Unit 4

Food, Nutrition, and

Community Health
Hygiene Concept

Prof. Sanjay Saxena

SMS Varanasi
Unit 4: Community Health Concept

Unit 4
Community Health Concept
1.1 Causes of Common Diseases Prevalent in society
and Nutrition Requirement
1. Diabetes
Diabetes is a disease caused by a deficiency or defect in the production of insulin
hormone in the body is called diabetes. Insulin hormone is secreted by the
pancreas of the human body.
Causes of Diabetes
• Hereditary
If the parents or any other family members are suffering from this diabetes
disease, then the chances of getting this disease in their children also increase
and the children become carriers of this disease. So, this disease is passed from
one generation to another. It is transmitted through generations. If a person
gets diabetes before the age of 40, then it is due to hereditary.
• Age
Diabetes can occur at any time in a person of any age. Even in infancy, diabetes
can occur, but then the disease is temporary, which gets cured after a few
days. The chances of getting diabetes increase to a great extent in the age
group of 40-50 years.
• Obesity
Diabetes is more common in obese people. In adulthood, especially at the age
of 35-40 years, the tendency to store fat in the body increases very much. The
physical activity of obese people is also less. As a result, the metabolism of
carbs is not done properly, because of the proportion in which the food items
containing carbs are consumed, insulin is not secreted in that ratio, due to this
the disease of diabetes occurs.
• Gender
Although this disease occurs in both women and men, men are more likely to
get this disease than women.

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• Mental Stress
Due to mental stress, anger, excitement, worry, and fear, a person does not
take food on time, which gives rise to irregularities. Therefore, carbohydrate
metabolism is affected, and diabetes occurs.
Types of Diabetes
The three main types of diabetes are:
• Type 1 diabetes: Type 1 diabetes is believed to be an autoimmune condition.
This means your immune system mistakenly attacks and destroys the beta cells
in your pancreas that produce insulin. The damage is permanent. What
prompts the attacks is not clear. There may be both genetic and environmental
reasons. Lifestyle factors are not thought to play a role.
• Type 2 diabetes: Type 2 diabetes starts as insulin resistance. This means your
body can not use insulin efficiently. That stimulates your pancreas to produce
more insulin until it can no longer keep up with demand. Insulin production
decreases, which leads to high blood sugar. The exact cause of type 2 diabetes
is unknown. Contributing factors may include genetics, lack of exercise, or
being overweight. There may also be other health factors and environmental
reasons.
• Gestational diabetes: Gestational diabetes is due to insulin blocking hormones
produced during pregnancy. This type of diabetes only occurs during
pregnancy.
Nutritional Requirement
A diabetes diet simply means eating the healthiest foods in moderate amounts and
sticking to regular mealtimes. The plan also tells you how much food to have. For
most people who have diabetes (and those without, too), a healthy diet consists
of:
• 40% to 60% of calories from carbohydrates
• 20% calories from protein
• 30% or fewer calories from fat
A diabetes diet is a healthy-eating plan that is naturally rich in nutrients and low in
fat and calories. Key elements are fruits, vegetables, and whole grains. In fact, a
diabetes diet is the best eating plan for most everyone. Make your calories count

