Insulin Dependent Diabetes Mellitus-IDDM)
It is also known as juvenile onset diabetes patients depend on insulin. There is usually sudden
onset and occur in the younger age group and there is an inability of pancreas to produce adequate
amount of insulin. This may be caused by virus or due to autoimmunity.

Type 2(Non-Insulin Dependent Diabetes Mellitus-NIDDM)

It is also known as adult-onset diabetes mellitus. Insulin may be produced by pancreas but action
is impaired.
Type 3(Malnutrition Related Diabetes Mellitus-MRDM)
Generally, people with MRDM are lean and under nourished. In this type of diabetes, the pancreas
fails to produce adequate insulin.
Type 4 (Gestational Diabetes Mellitus – GDM)
Presence of diabetes mellitus during pregnancy period.

Management of diabetes
The main modes of treatment of diabetes are
1.Diet -Small Frequent diet pattern

Principle of the diet

Restricted carbohydrate, adequate protein, low fat, high vitamins and minerals, high fiber and
liberal fluid.
The percentage distribution of total calories from carbohydrates, protein and fat:
Carbohydrates – 60 to 65 %
Protein – 15 to 20 %
Fats – 15 to 25 %
Foods to be included
Green leafy vegetable, other vegetable, low calorie fruits like apple, gua, orange, lemon, pulses,
fish, skimmed milk, salads, soups. Wholegrains, egg white, lean meat almonds
FOOD TO BE AVOIDED
Simple sugars like glucose, honey, fruit syrup, sweet, dry fruits, banana, jackfruit, mango, grape,
jaggery, roots and tubers, juices, alcohol, coconut water, all sweened bakery items, nuts.

2.Drugs – Tablets and Insulins

3.Exercise
Exercise plays an important role in facilitating a good control of diabetes. In addition to
strengthening and toning up the muscles, it consumes more energy derived from blood
glucose and sensitises the tissues to the action of insulin, which helps in keeping the blood
glucose in a lower range. Walking, bicycling, swimming and jumping rope are good
examples of exercise. In addition, exercise is known to reduce stress and strain and enhance
the quality of life.
4.Education
An adequate base information on diabetes enables the diabetic to comprehend and
improve their psychological acceptance of the disease. In addition, the importance of
following the doctor’s instructions regarding diet, exercise and drugs should be
explained.

Diabetics should be aware of the importance of

 • Monitoring urine and blood sugar and serum lipids at regular intervals to ensure overall
well-being.
• The principles of dietary modifications.
• Complications and preventing methods

OBESITY

Obesity is a clinical term that can be defined as generalized accumulation of fat in the body. A
person who is 20 to 30 percent or more above the standard weigh is referred to as obese. The
HWO defines “overweight’’as a BMI equal to or more than 25 and “obesity” as BMI equal to or
more than 30.
CAUSES
Genetic factor
Age and sex
Eating habits
Physical activity
Stress
Endocrine factor
Trauma
Prosperity and civilization
ASSESSMENT
BODY MASS INDEX (BMI)
Body mass index is a simple index of weight-for-height which is frequently used to indicate obesity
overweight in adult.
BMI = weight (kg) / height (meters)2
Classification of overweight and obesity
Classification BMI kg/m2
Underweight <18.5
Normal 18.5-24.9
Normal weight 25.0-29.9
 Obesity class I 30.0-34.9
Obesity class II 35.0-39.9
Extreme obesity III 40

TYPES
Grade I obesity: These people have body mass index more than 25 but less than 29.9. Over-
weight does not affect their health, they lead normal health and life expectancy is above normal.
They may reduce on their own.
Grade II obesity: The body mass index is between 30-39.9. These patients should be treated by
doctors and dietitians. For mechanical and metabolic reason these patients are at increase risk of
diabetes, atherosclerosis, hypertension, fatty, liver, gall bladder diseases, osteoarthritis, hernias
and varicose veins. mortality rate also increases.
Grade III obesity: The body mass index is above 40 and these patients are in pathetic condition.
Their day-to-day activity are restricted due to their enormous mass and susceptible to diseases
mentioned in grade II. They are susceptible to atherosclerosis, prone to accidents and have serious
psychological disturbances.
STRATEGIES OF WEIGHT LOSE AND MAINTANENCE ARE
• Diet therapy
• Physical exercise
• Stress management
• Pharmaco therapy
• Weigt lose surgery
PRICIPLES OF DIETETIC MANAGEMENT
Low calorie, normal protein vitamin and minerals (except sodium), restricted carbohydrate,
restricted fat and liberal fluid, high fiber diet are given in such cases.
ENERGY. About 20 kcal per kg ideal body weight is prescribed for a sedentary worker and 25
kcal for moderately active worker.
PROTEINS. About 0.8-1 gm of protein/kg body weight is prescribed for tissue repair and for
specific dynamic action.
CARBOHYDRATE. High carbohydrate content foods like potatoes and rice are restricted.
Sugar which gives empty calories should be totally avoided. Fruits rich in carbohydrate like
banana should be avoided.
FAT. Low fat or no fat diet should be given as calories are reduced. Foods rich in fat-like nuts
and oilseeds avoided. Skim milk should be the choice.
VITAMINS. With prolonged restriction of fats, there is likely to be a restriction of fat-soluble
vitamins A and D which may be supplemented.
MINERALS. Restriction of sodium as common salt is helpful in weight reducing diet as access
sodium predisposes to retention of fluid. Research suggests that a calcium rich diet especially one
that includes dairy sources (with limit in total calories) not only helps young women keep weight
in check but may reduce overall levels of body fat. Calcium may depress certain hormones which
consequently improves the body’s ability to break down fat in cells and slow fat production.
• FLUID. Fluids can be take an liberally as extra are excreted by healthy kidneys. Also a
glass of water before meals helps to cut down food intake.
• HIGH FIBRE. High fibre low calorie food like green leafy vegetables, fruits, vegetable
salads, whole grain cereals and pulses can be included in the diet. Inclusion of high fibre
in diets for obese has many advantages.

