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VFCFZ ;\,U™

,F\AFUF/FGF ZMUM

ARVIND PATEL
FOOD & NUTRITION BOARD
GOVT.OF INDIA
AHMEDABAD

8/14/2018 1
VFCFZo VF56[ H[ S\. BF.V[ VG[ T[G[F p5IMU VF56]\
XZLZ SZ[ T[ VFCFZP
5MQF6o H[ 5|lS|IF NJFZF XZLZ VFCFZGM p5IMU SZ[ K[
T[G[ 5MQF6 SC[ K[P

• VFCFZ D]bI +6 SFIM" SZ[ K[P

!P N[CWFlD"S SFI"

ZP DGMJ{7FlGS SFI"

#P ;FDFHLS SFI"

8/14/2018 2
!P N[CWFlD"S SFI"
VF SFI" +6 lJEFUDF\ JC[\RL XSFI
!P XlST NFIS SFI"o BMZFS VF56F HLJGG[ 8SFJL
ZFBJF TYF SFI" SZJF DF8[GL XlST 5}ZL 5F0[ K[P
! U|FD SFAM"lNT 5NFY"DF\YL $ lS,M
S[,ZL XlST D/[ K[P
! U|FD RZALDF\YL ) lS,M S[,ZL XlST
D/[ K[P
! U|FD 5|M8LGDF\YL $ lS,M S[,ZL
XlST D/[ K[P
! U|FD VF<SMCM,DF\YL * lS,M S[,ZL XlST
D/[ K[P
ZP XZLZ 30TZ sJ'l£ VG[ lJSF;fG]\ SFI"o AF/S
DM8]\ YT]\ CMI tIFZ[ T[GF\ JHG VG[ p\RF.
AgG[DF\ YTM JWFZM T[6[ ,LW[, VFCFZG[3
8/14/2018
VFEFZL K[P VFCFZGF VF BF; SFI"G[ XZLZ
Energy in foods

8/14/2018 4
ZP DGMJ{7FlGS SFI"
• VFCFZ VF56L E}B ;\TMQF[ K[ VG[ DFG;LS
;\TMQF VF5[ K[P
• EFJTM VFCFZ HDJFDF\ JW] VFG\N VFJ[
K[P
• UDTL jIlST Z;M. AGFJ[ TM EMHG JW]
:JFlNQ8 ,FU[ K[P
• ;O/TFGF 5]Z:SFZ TZLS[ VFCFZGM p5IMU
SZJFDF\ VFJ[ K[P
• AF/SG[ D/[,L ;O/TF DF8[ T[G[ RMS,[84
VF.:FS|LD JU[Z[
8/14/2018 5
#P ;FDFlHS SFI"

• VFCFZ ;FDFlHS ;\A\WM lJS;FJL


XS[ T[J]\ JFTFJZ6 5[NF SZ[ K[P
• ;FDFlHS ;\D[,GM TYF lJJFC S[
,uGGF ;DFZ\EMDF\ EMHGGL
jIJ:YFYL H]NF H]NF JU"4 7FlT VG[
nD"GF ,MSM4 ;UF;\A\WLVM4
lD+M JU[Z[G[ GHLS ,FJJFDF\4
VFG\N TYF VFlTyIv;tSFZGL EFJGF
jIST SZJFDF\ VFCFZ DNN~5 YFI
8/14/2018 6
VFCFZDF\ VFJ[, 5MQFS 38SMG]\
JUL"SZ6
!P SFAM"lNT
5NFY"
ZP RZAL A'CNDF+F
5MQFS 38SM
#P 5|M8LG

$P 5F6L

5P lJ8FDLG
;}1DDF+F
&P BGLH 1FFZ 5MQFS 38SM
8/14/2018 7
• Insert Figure 1.2

Approximate
percentages of
nutrients in young
male and female
bodies.

Vitamins are not


included, because they
are in very small
amounts.