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with these nutritious foods. Choose a low-calorie diet with healthy carbohydrates,
protein, fiber-rich foods, good fats, vitamins, and minerals. Good sources of these
are fruits, vegetables, whole grains, legumes, (beans and peas), low-fat dairy
products (milk and cheese), and fish. Foods containing monounsaturated and
polyunsaturated fats can help lower your cholesterol levels. These include
avocados, nuts, canola, olive, and peanut oils.
2. Hypertension
Blood Pressure is the pressure on the walls of the arteries. Pressure is essential for
blood to flow. If the blood pressure is not enough, then the blood flow in the
arteries will decrease. When the left ventricle of the heart is constricted, blood
flows from the ventricle to the arteries, at that time, the blood pressure is highest,
and this blood pressure is called systolic blood pressure, in which blood falls on the
walls of the arteries. Diastolic blood pressure is pressure in the arteries when the
heart rests between beats. The systolic blood pressure of a normal healthy person
is 110 to 145 mm Hg in its natural state, and the diastolic blood pressure is 70 to
90 mm Hg. The blood pressure of a healthy person is 120 by 80 mm Hg. If the
blood pressure is higher than this, it indicates high blood pressure.
High blood pressure (hypertension) is a common condition in which the long-term
force of the blood against your artery walls is high enough that it may eventually
cause health problems, such as heart disease.
Causes of Hypertension
The exact causes of high blood pressure are not known, but several things may
play a role, including:
• Smoking
• Being overweight or obese
• Lack of physical activity
• Too much salt in the diet
• Too much alcohol consumption (more than 1 to 2 drinks per day)
• Stress
• Older age
• Genetics
• Family history of high blood pressure

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• Chronic kidney disease

• Adrenal and thyroid disorders
• Sleep apnea: Sleep apnea is a potentially serious sleep disorder in which
breathing repeatedly stops and starts. If you snore loudly and feel tired even
after a full night's sleep, you might have sleep apnea.
Nutrition Requirement to Control Hypertension
One of the steps your doctor may recommend to lower your high blood pressure
is to start using the DASH diet. DASH stands for Dietary Approaches to Stop
Hypertension. Following are the DASH Diet suggestions:
• Add a serving of vegetables at lunch and at dinner.
• Add a serving of fruit to your meals or as a snack. Canned and dried fruits are
easy to use, but check that they don't have added sugar.
• Use only half your typical serving of butter, margarine, or salad dressing, and
use low-fat or fat-free condiments.
• Drink low-fat or skim dairy products any time you would normally use full-fat
or cream.
• Limit meat to 6 ounces a day. Make some meals vegetarian.
• Add more vegetables and dry beans to your diet.
• Instead of snacking on chips or sweets, eat unsalted pretzels or nuts, raisins,
low-fat and fat-free yogurt, frozen yogurt, unsalted plain popcorn with no
butter, and raw vegetables.
• Read food labels to choose products that are lower in sodium.
3. Obesity
Obesity is a complex disease involving an excessive amount of body fat. Obesity is
not just a cosmetic concern. It is a medical problem that increases the risk of other
diseases and health problems, such as heart disease, diabetes, high blood
pressure, and certain cancers. Obesity means having excess body fat. Adults 35
years of age and older with a BMI (Body Mass Index) greater than 30 are obese.
Causes of Obesity
The most common causes of obesity are overeating and physical inactivity.
Ultimately, body weight is the result of genetics, metabolism, environment,
behavior, and culture. Following are some common causes of obesity:

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Physical inactivity: Sedentary people burn fewer calories than people who are
active. The National Health and Nutrition Examination Survey (NHANES) showed a
strong correlation between physical inactivity and weight gain in both sexes.
Overeating: Overeating leads to weight gain, especially if the diet is high in fat.
Foods high in fat or sugar (for example, fast food, fried food, and sweets) have
high energy density.
Genetics: A person is more likely to develop obesity if one or both parents are
obese. Genetics also affect hormones involved in fat regulation. For example, one
genetic cause of obesity is leptin deficiency. Leptin is a hormone produced in fat
cells and in the placenta. Leptin controls weight by signaling the brain to eat less
when body fat stores are too high. If, for some reason, the body cannot produce
enough leptin or leptin cannot signal the brain to eat less, this control is lost, and
obesity occurs.
A diet high in simple carbohydrates: Carbohydrates increase blood glucose
levels, which in turn stimulate insulin release by the pancreas, and insulin promotes
the growth of fat tissue and can cause weight gain. Some scientists believe that
simple carbohydrates such as sugars, fructose, desserts, soft drinks, beer, and
wine, contribute to weight gain because they are more rapidly absorbed into the
bloodstream than complex carbohydrates such as pasta, brown rice, grains,
vegetables, and raw fruits.
Medications: Medications associated with weight gain include treating
depression, seizures, diabetes, hypertension, hypothyroidism, insulin resistance,
and polycystic ovary syndrome.
Psychological factors: For some people, emotions influence eating habits. Many
people eat excessively in response to emotions such as boredom, sadness, stress,
or anger.
Social issues: There is a link between social issues and obesity. Lack of money
to purchase healthy foods or lack of safe places to walk or exercise can increase
the risk of obesity.
Nutrition Requirement to Control Obesity
Reduce the intake of sugar, salt, fatty foods, refined foods, soft drinks, and alcohol.
Eat complex carbohydrates, low glycemic foods, and fiber-rich diets. Increase

