nutrition and health

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1 : Nutrition and Health Nooriya T K 3rd BDS
2 : Introduction Nutrition The sum of the processes by which an individual takes in and utilizes the food(FDI,1994) Exerts systemic effects upon the dentition via the pulpal blood supply and the saliva Diet The types and amount of food eaten daily by an individual
3 : Malnutrition A pathologic state resulting from a relative or absolute deficiency or excess of one or more essential nutrients Teeth are unusual in that nutritional influences are exerted solely during their formation.
4 : Classification of foods By origin Foods of animal origin Foods of vegetable origin By chemical composition Proteins Fats Carbohydrates Vitamins Minerals
5 : By predominent function Body building foods Milk, meat, poultry Energy giving foods Cereals, sugars, roots Protective foods Vegetables, fruits, milk By nutritive value
6 : Nutrients Organic and inorganic complexes contained in food Macronutrients Proteins Fats Carbohydrates Micronutrients Vitamins Minerals
7 : Proteins Composed of carbon, hydrogen, oxygen, nitrogen and sulphur Obtained from animal and vegetable sources 1g protein/kg body wt – ICMR Sources- Milk,meat,egg,pulses,cereals,nuts
8 : Functions Body building Repair and maintenance of tissues Synthesis of antibodies, plasma proteins, hemoglobin, enzymes and chromosomes Supply energy(4 kcal/g)
9 : Fats Concentrated sources of energy Classified as, Simple lipids –triglycerides Compound lipids- phospholipids Derived lipids- cholesterol 99% body fats- triglycerides
10 : Functions Supply energy Carry flavor of food Add satiety and variety to a meal Integral part of cells and cell membranes Carry the fat soluble vitamins May act to reduce dental caries
11 : Sources Ghee Butter Cheese Egg Fat of meat and fish Groundnut Coconut Mustard Rice Wheat Jowar
12 : Carbohydrates 3rd major component Cereals, fruits and vegetables Source of both glucose and cellulose Major source of energy
13 : Functions Supply energy Essential for oxidation of fats Synthesis of certain non-essential aminoacids
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18 : Minerals
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21 : BALANCED DIET A balanced diet is one which contains a variety of food in such quantities and proportions that the need for energy, amino acids, vitamins, minerals fats and other nutrients is adequately maintaining health vitality and general well being and also makes a small provision for extra nutrients to withstand short duration of leanness. Needed to maintain optimum health
22 : FOOD PYRAMID Bread,cereal,rice and pasta group 6-11 servings Vegetable group 3-5 servings Fruit group 2-4 servings Milk , yogurt and cheese group 2-3 servings Meat, poultry,fish,dry beans eggs and nuts group 2-3 servings Fats, oils and sweets Use sparingly
23 : Recommended dietary allowance Amount of nutrients sufficient for the maintenance of health. Dietary goals Dietary fats should be 20-30% of total daily intake. Saturated fats- not more than 10%. Excessive consumption of refined carbohydrate should be avoided. Energy rich sources such as fats and alcohols consumption to be restricted. Salt intake should be reduced, to not more than 5g/day. Protein 15-20% of daily intake. Reduced consumption of colas, ketchups and other foods that supply empty calories.