8/14/2018 8
!P SFAM"lNT 5NFYM"GF
5|Fl%T:YFG K[P RZAL VG[ 5|M8LGDF\YL 56 XlST D/[ K[P VF56F
VFCFZDF\ SFAM"lNT 5NFYMG\] 5|DF6 36\] JWFZ[ CMI K[P T[YL
SFIM"
XlST 5|F%T SZJFG]\ T[ DCtJG]\ 5|Fl%T:YFG K[P
ZP 5|M8LGGM V5jiFI YTM V8SFJJFG]\ SFI"o 5|M8LG XZLZG]\
30TZ SZJF DF8[ H~ZL K[P XZLZ 30TZG]\ SFI" SFAM"lNT 5NFYM"
S[ RZAL SZL XSTF GYLP SFAM"lNT 5NFYM" VG[ RZALGL p65
CMI tIFZ[ 5|M8LG XZLZG[ XlST 5]ZL 5F0[ K[P 5|M8LGGM p5IMU
XlST D[/JJF DF8[ SZJFDF\ VFJ[ TM T[ V5jII U6FIP VFYL VF56F
VFCFZDF\ SFAM"lNT 5NFYM" VG[ RZAL 5}ZTF 5|DF6DF\ CMJF
H~ZL K[P H[YL 5|M8LG XZLZ 30TZGF SFI" DF8[ H p5IMUL Y.
XS[P
#P RZALG[ p5IMUDF\ ,[JFG]\ SFI"o HM VFCFZDF\ SFAM"lNT
5NFYM" 5}ZTF 5|DF6DF\ CMI TM H T[ XZLZDF\ RZALGM IMuI
p5IMU SZJFDF\ DNN~5 YFI K[P
$P VFCFZG[ :JFlNQ8 AGFJJFG]\ SFI"o BF\04 UM/4 DW H[JF
SFAM"lNT 5NFYM" VFCFZG[ ;]U\lWT4 :JFlNQ8 VG[ ~lRSFZS
AGFJ[ K[P
5P 5FRG8/14/2018
;\A\lW SFI"o SFAM"lNT 5NFYM"GF\ S[8,FS :J~5M H[9
Z[;F TZLS[ VM/BFI K[P T[DG]\ XZLZ wJFZF 5FRG YT]\ GYL4 T[YL
BF\04 UM/ VG[ DW V[ GIF" SFAM"lNT 5NFYM" K[P VGFH4
S9M/ TYF A8F8F4 XSSlZIF4 AL84 ;}Z6 H[JF S\ND}/DF\YL
36F 5|DF6DF\ SFAM"lNT 5NFYM" D/[ K[P O/O/FNL BF;
SZLG[ S[/F4 S[ZL4 5F.G[5, TYF ãF1FDF\YL 56 SFAM"lNT
5NFYM" ;FZF 5|DF6DF\ D/[ K[P
XZLZ 5Z V;ZMo
SFAM"lNT 5NFYM"GL XZLZ 5Z YTL V;ZM VFCFZDF\
SFAM"lNT 5NFYM"GL p65 S[ VlWSTF 5Z VFWFZ ZFB[ K[P
VFCFZDF\ SFAM"lNT 5NFYM"GL µ65GF 5lZ6FD[ XlSTGL
µ65 JZTFI K[P 5lZ6FD[ JHG n8[4 YFS ,FU[ VG[ SFI"1FDTF
n8[ K[P
VFCFZDF\ SFAM"lNT 5NFYM"GL VlWSTFo
VFCFZDF\ SFAM"lNT 5NFYM"G]\ 5|DF6 JWFZ[ CMI TM
T[G]\ RZALDF\
8/14/2018 ~5F\TZ Y. T[GM XZLZDF\ ;\U|C YFI K[P 10
ZP RZAL GF SFIM"
• !P RZALDF\YL ;F{YL JW] 5|DF6DF\ XlST D/[ K[P ! U|FD
RZAL ) lS,M S[,ZL VF5[ K[P H[ T[8,FH JHGGF
SFAM"lNT 5NFY" S[ 5|M8LG DF\YL D/TL XlST SZTF
VFXZ[ ;JF A[ U6L K[P
• ZP RZAL NFjI lJ8FDLGM H[JF S[ V[4 0L4 . VG[ S[ GF
XMQF6 VG[ p5IMU DF8[ RZALGL H~Z 50[ K[P
VFCFZDF\ IMuI 5|DF6DF\ RZAL G CMI TM XZLZDF\
p5I]ST lJ8FDLGMGL p65 JTF"I K[P
• #P tJRF GLR[G]\ RZALG]\ 50 XZLZG]\ TF5DFG HF/JL
ZFBJFDF\ DNN~5 YFI K[P
• $P RZAL XZLZGF\ VUtIGF\ VJIJMGL VFH]AFH] UFNL
H[J]\ VFJZ6 AGFJL T[DG]\ AFCI VF\RSF VG[ .HFVMYL
Z1F6 SZ[ K[P
• 5P8/14/2018
ZF\WJFDF\ VG[ T/JFDF\ RZALGM p5IMU YFI K[4
11
JG:5lTH RZALGF 5|Fl%T:YFGo DUO/L4 ;Z;J4 T,4
;MIFALG4 S5F;LIF4 ZFI0M4 T[,LALIF\ VG[ SM5ZF JU[Z[
JG:5lTHgI RZALGF 5|Fl%T:YFG K[P
5|F6LH RZALGF 5|Fl%T:YFGo N}W4 .\0FGL HZNL4 3L4
DFB64 D,F.4 DFK,LG]\ T[, JU[Z[ 5|F6LHgI RZALGF
5|Fl%T:YFG K[P
XZLZ 5Z V;ZMo
• RZALGL p65o VFCFZDF\ RZALGL VlWSTF
VG[ p65 AgG[GL XZLZ 5Z V;Z 50[ K[P
VFCFZDF\ RZALGL p65YL XlSTGM VEFJ YFI
K[P 5lZ6FD[ JHG VG[ SFI"1FDTF 38[ K[4 YFS
,FU[ K[P VFCFZDF\ RZAL VMKL CMI TM
XZLZDF\ lJ8FDLG V[4 0L4 . G[ S[ GL p65
JTF"I K[P
• RZALGL VlWSTFo VFCFZDF\ RZALI]ST
5NFYM"
8/14/2018 JW] ,[JFYL XZLZG]\ JHG JW[ K[4 12
#P 5|M8LGGF SFIM"
!P XZLZGL J'lwWGL HF/J6L DF8[o XZLZGL
5[XLVMGL J'lwW DF8[ 5|M8LG H~ZL K[P
XZLZGM lJSF; YTM CMI tIFZ[4 GJL 5[XLVMGL
ZRGF DF8[ 5|M8LGGL JW] H~Z ZC[ K[P VFYL H