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consumption of fruits and vegetables, legumes, whole grains, and nuts. Limit fat
intake and shift from saturated to unsaturated fats.
4. Constipation
Constipation is a condition in which you may have fewer than three bowel
movements a week; stools that are hard, dry, or lumpy; stools that are difficult or
painful to pass; or a feeling that not all stool has passed.
Causes of Constipation
Following are the common causes of constipation:
• Eating foods low in fiber.
• Not drinking enough water (dehydration).
• Not getting enough exercise.
• Changes in your regular routine, such as traveling, eating, or going to bed at
different times.
• Eating large amounts of milk or cheese.
• Stress.
• Resisting the urge to have a bowel movement.
Nutrition Requirement to Relieve Constipation
Following should be eaten and drank to relieve constipation:
• Fiber: Depending on your age and sex, adults should get 25 to 31 grams of
fiber a day. The good sources of fiber are:
o whole grains, such as whole-wheat bread and pasta, oatmeal, and bran
flake cereals
o legumes, such as lentils, black beans, kidney beans, soybeans, and
chickpeas
o fruits, such as berries, apples with the skin on, oranges, and pears
o vegetables, such as carrots, broccoli, green peas, and collard greens
o nuts, such as almonds, peanuts, and pecans
• Drink Plenty of Water: You should drink water and other liquids, such as
naturally sweetened fruit and vegetable juices and clear soups, to help the fiber
work better. This change should make your stools softer and easier to pass.

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5. Diarrhea
People suffering from diarrhea have loose, watery, and more frequent bowel
movements. It may be present alone or be associated with other symptoms such
as nausea, vomiting, abdominal pain, or weight loss.
Luckily, diarrhea is usually short-lived, lasting no more than a few days. But when
diarrhea lasts beyond a few days into weeks, it usually indicates that there is
another problem — such as irritable bowel syndrome (IBS) or a more serious
disorder including persistent infection, celiac disease, or inflammatory bowel
disease (IBD).
Causes of Diarrhea
Several diseases and conditions can cause diarrhea, including:
• Viruses: Viruses such as norovirus can cause diarrhea.
• Bacteria and parasites: Exposure to pathogenic bacteria, such as E. coli or
parasites through contaminated food or water, leads to diarrhea.
• Medications: Many medications, such as antibiotics, can cause diarrhea.
Antibiotics alleviate infections by killing bad bacteria, but they also kill good
bacteria. Other drugs that cause diarrhea are anti-cancer drugs and antacids
with magnesium.
• Lactose intolerance: People who have difficulty digesting lactose have
diarrhea after eating dairy products.
• Fructose: Fructose can lead to diarrhea in people who have trouble digesting
it.
• Artificial sweeteners, Sorbitol, erythritol, and mannitol: Artificial
sweeteners are nonabsorbable sugars found in chewing gum and other sugar-
free products — can cause diarrhea in some otherwise healthy people.
• Surgery: Partial intestine or gallbladder removal surgeries can sometimes
cause diarrhea.
• Other digestive disorders: Chronic diarrhea has a number of other causes,
such as IBS, Crohn's disease, ulcerative colitis, celiac disease, microscopic
colitis, and small intestinal bacterial overgrowth (SIBO).

