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Nutritional errors and disorders in children – Challenges and scope of Ayurvedic RUTFs & RUSFs

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Nutritional errors and disorders in children – Challenges and scope of Ayurvedic RUTFs & RUSFs

  1. 1. Nutritional errors and disorders in children – Challenges and scope of Ayurvedic RUTFs & RUSFs Snehalatha SN Dornala Associate Professor, PG Dept of Kaumarabhritya VYDS Ayurved Mahavidyalaya, Khurja, Bulandshar Dist., UP, India.
  2. 2. Copyright & Disclaimer All material in this presentation particularly ACRONYMS and other unique thought contents may be copied, reproduced, distributed, republished, displayed, posted or transmitted in any form or by any means with proper citation.
  3. 3. Introduction  Article 47 of the Indian Constitution clearly states that a key responsibility of the state is to ensure the “raising of the level of nutrition and the standard of living of its people and the improvement of public health”. • Right to adequate nutrition - UNCRC  India Health Report: Nutrition 2015’ states that “child under nutrition rates in India are among the highest in the world with nearly one half of all children under three years of age being either underweight or stunted.
  4. 4. Dual epidemic – Hypo/Hyper nutrition India - 20% of the poor of the world, is facing obesity crisis.
  5. 5. Ages and stages of development of children Age Stage 0 – 1 year Infants 1 – 3 yrs Toddlers 3 – 5 yrs Pre - schoolers 6 – 11 yrs Middle childhood 12 – 14 yrs Young Teens 15 – 17 yrs Teenagers https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/preschoolers.html
  6. 6. Nutritional errors  The word ‘error’ in relation to Nutrition refers to improper selection of foods, unhealthy eating habits, incorrect combination of foods, untimely food consumption etc.,  Ayurveda has given due importance to Nutritional errors in the causation of nutritional disorders under the heading of “Nindita Ashana”.
  7. 7. Nindita Ashana • Anashana – Taking no food or fasting • Pramitashana – Habitual intake of food in extremely small quantities. • Atyashana or Mahashana – Excessive food intake or having frequent meals without any need or voracious eater or eating much either in quantity and/or frequency • Ajirnashana – Consuming food when the previously taken food is not digested. • Viruddhashana - Consuming incompatible foods like fish and milk together • Vishamashana- Consuming less or more quantity at improper time (akale bahucha alpam va bhuktam tu vishamashana) • Adhyashana - Consuming large quantity of food even before the previous meal is digested constitutes Adhyasana • Samashana - Consuming suitable and unsuitable foods mixed together constitutes Samashana
  8. 8. Anashana – Taking no food or fasting  “Between the ages of two and five, the average child grows about 2½ inches taller each year, and also gains 2 to 2.5kgs each year.  Non- availability leads to Kwashiorkar, marasmus, wasting, stunting, underweight etc “Anashanam aayusho hraswakaraanaam”  Food jags
  9. 9. Pramitashana – Habitual intake of food in extremely small quantities.  8 to10 times a small quantity  Digestive system needs rest – for effective gut microbiome. (The telegraph By Helen Foster 2015)  Micronutrient malnutrition like vitamin & mineral deficiencies, malabsorption syndrome  High frequent meals associated with low body weight.(Eating Frequency and Overweight and Obesity in Children and Adolescents: A Meta-analysis) “Pramitashanam karshaniyanaam”
  10. 10. Atyashana or Mahashana  Metabolic disorders such as diabetes & diet-related non-communicable diseases (such as heart disease, stroke, diabetes and some cancers) and Fatty liver  Chocaholic  Billy bunter  Overweight & obesity “Atimatraashanam aamapradhoshahetunaam”
  11. 11. Ajirnashana – Consuming food when previously taken food is not digested  Children with habit of pica have difficulty in digestion “Ajirnaashanam grahanidoshananaam”
  12. 12. Viruddhashana -Consuming incompatible foods like fish and milk together The most common food allergies in children are milk, eggs, peanuts, tree nuts, soy and wheat.  Food Allergy – Attacks immune system Ex Milk allergy.  Food intolerance- Ex Lactose intolerence  “Viruddhaviryashanam ninditavyadhikaranaam”  “Pathya sevanamaarogyam”  Vaghbhat – Gara visha
  13. 13. Giving soft drinks to kids is child abuse
  14. 14. Vishamashana - Consuming less or more quantity at improper time  Not offering as per demand of child.  Offer food forcefully when they are sleeping  Just before giving bath/ late night  convienient time of working mother  “Vishamashanam agnivaishamyakaranaam”  “Kaala bhojanam aarogyakaranaam”
  15. 15. Adhyashana - Consuming large quantity of food even before the previous meal is digested  Binge eating disorder  Birthday parties
  16. 16. Samashana - Consuming suitable and unsuitable foods  Sweetened bevarages like coke, sprite, cookies along with staple food.  Endocrine disruptor chemicals such as bisphenol A – BPA (present in children’s toys, plastic bottles and food containers, food can linings.