There are; -
1. Low in calorie density.
2.Foods like greens provide many vitamins and minerals (which are difficult to meet with
restricted food)
3. Give satiety.
4. Help in regulating bowel movements.
5. Reduce blood cholesterol.
6. Promote chewing and decreases rate of ingestion. Higher intake of fiber automatically
cut down fat and calories.

TREATMENT OF OBESITY

➢ Diet therapy
➢ Physical exercise
 ➢ Stress management
➢ Pharmacotherapy
➢ Behaviour therapy
➢ Surgery
Important Tips to Remember
1.Avoid snacks between the meals
2.Drink water before meals
3.Choose whole grain cereals over refined cereals
4.Always choose chapatis over puries and paratthas
5.Always choose skimmed milk over whole milk or butter
6. Include high fibre foods
7. Exercise should be the part of daily life
8. Check your weight after every 15 days
9. Breakfast should not be skipped
10.Include more low-calorie fruits and vegetables
11.Include vegetable salads
12.Avoid too much sugar, oil and salt
13. Avoid fruit juices, squashes and carbonated beverages
14. Avoid junk foods
15.Avid Alcohol and tobacco
CARDIOVASCULAR DIESEASES
Heart disease affects people of all ages, but is most frequent in middle age and is most often
caused by atherosclerosis. Disease of the heart may affect the pericardium, myocardium or
endocardium. In addition, the blood vessels within the heart, leaving the heart or the heart valves
may be diseased. In atherosclerosis the valves of small arteries become thickened to ageing or
due to hypertension.
TYPES
Coronary artery diseases, hypertension, hypercholesteremia, heart attack etc...
PRINCIPLE OF THE DIET
Low calorie, low fat, particularly low saturated fat, low cholesterol, high in PUFA (omega 3 and
omega 6), low carbohydrate and normal protein, minerals and vitamins are suggested. High diet
is also recommended. Sodium should be restricted.
DIETARY MODIFICATIONS
• Patient should maintain slightly lower than the standard weight. Accordingly total calories
should be restricted.
• The diet should be rich in fiber by including foods like raw salad, fruits, green leafy
vegetables and whole grains.
• Five servings of fruits and vegetables should be included in the diet not only to meet the
nutritional requirement but also to meet antioxidants and fiber.
• Vegetable oils rich in poly unsaturated fatty acids like sunflower oil and safflower oil
should be included in the diet.
• Inclusion of fish in the diet is beneficial as they contain omega 3 fatty acids
• Concentrated foods like sweets, chocolate cakes, pastries, ice creams and fried foods
should be restricted pr preferably avoided.
• Foods giving only empty calories like carbonated beverages, alcohol, sugar are totally
avoided.
• Small quantities of almonds can be consumed to bring down the cholesterol levels.
• Egg yolk contains cholesterol. It should be limited in the diet.
• Coconut should be avoided in the diet as it contains high amount of saturated fatty acids.
• Coffee and tea can be taken in moderation. Excess amount of caffeine increases the heart
rate
• To restrict sugar intake, artificial sweeteners can be included in the diet.
• Animal foods like meat and pork which contain high amount of saturated fat should be
avoided. Intake of shell fishes should be limited. All sea foods are rich in sodium.
• Foods that have hypocholesterolmic effects like fenugreek, garlic, turmeric should be
included in the diet.
• Constipation should be prevented by including plenty of water and fiber in the diet.
• Heavy meals should be avoided. Small and frequent meals are preferred.
 • If the patient is suffering from hypertension sodium should be restricted.
HYPERTENSION
Hypertension is a common public health problem all over the world, especially developed
countries. If left un treated, it can lead to many degenerative diseases, and peripheral vascular
diseases, such as congestive heart failure, end-stage renal diseases, and peripheral vascular
diseases. Hypertension is the elevated blood pressure. Normal value – 120/80 mm Hg.It is
often known as a ‘silent killer’ because hypertensive people may be asymptomatic for years
and then suddenly have a fatal stroke or heart attack. Since there is no cure it, prevention and
management decrease the incidence of hypertension and the diseases that may follow.
Causes
• Fluctuation in blood pressure
• Family history of hypertension
• Overweight
• Excessive salt consumption
• Sedentary lifestyle
• Excess alcohol consumption
• Stress
• Low K,Mg and Ca intake
Symptoms
Many persons with hypertension have no symptoms. Headache, dizziness, impaired vision,
failing memory, shortness of breath, pain over the heart gastrointestinal disturbance, unexplained
tiredness are some of the symptoms.
Lifestyle Modifications
• Weight reduction for obese people
• Limit alcohol in take
• Increase physical activity
• Reduce sodium in take
• Take adequate amount of dietary potassium
• Stop smoking
• Reduce in take of dietary saturated fat and cholesterol
Principles of Diet
Low calorie, low fat, low sodium diet with normal protein intake is prescribed.