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Nutritional Requirement to Control Diarrhea

When you have diarrhea, eat some foods high in potassium, such as ripe bananas,
apricot or peach nectar, potatoes, fish, and meat. Drink fluids between meals. Eat
small amounts of food frequently. Fatty foods such as fried foods, sauces, gravies,
and salad dressings should be avoided. Highly spiced foods may not be well
tolerated.
6. Typhoid
Typhoid is a bacterial infection that can lead to a high fever, diarrhea, and
vomiting. It can be fatal. It is caused by the bacteria Salmonella typhi. The infection
is often passed on through contaminated food and drinking water, and it is more
prevalent in places where handwashing is less frequent.
Nutrition Requirement to Control Typhoid
On the typhoid diet, you should opt for foods lower in fiber, such as cooked
vegetables, ripe fruits, and refined grains. It is also important to stay hydrated and
drink plenty of water. Here are some foods to enjoy on the typhoid diet:
• Cooked vegetables: potatoes, carrots, green beans, beets, squash
• Fruits: ripe bananas, melons, applesauce, canned fruit
• Grains: white rice, pasta, white bread, crackers
• Proteins: eggs, chicken, turkey, fish, tofu, ground meat
• Dairy products: low fat or fat-free pasteurized milk, yogurt, cheese, and ice
cream (as tolerated)
• Beverages: bottled water, herbal tea, coconut water, juice, and broth

1.2 National Programs and Policies for Improving

Dietary Nutrition in India
To maintain a good cycle of dietary nutrition, the government of India has launched
some national programs on dietary nutrition. We are describing these programs here,
which are made accessible to every section of society through different mediums.
1. National Nutrition Policy 1993
The National Nutrition Policy was adopted by the government in the year 1993.
Under this, a multi-sector plan was advocated to eradicate malnutrition and

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achieve the goal of optimum nutrition for all. The scheme lays emphasis on
monitoring the level of nutrition across the country and sensitizing the government
machinery about the need for good nutrition and the need to prevent malnutrition.
2. National Nutrition Mission
The Government of India is running a nutrition campaign in a phased manner by
adopting a life cycle approach to eradicate malnutrition, maintain the health and
nutritional level of children from 0 to 6 years, and pregnant and lactating mothers.
POSHAN Abhiyaan or National Nutrition Mission has been designed by NITI Aayog
under the 'National Nutrition Strategy'. The objective of this strategy is to build a
"malnutrition-free India" by the year 2022. The goal of this campaign is to benefit
10 crore people across the country with a budget of about Rs 9046.17 crore. 50
percent of the total cost of the campaign is being provided through budgetary
support, while the remaining 50 percent is being provided by the World Bank and
other multilateral development banks.
Under the National Nutrition Mission, targets have been set for the next 3 years to
eliminate malnutrition in a phased manner. Objectives and Targets:
• To prevent stunting in children of 0 to 6 years and to reduce it at the rate of
2% per annum, to 6 percent.
• Prevention of undernutrition of children of 0 to 6 years and to reduce it by 6%
in total, 2% per year
• To reduce the prevalence of anemia in children aged. 3.6 to 59 months by 9%
in total, by 3% per year.
• To reduce the prevalence of anemia in adolescent girls, pregnant and lactating
mothers in the age group of 15 to 49 years at the rate of 3% per year.
• To reduce the number of children born with low birth weight by 6%, 2% per
annum.
3. Mid-Day Meal Program
The mid-day meal program was started in the year 1995 as a centrally sponsored
scheme. After this, in the year 2004, making a major change in the program, the
system of providing cooked food based on the menu was started. Under this
scheme, there is a provision to provide a minimum of 300 calories of energy and
8-12 grams of protein per day for the lower primary level and a minimum of 700

