FOOD HYGIENE, MARKET SANITATION AND NUTRITION - BSPH 223

MILTON MARGAI COLLEGE OF EDUCATION AND TECHNOLOGY

BROOKFIELDS CAMPUS
FACULTY OF ENVIRONMENTAL SCIENCES
DEPARTMENT OF PUBLIC HEALTH

Instructor: Mr. Prince T. Lamin-Boima - Certificate in nursing {National School of Nursing}, Certificate in
nursing {COMAHS, University of sierra Leone} and BSc (Hons.) Public Health {Njala University}. MPH in
candidate {Njala University}, PHD candidate in public Health with Specialty in Epidemiology {Atlantic
International University-AIU}
Office: MMCE &T-Brookfield’s Campus the Clinic and Ag. HOD Public Health
Contact: princelboima@yahoo.com, Phone +23276697522 or +23277697522

BSC (HONS) PUBLIC HEALTH - SECOND YEAR SECOND SEMESTER

Food hygiene, Market Sanitation and Nutrition - BSPH 223

COURSE
ELEMENTS TOTAL
CONTENT
Importance of food hygiene, types of food establishments and their hygiene, routine
inspection of food premises, food sampling and examination, disposal of food unfit for human
Definition and consumption, food spoilage and food preservation, microbial growth in food, sources of food
principles of Food contamination (natural), food poisoning and food-borne diseases, investigation and control of
Sanitation food-borne disease outbreak, visit to food premises and inspection, definition of food and
food hygiene. Characteristics of food items including meat, fish, poultry, vegetables, eggs,
fruit, provisions, milk and milk products, grains etc. Market sanitation and layout.
Inspection of meat before slaughter and post-mortem changes, transportation and
preservation, diseases of food animals and their control. Modern abattoir and slaughter slab
Meat-borne
operations. Regions of the body of food animals, organs of food animals and their functions, 3
diseases and their
identification of abnormal organs, inspection of carcass (antemortem and postmortem), signs
control (zoonosis)
of infection in food animals and their effect on meat quality, diseases associated with meat
decision making and inherent action.
The importance of Food Classification of nutrients, Diet, balanced diet, Constituents of Food
Definition of the nutrients. Eating Behaviour (i) Definition of satiety, hunger and appetite. (ii)Physiological,
terms psychological, biochemical factors. Strategies for the promotion and protection of breast
feeding.
Factors (i) Individual likes and dislikes. (ii) Values and beliefs; religious principles and cultural
influencing food influences. (v) Cultural food-related customs and practices. (ix) Impact of globalization,
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choices, Patterns
including trade, media, advertising, migration and tourism.
and practices
Principles of human nutrition – relationship between nutrition, health & disease Nutritional
Nutrition-Related factors in selected/ major diseases (Cardiovascular, Diabetes, Obesity, Cancer), (i) Factors
Disorders contributing to the life-style diseases. (ii) Approaches to prevention, control and management
of nutrition-related disorders and deficiencies

Course Description

Serious outbreaks of foodborne disease have been documented on every continent in the past decade,
illustrating both the public health and social significance of these diseases. Consumers everywhere view
foodborne disease outbreaks with ever-increasing concern. Outbreaks are likely, however, to be only the most
visible aspect of a much broader, more persistent problem. Foodborne diseases most seriously affect children,
pregnant women, the elderly and people already affected by other diseases. Foodborne diseases not only
significantly affect people’s health and well-being, but they also have economic consequences for individuals,
families, communities, businesses and countries. These diseases impose a substantial burden on health-care
systems and markedly reduce economic productivity. Poor people tend to live from day to day, and loss of
income due to foodborne illness perpetuates the cycle of poverty.

