1. Dr.S. Nayak 1 Nutrition Related Disease Dr. Shivananda Nayak Senior Lecturer Faculty of Medical Sciences Faculty of Medical Sciences Dept of Preclinical Sciences Biochemistry Unit

2. Dr.S. Nayak 2 Clinical signs of nutritional deficiency Hair Spare and thin Easy to pull out Corkscrew coiled hair Due to protein or zinc deficiency Protein deficiency Vitamin C and A deficiency MouthGlossitis Angular stomatitis cheilosis & fissured tongue Bleeding & spongy gums Leukoplakia Sore mouth & tongue Riboflavin and niacin Riboflavin, pyridoxine & niacin deficiency Vitamin C or A deficiency Vitamin A, B12, folic acid & niacin deficiency pyridoxine, niacin & iron deficiency

3. Dr.S. Nayak 3 Eyes Night blindness and exophthalmia Photophobia, blurring and conjuctival inflammation Vitamin A deficiency NailsSpooning Transverse lines Iron deficiency Protein deficiency SkinPallor Follicular hyperkeratosis Flaking dermatitis Pigmentation and desquamation Bruising purpura Folic acid, iron, B12 deficiency Vitamin B and C deficiency Vitamin B12, A, PEM, zinc & niacin deficiency Niacin & protein energy malnutrition Vitamin K, C and folic acid deficiency Thyroid gland Goiter Iodine deficiency

4. Dr.S. Nayak 4 Bones and Joints Rickets Scurvy Vitamin D deficiency Vitamin C deficiency Protein-calorie malnutrition (PCM) PCM is present when sufficient energy and/or protein is not available to meet metabolic demands, leading to impairment in normal physiologic processes Kwashiorkor Marasmus Causes Inadequate dietary intake Poor quality dietary protein Increased metabolic demands Increased nutrient losses

5. Dr.S. Nayak 5 KWASHIORKAR is a condition which develops when there is gross protein deficiency and non-protein calorie intake may be adequate. It’s a high mortality deficiency disease known as kwashiorkor meaning red boy. The name comes from the odd reddish orange color of the hair, as well as from the skin rash, characteristic of the disease. Moderate to severe growth failure is present For the 1st few months of life, the breast fed infant in the developing countries grows at a rate that is comparable to that of well fed infants, but thereafter symptoms starts occurring of a kwashiorkor child if the nutrition is not adequate

6. Dr.S. Nayak 6 Symptoms The increase in stature & retarded tissue development. The increase in stature & retarded tissue development. Poorly developed muscle that lack tone. Poorly developed muscle that lack tone. Severe edema. Severe edema. Potbelly (protruding of the stomach) Potbelly (protruding of the stomach) Swollen legs & face. Swollen legs & face. Anorexia & diarrhea are common. Anorexia & diarrhea are common. Whimpering, but does not cry or scream. Whimpering, but does not cry or scream. The child is not interested in or curious The child is not interested in or curious about his surrounding.

7. Dr.S. Nayak 7 Pathologic & biochemical changes: Fatty infiltration of the liver. Fatty infiltration of the liver. Decreased serum levels of triglycerides, phospholipids, & cholesterol. Decreased serum levels of triglycerides, phospholipids, & cholesterol. Reduced amylase, lipase and trypsin. Reduced amylase, lipase and trypsin. Serum proteins and albumin fractions are markedly reduced. Serum proteins and albumin fractions are markedly reduced. Low hemoglobin levels, especially if parasite infestation is also present. Low hemoglobin levels, especially if parasite infestation is also present. Vitamin A levels are usually reduced. This could be a serious complication leading to blindness & death in some children Vitamin A levels are usually reduced. This could be a serious complication leading to blindness & death in some children

8. Dr.S. Nayak 8MARASMUS It is a protein-caloric malnutrition caused by a diet deficient in both protein and carbohydrates Severe growth failure and emaciation are the most striking characteristics of the marasmic infant

9. Dr.S. Nayak 9

10. 10 Anemia Vitamin B12 deficiency and folate (folic acid) deficiency cause megaloblastic anemia The bone marrow produces large and abnormal red cells (megaloblasts) Symptoms People may be weak, short of breath, and pale. People may be weak, short of breath, and pale. Nerves may also malfunction. Nerves may also malfunction. Blood tests can detect abnormal cells that indicate vitamin deficiency anemia. Blood tests can detect abnormal cells that indicate vitamin deficiency anemia.

11. Dr.S. Nayak 11 Iron-deficiency anemia, often caused by insufficient iron intake, is the major cause of anemia in Childhood Causes insufficient iron in the diet insufficient iron in the diet poor absorption of iron by the body poor absorption of iron by the body ongoing blood loss, most commonly from menstruation or from gradual blood loss in the intestinal tract ongoing blood loss, most commonly from menstruation or from gradual blood loss in the intestinal tract periods of rapid growth periods of rapid growthSymptoms fatigue and weakness fatigue and weakness pale skin and mucous membranes pale skin and mucous membranes rapid heartbeat or a new heart murmur rapid heartbeat or a new heart murmur irritability irritability decreased appetite decreased appetite dizziness or a feeling of being lightheaded dizziness or a feeling of being lightheaded