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grams of calories of energy and 20 grams of protein for the upper primary level
for a minimum of 200 days. This program comes under the Department of School
Education and Literacy, Ministry of Human Resource Development.
4. Bhartiya Poshan Krishi Kosh
The Ministry of Women and Child Development had established the Bharatiya
Poshan Krishi Kosh (BPKK) in the year 2019. It aims to develop a multi-sectoral
framework to address malnutrition under which emphasis will be given to the
production of diverse crops in 128 agro-climatic zones for better nutritional
products.
5. Aahar Kranti Mission
The "Aahar Kranti Mission" aims to understand the need for a nutritionally balanced
diet and access to all local fruits and vegetables. Vigyan Bharati (VIBHA) and
Global Indian Scientists and Technocrats Forum (GIST) have jointly started this
mission with the goal of "Good Food - Good Thought". The objective of the Diet
Revolution Movement is to find a solution to the problem of hunger and many
diseases in India and the whole world. Studies have found that India produces
twice as many calories as it consumes, but still many people in the country are
malnourished. The root of this strange issue is the lack of nutrition awareness in
any section of our society. In the time of the current COVID-19 pandemic, there is
an even greater need for a nutritionally balanced diet.

1.3 International Programs for Improving Dietary

Nutrition
1. SAARC Food Bank
In pursuance of the decision taken at the 14th SAARC Summit held in New Delhi
during April 3-4, 2007, South Asian Association for Regional Cooperation (SAARC),
the heads of states of the countries have signed an agreement to establish a SAARC
Food Bank. This foodbank will complement the national efforts to provide food
security to the population of the region. The Agreement on the establishment of
the SAARC Food Bank has been approved by the President of India on 17th April

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2007. In accordance with this Agreement, there shall be wheat or rice, or both
given to the state as per the assessed share of the SAARC Food Bank.
2. Food and Agriculture Organization (FAO)
The Food and Agriculture Organization (FAO) is one of the largest specialized
agencies of the United Nations system, established in 1945 to improve the
nutritional status of the rural population by improving agricultural productivity and
living conditions, with the mission to raise the standard of living. The World Food
Security Committee (CFS) serves as a forum in the United Nations mechanism for
the review and compliance of world food security policies, including production of
food, physical and economic access to food. India is a member of both FAO and
CFS, ‘Committee on World Food Security.’ CFS monitors the progress of
implementation of the WFS Action Plan.
3. World Food Program
In a world of plenty, where enough food is produced to feed everyone on the
planet, hunger should be a thing of the past. However, conflict, climate change,
disasters, inequality, and – most recently – the COVID-19 pandemic means one
out of nine people globally is still going to bed hungry and famine looms for
millions.
Powered by the passion, dedication, and professionalism of its 20,000 staff
worldwide, the World Food Program (WFP) works in over 80 countries to bring life-
saving food to people displaced by conflict and made destitute by disasters, and
help individuals and communities find life-changing solutions to the multiple
challenges they face in building better futures.
They work to enhance nutrition in women and children, support smallholder
farmers in improving productivity and reducing losses, help countries and
communities prepare for and cope with climate-related shocks, and boost human
capital through school feeding programs.
In conflict situations, they bring relief to exhausted populations and use food
assistance to build pathways to peace and stability – work for which WFP was
awarded the Nobel Peace Prize in 2020.

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3.3 Immunity-Boosting Food

Feeding your body certain foods may help keep your immune system strong. If you
are looking for ways to prevent cold, flu, and other infections, your first step should
be a visit to your local grocery store. Plan your meals to include the following eatables,
which are powerful immune system boosters.
1. Citrus Fruits
Vitamin C is thought to increase the production of white blood cells, which are key
to fighting infections. Almost all citrus fruits are high in vitamin C. With such a
variety to choose from, it is easy to add a squeeze of this vitamin to any meal.
Popular citrus fruits include grapefruit, oranges, clementine’s, tangerines, lemons,
and limes.
2. Red Bell Peppers
Red bell peppers contain almost 3 times as much vitamin C as exists in oranges.
They are also a rich source of beta carotene. Besides boosting your immune
system, vitamin C may help you maintain healthy skin. Beta carotene, which your
body converts into vitamin A, helps keep your eyes and skin healthy.
3. Broccoli
Broccoli is supercharged with vitamins and minerals. Packed with vitamins A, C,
and E, as well as fiber and many other antioxidants, broccoli is one of the healthiest
vegetables you can put on your plate.
4. Garlic
Garlic is valuable in fighting infections. Garlic may also slow down the hardening
of the arteries, and it helps lower blood pressure. Garlic’s immune-boosting
properties seem to come from a heavy concentration of sulfur-containing
compounds, such as allicin.
5. Ginger
Ginger may help decrease inflammation, which can help reduce sore throat and
inflammatory illnesses. Ginger may help with nausea as well.
6. Spinach
Spinach is not only rich in vitamin C but also packed with numerous antioxidants
and beta carotene, which may both increase the infection-fighting ability of our
immune systems.