Learning Objectives

After completing this module the students will be able to:

1. Describe the epidemiology of food-borne diseases.
2. Define and classify food-borne diseases
3. Identify the causes of most common food borne diseases.
4. Describe the clinical features and complications of food-borne diseases.
5. Explain the general diagnostic and management approaches to some foodborne diseases.
6. Investigate and control outbreaks of food-borne diseases.
7. Develop preventive and control strategies for common food-borne diseases.
8. Explain the basic principles of food sanitation
9. Implement prevention and control measures of food borne diseases.
10. Elaborate the methods of inspection and preservation of food
Conduct of course
1. Format: The course will include lectures, group discussion and practical exercises (in class
presentations and projects)
2. Students’ Responsibility: Student should be prepared for discussions and exercises. Also, to find
reading materials from the internet as it will be required.
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 3. Examination: One examination will be given at the end of the term and students are expected to take
two assignments and one test during the course for the continuous assessment.
4. Method of Grading and evaluation: Final examination (60%), Mid-term test (10%), Semester Paper 10%
Assignment (10%), class participation (5%) and attendance (5%).

Review Questions
1. Write down the constituent of an egg.
2. Discuss the different methods of egg preservation.
3. Discuss the signs of freshness and decomposition of an egg.
4. What are the diseases of fish?
5. What are the purposes of meat hygiene?
6. What is the rationale of knowing the sex of food animals?
7. Discuss the main features of slaughterhouses.
8. Discuss methods of inspection in meat hygiene.
9. What are the common causes of meat-borne diseases:
a. Bacteria?
b. Viruses?
c. Parasites?
d. Fungi?
10. What are the main symptoms for anthrax identification during ante mortem examination?
11. What are the main symptoms for tetanus identification during post mortem examination?
12. Discuss the various measures to be taken to prevent anthrax diseases.
13. Define food-borne diseases.
14. Describe the two major classifications of food-borne diseases and give examples for each.
15. Mention some factors contributory to the widespread occurrence of food-borne diseases. Mention some of
them.
16. List some of the general diagnostic approaches of food-borne diseases.
17. What are the three basic principles in the prevention and control of food borne diseases?
18. Which of the following food-borne diseases is caused by a protozoon?
a. Typhoid fever
b. Shigellosis
c. Amebiasis
d. Cholera
19. Describe how one may differentiate between amebic and bacillary dysentery.
20. The most important complication of cholera is:

