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IMPORTANCE OF NUTRITION – Mother Miracle Project and Nutrition Education Rachel Peters - Dietitian MY PROJECT To assess the nutritional adequacy of the diets of the children at Mother Miracle and to make recommendations that would improve their diets Adequate nutrition intake is important for good growth and health and also helps children perform better and concentrate at school MOTHER MIRACLE PROJECT I have measured the height and weight of the children and compared to standard levels Most children (82.1%) are growing well Almost 1 in 5 children show signs of being underweight or malnourished (18%) 3 children appear to be close to being overweight for their age This is based on updated date of birth records and relies on accurate age for the child MOTHER MIRACLE PROJECT I measured the difference in growth in children compared to the measurements taken by the dietitian in 2011 (53 children) Most children are growing well Only 1 out of 53 appeared to have only grown 3.5cm in 2 years Age Height Difference (cm) Percentage Weight Growth since Difference 2011 (kg) Percentage Growth since 2011 6-9 3.5 - 15.9cm 3.18 -14.65% 4 - 10.1kg 22.63 -50.5% 10-13 8.3 – 17.1cm 7.7 - 14.15% 3.3 – 12.4kg 17.67 – 47% MOTHER MIRACLE PROJECT I have taken diet histories from the children to find out about their usual diet. I then analysed this to look at what nutrients they are low in. UGK to 3rd class – 3 day diet history 5% had missed breakfast once, 15% had missed at least one evening meal 17.5% did not have vegetables at home in the past 3 days 42.5% did not have dahl at home in the last 3 days 45% had fruit less than once per week 47.5% had milk less than twice per week 65% ate nuts once per month or less MOTHER MIRACLE PROJECT 4th and 5th Class Asked about the frequency they eat a list of foods Analyzed for nutrients that are commonly inadequate in Indian diets Vitamin A. B12. C, D, iron, iodine, zinc, calcium and protein Found that most children were not meeting their recommended dietary allowance (RDA) Mother Miracle Project Results 4th and 5th class Vitamin Vit A /Mineral µg Vit B12 µg Intake range 81.28 - 0.14 723.55 3.53 Intake average 387.17 Vit D µg - 0.07 1.63 Iron Mg Zinc mg - 4.39 19.89 – 2.7112.91 Iodine µmol Calcium mmol Vit C mg Protein g 0.17-6.11 104.981110.78 13.24105.26 16.6594.82 31.67 45.11 1.3 0.45 9.68 6.8 2.2 497.6 RDA: (7- 600 9, 10-12, 13+ yrs) 0.2- 1 10 16- 32 8 - 11 0.95-1.19 600 - 800 40 29.5-54.3 No. not 32 meeting RDA Deficient 86% under RDA (%) 16 37 36 35 12 36 31 13 43% No** 97% 95% 32% 97% 84% 35% RECOMMENDATIONS Double fortified salt Consider providing children with a glass of milk Vitamin A, B12 and C, calcium, protein, zinc, iodine Vitamin A fortified oil increase iron intake Vitamin A and D Change frequency of vegetables Vitamin A rich vegetable at least 2/wk Vitamin C rich vegetable at least 2/wk Include soya bean in subji with vitamin C rich vegetable Include Nutrela (soya protein) 1/wk Mother Miracle Project Changes to children’s intake if recommendations are implemented Vitamin Vit A Vit B12 Vit D Iron Zinc Iodine Calcium Vit C /Mineral µg µg Increased provision 81.28 - 0.14 723.55 3.53 % increase meeting RDA Childre n meeting RDA 387.17 1.3 600 0.2- 1 mg Protein g 0.17-6.11 104.981110.78 13.24105.26 16.6594.82 6.8 2.2 31.67 45.11 8 - 11 0.95-1.19 600 - 800 40 µg Mg mg - 0.07 1.63 - 4.39 19.89 – 2.7112.91 0.45 9.68 10 16- 32 µmol mmol 497.6 29.5-54.3 Hygiene Hygiene is very important to stay healthy and prevent disease Simple things to help improve hygiene Wash hands regularly with soap – after toilet, before and after eating, before preparing food Wash vegetables and fruit thoroughly before cutting and eating Boil water and milk to kill bacteria Keep dairy, meat and fresh vegetables at less than 