Foods to be Avoided
• Salted foods such as salty chips, popcorn, chutneys, sauces, papads, all foods canned in
brain
• All fried snacks such as samosas, pakoras, Vada and puries, etc
• Salted butter and processed cheese
• Baked foods containing baking powder
and baking soda
• Food containing MSG (mono sodium glutamate)
• Sea fish, luncheon meats, bacon, sausages, etc.
• High sodium vegetables, etc.

Helpful Tips for Hypertension people

• Use limited amount of salt during cooking avoid adding extra salt at the table
• Use limited amounts of animal foods as they contain sodium. Add fruits and
vegetables in daily diet which provide much needed vitamins and minerals.
• Use cooking methods which require less amount of oil. May use non-stick pans
to do so. Prepare foods by baking, broiling, steaming and boiling.
• Avoid the use of baking power and baking soda in cooking.
• Read food labels to check the amount of sodium/sodium chloride in them.

CONSTIPATION
 Digestive disorders are among the most common in healthcare. Dietary habits and specific
food types can play a significant role in the onset, treatment and prevention of many GI disorders.
In many cases, diet can also play a role in improving patients sense of wellbeing.
Constipation may be defined as less than 3 motions per week or as difficult or painful
defecation this condition, hypermotility of the sigmoid colon increases resistance to movement
of intestinal contents -consequently, there is distention and infrequent or difficult evacuation of
feces from the intestine. An accurate definition is related to personal habits since the frequency
of bowel movements varies greatly among individuals.
Infrequent or insufficient emptying of the bowel may lead to headache, abdominal
discomfort, coated tongue, vomiting tendency and lack of appetite.

DIETARY MANAGEMENT
The intake of dietary fiber should be increased by eating whole cereals and increasing
consumption of fruit and vegetable. The most important factor is the water-holding capacity of
the fiber. Coarse bran has a capacity of 6g water /g of fiber, but fine bran holdsonly2-3g water/g.
Patients should be encouraged to take coarse bran as a breakfast cereal. One tablespoon of bran
may be taken in the first week and two thereafter. The bran may be made more palatable by
adding cooked fruits. Fruit and vegetable whose fiber hold waters effectively are orange, apple,
carrot and the cabbage family. The diet should contain a helping of vegetables particularly in raw
form and two such fruits each day preferably with skin and seed. Whole grain breads and cereals
should be substituted for refined ones.
A fluid intake of 8 to 10 glasses a day is useful in keeping the intestinal contents in a
semisolid state for easier passage along the tract. They can also include 1or2 glasses of hot or
cold water, plain or with lemon, are helpful in initiating peristalsis when taken before breakfast.
Many laxatives are available, but it is not good for daily use. Worry, anxiety, fatigue should be
avoided. Regular toilet training is important to overcome the constipation.

LACTOSE INTOLERANCE
The milk sugar lactose is digested by infants and children by the enzyme Beta -glucosidase.
Lactose is supposed to enhance calcium absorption in children. However, the activity of this
enzyme decreases in adults which results in a poor tolerance of milk.
Lactose intolerance can lead to bloating, cramps, flatulence and diarrhoea after taking milk and
milk products.
Small quantities of dairy foods with 10-15gms of lactose can be taken rather than large amounts
at one time. Dairy foods can be had with meals rather than between meals. Curd and butter milk
may not produce any discomfort to the patient. Lactose free and lactose reduced milk, cheese and
ice cream can be consumed if available. Lactase tablets can be taken along with high lactose food.

