NUTRITION AND

FOOD SECURITY

Dr Fouzia Khanam

Lecturer

Department of Public Health

North South University

[email protected]
Content
▶ Food safety (food contamination and adulteration)

▶ Food security and its dimensions

▶ Nutrients and its classifi cation

▶ Function of diff erent nutrients

▶ Classifi cation of malnutrition

▶ Nutrition interventions
Nutrition and Nutrients

▶ Nutrition is the process of utilizing nutrients from food for growth and
maintenance of our body. Nutrients are chemical substance found in food that are
used for growth and maintenance of our body

▶ Good nutritional status means having all the required nutrients in right balance,
as both deficiency and excess of nutrients can cause disease

▶ Poor/Deficienct nutritional status is associated with reduced immunity, impaired

physical and mental development, and reduced productivity. Excess of nutrients
like fat can result in non-communicable diseases
Nutrient
s at a
glance
Macronutrients

Name Function Source Good/Bad

Carbohydrate Energy production Cereals, legumes, Glycemic index (low),

Glucose, Fructose, (4 kCal/gm) grains etc. high dietary fiber
Lactose

Protein (made up of Growth and repair, Pulses, meat, fish, Animal source are
amino acids) energy production egg, milk, considered better
(4kCal/gm) (complete protein)

Fat (Lipid) Energy storage Milk and milk Unsaturated fats are
(9kCal/gm), products, nuts and good/saturated and
insulation, shock seeds, meat, fish, egg trans-fat are bad
absorption, vitamin
metabolism
Micronutrients

▶ Vitamins and minerals are considered as micronutrients, they perform wide range
of functions, but do not produce energy in our body

▶ Minerals are inorganic substances and can be classified into major mineral
(Calcium, Sodium, Potassium, Phosphorus, Magnesium, Chlorine, Sulfur) and
trace minerals (Iron, Zinc, Iodine, Copper etc.) based on their abundance in our
body and requirement

▶ Vitamins are organic substances can be classified into fat-soluble vitamins

(Vitamin A, D, E, K) and water-soluble vitamins (Vitamin B complex and Vitamin
C) based on their solubility. Fat-soluble vitamins are stored in liver
 Micronutrients – minerals
Name Function Source Deficiency syndrome
Calcium Bone and teeth formation Milk and Milk products Thinning of bones, Fracture,
Blood Clotting Green leafy vegetables tooth erosion, Heart rhythm
Normal Heart Function (Spinach) problems, rickets (in children)
Small fishes (fish bone)
Zinc Enzyme activities (~300) Meat, Nuts and seeds Growth faltering, loss of taste,
Healing of wounds, Proper Shellfish, Cereal products immune impairment, loss of
immune functioning, Taste Dairy products reproductive functions
sensation, Growth Animal > Plant (phytate)

Iron Transport of O2 and CO2 around Dark green vegetables Anemia, Neurocognitive
the body (hemoglobin), Legumes, whole grain impairment
Enzyme function cereals, Liver
Animal > Plant (phytate)

Iodine Used to make thyroid Iodized salt (fortification), Goiter, Mental and physical
hormone, that regulates nuts and seeds, seaweed, growth retardation in children
metabolism in the body cereals and grains (Cretinism), lack of thyroid
function (Hypothyroidism)
 Micronutrients – vitamins
Name Function Source Deficiency syndrome
Vitamin A Helps in vision (night Liver, milk, cheese and Blindness, night blindness,
vision), Fights infection butter, Carrots & dark increased infection
Anti-oxidant (against vegetables, fortified oil
ROS), epithelial integrity
Vitamin C Anti-oxidant (against ROS) Citrus fruits, green Scurvy (joint pain and
Wound healing (synthesis vegetables, peppers and bleeding gum)
of collagen), Iron tomatoes
absorption

Vitamin D Calcium distribution in Sunlight (our body can Poor bone growth, Rickets in
bones make own vitamin D) can children
be from fortified food,
fish, eggs
Balanced diet