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a. Dehydration
b. Fever
c. Intestinal perforation
d. Blood loss
21. Discuss how consumption of raw or undercooked food may predispose for foodborne disease.
22. Outline the steps in food-borne disease outbreak investigation.
23. The nursing intervention goals that we can set for a patient with food borne disease includes all except:
A. Relief pain
B. Regaining normal bowel patterns
C. Prevent the spreading of the infection to others
D. Reduction of symptoms
24.All are the nursing interventions used to reduce/eliminate the effects of the poisonous chemicals, poisonous
plant or toxin that is responsible for food borne disease except:
A. Attaining control of the airway, ventilation, and oxygenation.
B. Induction of vomiting
C. Administering a warmth sitz bath
D. Administering multiple doses of charcoal
25. In patients with irregular pattern of bowel elimination, the signs such as dry skin and mucus membranes and
sunken eyes suggest:
A. Rehydration
B. Dehydration
C. Hypertension
D. Anemia
26. Identify an incorrect statement about the prevention of food borne disease
A. Instruct the patient about personal hygiene
B. Teach the people about proper storage of the food items
C. Eliminate flies for they are the vectors that causes the disease
D. Teach the people that roaches have nothing to do in causing food borne diseases
27. Which sort of fluids can be given for patients with food borne disease to combat fluid volume deficit?
A. Water
B. Juice
C. A and B
D. Alcohol
28. Preventing the spread of food borne diseases to others can be accomplished by:
A. Hand washing thoroughly after giving care
B. Using glove when handling anybody fluid from the patient
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C. To prevent patient-to-patient infection spread provide isolation according to the general rule of body
substance isolation, or individual institution adaptation of isolation
D. All are answers
29. If a patient with diarrhea secondary to food borne disease is dehydrated his/her weight
A. Increases
B. Decreases
C. Shows no change
D. Sometimes increases and sometimes decreases
30. What is food sanitation?
31. Which of the following is among the reasons why food-borne diseases are a major public health problem in
Ethiopia?
a. Lack of awareness
b. Lack of safe water supply
c. Poor environmental sanitation
d. All of the above
33. Organo-leptic tests are related to:
a. Physical tests using sensory organs
b. Chemical tests
c. Toxicologic tests
d. Bacteriological tests
34. List some of the benefits of effective food sanitation program.
35. What are the three basic principles of food sanitation in the control of food borne illnesses?
36. Mention at least 3 contaminants of food that may have deleterious effect on human health.
37. List the stages at which food may be contaminated.
38. List the sources of food contamination.
39. What are the four components important in the transmission of food-borne diseases?
40. List factors that are most commonly contributors in food-borne disease outbreaks.
41. Mention two preventive measures for ensuring food safety at each of the following stages.
a. During production of raw materials
b. During food processing
c. Food preservation and storage
d. Food preparation at home
e. Food preparation in the food service industry
42. What is HACCP? What are its elements?
43. List methods used to keep food safe.
44. What are the essentialities that determine the need for food sample collection?
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45. Which one of the following parasites causes dysentery?
a. Taenia species
b. Giardia lamblia
c. Entameoba histolytica
d. Ascaris lumbricoides
46. The laboratory diagnosis of Ascaris lumbricoides is by:
a. identifying adult worms expelled through the anus or mouth
b. identifying the egg microscopically from feces
c. a and b
d. none of the above
47. Culture is the gold-standard for diagnosis of typhoid and paratyphoid fevers a. true b. false
48. A transport medium used for transporting feces that may contain Enterobacteria:
a. Amies medium
b. Alkaline peptone water
c. Phosphate buffered saline
d. Cary-Blair medium
49. Which one of the following bacteria can cause food-borne infection?
a. Salmonella
b. Shigella
c. V. cholerae
d. Brucella
e. All
50. Serological test used for the diagnosis of typhoid fever is________________.
51. Discuss the chemical composition and physical properties of milk.
52. Mention at least four diseases due to raw milk consumption.
53. What is the difference between a sediment test and a methylene blue reduction test?
54. Discuss the various methods of milk preservation.

1.0 INTRODUCTION
In this era of emphasis on food safety and security, high-volume food processing and preparation operations
have increased the need for improved sanitary practices from processing to consumption. This trend presents a
challenge for the food processing and food preparation industry. As we start another semester into the world of
Food hygiene, Market Sanitation, nutritional disorders and health, our focus will be in demonstrating that
nutritional science is an evolving field of study, continually being updated and supported by research, studies,
and clinical trials. As the semester progresses with establishing this fact through lectures, discussions, and the
incorporated seminar series, students confidence will be strengthened as a true guide to our eating habits, an
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advisory base for our target clients, grounds for confirming or revolting cultural-traditional-taboo beliefs around
food and nutrition and health. The course lectures will cover and show that there are many conditions and
deadly diseases that can be prevented by good nutrition. You will also learn about the many other determinants
of our food choice, health and disease, how the powerful tool of scientific investigation / data collection is used
to design dietary guidelines, and recommendations that promote health and prevent disease.