CELIAC DISEASE
Celiac disease, often called gluten- sensitive enteropathy. It is caused by a reaction to gliadin.
The resulting damage to the villi of the intestinal mucosa results in potential or actual
malabsorption of virtually all nutrients.
The most common symptoms in children 6 months to 3 years of age are diarrhoea, growth failure,
vomiting, a bloated abdomen and stools that are abnormal in appearance, odour and quantity.
Adults may experience weight loss despite increased appetite, weakness and fatigue. They may
also suffer from anaemia and osteopenic bone disease.
Complete withdrawal of gliadin from the diet results in prompt clinical improvement. During the
first few weeks of gliadin omission the diet should be supplemented with vitamins, minerals and
extra protein to remedy deficiencies and replenish nutrient stores.
In gliadin – free diet, wheat, oats, rye, and barley are excluded. Products made from rice, corn,
potato, tapioca, soyabean, arrowroot and millets can be included in the diet.
 CHINESE RESTAURANT SYNDROM
Introduction
MSG was discovered in 1908 at Tokyo Imperial University. • This led to the discovery of the
umani flavour, and the source of that flavour was MSG. • It is naturally occurring in seaweed.
• It is synthesized, and the process used now is fermentation using ammonia and sugar beets
to produce amino acids, then add salt to produce MSG.

What MSG Is Used For. • MSG is used as a flavour enhancer, because of its abilities to
enhance the flavour in foods.
Benefits • Increasing the flavour in foods. • Allowing the use of less salt in foods.
Risks • Many common side effects such as, burning in arms face or chest, headaches, chest
pains, heart palpitations, weight gain, difficulty breathing (especially in asthmatics) • Serious
side effects such as brain damage, temporal paralysis around mouth, reproductive issues, sleep
disturbances.

Chinese restaurant syndrome: A syndrome first described in 1968 in people who had eaten
Chinese food on which MSG (monosodium glutamate) had been lavished. The syndrome only
seems to occur in some people. Their symptoms may include headache, throbbing of the
head, dizziness, lightheadedness, a feeling of facial pressure, tightness of the jaw, burning or
tingling sensations over parts of the body, chest pain, and back pain. Large amounts of MSG may
cause arterial dilatation (widening of arteries). Many Chinese do not believe in the existence of
the Chinese restaurant syndrome. It may be a hypersensitive (allergic) reaction.

MSG is a sodium salt of the amino acid glutamic acid that enhances the flavor of certain foods.
Originally isolated from seaweed, MSG is now made by fermenting corn, potatoes and rice. It
does not enhance the four basic tastes (bitter, salty, sour, sweet) but it does enhance the complex
flavors of meat, poultry, seafood, and vegetables. MSG is an important ingredient in the cuisines
of China and Japan and is used commercially worldwide in many types of foods. It is naturally
present at high levels in tomatoes and Parmesan cheese. In China, MSG is known as wei jing,
which means flavor essence.
Chinese Restaurant Syndrome (CRS) During that time, there is no comment on the FDA
regarding to the MSG as a safe food additive (GRAS). Until 1968, Dr. Robert Ho Man Kwok,
become the first one to produce a published report on the reaction of MSG in the body. He
described the symptom he experienced a few minutes after he eating Chinese cuisine which were
numbness of the back and neck, feeling pressure in the face and upper chest muscle. He called
this collection of symptoms as “Chinese Restaurant Syndrome”. This syndrome is also called as
„Hot dog headache‟, „Glutamate induced asthma‟ or MSG syndrome .MSG was felt to be the
cause of these symptoms. However, many studies have failed to show a connection between MSG
and the symptoms that some people describe after eating Chinese food. For this reason, MSG
continues to be used in some meals. Still, it is possible that some people are particularly sensitive
to the MSG but the reaction is mild and not lasting.

MODULE 3 FOOD ADULTERATION

INTRODUTION
Food is a basic need to sustain life and every human being has the write to get
pure and nutritious food free from any type of adulteration for proper maintenance of good health.
Adulteration of food is a common practice in India by the traders. To combat this problem and to
protect the health of consumers, the government of India has passed the prevention of food
adulteration act (PFA act) in1954 to bring up the awareness.
Under this act the manufacture, sale and distribution contaminated and misbranded
food are prohibited. This Act has also established a central food laboratory which is located in
Kolkata, which is responsible for reporting on suspected food products. The central food
technological research institute (CFTRL), Mysore is a more recent development. The CFTRI has
a laboratory for the testing of adulterated foods. In addition, this act also constituted ’A central
committee for food standards’. The function of this committee is to advise the central government
on matters relating to the food standards. The food inspectors may be appointed with definite
power.
WHAT IS FOOD ADULTERATION
Food adulteration can be defined as a process of degrading the quality of food being by sold by
the addition or use of inferior quality substances or by extracting some valuable component(s) of
a food article. It is a common fraudulent practice adopted by the seller to earn profit.
ACCORDING TO PFA ACT,1954, FOOD ADULTERATION IS DEFINED AS:
I. “Intentional addition, substitution or substance (s) which adversely affect the quality of
food.
II. Incidental contamination of foods with deleterious constituents such as toxins,
insecticides, pathogenic bacteria and fungi, etc. Due to ignorance, negligence or lack of
proper storage facilities and,
III. Contamination of food with harmful microorganisms during production, storage and
handling
-(Swaminathan, vol2)

What is adulterated food?