▶ We need to “mix and match” different food items in right proportion to ensure all
essential nutrients are consumed

▶ A balanced diet should contain required energy adjusted for the age, sex, body
weight and physical activity of an individual (energy balance). On average a male
should consume 2,500 kcal/day and a woman should consume 2,200kcal/day

▶ Consuming extra calories will result in weight gain through deposition of fat,
consuming less will not allow body function optimally

▶ When the diet of a community is not balanced, they suffer from micronutrient
deficiency, a condition known as “Hidden Hunger”
Classifi cation of malnutrition

Abnormal Nutrition
Normal Nutrition
(Malnutrition)

Under-Nutrition Over-Nutrition
Overweight and Obesity,
Hypervitaminosis A

Protein Energy Micronutrient

Malnutrition Deficiency
Wasting Vitamin A deficiency
Stunting Zinc deficiency
Underweight Iodine deficiency
Iron deficiency
Protein Energy Malnutrition
ACUTE ACUTE AND
CHRONIC

MILD MODERATE
SEVERE
CHRONIC

To detect these, you need to know – Age, Weight and Height/Length

Cause of Undernutrition
Eff ect of Undernutrition
Global distribution of child
mortality
Global distribution of child
mortality
Countries with highest burden of
malnutrition
Countries with highest burden of
malnutrition
UNDER-5 WASTING, STUNTING, UNDERWEIGHT (MICS 2019)

Percentage of under-5 children with different type of malnutrition in Bangladesh

30
28

25
22.6

20

15

9.8
10 8.8

5.2
5
2.3 2.4
0.8
0
Any stunting Severe Any Severe Any wasting Severe Overweight Obesity
stunting underweight underweight
wasting
 NUTRITIONAL STATUS OF WOMEN (BDHS 2014)
Trend in nutritional status of women aged 15 – 49
60 years

52
50
45

40
34
30
30 29
24 24

20 17

19 14
9
10 12
3
5
0
BDHS 1996-97 BDHS 1999-00 BDHS 2004 BDHS 2007 BDHS 2011 BDHS 2014 BDHS 2018

BMI < 18.5 kg/m2 BMI > 25 kg/m2

Overnutrition

▶ Overnutrition is commonly used for the conditions overweight and obesity, a

condition where there is excess fat accumulation in body that poses health risk

▶ BMI is commonly used to determine overweight and obesity. BMI is calculated by

dividing weight in kg by squared height in meter square. A BMI of ≥25 kg/m 2 is
considered as overweight and a BMI of ≥30 kg/m2 is considered as obese

▶ Obesity and overweight are strongly associated with more than 40 diseases
including all major NCDs.

More to be discussed in the next lecture

Nutritional Transition

▶ When both undernutrition and over-nutrition prevails in the same

community/country that country is considered to be going through “nutritional
transition” phase

▶ It can be also family level or even at individual level

▶ Developing countries are mostly affected

▶ Increases the risk of non-communicable disease in the future generation

▶ Once an individual is affected, s/he carries it throughout the life and passes to next
generation
Food safety
▶ Food Safety refers to handling, preparing and storing food ( from farm to
fork) in a way to best reduce the risk individuals becoming sick from
foodborne illnesses (e.g. diarrhea, cholera, typhoid, hepatitis)

▶ Lack of food safety or “unsafe food” aff ects 1 in 10 people every year and
children are the worst suff erer because it initiates a vicious cycle
between infection and malnutrition