AF/SM VG[ UE"GL J'lwW DF8[ ;U"EF :+LVMG[
JW] 5|M8LGGL H~ZL 50[ K[P AF/SG[ DFTFG\]
N}W 5}ZTF 5|DF6DF\ D/L ZC[ T[ DF8[ WF+L
DFTF VMG[ JW] 5|M8LGGL H~Z ZC[ K[P
ZP N[CWFlD"S lS|IFVMG]\ lGIDGo pt;[RSM VG[
V\To:+FJMGF\ :J~5[ 5|M8LGGL CFHZL DCtJGL
N[CWFlD"S lS|IFVMG]\ lGIDG SZ[ K[P R[5L
ZMUMGM ;FDGM SZJFDF\ 5|M8LG XZLZG[
DNN
8/14/2018SZ[ K[P 13
5|M8LGGF 5|Fl%T:YFG
• 5|F6LH 5|M8LGGF 5|Fl%T:YFGo N}W4 RLh4
NCL4 N}WGL AGFJ8M4 BMIF4 .\0F4 DF\;4
DFK,L4 5|F6LH 5|M8LGGF 5|Fl%T:YFG K[P VF
BFn 5NFYM"DF\YL p\RL U]6JttFFJF/]\ 5|M8LG
VYJF TM 5}6" 5|M8LG D/[ K[P XZLZ 5}6"
5|M8LGGM ;\5}6" p5IMU SZL XS[ K[P
• JG:5lTH 5|M8LGGF 5|Fl%T:YFGo ;MIFALG4 NF/4
S9M/4 DUO/L4 T[,LALIF\4 ANFD4 SFH]4 ;}SF
D[JF DF\YL JG:5lTH 5|M8LG ;FZF 5|DF6DF\ D/[
K[P 3p\ VG[ RMBF H[JF VGFHDF\YL YM0F
5|DF6DF\ 5|M8LG D/L ZC[ K[P VF BFn
5NFYM"DF\YL D/TF 5|M8LGGL U]6JtTF p\RF
5|SFZGL CMTL GYLP T[YL 5|F6LH VG[ JG:5lTH
8/14/2018 14
XZLZ 5Z V;ZMo
5|M8LGGL p65YL GFGF AF/SMDF\ XZLZGL
J'lwW D\N ZC[ K[P A{FlwWS 5KFT56]\ ZC[ K[P
V[0LDF4 JF/ E]ZF YJF4 RFD0LDF\ SZR,L VG[
;MHF HMJF D/[ K[P IS'TDF\ RZAL HDF YFI K[P
R[5L ZMUMGM ;FDGM SZJFGL XZLZGL XlST
38[4 hF0F YFI K[P VF l:YlTG[ ccSJFlXIS"Zcc
SC[JFI K[P H[G[ CFY5U NMZ0L4 5[8 UFUZ0L
TZLS[ J6"JL XSFIP
5|M8LGGL ;FY[ S[,ZLGL p65 YJFYL cDZF:D;c
GFDGM ZMU YFI K[P H[DF\ AF/S S'XSFI4 RZAL
JUZG]\4 -L,L VG[ SZR,L JF/L RFD0L H6FI K[P
cDZF:D;c TYF cSJMlxIMZSZc A\G[ ZMU ;FY[
YJFYL cDZFl:DS SJMlxIMZSZc YFI K[P
8/14/2018 15
$P 5F6L
• 5F6L V[ XZLZDF\ ;F{YL JW] 5|DF6DF\ D/L VFJT]\
5MQFS n8S K[P XZLZGM Zq# EFU T[GFYL AG[,M
K[4 XZLZGL NZ[S 5[XLVMDF\ 5F6L CMI K[4
XZLZG\] DF/B\] AGFJJ\] VG[ RIF5RIGL
lS|IFVMDF\ ;FD[, YJ\] T[ 5F6LGF D}/E}T SFIM"
K[P
• XZLZG\] TF5DFG HF/JL ZFBJF DF8[ 5F6L
DCtJG\] K[P 5F6L N|FJS TZLS[ 5NF"YM"G]\
5lZJCG SZ[ K[P 5F6L XZLZDF\ BMZFSG]\ 5FRG4
,MCLG]\ E|D64 GSFDF 5NFYM"G]\\ pt;H"G TYF
XZLZG]\ TF5DFG HF/J[ K[P 5F6L XZLZGL
VF\TZLS
8/14/2018 5[XLVMGL VF;5F; ZCL T[G]\ AFCI16
5P lJ8FDLG
• T\N]Z:TL DF8[ lJ8FDLG DCtJGF 5MQFS n8SM
K[P XZLZG[ V<5 DF+FDF\ lJ8FDLGGL H~Z
50[ K[P XZLZ HFT[ lJ8FDLGM AGFJL XST\]
GYL4 VFYL H BMZFSDF\ T[ CMJF H~ZL K[P
lJ8FDLGMG[ A[ lJEFUDF\ JC[\RJFDF\ VFJ[ K[P
• !P RZALãFjI lJ8FdFLGMo VF lJEFUDF\ lJ8FDLG
V[4 0L4 . G[ S[ GM ;DFJ[X YFI K[P VF
lJ8FDLGMGF XMQF6 DF8[ VFCFZDF\ RZAL
CMJL H~ZL K[P T[ RZALDF\ N|FjI CMJFYL4
VFCFZDF\GM T[GM JWFZFGM HyYM RZAL
;FY[ XZLZDF\ IS'TDF\ HDF YFI K[P
• ZP H,ãFjI lJ8FdFLGMo AL ;D}CGF lJ8FDLGM
VG[
8/14/2018
lJ8FDLG ;L VF 5|SFZGF K[P H,ãFjI17
lJ8FDLGM[GM JWFZFGM HyYM D}+ wJFZF
RZALãFjI lJ8FdFLGM
lJ8FDLGvV[
• VF56[ VFCFZDF\YL A[ :JZ]5[ lJ8FDLG D[/JLV[
KLV[P
• !P Z[l8GM,o Z[l8GM, lJ8FDLGvV[ G\] XZLZ
wJFZF p5IMUDF\ ,[JFT\] :J~5 K[P H[ lJ8FDLG V[
TZLS[ VM/BFI K[P T[ DM8[EFU[ 5|F6LHgI BFW
5NFYM"DF\ CMI K[P
• ZP S[ZM8LGo S[ZM8LG4 Z[l8GM,G\] 5}J"UFDL
:J~5 K[P H[ JG:5lTHgI 5NFYM"DF\ CMI K[P
XZLZDF\ S[ZM8LGG\] Z[l8GM,DF\ ~\5FTZ YIF
5KL T[GM p5IMU YFI K[P
• 5|Fl%T:YFGMo
• DFB64
8/14/2018
N}W4 NCL\4 .\0F4 DFK,LGF IS'TG\] T[,
18
Vitamin A