10oC (eg in fridge) where possible Filtered water Brush your teeth Water Many children reported having headaches often Some only had 2-3 glasses of water per day It is recommended to have at least 8 cups of water per day and more when it is summer time. Encourage the children to have regular intake of water during the day Nutrients studied Protein Vitamin A Vitamin B12 Vitamin D Iron Zinc Iodine Calcium Vitamin C PROTEIN Function Growth and repair, make new cells and hormones Sources Meat, dahl and beans, dairy, eggs, nuts and seeds, soya beans, wheat (eg roti) Important to have a variety Deficiency poor growth in children, poor immune system, weakness in strength, anaemia Higher risk in vegetarian and poorer communities VITAMIN A Function Sources Important for normal vision, particularly at night, helps strengthen immunity and important for health skin and gut lining Cheese, eggs, milk, Deficiency Night blindness, bitot spots VITAMIN B Group foods of 8 vitamins found in various B1, B2, B3, B5, B7 folate, B12 B12 is common deficiency found in India Vitamin B12 Function Sources helps protects nerves, maintain mental ability, make red blood cells, make energy for the body meat, liver, milk, cheese, eggs only found in animal based foods Deficiency fatigue, nerve damage, depression, weight loss VITAMIN C Function Sources Immune system, wound healing, important to keep organs and cells healthy and strong Tomato, cauliflower, cabbage, potato, giant chilli/capsicum, citrus fruit (orange, lemon, lime, grapefruit), alma, guava, coriander leaves, agathi, Deficiency Poor immune system, Scurvy – bleeding and swollen gums, red dots on skin, tiredness, muscle and joint pain VITAMIN D Function Sources Eggs, powdered milk, fortified oil, oily fish The Sun!! The body creates Vitamin D when the skin is exposed to the sun. Deficiency Weak bones and decreased bone density, increased risk of osteoporosis in adulthood Increased risk in those who do not go outside often. Also, if the skin is covered up then you cannot produce Vitamin D IRON Function Sources Creating heamglobin (blood), mental function, improve immune system Red meat, legumes, soya beans, green leafy vegetables - Amaranth, bengalgram leaves, cauliflower greens and radish leaves Deficiency Anaemia – 50-70% of the Indian population have anaemia and most is related to poor iron intake Feeling very tired, no energy, poor immune system WAYS TO IMPROVE IRON INTAKE • Eat foods high in Vitamin C at the same time to improve absorption Some foods reduce iron absorption and should be limited at meal time with iron rich foods • Tomato, cauliflower (gaubi), cabbage (patta gaubi), fruit – citrus, alma, guava Tea, coffee, chocolate, eggs, peppermint and chamomile Sprouting beans will help improve iron (and zinc) content CALCIUM Function Sources Important for strong bones, muscle contraction, heartbeat Dairy foods – milk, cheese (paneer), yoghurt/curd, green leafy vegetables, soya bean, almonds (badam), fish eaten with bones Deficiency Poor growth, weak and soft bones that can break easily, bone pain, bone deformaties – bowed legs, dental cavities IODINE Function Helps to make hormones that are important for metabolism and keeping cells healthy Sources Sea fish, milk, eggs, iodized salt, legumes, seaweed Important not to have too much salt as this will increase blood pressure Deficiency In children – stunted growth, decreased intelligence, retardation Goitre – enlarged thyroid, dry skin, hair loss, fatigue and slowed reflexes. ZINC Function Sources Helps make new cells and enzymes, helps digest protein, fat and carbohydrate, wound healing Dairy - milk, paneer, curd, cereal product (wheat) eg bread/chapati, meat, shellfish, legumes, nuts, tofu Deficiency Decreased immune system, diarrhea, decreased eyesight, taste, smell, poor memory Thank you!!!