According to prevention of food prevention of food adulteration act any article of food is
considered adulterated:
1. If the food article sold at the counter by the vendor is not of the nature demanded by the
purchaser.
2. If any inferior or cheaper substance has been substituted wholly or partly.
3. If any constituent of the article has been wholly or partly abstracted which in turn, seriously
affects the nature, substance or quality of the food.
4. If the article had been prepared, packed or kept under insanitary conditions due to which it
may have become contaminated or harmful to health.
5. If the article is obtained from a diseased animal.
6. If the article consists wholly or partly of any filthy, rotten, decomposed or diseased animal
or vegetable substance or is infested with insects.
7. If the article contains any poisonous ingredients.
8. If the containers used for packing article is composed of any poisonous substance.
9. If the article contains prohibited coloring agents or if it contains these agents in excess of
the prescribed limits.
10. If the article contains any prohibited preservatives are in excess.
11. If the quality or purity of the article falls below the prescribed standards.
 Common Food Adulterants in India

Food Articles Adulterants

Milk Water is added, Butter is removed, Hydrogenated fat is

added, skimmed milk is added, Urea is added
Ice cream Addition of washing powder
Powdered milk Addition of starch and destrins
Cream Addition of other fats
Butter Other Fats
Ghee Hydrogenated fats
Vanaspati ghee Animal fats or other high melting fats
Vegetable oils Argemone oil, mineral oil or cheap edible oil
Turmeric powder Metanil yellow, coal tar color
Chilly powder Starch coloured with coal tar dye
Mustard seeds Argemone seeds
Black pepper Papaya seeds
Wheat, rice Stones, marbles
Wheat flour Chalk powder, tapioca powder
Bengal gram Kesari dal
Honey Cane sugar syrup, invert sugar, water
Coffee powder Chicory, roasted date seed, tamarind seed powder
Tea Exhausted tea leaves, colored leaves of other plants
Common salt White powdered stone
Sugar Chalk
 MODULE 4 FOOD ADDITIVES
Humans have added various things such as spices, preservation, and flavouring agents to their
food for many – many years. Even today it is necessary to food fresh and edible till it is consumed.
A food additive is defined as a substance or mixture of substances, other than a base food stuffs,
which may be present in food as a result of production, processing, storage or packaging. This
definition does not include any chemicals which are considered contaminants, pesticides, color
additives etc.
An expert committee on food additives made up of members of FAO and WHO has defined food
additives as non -nutritive substances added intentionally to food, generally in small quantities,
to improve its appearance, flavor, texture or storage properties. The following guidelines be kept
in mind when additives are used in a food product.
• Additives should be used only to maintain the nutritional quality of food stuff, to improve
the shelf life of food, to improve the appearance of food, or to help in processing,
packaging or transporting the food product.
• An additive is not justified if it reduces the nutritive value of a food, or if it decreases the
quality of food, and if it deceives the custom of er.
• The amount of additives used must be very small that will bring the desired effect under
good manufacturing practices. The additives used must conform to the standard of purity.

USES OF ADDITIVES
As Additives Nutrients

a. Restoration: Some ingredients are added to restore of original nutritive value of the
product which may have been lost through processing.
b. Enrichment: The amount added are designed to meet specific legal standards of
minimum and maximum levels of nutrient. For example, during processing of cereals,
 such as wheat flour, ready-to-eat and uncooked cereals, etc. May lose some nutrients.
Therefor, these products may need to be enriched with thiamin, riboflavin, niacin, iron,
etc.
c. Fortification: Ingredients not normally present in a food are added to achieve a
particular dietary purpose. For example, salt is iodized to prevent the occurrence of
goiter. Breakfast cereals are fortified with various vitamins and minerals to ensure a
completely balanced nutritional meal.
AS BLEACHING AND MATURING AGENTS
Bleaching and maturing agents are very important in flour milling and bread making
industries. Freshly milled flour lacks the capacity to form and elastic, stable dough. This
result in heavy product. The colour of freshly milled flour is light yellow to creamsh. If
the flour is allowed to age, it will oxidize, lose its colour, and improve its baking
performance. But natural aging takes time and the cost of it increases tremendously, so
to speed up the natural aging and bleaching
Process, chemicals such as chlorine dioxide and chlorine are added.

AS ACIDS, ALKALIES AND BUFFERS

Additives used to control the acid alkaline balance of food also add flavor and texture
and improve its cooking properties. Excessive acidity that may have developed in cream
is neutralized by the addition of alkaline substances to control the flavor ad shelf-life
butter. Citric acid, potassium citrate, and phosphoric acid are used in sherbets,
carbonated beverages and fruit drinks to enhance the flavor and tart taste.