  17. 17. Ashana trayam  Vishamashana  Adhyasana  Samashana All the above three conditions either cause death or dreaded diseases. (AH Su.8/33 – 34)  Ashana due to pragnyaparadha:
  18. 18. Children are Faddy eaters  Picky eaters – remove fibre, tomoto peels, jeera etc from plate.  Child size portions  say no  hold food in their mouth and refuse to swallow it  keep their mouth shut  spit food out repeatedly or vomit  turn their head away  cry, shout or scream  push away a spoon, bowl  gag or retch
  19. 19. Diversified diets  Shadrasa yukta ahar is ideal  Preserve the treasure of gut microbial diversity
  20. 20. Wholesome Vs Unwholesome food  Food jags  Eating only aloo or dal  “Ekarasabhyaso daurbhalyakaranaam”
  21. 21. Vulnerable group  Rural & Urban poor children  Children whose care is under paid maid  Children staying at Day care centre  Poor SES with Big family size  Differently abled children  Celiac disease, cystic fibrosis etc
  22. 22. Outcome of Nutritional errors leading to Common nutritional problems  Irreversible stunting  Failure to thrive  Marasmus  Underweight  Refusal of foods  Allergies and intolerances  Iron deficiency anemia  Vitamin deficiencies  Electrolyte Imbalance  Risk of chronic diseases  Poor cognitive development  Childhood obesity  Inflammatory BD  Irritable BS  Constipation  Tooth decay
  23. 23. Malnutrition & Micronutrient Malnutrition  Medium – Wasting & Stunting; High – Underweight  Iron deficiency anemia, Vit A, Zn, Se  May be delay in Balance & co ordination of motor movements.  Insignificant growth in communication skills & language development -A bad start for education
  24. 24. Worms affecting Nutrition  Highest Intensity of infection in pre school children- inadequate sanitation, access to safe water n food.  By feeding on the contents of the host's gut, tissues, maldigestion, malabsorption, inflammatory disorders  Deworming is safe easy and cheap  Worms aggravate malnutrition, anaemia and stunting levels and retard both physical and cognitive development.  Body constitution
  25. 25. Nutrition - Disability  Nutrition and disability are intimately related: both are global development priorities;  CP- feeding difficulties; ASD- complex reaction to particular food, texture & colour  Down syndrome – prefer smooth foods  Collabaration between health & disability  Educating & training  Community based approach &Twin track approach
  26. 26. Role of Ayurvedic pediatric dietician is to advise pathyapathya ahara and to provide therapeutic foods  Preventing the nutritional disorders  Managing food allergies  Treating diagnosed nutrient deficiencies  Managing faddy eating  Managing obesity and weight related issues  Managing faltering growth  Appropriate prescribing.