1.1 Definition and principles of Food Sanitation

The word sanitation is derived from the Latin word sanitas, meaning “health.” Applied to the food industry,
sanitation is “the creation and maintenance of hygienic and healthful conditions.” It is the application of a
science to provide wholesome food processed, prepared, merchandised, and sold in a clean environment by
healthy workers; to prevent contamination with microorganisms that cause foodborne illness; and to minimize
the proliferation of food spoilage microorganisms. Effective sanitation refers to all the procedures that help
accomplish these goals.
Sanitation: An Applied Science
Sanitation is an applied science that incorporates the principles of design, development, implementation,
maintenance, restoration, and/or improvement of hygienic practices and conditions. Sanitation applications refer
to hygienic practices designed to maintain a clean and wholesome environment for food production, processing,
preparation, and storage. However, sanitation is more than just cleanliness. Done properly it can improve the
aesthetic qualities and hygienic conditions of commercial operations, public facilities, and homes. Also, applied
sanitary science can improve waste disposal which results in less pollution and an improved ecological balance.
Therefore, when effectively applied, food sanitation and general sanitary practices have a beneficial effect on
our environment.
Sanitation is considered to be an applied science because of its importance to the protection of human health
and its relationship with environmental factors that relate to health. Therefore, this applied science relates to
control of the biological, chemical, and physical hazards in a food environment. Sanitarians must be familiar
with all these hazards and thoroughly understand the basic food microbiology and the organisms that are most
likely to affect human health. By identifying, evaluating, and controlling hazards and through the effective
application of sanitary practices, a safe and wholesome food supply can be assured.
1.2 Importance of food hygiene
Food is a silent vehicle for microbial, chemical and physical hazards. There is concern about transmission of
multiple antimicrobial resistant bacteria via the food chain. Several devastating outbreaks of food borne
diseases have been reported. Food Hygiene relates to the conditions, actions and legislation employed to
ensure that food is safe from contamination at point of product cycle. Food can become contaminated at any
point of the process from production to consumption.
Food hygiene

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Food hygiene is a subject of wide scope. It aims to study methods for the production, preparation and
presentation of foods that are safe and that are of good keeping quality. It covers not only the proper handling of
many varieties of foodstuff and drink but also all the utensils and apparatus used in their preparation, service
and consumption. It also covers the care and treatment of foods known to be contaminated with food poisoning
bacteria which may have originated from the animal host supplying the food.
Food hygiene is the practice of ensuring food is safe, sound and wholesome, by protecting it from
contamination, preventing bacterial multiplication and by the destruction of harmful bacteria.

Food hygiene is important for the following reasons:

If food or drink is not safe to eat, you cannot eat or drink. The easiest example of this is safe drinking water. We
would never drink water that did not come from a reputable source. The very same principle applies to food.
Every day, people worldwide get sick from the food or drink they consume. Bacteria, viruses and parasites
found in food can cause food poisoning.
There is no immediate way of telling if food is contaminated because you cannot see, taste or smell anything
different from the norm.
Food poisoning can lead to gastroenteritis and dehydration or potentially even more serious health problems
such as kidney failure and death. Food poisoning is an illness that occurs usually between 1 and 36 hours after
eating contaminated or poisoned food, the most common symptoms being diarrhoea, vomiting and dehydration.
This risk is especially significant for those in the high-risk category: Small children/ babies, pregnant moms, the
elderly and immunocompromised, especially HIV infections and cancer patients.
Food hygiene and safety prevent germs from multiplying in foods and reaching dangerous levels.
Keeping one healthy and preventing the additional cost of buying medication and medical check-ups. This is
especially important is business. Companies worldwide loss Billions of Dollars per year due to staff downtime.
Hand washing accounts from 33% of all related food poisoning cases. It is therefore important to maintain good
personal hygiene practice. This is something we are taught early in our childhood, yet hand washing is still a
critical problem in the kitchen
Cross-contamination is a major cause of food poisoning and can transfer bacteria from one food to another
(usually raw foods to ready to eat foods).
It is crucial to be aware of how it spreads so you will know how to prevent it. Good food hygiene is therefore
essential for food factories to make and sell food that is safe to eat.

Food workers must report all instances of diarrhoea, vomiting and skin infections to a supervisor before
returning to work and must not work while suffering from these symptoms. Failure to observe these rules is the
most common reason for food workers being prosecuted.