AS PRESERVATIVES
The main aim of using chemicals preservatives is to retard food spoilage caused by
microorganisms. This spoilage can be partially prevented by use refrigeration, drying, freezing,
etc. The use of chemical preservatives can improve the shelf life of the food.
Preservatives may also be used as antioxidants, as stabilizers etc. The most commonly
and frequently used preservatives are table sugar (sucrose) and table salt (sodium chloride). The
use of salt increases the osmotic pressure, thereby causes the cells of microorganisms to dry up.
The more salt used, the greater the protection given to the food.
 AS ANTIOXIDANTS
Antioxidants help prevents rancidity in fats and foods that contain fats. If fats are exposed
to air, light, moisture, heat or heavy metal ions, they become activated and oxidize (react with
available oxygen) to peroxides. Antioxidants are used in the fats containing foods such as
margarine, cooking oils, potato chips, cereals, salted nuts, soup mixes, etc. If antioxidants are not
used, shelf life of these products will be reduced. The most frequently used antioxidants are BHA
(butylated hydroxyanisole) and BHT (butylated hydroxytoluene) and vitamin E (synthetic
tocopherol). Antioxidants delay enzymatic browning in cut or peeled fruit juices, frozen fruits
etc.

. AS LEAVENING AGENTS
Chemical agents are used to prepare a variety of light cakes, biscuits, muffins, and
doughnuts. This lightness and volume is the result of chemicals reaction in which carbon dioxide
is liberated from sodium bicarbonate (baking soda)

AS COLOR ADDITIVES
The acceptance of food products depends on its appearance. The customer become used
to the standardized colors of foods which helps them purchase it. Food colors are used to mask
the undesirable color of foods, to make it more attractive to the consumer or to replace the natural
colors were not added, and canned peas would be brownish-green in color. There are two types
of coloring agents – natural and synthetic. Natural colors extracted from fruits, seeds and flowers.
For example, carotene from carrots, saffron, turmeric, a herb which gives yellow color to curries;
caramel gives brown color and is obtained from burnt sugar
Synthetic colors are considered hazardous to health since they are part of the coal tar
colors. However, most synthetic colors can now be produced without coal tar as a base. They are
inexpensive as compared to natural ones, remain stable to high processing temperatures, acid and
storage.
AS FLAVOR ADDITIVES
 Flavor is one of the most important properties of cooked foods. It can be detected by the
senses of taste and smell. Flavoring agents have been used for centuries to increase the
attractiveness of food. The flavoring agents commonly used, are alcohol, spices, monosodium
glutamate, etc. The natural food flavors are rarely used because the manufacturing process is
expensive and it will be difficult to meet the demands economically. Therefore, it becomes
necessary to make artificial flavors, e.g. essential oils, amyl acetate for banana flavor, alpha -ione
for strawberry flavor, allyl caproate for pineapple flavor etc. Some other commonly used flavor
additives are vanilla and chocolate. The most common flavor enhancer is monosodium glutamate
(MSG) which is the salt of the non-essential amino acid glutamate.
AS EMULSIFIERS
Emulsifiers are used to mix two molecules that are mutually antagonistic (oil and water).
They also improve texture, volume and body of baked products and maintain an even distribution
of ingredients. They are also used to retard the rate of staling in baked foods. If emulsifiers are
not added, salad dressings and puddings, would separate. Lecithin is one of the most commonly
used emulsifiers which is found in eggs, milk and soyabean.
 FOOD ALLERGY

Food allergy is an abnormal response to a food triggered by the

body’s immune system. Food allergy refers to a particular type of response of the immune
system in which the body produces what is called an allergic, or IgE, antibody to a food. (IgE,
or immunoglobulin E, is a type of protein that works against any type of foreign body entering
in the body.)
Sometimes, a reaction to food is not an allergy at all but another type of
reaction called “food intolerance’. In adults, the foods that most often cause allergic reactions
include Shellfish such as shrimp, crayfish, lobster, and crab, Peanuts, Tree nuts such as
walnuts, Fish and eggs. The most common foods that cause problems in children are: Eggs,
Milk, Peanuts. Tree nuts.
An allergen is any normally harmless substance that causes an immediate
allergic reaction in a susceptible person. Food allergens are almost always proteins although
other food constituents, such as certain additives, are known to have allergenic (allergy-
causing) properties.

What are the symptoms of food allergies?

The symptoms of food allergies range from mild discomfort to severe, life-threatening
reactions, which require immediate medical intervention. Symptoms may be triggered in the
skin (e.g. itching, redness, swelling), gastrointestinal tract (e.g. pain, nausea, vomiting,
diarrhea, itching and swelling of oral cavity), respiratory tract (e.g. itching and swelling of the
nose and throat, asthma), eyes (e.g. itching and swelling), and/or cardiovascular system (e.g.
chest pain, abnormal heart rhythm, very low blood pressure causing fainting, and even loss of
consciousness).

