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Role of Nutritional Factors in Diseases

  1. Cardiovascular disease
    1. Uppermost acceptable level of cholesterol is 240 mg/dl.
    2. Optimum level should be less than 200 mg/dl.
    3. C12, C14, C16 acids produce cholesterol raising effect; stearic acid and FA less than 12 C have smaller effect on plasma cholesterol.
      Unsaturated FA with 2 or more double bond lowers plasma cholesterol.
      PUFA e.g. linolenic and arachidonic acid inhibit platelet aggregation and prevents thrombus formation.

      Consumption of complex carbohydrate decreases risk of CHD.
      Hypertension can be significantly treated with low sodium diet i.e. less than 10 mmol/day.
  2. Diabetes
    1. Diabetics eat on an average 1000 kcal more than non-diabetics.
    2. Deficiency of zinc, copper and chromiumDiabetes
    3. Malnutrition / protein deficiency/alcohol intake diabetes
  3. Nutritional factors associated with Cancer

Nutritional factors


High fat intake

Colon cancer, breast cancer

Dietary fibers

Colon cancer is inversely related to dietary fiber intake


Liver cancer and cancer rectum.

Food additives and contaminants


Saccharine & cyclamate



Gastric carcinoma

Ca Bladder

Ca Bladder, pancreatic cancer


Low intake of vitamin A

Deficiency of vitamin C


Lung cancer

Stomach cancer 

  1. Assessment of Dietary intake
    1. Weighment of raw food
      1. Duration of survey 1-21 days.
      2. Dietary cycle: 7 days.
      3. Weighment of cooked food
    2. 24 hours recall oral questionnaire method
      1. Diet survey of large number of people in short time.
      2. If carried out properly it gives reliable results.
      3. Data collected is translated
        1. Mean intake of nutrients (grams)
        2. Mean intake of nutrients per adult man value/ consumption unit.
    3. ​​Assessment of ecological factors
      1. Food balance sheet is cheap and simple.
      2. Indirect method of assessing food consumption.
      3. Supplies are related to census population.
  2. ​​Growth monitoring and nutritional surveillance
    1. Growth monitoring
      1. Oriented to individual child.
      2. Focuses on normal nutrition.
      3. Promotes continued growth and good health.
      4. Monthly recording.
      5. Infants are enrolled in first 6 months.
    2. Nutritional Surveillance
      1. Oriented to representative sample from community.
      2. Gives nutritional status of community whether it is improving or deteriorating.
      3. It helps to diagnose malnutrition.
      4. It assesses the impact of occurrence like drought or measures to alleviate malnutrition in community.
  3. ​​Milk Hygiene
    1. Milk borne diseases
      1. Infections of animals transmitted to manQ
        1. Primary importance: Tuberculosis, Brucellosis, Streptococcal infection, Staphylococcal enterotoxin poisoning, Salmonellosis and Q fever.
        2. Lesser importance: Cowpox, Foot & mouth disease, Anthrax, Leptospirosis and Tick borne encephalitis.
      2. Infections primary to man that can be transmitted through milk
        Typhoid and Para-typhoid fever, Shigellosis, Cholera, Enteropathogenic E coli
        Non-diarrheal diseases: Streptococcal infection, Staphylococcal food poisoning, Diphtheria, 
        Tuberculosis, enterovirus and Viral hepatitis.
    2. Test
      1. Methylene blue reduction test
        1. Indirect method for detection of microorganism in milk.
        2. Carried out on milk accepted for pasteurization.
        3. Methylene blue is added to 10 ml milk and sample is held at 37 degree C until blue color has disappeared.
        4. Milk that remains blue longer is good quality.
        5. Bacteria growing in the milk bring about a decrease in colour.
        6. Cheap and time saving.
      2. Pasteurization of Milk
        • Holder (Vat) method: milk is heated at63-66 degree C for at least 30 minutes
                                           Cooled to 5 degree C.
        • HTST method (High Temperature and Short Time method)
          72 degree C for not less than 15 seconds rapidly cooled to 4 degree C.
        • UHT method (Ultra High Temperature Method)
          Milk is rapidly heated in two stages to 125 degree C for few seconds only
          Second stage is under pressure rapidly cooled and bottled.
        1. Pasteurization
          Kills 90% of bacteria including more heat resistant tubercle bacillus and Q fever organism Q.
          It doesn’t kill thermoduric bacteria or the bacterial spores.
        2. Test of pasteurized milk (AIIMS Nov’08)
          • ​​Phosphatase test: raw milk contains phosphatase which is destroyed on heating.
          • Standard plate count: a limit of 30,000 bacterial count per ml.
          • Coliform count: coliforms be absent in 1 ml of milk.
  4. ​​​​Food toxicants Q

Name of the toxicant

Fungus from which it is derived

Grains infested



Aspergillus flavus

Aspergillus parasiticus

(Storage fungus)

Groundnut, maize, parboiled rice, sorghum, wheat, rice, cotton seeds and tapioca

Human liver cirrhosis

(Attempts are made to relate)


Claviceps fusiformis

(Field fungus)

Bajra, rye, sorghum and wheat




Sorghum, rice


  1. Epidemic dropsy
    • ​​Contamination of mustard oil with argemone oil (from Argemone mexicana or prickly poppy)
    • Toxic alkaloid: Sanguinarine
    • Tests for detection of argemone oil​
    1. ​​Nitric acid test: positive only when argemone oil is 0.25%
    2. Paper chromatography is most sensitive. It can detect contamination up to 0.0001% Q
  2. Endemic ascites: (AIIMS May’08)
    • Millets get contaminated with the seeds of Crotalaria/ jhunjhunia.
    • Toxic alkaloid is pyrrolidine a hepatotoxic alkaloid. Q
  3. Food additives
    1. Non- nutritious substance
    2.  Added intentionally to food
    3. Small quantity
    4. Improve appearance, flavour, texture or storage.
    5. First category: colouring agent, flavouring agent, sweeteners, preservative and acid imparting agents.
    6. Second category: contaminants during packing, processing, faming practices and other environmental conditions.
  4. Food fortification
    1. The vehicle fortified should be consumed regularly, consistently by considerable section of total population.
    2. Amount of nutrient added must provide effective supplementation to low consumers without having any toxic hazard in high consumers.
    3. No change in taste, smell, appearance or consistency.
    4. No rise in the cost.
  5. Prevention of Food Adulteration (PFA) Act
    • Enacted in 1954 and amended in 1964, 1976 and 1986.
    • Minimum imprisonment 6 months and 1000 rupees fine for proven case of adulteration.
    • Life imprisonment and fine not less than rupees 5000 if adulteration leads to death.
    • 1986 amendment: consumers and voluntary organizations can take samples of food.
  6. Food standards

Food standard

Set by


Codex Alimentarius

Joint FAO/WHO Food Standards Programme

For international market

PFA standards

Central Committee for Food Standards

Minimum level of quality of foodstuff attainable under Indian conditions

Agmark standards

Not mandatory purely voluntary

Directorate of Marketing and inspection, GOI

Quality assurance

Bureau of Indian standards

Not mandatory purely voluntary

Bureau of Indian standards

Guarantee of good quality

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