8/14/2018 19
SFIM"o VF\BMGL T\N]Z:TL DF8[ lJ8FDLGvV[ B}AH
DCtJG\] K[P lJ8FDLG V[GF SFZ6[ V\WFZF VMZ0FDF\ HF\B]
HM. XSFI K[P tJRFGL T\N]Z:TL4 VgGDFU" VG[ D}+HgI
DFU"GF `,[QDLI VFJZ64 XZLZGF lJSF; VG[ J'lwW DF8[
lJ8FDLG
• XZLZ V[
5ZDCtJG\]
V;ZMoK[P
• VFKF 5|SFXDF\ G N[BFI T[ lJ8FDLGvV[ GL p65G\] 5C[,\]
,1F6 K[P VF ZMUG[ Z\TFW/F56\] SC[ K[P HM VF l:YlTV[
p5RFZ G SZJFDF\ VFJ[ TM WLD[ WLD[ 5F\56M ;]SFI K[
VG[ VF\BM lG:T[H AG[ K[P KTF 56 p5RFZ G SZJFDF\ VFJ[
TM VF\BM 5MRL 50[ VG[ R[5 ,FU[ K[P VF\BGF ;O[N
EFUDF\ 85SF\ 50[ K[P SF/M EFU WLD[ WLD[ ;O[N YFI K[4
VG[ K[J8[ V\WtJ VFJ[ K[P
• VF p5ZF\T RFD0LGL T\N]Z:TL ;RJFTL GYLP tJRF ;]SL VG[
S/R,LJF/L AG[ K[P RFD0L BZAR0L VG[ hL6LhL6L OM<,LVM
8/14/2018 20
JF/L AG[ K[P H[ SM6L4 3]\86 TYF YF5FGF EFU p5Z N[BFI
lJ8FDLGv0L
• 5|Fl%T:YFGMo
• lJ8FDLGv0L ;}I"GF lSZ6M4 IS'T4 DFK,L4 .\0FGL
HZNL4 N}W4 DFB6 VG[ WL DF\YL D/[ K[P
DFK,LGF IS'TG\] T[, lJ8FDLG 0L G\] AC]H ;F~
5|Fl%T:YFG K[P ;}I"GF lSZ6M VF56L RFD0L 5Z
50[ tIFZ[ RFD0L GLR[ ZC[,F
0LCF.0=MSM,[S[<;LO[ZMZM, GFDGL RZALG[
lJ8FDLG 0L DF\ ~5F\TZ SZ[ K[P DF8[ RFD0L 5Z
;}I"GM S}D/M T0SM 50[ T[ 36]\ HZ]ZL K[P
• SFIM"o
• lJ8FDLGv0L BF; SZLG[ S[l<xFID TYF OM:OZ;GF
XMQF6DF\
8/14/2018
VG[ CF0SFGF A\WFZ6DF\ DNN SZ[21
Vitamin D