FOODBORNE DISEASES
Food poisoning: The illness resulting from eating food or drinking water containing poisonous
substances including bacteria, viruses, pesticides, or toxins. Symptoms generally begin within 2
to 6 hours and include abdominal cramping, diarrhea, fever, headache, nausea, vomiting,
and weakness.
 Food borne disease (FBD) is caused by consuming contaminated foods or beverages. In
addition, poisonous chemicals or other harmful substitutes can cause food borne diseases if they
are present in food. More than 250 different food borne diseases have been described. A
classification of food borne diseases is given in Figure 9.1. Food borne diseases may be intestinal
diseases but can be other type as well.
TYPES OF FOOD BORN DISEASES
With regard to their epidemiology, they can be divided into two major categories
i) Food borne Intoxication: Examples include botulism or staphylococcal food poisoning, the
causative microorganism produces an exotoxin in food: when a person consumes the food, the
toxin is ingested and gives rise to disease.
ii) Food borne Infections: the causative organisms are ingested: these subsequently grow within
the body and cause damage.
Microorganisms that produce infectious diseases in human are categorized as pathogens, because
they have the ability to injure body tissues and/or alter body functions. In general, pathogenic
microorganisms express their disease-producing properties through two kinds of mechanisms: (1)
invasion of tissues (invasive microorganisms) and (2) production of toxins (toxigenic
microorganisms). Invasive pathogens have the ability to produce and excrete one or more kinds
of extracellular enzymes resulting in injury to host tissues. Toxigenic microorganisms produce
toxins of two types:
• Exotoxins − produced within certain kinds of bacteria and excreted into their surrounding
environment. They are proteins in chemical composition and are relatively specific in terms of
damage to the host.
• Endotoxins − are complex polysaccharides cell wall components of certain kind of bacteria.
They are not released until the cell disintegrates. They are relatively heat stable, less specific in
their actions and less potent than exotoxins

Food borne diseases are caused by:

The disease transmitted by foods are typhoid fever, bacillary dysentery, streptococci
sore throat, botulism, amebic, dysentery, trichinosis, infectious hepatitis, and cholera. Some of
these diseases are enteric that have symptoms such as mild to severe nausea, vomiting, abdominal
pain, and diarrhea. Other foodborne diseases involve the system where the organisms invade the
circulation and produce symptoms in organs and tissues.

FOODBORNE DISEASES ARE CAUSED BY:

• Eating food from an animal or plant that has been infected.
• Foods contaminated by organism transmitted by insect, files, roaches, or rodents.
• Foods contaminated by the food handlers with poor personal hygiene or unaccepted food-
handling practices.
• Human body is also a source of potential food poisoning, which may be transferred easily
from mouth, nose and bowl to food.
• Food handlers who are suffering from infections may pass on the infection to others who
are not ill.
• Foods containing pathogenic bacteria or toxins can precipitate gastroenteritis with nausea,
vomiting and fever. This is the most common type of food poisoning.

BACTERIAL FOOD INFECTIONS

This usually causes acute gastroenteritis, which is often short and has a limited course.
It may lead to deaths among very young or those who have weakened immunological defenses
because of some other conditions. However, food poisoning is the major cause of morbidity and
economic losses apart from distress and discomfort it causes. Gastroenteritis causes severe
dehydration and loss of electrolytes, which are the leading causes infant mortality in the
developing world.
SALMONELLOSIS
Over thousands of the Salmonella genus have been identified and each one is capable
of causing infections in humans. There organisms are easily killed by boiling for 5 minutes, but
can survive in foods that are not heated adequately. Typhoid fever, quite frequently seen in India,
is the most serious of the Salmonella infections. This type of fever is systemic and the symptoms
of the gastrointestinal tract may be so severe that it may cause ulceration of the mucosa. The
organism particularly affects the liver and gallbladder. Foods, such as meat, poultry, fish, eggs
and dairy products, which are not heated adequately cause the disease.

Where does salmonella come from?

There are approximately 2,500 different types of salmonella bacteria: the most common are
salmonella enteritidis and salmonella typhimurium. The bacteria originate in the gut of many farm
animals and so can easily contaminate meat products, poultry, eggs and milk, as well as fruit and
vegetables that have come into contact with animal manure. Some pets also carry salmonella
bacteria.

How do you get salmonella?

People get salmonella when they eat food contaminated with the bacteria. This may be because
the bacteria have affected the food products, because raw and cooked foods have been stored
together (cross contamination) or due to poor hygiene practices of the food handler.

What are the symptoms of salmonella?

Symptoms include abdominal pain, diarrhea, vomiting and fever. On average, it takes between
12-72 hours for the symptoms to develop following consumption of the salmonella bacteria.

How do you prevent salmonella?