24 : ORAL MANIFESTATION ASSOCIATED WITH MALNUTRITION Lips: Changes usually on exposed mucosa and angle of mouth Associated with riboflavin, niacin and iron deficiency Most common lesion- Cheilosis, Angular lesions Teeth: Mottled enamel Linear hypoplasia Melanodontia Malpositions
25 : Gums: Scorbutic type Gingivitis Hypertrophic gingivitis Tongue: Filiform and fungiform papillary hypertrophy/ hyperemia Magenta tongue Scarlet red glossitis Beefy red glossitis
26 : NUTRITION AND MALOCCLUSION A chronic postnatal malnutrition would result in stunted jaw development after the teeth have differentiated. This results in poor alignment and crowding leading to increased caries and periodontal diseases
27 : NUTRITION AND PERIODONTAL DISEASE Involve episodic, progressive disruption of several different tissues Main targets Epithelial barrier and attachment Periodontal ligament Gingival connective tissue Alveolar bone Cellular and humoral immune mechanism Inflammatory response Composition of gingival fluid
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30 : Nutrition and oral cancer Nutrition play an important role in the oral and pharyngeal cancer Malnutrition increases the susceptibility to cancer of the head and neck Nutritional factors protect against tumorigenesis by Acting as blocking agents Altering metabolism of the carcinogens through decreased activation increasing detoxification by scavenging the active molecular species of carcinogens Competitive inhibition
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32 : Food stuffs: Protective effects by Fruit, fish, butter milk, milk, dairy products, oranges, cabbage and sea foods Increased risk by vegetable oil and excess animal fat
33 : Nutrition in the elderly Inability to chew food Appetite is diminished Dental and medical infirmities Nutritionally related maladies Alveolar osteoporosis
34 : NUTRITIONAL PROBLEMS IN PUBLIC HEALTH Low birth weight: Less than 2.5kg 30% of babies born in India Causes maternal malnutrition and anemia Physical labour during pregnancy Illness
35 : Protein energy malnutrition: Protein deficiency Kwashiorkor and marasmas Causes Inadequate food intake , both in quantity and quality Infections Poor environmental conditions, Large family size, Poor maternal health, failure of lactation and premature termination of breast feeding
36 : Xerophthalmia: Ocular manifestation of vitamin A deficiency most common in children, Often related to weaning Nutritional anemia: “A condition in which the hemoglobin content of blood is lower than normal as a result of a deficiency of one or more essential nutrients, regardless of the cause of such deficiency” Causes- Iron deficiency, folate/vitamin B12 deficiency
37 : Iodine deficiency disorders(IDD): Goitre Hypothyroidism Retarded physical development Impaired mental function Increased rate of spontaneous abortion Neurological cretinism Lathyrasm: Paralyzing disease of humans and animals In humans neurolathyrasm affecting nervous system Paralysis of lower limb
38 : Endemic fluorosis: Dental fluorosis Excess fluoride ingesion Mottling of dental enamel Skeletal fluorosis Heavy deposition of fluoride in skeleton Fluoride greater than 10mg/ litre Genu-valgam
39 : Preventive and social measures Action at the family level: Nutritional education Identification and correction of harmful food Promotion of breast feeding Promotion of kitchen garden or keeping poultry
40 : 2. Action at the community level: Analysis Conduct of diet and nutrition surveys Planning realistic and feasible approaches Increasing quality and quantity of available food 3. Action at the National level: Rural development Increasing agricultural production Stabilization of population Nutritional intervention programmes Nutrition related health activities
41 : Community nutrition programmes Vitamin A prophylaxis programme Prophylaxis against nutritional anaemia Iodine deficiency disorders control programme Special nutrition programme Balwadi nutrition programme ICDS programme Midday meal programme
42 : Vitamin A prophylaxis programme For control of blindness Administer a single massive dose of an oily preparation of vit.A orally to all pre-school children By the ministry of health and family welfare Evaluation- significant reduction in Vit.A deficiency
43 : Prophylaxis against nutritional anemia Distribution of iron and folic acid tablets to pregnant women and young children Mother and child health centers(MCH), Primary health centers and ICDS projects
44 : Control of Iodine Deficiency Disorders Identification of the goiter endemic areas Supply iodized salt in place of common salt Assess the impact of goiter control measures
45 : Special nutritional programme To improve the nutritional status of the target group Children below 6 years of age, pregnant and nursing mothers 300days in a year
46 : Balwadi nutritional programme Children 3-6years Department of social welfare Implement through Balwadi 300kcal 10g of proteins /child/day
47 : ICDS programme Integrated child development services-1975 Supplementary nutrition, Vit.A prophylaxis, Iron and folic acid distribution- are the nutritional components Beneficiaries are: Pre-school children below 6 years Adolescent girls 11-18years Pregnant and lactating mothers At village level- Anganwadi workers
48 : Mid-day meal programme School lunch programme-1961 Meal should be a supplement Should supply 1/3rd of total energy requirement Cost of meal should be low Can be prepared in schools
49 : Conclusion Nutrition is vital to human development, growth and health maintenance combined with other health care workers, dentists reach a larger number of general public per year. The dental visit, which is longer in duration affords better opportunities for motivational intervention to enhance self care and health care.
50 : Bibliography Essentials of preventive and community dentistry- Soben peter Preventive and social medicine – K.Park Text book of preventive and community dentistry- Joseph John


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