8/14/2018 22
• XZLZ 5Z V;ZMo
• ;}I"5|SFX JUZGL V\WFZL HuIFDF\ ZC[TF
AF/SM TYF :+LVMDF\ lJ8FDLG 0L GL p65
;FDFgI K[P 5lZ6FD[ AF/SMG[ lZS[8|;
sVl:YDFN"JfGFDGM ZMU YFI K[P VF
ZMUYL l50FTF AF/SMGF XZLZDF\
S[l<XID VG[ OM:OZ;G\] IMuI XMQF6
YT\] GYL4 T[YL CF0SF\ VG[ NF\T 5MRF
VG[ GA/F ZC[ K[P AF/SGL J'lwW GA/L
YFI K[P AF/S YL 5MTFG\] JHG HLZJFT\]
GYL4 5U JF\SFJ/L HFI K[P CFY VG[ 5UGF
CF0SFGF K[0F DM8F SNGF Y. HFI K[P
VFJ\] AF/S RF,JFG\] DM0[YL XLB[ K[P
50L HFI tIFZ[ CF0SF\ H<NLYL EF\UL HFI23
8/14/2018
lJ8FDLGv.
• 5|Fl%T:YFGMo
• VFBF VGFH4 ;MIFALG4 DUO/L4 GFl/I[Z4
DUO/L4 T, TYF VgI T[l,ALIF4 .\0FGL HZNL4
N}W VG[ DFB6 DF\YL lJ8FDLG . ;FZF
%F|DF6DF\ D/[ K[P
• SFIM"o
• lJ8FDLG . RZALDF\ N|FjI K[P ;]JF/L RFD0L
TYF XZLZGF 5|HGGT\+GL IMuI T\N]Z:TL G[
SFI" DF8[ T[ DCtJG]\ K[P lJ8FDLG . UE"
8SFJL ZFBJFDF\ DNN SZ[ K[P
• XZLZ 5Z V;ZMo
8/14/2018 24
Vitamin E