  27. 27. Ready to Use Therapeutic Foods (RUTFs) • RUTF, the remedy recommended by UNICEF for the community- based treatment of SAM, is an energy-dense paste consisting of milk powder, vegetable oil, sugar, peanut butter and powdered vitamins and minerals used in therapeutic feeding. • Govt of India in a major change in its nutrition policy has decided in November 2017 that states are free to take a call on providing ready-to-use therapeutic food to children suffering from severe acute malnutrition. • Nuflower – Unicef accredidated - Collaborated with India
  28. 28. Scope of Ayurvedic RUTF  It can be planned for MAM & SAM.  Limited Nurtitional rehabilitation center’s- limited geographic reach & cost intensive.  RUTF along with RUSF.  Promotion of use of nutritious, safe and locally available herbs.  Ladoos, dry soups, hot infusions-tea bags, lozenges, jellies, snack foods etc
  29. 29. Ayurvedic RUTFs & RUSF  Mridu, madhura surabhi sheeta sharkara  Balapanchamrit – Hingu, Sunti, Kana, Pathya, Mishi (RRS) - to enhance the bioavailability of foods Advantages:  Improves food standard, quality  Helps in optimum growth & development  Acts as antioxidants and prevent recurrent infections  Preventing & managing diet related to non communicable diseases
  30. 30. Plant milk  Plant milk has been consumed for centuries in various cultures, both as a regular drink and as a substitute for dairy milk.  Rice milk, soy milk, coconut milk, almond milk  Shadrasa yukta ahara
  31. 31. Hot infusions- just like Tea bags  Small pottali filled with herbs like Yastimadhu, satavari coarse powder and dipped in a cup of milk..  Antioxidant tea bags– Tulasi, Guduchi  Dipan pachan tea bags– Panchakola, Ela, Ginger, teja patra
  32. 32. Srikhand
  33. 33. Roti  Clinical condition specific roti’s can be made for example whole wheat -pippali roti, Whole wheat - ashwagandha roti etc)
  34. 34. Chywanprash Lollypops  Yastimadhu stick with chyawanprash
  35. 35. Lozenges  They can be prepared to enhance immunity and to supplement vitamins and minerals.  Zandu - Immu
  36. 36. Worm infestation  Modaka – prepared with vidanga, tila and jaggery
  37. 37. Malnutrition laddoo  Crushed dry dates with nuts and coconut powder mixed with chousasth pippali and made into laddoo
  38. 38. To enhance cognitive development  Mini dose packing of Different Avalehya with add on flavours.
  39. 39. Buttermilk- Appetizer  Buttermilk mixed with lavana bhaskar churna
  40. 40. Probiotic yogurt or curd
  41. 41. Nourishing cookies – Ashwaganda cookies
  42. 42. Yusha (Soups)  Mudga yusha  Dadima yusha  Moolaka yusha  Ready to use soup packets
  43. 43. Recipes with shigrudala (Moringa oleifera)
  44. 44. Oral Rehydration Solution  Shadanga paniya with saindha lavana and mishri
  45. 45. Tofee (Desirable Vs Undesirable)
  46. 46. Chyawanprash cookies  Kesar badam chyawanprash  Chyawanprash with gold  Mukta yukt chyawanprash  Chyawanprash with rajata bhasm, loha bhasm, swarnamakshika, yasada added with dry fruits – made into toffee
  47. 47. Prevention  Improving maternal nutrition  Promoting optimal IYCF.  Providing Home made foods  Eating all together  Stop eating junk foods - whole family  Regular nutritional status health check up
  48. 48. Conclusion  Food and Nutrition Security at National, Community and Household Levels through Ayurvedic RUTFs & RUSFs.  Appropriate complementary feeding with Ayurvedic RUTF & RUSF to achieve the mission of India i.e., “kuposhan mukt bharat”  Introducing Ayurvedic therapeutic & supplementary foods in community nutritional programmes.  Promoting effective nutritional education
  49. 49. Dr. Snehalatha SN dornala 9310475039/ dornala.snehalatha@gmail.com