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7. Yogurt
Yogurt is the best source of probiotics. It is the good bacteria that keep the immune
system and digestive system healthy. Some recent studies have also found
probiotics to be effective in fighting respiratory infections such as the common cold
and influenza. Doctors recommend eating plain yogurt instead of flavored.
8. Almonds
Almond is rich in vitamin E, which is a powerful antioxidant that is key to a healthy
immune system. It is a fat-soluble vitamin, which means it requires the presence
of fat to be absorbed properly.
9. Sunflower Seeds
Sunflower seeds are full of nutrients, including phosphorous, magnesium, and
vitamins B-6 and E. Sunflower seeds are also incredibly high in selenium. Just 1
ounce contains nearly half the selenium that the average adult needs daily.
10. Turmeric
Turmeric is a key ingredient in many curries. This bright yellow, bitter spice has
also been used for years as an anti-inflammatory in treating both osteoarthritis and
rheumatoid arthritis.
11. Green Tea
Green tea is packed with flavonoids, a type of antioxidant. Where green tea really
excels is in its levels of epigallocatechin gallate (EGCG), another powerful
antioxidant. In studies, EGCG has been shown to enhance immune function. Green
tea is also a good source of the amino acid L-theanine. L-theanine may aid in the
production of germ-fighting compounds in your T cells.
12. Papaya
Papaya is another fruit that contains vitamin C, potassium, magnesium, folate, and
a digestive enzyme called papain (that has anti-inflammatory effects), which are
beneficial to your overall health.
13. Kiwi
Kiwis are naturally full of a ton of essential nutrients, including folate, potassium,
vitamin K, and vitamin C.

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14. Poultry
Poultry, such as chicken and turkey, is high in vitamin B-6. About 3 ounces of light
turkey or chicken meat contains nearly one-third of your daily recommended
amount of B-6. Vitamin B-6 is an important player in many of the chemical
reactions that happen in the body. It is also vital to the formation of new and
healthy red blood cells.
15. Shellfish
Some types of shellfish are packed with zinc. Our bodies need zinc, so that our
immune cells can function as intended. Varieties of shellfish that are high in zinc
include oysters, crab, lobster, and mussels.

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References
1. Bansal. R. (2021). Food, Nutrition, and Hygiene, SBPD Publishing House, Agra,
India.
2. Singh. Anita. (2018). Food and Nutrition. Star Publications, Agra, India.
3. https://familydoctor.org/changing-your-diet-choosing-nutrient-rich-foods/
4. https://www.healthline.com/health/food-nutrition/six-essential-nutrients
5. https://www.foodstandards.gov.scot/consumers/healthy-eating/nutrition/the-
five-food-groups
6. https://www.brainkart.com/article/Functions-of-food_33938/
7. http://conditions.health.qld.gov.au/HealthCondition/condition/8/78/412/introduci
ng-complementary-foods-feeding-from
8. https://www.webmd.com/hypertension-high-blood-pressure/guide/blood-
pressure-causes
9. https://www.niddk.nih.gov/health-information/digestive-
diseases/constipation/eating-diet-nutrition
10. https://www.mayoclinic.org/diseases-conditions/diarrhea/symptoms-causes
11. https://www.healthline.com/health/food-nutrition/foods-that-boost-the-immune-
system

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