8/14/2018 25
lJ8FDLGvS[
• 5|Fl%T:YFGo
VF lJ8FDLG DF\; TYF ,L,F 5F\N0FJF/F XFSEFHL
H[JF S[ D[YL4 5F,S VG[ TF\N/HM JU[Z[GL
EFHLDF\YL D/[ K[P
• SFIM"o
VF lJ8FDLG Z]lWZG[ HFDJFDF\ DNN SZL
XZLZDF\YL JCL HT\] ,MCL V8SFJ[ K[P
• XZLZ 5Z V;ZMo
• lJ8FDLG S[ GL p65 CMI TM WF YFI tIFZ[
5]QS/ Z]lWZ JCL HFI K[4 5lZ6FD[ XZLZ W6\]
Z]lWZ U]DFJ[ K[P AF/SGF HgD ;DI[ UE"JTL
:+LG[ JCL HTF Z]lWZGF lGI\+6 DF8[[ TYF
8/14/2018 26
GJHFT XLX]G[ A|[.G C[DZ[H YT]\ V8SFJJF
Vitamin K

8/14/2018 27
Summary
Vi Source Deficiency Toxicity
t
Vegetables; Night Embryo
Dairy; liver Blindness defects; Organ
A
Embryo damage
Defects
Sun; Rickets Calcium
fortified Osteomalacia deposits
D 8/14/2018 28
H,ãFjI lJ8FdFLGM
AL v ;D}CGF lJ8FldFGMo
• lJ8FdFLG ALv! sYFIlDGf
• lJ8FdFLG ALvZ slZAMO,[lJGf
• lJ8FdFLG ALv# sGFIl;Gf
• OMl,S V[l;0
• lJ8FdFLG ALv!Z
• lJ8FDLGv;L
8/14/2018 29
lJ8FdFLG ALv! sYFIlDGf
• 5|Fl%T;YFG ov
VFBF VGFH VG[ BF; SZLG[ S9M/GF ALHF\S]ZGF EFUDF\
T[ D/[ K[P ,L,F XFSEFHL4 DF\;4 .\0FGL HZNL4 N}W4
N}WGL AGFJ8M DF\YL YFIFlDG D/[ K[P
• YFIDLGGF SFIM"o
YFIFlDG D]bItJ[ 7FGT\+ TYF SFAM"lNT 5NFYM"GF\
NCGGF\ SFI"DF\ DNN SZ[ K[P XZLZDF\ 5F6LGL
VF5,[DF\4 5FRGT\+ jIJl:YT SZL E}B ,UF0JFDF\4
YF.ZM.0U|\lYGF :+FJDF\ VG[ ,MCLGF E|D6DF\ DNN SZ[
K[P
• p65GF lRgCMov
YFIlDGGF VEFJYL E}B DZL HFI4 p<8L H[J] YFI4 JHG 38L
HFI4 7FGT\T]VM GA/F 50JFYL DFGl;S GA/F. TYF
SFDDF\ Z; VMKM YFI K[P DF6; VS/F. HFI TYF VF/;] AGL
HFI K[P RFD0L 5Z BZHJF H[J]\ YFI K[P RFD0LGF VF
ZMUG[ A[ZLA[ZL SC[ K[P ,]bBL RFD0L Y. T[DF\YL 5F6L
8/14/2018 30
hZ[ T[G[ J[8 A[ZLA[ZL SC[ K[P H[DF\ 5UDF\ 5F6L EZFI
lJ8FdFLG ALvZ slZAMO,[lJGf
• VF lJ8FDLG UZDLYL GFX 5FDT] GYL 56 5|SFXGF lSZ6M
TYF VF<S,LGL CFHZLYL GFX 5FD[ K[P VF lJ8FDLGGM
V[l;0DF\ GFX YTM GYLP
• 5|Fl%T:YFGMov
,L,FXFSEFHL4 VFBF VGFH4 S9M/4 ;MIFALG4 T[l,ALIF4
DF\;4 IS'T4 lS0GL4 .\0F4 DF\K,L4 N}W4 N}WGL
AGFJ8M4 IL:8 TYF ;}SF O/MDF\YL D/[ K[P
• SFIM" ov
ZF.AMO,[lJG 56 7FGT\+GF SFI"DF\4 BMZFSGF\ 5FRG
TYF NCGDF\ DNN SZ[ K[P 5|HMt5lT TYF I]JFJ:YF
HF/JL ZFBJFDF\ DNN SZ[ K[P pt;[RSMGL AGFJ8DF\
TYF XZLZGL J'lwWDF\ DNN SZ[ K[P :GFI]VMG[
DHA]TL VF5[ K[P
• é65GF lRgCMov
ZF.AMO,[lJGGL
8/14/2018
VKTYL HLE 5Z RF\NF 50[ VG[ ,L:;L
31
lJ8FdFLG ALv# sGFIl;Gf
• 5|Fl5T:YFGMov
T[,LlAIF4 VFBF VGFH4 S9M/4 IL:84 VFYM VFJ[,L JFGUL
TYF DF\;4 IS'T4 SL0GL4 DFK,L4 N}W TYF N}WGL
AGFJ8M TYF ;}SF O/M DF\YL GFIFl;G ;FZF 5|DF6DF\
D/[ K[P 8=L%8MO[G GFDGF V[lDGM V[l;0 DF\YL
XZLZDF\ GFIFl;G AG[ K[P
• GFIFl;GGF SFIM"o
VF lJ8FDLG 56 7FGT\+GF SFI"DF\4 BMZFSGF 5FRGDF\
TYF SFAM"lNT 5NFYM"GF NCGDF\ DNN SZ[ K[P
XZLZGL J'lwW SZ[ K[P CMHZL TYF GFGF VF\TZ0FGF
SFI"DF\ DNN SZ[ K[P RFD0LGL T\N]Z:TL HF/JL ZFB[
K[P
• é65GF lRgCMov
GFIFl;GGL
8/14/2018 VKTGF ,LW[ 5FRG AZFAZ YT]\ GYL TYF
32
OMl,S V[l;0
• 5|Fl5T:YFGMo
,L,F 5F\N0FJF/F XFSEFHL H[JFS[ D[YL4 5F,S4
TF\N/HM JU[Z[ TYF S9M/DF\YL OMl,S V[l;0
;FZF 5|DF6DF\ 5|F%T YFI K[P DM8F VF\TZ0FGF
HLJF6]\VM VF lJ8FDLG AGFJTF CMJFYL T[GL
N{lGS H~ZLIFT B}A VMKL ZC[ K[P ;FDFgI
VFCFZDF\YL T[ _P& YL !P_ lDPU|FP D/L ZC[ K[P
• SFIM"o
,MCLDF\ ZSTS6MGL AGFJ8DF\ TYF RIF5RIDF\
DNN SZ[ K[P
• é65GF lRgCMov
VF lJ8FDLGGL VKTYL ,MCLGL OLSSFXGM ZMU
8/14/2018 33
lJ8FDLG ALv!Z
5|Fl%T:YFGMo
lJ8FDLG ALv!Z4 ,L,F 5F\N0FJF/F
XFSEFHL4 N}W4 RLh4 S[;LG VG[
,LJZ DF\YL D/[ K[P
SFIM"o
VF lJ8FDLG ,MCLGL pt5lTDF\
D]bItJ[ DNN SZ[ K[P 7FGT\+GF
SFI"DF\ 56 DNN SZ[ K[P
é65GF lRgCMov
8/14/2018 34
lJ8FDLGv;L
• 5|Fl%T:YFGo
lJ8FDLG ;L G[ 36L JFZ cTFHF VFCFZG]\ lJ8FDLGc SC[
K[P SFZ6S[ ZF\3JFYL T[GM GFX YFI K[P T[ TFHF VG[
BF8F O/M H[JF S[ GFZ\UL4 DF;\AL4 ,L\A]4 VFD/F4
HFDO/4 SF/L §F1F VG[ XFSEFHL DF\YL D/[ K[P
lJ8FDLG ;L 5|SFX TYF VMlS;HGGL CFHZLYL GFX
5FDT]\ CMJFYL SR]\AZ TYF O/MG[ EMHGGF YM0F
;DI 5C[,F SF5JFP XFSDF\ SMYDLZ EEZFJJFGM TYF
YF/LDF\ ,L\A] VF5JFGM lZJFH lJ8FDLG ;L GM GFX
YTM V8SFJ[ K[P
• SFIM"ov
lJ8FDLG ;L NF\T4 5[-F\ G[ tJRFG[ T\N]Z:T ZFB[ K[P
SMQF lNJF,GL T\N]Z:TL HF/J[ K[P NF\TGF p5ZGF
50GL Z1FF SZ[ K[P 5[-FG[ DHA}TF. VF5[ K[P ,MCLGL
AGFJ8DF\ DNN SZ[ K[P XZLZG[ ZMU 5|lTSFZS XlST
VF5[ K[P XZLZDF\ G]SXFG ST"F h[ZL TtJMYL ARFJ[
K[P 5|HMt5lTDF\ DNN SZ[ K[P
8/14/2018 35
• é65GF lRgCM ov
BGLH 1FFZ