▶ Among the factors that aff ect the safety of our food, contamination and
adulteration are of prime importance
Contamination vs Adulteration
Contamination Adulteration
Food contamination happens when Food Adulteration refers to the process by
“something” (contaminant) gets into food which the quality or the nature of a given
that shouldn’t be there food is reduced through addition of
adulterants or removal of vital substance
Contaminant can be physical, chemical or Adulterants are non-nutritious or even
Biological harmful substances
Contamination is usually done Adulteration is done intentionally for more
unintentionally profit (by increasing shelf-life, increasing the
weight or improving the texture of food
items)
Examples of contaminants are hair, dust, Example of adulterants are carbide (to ripen
pest or pest dripping (physical), heavy fruit) formalin (to increase shelf-life), textile
metal, non-food grade plastic, dishwasher, color (to make vegetable more attractive),
insecticide (chemical) bacteria, virus, prion, stone-chips (to increase weight of rice or
parasite (Biological) other grains)
Eff ect of contamination and adulteration
Contamination Adulteration
▶ Food borne disease(cholera, typhoid, ▶ Acute problems like food poisoning
hepatitis, food poisoning). Often these
diseases are characterized by: ▶ Long term use can cause problems in
heart, liver, kidney, stomach and cancers
▶ Abdominal cramps
in different parts of the body
▶ Nausea
▶ Chronic consumption of non-nutritious
▶ Vomiting
adulterants can lead to malnutrition,
▶ Diarrhea – dehydration especially in children.
▶ Fever

▶ Allergic reactions

▶ Poisoning from chemical substances, e.g.

Mercury
Cause and prevention of Adulteration
Causes Prevention

▶ Profit motive of traders: Done as a part of ▶ Individual level: Consumers should be

the business strategy aware of adulteration and avoid
adulterated food/food items
▶ Scarcity of food and high population
demand ▶ Policy level: Government should make
strict law against adulteration. Regular
▶ Lack of consciousness of proper food
monitoring should be done along with
consumption
proper implementation of law and harsh
punishment for those who are involved in
▶ Lack of effective food laws and
it
government initiative
Prevention of food contamination
▶ Wash your hands before handling food, after going to the toilet. Wash
and sanitize all surfaces and equipment used for food preparation

▶ Separate raw and cooked food, use separate equipment and utensils
such as knives and cutting boards for handling raw foods and store
separate containers for raw and prepared food

▶ Cook food thoroughly, especially meat, poultry, eggs and seafood. Bring
foods to boiling to make sure that they have reached 70°C. Reheat
cooked food thoroughly
Prevention of food contamination
▶ Keep food at safe temperatures, do not leave cooked food for more than
2 hours. Refrigerate promptly (preferably below 5°C).Keep cooked food
piping hot (more than 60°C) prior to serving

▶ Use safe water(or treat it to make it safe) and raw materials. Choose
foods processed for safety, such as pasteurized milk. Wash fruits and
vegetables, especially if eaten raw. Do not use food beyond its expiry
date
Food Security
▶ Food security means ensuring (securing) food for everyone in the
population for all the time. It is usually measured at the household
level.

▶ Food security exists when all people, at all times, have physical, social
and economic access to suffi cient, safe and nutritious food that meets
their dietary needs and food preferences for an active and healthy life

▶ Absence of food security (food insecurity) can be due to many reasons,

almost all of them aff ecting the agricultural production (water crisis,
climate change, land degradation, urbanization). It can also be due to
natural disaster or humanitarian crisis
Classifi cation of Food insecurity – severity
Fortifi cation vs Supplementation

Fortification Supplementation
Fortification refers to the process by which Supplementation refers to providing
nutrients are added to usually staple foods to concentrated sources of nutrients (i.e.
maintain or improve the quality of the diet of mineral and vitamins) that is meant to
a group, a community or a population supplement nutrients in the diet

Long term preventive approach Short term corrective approach

Fortification cost is low Supplementation is expensive

Supplementation targets a specific groups of

Fortification covers the whole population
people
Example of Supplementation are
Micronutrient supplementation for children
Examples of Fortification are Salt Iodization,
(MoniMix), Iron-Folic Acid supplementation for
Vitamin A fortification of edible oil
Pregnant women, Vitamin A campaign for
children
THANK YOU