Keeping raw and cooked foods separate at all times is essential for preventing cross
contamination. All work surfaces and equipment must be thoroughly cleaned and food handlers
should ensure that they maintain a high standard of personal hygiene at all times

CLOSTRIDIUM BOTULINUM
Illness caused due to Clostridium botulinum is known as botulism. It is an extremely
serious condition. These bacteria are found in the soil and on the vegetables which come in contact
with contaminated soil. It is also found in the intestines of the fish and pigs. The bacteria do not
grow in the presence of oxygen. They are spore-formers and are resistant to ordinary boiling
temperature. Non-acid canned foods, such as meat, beans, corn and peas are very good media for
the growth, contrary to this acid-containing foods, such as tomatoes, and some fruits are
unfavorable to growth.

The symptoms of botulism manifest in 8 to 72 hours after ingestion of contaminated

food. The common symptoms are headache, dizziness, double vision, difficulty in swallowing,
speech difficulty and paralysis. Death usually occurs due to respiratory paralysis and cardiac
failure.

Where does clostridium botulinum come from?

Botulism is a rare form of food poisoning caused by clostridium botulinum bacteria but it can
have fatal results. The bacteria are found in soil, dust and river/sea sediments and can produce
toxins if deprived of oxygen. This makes canned, bottled and vacuum-packed foods particularly
at risk from contamination.

How do you get clostridium botulinum?

The illness is contracted when the bacteria are consumed by eating food that is contaminated with
infected soil or if the food has not been correctly canned or preserved. The bacteria then multiply
within the body and attack the nervous system.

What are the symptoms of clostridium botulinum?

Symptoms can be quite severe and include fatigue, headache, nausea, blurred vision, difficulty
swallowing and speaking and even paralysis. Botulism requires serious medical attention and can
cause death if not quickly treated. If you develop the symptoms of botulism then the emergency
services must be called straight away.

How do you prevent clostridium botulinum?

As the bacteria are incredibly rare it’s unlikely that the illness will develop, especially because
there are strict controls in place for manufacturers of canned foods. However, the risk is slightly
higher if you can your own food, in which case strict hygiene measures must be followed. For
pre-packaged foods, always discard cans that are visibly bulging or damaged as well as any
preserved foods that smell foul or are out of date.

STAPHYLOCOCCUS AUREUS

Foods infected with these bacteria rapidly absorbed and always cause illness. Heat
treatment can easily kill these bacteria. Boiling for 30 minutes is sufficient to kill these. It is
usually caused by eating cream-filled cakes, or by cooked meats contaminated by food handlers.
They can grow in large concentration of salt, thus can be found in foods, such as ham and bacon
which are very high in salt. Where does staphylococcus aureus come from? Staphylococcal
infections, also referred to as ‘staph infections’, originate from bacteria found on human skin.
The bacteria are normally harmless but can cause illness if they enter the body through a break in
the skin, like a cut, graze, insect bite or injection.

How do you get staphylococcus aureus?

The bacteria are transferred between people through close skin contact or from touching
contaminated objects, like hand towels or door handles. Poor personal hygiene can result in food
being contaminated, particularly meat, which can then result in food poisoning.

What are the symptoms of staphylococcus aureus?

Symptoms include abdominal pain, diarrhea and vomiting which generally occur around 2-4
hours after eating the contaminated food. Staph bacteria can also cause minor skin infections and,
in a small number of cases, infections of the joints, bones and internal organs.

How do you prevent staphylococcus aureus?

Because the bacteria are commonly transferred from surface to surface it’s essential that effective
hygiene controls are in place. All food handling equipment and surfaces must be thoroughly
cleaned and food handlers should ensure that they maintain good personal hygiene and wash their
hands regularly.

ESCHERICHIA COLI (E coli)

E coli are present on foods that are eaten or in drinking water. Food poisoning is
caused by eating meats or poultry which are inadequately cooked or where cooked meat is
contaminated by E coli from raw meats.

Where does E. coli come from

? E. coli bacteria are found in the digestive systems of animals and are generally harmless, but
certain strains of the bacteria can cause food poisoning. The bacteria are very tough and can
survive for up to 60 days on work surfaces and equipment. E. coli is common in cattle and so
often affects beef products (in particular mince and mince products) and milk.

How do you get E. coli?

Most cases of E. coli occur from eating undercooked beef or drinking raw, un pasteurized milk.
When consumed the bacteria enters the intestine and can be incubated there for several days
before causing illness.

What are the symptoms of E. coli?

Symptoms include abdominal pain, diarrhea, fever and vomiting and can be fatal for people who
are vulnerable to illness, such as the elderly, young children or people with weakened immune
systems. The symptoms can last for days or even weeks and emerge from 12 hours after eating
contaminated food.

How do you prevent E. coli?

Preventing cross contamination between raw and cooked foods is essential, so these foods should
always be stored and prepared separately. Avoid using raw milk in food products and ensure that
beef is cooked thoroughly and to the correct temperature before eating (70°C for a minimum of
2 minutes).