• 1FFZM XZLZGF A\WFZ6DF\ DNN SZ[

K[P VF56F XZLZDF\ D]bI 1FFZM

S[l<xFID4 OM:OZ;4 VFIG" TYF

VFIMl0G K[P VF p5ZF\T ALHF 36F

1FFZM H}H 5|DF6DF\ CMI K[P VF

1FFZM HDLGDF\ YTF\ S9M/ TYF


8/14/2018 36
!P S[l<XID
XZLZDF\ 1FFZMGL ;ZBFD6LDF\ S[l<XID ;{FYL JW]
5|DF6DF\ CMI K[P CF0SF\ VG[ NF\TDF\ T[ ;F{YL JW]
5|DF6DF\ CMI K[P
• 5|Fl%T:YFGMo
ZFUL VG[ T, S[l<XIDG]\ p¿D 5|Fl%T:YFG K[P DFB6 VG[
3L l;JFIGL N}WGL AGFJ8M4 N}34 ,L,F XFSEFHL4 ;}SF
O/M4 S\ND]/4 VGFH4 S9M/ JU[Z[ DF\YL S[l<XID D/[
K[P
• SFIM"o
S[l<XIDGF D]bI SFI"DF\ CF0SF\ VG[ NF\TG]\ 30TZ G[
T\N]Z:T ZFBJFG]\ K[P S[l<XID VF SFI" lJ8FDLG 0L GL
CFHZLDF\ OM:OZ; ;FY[GF ;\lDz6YL SZ[ K[P T[DH lJlJW
N[C3FlD"S lS|IFVM[DF\ DNN SZ[ K[P
• XZLZ 5Z V;ZMo
S[l<XIDGL p65 ;UEF" :+LVM4 WF+LDFTFVM TYF
AF/SMDF\ HMJF D/[ K[P T[GF ,1F6M lJ8FDLGv0L GL
p65YL
8/14/2018 YTF\ lZS[8;GF ,1F6M H[JF CMI K[P H[DF\ CFY
37
5U N]oB[4 ,MCL H<NL HFDT]\ GYL4 5FRGDF\ TS,LO
ZP VFIG"
XZLZ DF8[ ALH] DCtJG]\ BGLH T[ VFIG" K[P XZLZG[ T[GL B}A
VMKF 5|DF6DF\ H~Z CMI K[P T[YL T[G[ V<5DF+F TtJ 56 SC[
K[P
• 5|Fl%T:YFGMo
VFCFZDF\ VFIG" VFBF VGFH4 ,L,F 5F\N0FJF/F XFSEFHL4 T,4
UM/4 BH]Z4 ;}SF O/M4 .\0F\GL HZNL4 IS'T VG[ DF\; DF\YL
D/[ K[P
• SFIM"o
ZSTS6MDF\ ZC[, ,F, Z\U H[G[ lCDMu,MALG SC[ K[ T[GL
AGFJ8DF\ VFIG" VUtIGM EFU EHJ[ K[P lCDMu,MALG
O[O;FDF\YL VMlS;HGG[ 5[XLVM ;]WL VG[ 5[XLVMDF\YL
SFA"G0FIMS;F.0 O[O;F ;]WL 5CM\RF0[ K[P
• XZLZ 5Z V;ZMo
VFIG"GL p65JF/L l:YlTG[ cVG[lDIFc SC[ K[P ;FDFgI ZLT[
8/14/2018 38
5|HMt5FNS p\DZGL :+LVM TYF AF/SMDF\ VFIG"GL p65 HMJF
#P VFIM0LG
VFIM0LG V<5DF+ TtJ K[P lJlJW N[CWFlD"S
lS|IFVMG]\ lGI\+6 SZGFZ YF.ZM.0 V\To:+FJ
YF.ZMlS;GG]\ DCtJG]\ 38S K[P
• 5|Fl%T:YFGMo
VFIMl0G HDLGDF\ CMI K[P JG:5lT HDLGDF\YL
VFIMl0G D[/J[ K[P H[ HDLGDF\ 5QS/ VFIMl0G CMI
T[DF\ pUF0[,F 5FS VFIMl0GGF ;FZF 5|Fl%T:YFGM K[P
NlZIF. BFn 5NFYM" H[JF S[ DL9]\4 NlZIF. JG:5lT TYF
DFK,LDF\ 5]QS/ VFIMl0G CMI K[P
• SFIM"o
VFIMl0G lJlJW N[CWFlD"S lS|IFVMG]\ lGI\+6 TYF
YF.ZMlS;G GFDGF V\To:+FJDF\ DNN SZ[ K[P
YF.ZMlS;GYL XZLZDF\ BMZFSG]\ NCG YFI K[P
• XZLZ 5Z V;ZMo
5J"TLI 5|N[XMGL HDLG JZ;FN VG[ 5LU/TF AZOYL
WMJF. HTL CMJF YL tIF\ VFIMl0GGL p65 ;FDFgI K[P
8/14/2018 39
VFIMl0GGL p65YL U/FDF\ UF\9 sUM.8Zf YFI K[P
Protein Deficiency Sign

Kwashiorkor

8/14/2018 40
Protein Deficiency Sign
Edema
Apathy
Dull, lifeless hair
Swollen abdomen
Underdeveloped,
Flabby muscles
Pigeon chest
Underweight
Easily irritated
Depressed
Poor attention
8/14/2018 41
Protein Deficiency Sign

8/14/2018 Edema 42
Protein Deficiency Sign
Marasmus

• Poor quality hair * Mottled complexion * Bloated abdomen


• Dull expression
8/14/2018 * Spindly arms and legs 43
Protein Deficiency Sign

8/14/2018 Marasmus 44
Protein Deficiency Sign

8/14/2018 45
Protein Deficiency Sign

8/14/2018 46
Protein Deficiency Sign

A vulture waits for a child to die


8/14/2018 47
Vitamin-A Deficiency sign

8/14/2018 48
Vitamin-A Deficiency sign

8/14/2018 49
8/14/2018 50
BITOT SPOT KERATOMALACIA

V
A
D

BILATERAL
BLINDNESS

8/14/2018 51
Vitamin A

From Lohnes et al., 1994 From Abu-Abed et al., 2001

VITAMIN A DEFICIENCY VITAMIN A EXCESS

8/14/2018 52
Vitamin-D Deficiency Sign

8/14/2018 53
Rickets
Vitamin-D Deficiency Sign

8/14/2018 Rickets involving hands 54


Vitamin-D Deficiency Sign

Rickets

8/14/2018 55
Vitamin-D Deficiency Sign

8/14/2018 56
Vitamin-D Deficiency Sign

Rickets
8/14/2018 Rickets 57
Vitamin-D Deficiency Sign

Rickets involving legs

8/14/2018 58
Vitamin-D Deficiency Sign

Rickety Rosary
8/14/2018 59
Thiamin Deficiency Sign

8/14/2018
Beriberi 60
Thiamin Deficiency Sign

8/14/2018
Beriberi 61
Thiamin Deficiency Sign

8/14/2018
Beriberi 62
Riboflavin Deficiency Sign

8/14/2018 63
Riboflavin Deficiency Sign

Angular Cheilosis

8/14/2018 64
Niacin Deficiency sign

Kasal’s Neckless
Flacky paint dermetosis
8/14/2018 65
Niacin Deficiency Sign

8/14/2018 66
Niacin Deficiency sign

Dermetitis
8/14/2018 67
Niacin Deficiency sign

8/14/2018 68
Glossitis
Niacin Deficiency sign

Flaky paint dermatitis


8/14/2018 Dermatitis 69
Niacin Deficiency sign

8/14/2018 70
Pellagra
VITAMIN-C Deficiency Sign

Scurvy, periungual hemorrhage


8/14/2018 71
VITAMIN-C Deficiency Sign

scurvy, gingival hemorrhage


scurvy corkscrew hairs

8/14/2018 72
Vitamin-C Deficiency sign

8/14/2018 73
Vitamin-C Deficiency Sign

Cessations of gums
8/14/2018 74
Vitamin-C Deficiency Sign

8/14/2018 75
Calcium-Vit D Deficiency Sign

8/14/2018 Epiphysial enlargement 76


Iron Deficiency Sign

8/14/2018
Anemia 77
Anemia

8/14/2018 78
Sickle Cells Anemia

8/14/2018 79
Genetic disorder
Signs and symptoms of Anemia in
children:
Lethargy
Irritability
Feeling tired
Pale skin, tongue,
gums, and nail
beds
Feeling dizzy
Headache
Shortness of
breath
Chest pain
Loss of
concentration
8/14/2018
Poor appetite 80
Iodine Deficiency Sign

Goiter
8/14/2018 81
Iodine Deficiency Sign

Thyroid Gland

Goiter
8/14/2018 82
Iodine Deficiency Sign

• Endemic Cretinism
• Note normal man and
three adult women with
cretinism:
• Short stature
• Protuberant abdomen
• Swollen features

8/14/2018 83
Iodine Deficiency sign

8/14/2018 84
Zinc Deficiency Sign

8/14/2018 85
Teeth

Attrition

8/14/2018 86
Excess calories (over nutrition) Obesity

8/14/2018 87
Low calories (under nutrition) linness

8/14/2018 88
Balance Nutrition

8/14/2018 89
8/14/2018 90
Determining Nutrient Needs: AMDR

8/14/2018 91