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Foodborne illness is an illness that occurs when food containing harmful bacteria is ingested. This term also
covers foodborne disease and food poisoning.
What are the causes of food poisoning?
• Bacteria – Pathogenic bacteria are the most common cause
• Viruses
• Metals
• Chemicals
• Natural poisons in food (toadstools, green potatoes, and red kidney beans)
• Moulds
Factors contributing to food poisoning cases
• Food prepared too far in advance
• Cooling food too slowly
• Not re-heating food to high enough temperatures
• Using cooked food contaminated with food poisoning bacteria
• Poor food safety practices
People most at risk
• The elderly
• Babies and toddlers
• Pregnant women
• Individuals who are already unwell
Spores are small round bodies with thick walls which allow the bacteria to stay dormant but alive, over long
periods of time, e.g. during freezing, defrosting, cooking and cooling. When conditions become favourable the
spores germinate and active bacteria are produced once more. It is vital therefore that food is kept out of the
danger zone as far as possible.
Toxins are poisonous chemicals produced by certain types of bacteria, e.g. the bacteria Staphylococcus aureus
produces a toxin in food, which normally causes severe illness very soon after the food is eaten.

Define the term ‘due diligence’

A food business must be able to demonstrate that it has done everything within its power to safeguard
consumer health.
The legal requirements of food handlers
• Keep yourself clean
• Keep the workplace clean
• Protect food from contamination or anything that could cause harm
• Follow good personal hygiene practices – e.g. hand washing
• Wear appropriate protective clothing
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• Tell your employer if you are suffering from or are a carrier of a foodborne disease
Contamination is the presence of any harmful or objectionable substance in food.
Examples of cross contamination -
Bacterial contamination of food
• Direct - Raw meats touching ready-to-eat products
• Indirect - Using a knife to cut raw meat and then using the same knife to cut a ready-to-eat product
• Airborne contamination – sneezing over food
High-risk foods support the growth of pathogenic bacteria because they are high in protein and water. High risk
foods are usually ‘ready-to-eat foods intended for consumption without further cooking, such as coleslaw, ready
washed salad, and cooked rice.
Symptoms of allergic reactions
• Tingling around the mouth
• Swelling around the nose, mouth and throat
• Difficulty breathing
• Rashes
• Vomiting
• Diarrhoea
• Cramps
• Anaphylactic reactions
Understand procedures required for dealing with foods that may cause allergic reactions
As a food handler you must be careful not to inadvertently contaminate food that is supposed to be free from
allergens. For example, do not place peanuts on a surface or next to another food group that wouldn’t naturally
contain peanuts.
You must be careful to give the correct information about ingredients to customers who ask.
The importance of ‘use-by’ and ‘best-before’ dates on foods:
All pre-packaged foods come with a date indication on the label. These are either:
Best before dates – these usually appear on canned, dried and frozen products and indicate the date until the
food may be in its best condition.
It is NOT an automatic offence to sell products past their best before dates, but their quality might be
compromised, e.g. biscuits can go soft.
Use by dates – are found on high risk foods likely to cause food poisoning. It is an offence to sell food past its
use by date. If food is past its use by date it should be disposed of immediately.
Enforcement officers have powers to:
• Enter and inspect food and premises
• Investigate and inspect food and premises
• Investigate outbreaks of food-borne disease and possible offences
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• Remove suspect food and have it destroyed if it is considered to be unsafe to eat
• Serve improvement and prohibition notices
• Take food businesses to court for breaking food safety laws
If the business is an imminent risk the enforcement officer can immediately close the business.
A hazard is anything that could cause harm to consumers and a risk is the likelihood that a hazard will cause
harm.
The use of documented food safety management systems
• It is a legal requirement to keep records as part of the HACCP - based food safety management system
• Record keeping helps to ensure that the business complies with the law and provides evidence of how the
food is produced and handled
• Records need to show that the steps in the production and sale of food that are critical to food safety are being
controlled.

DEFINITIONS
Adulteration of milk: This is the adding of water or extracting the fat by removing the cream.
Milk fat: This refers to the pure fat which consists of glycerol and fatty acids.
PH: This is the hydrogen ion concentration of milk.
Raw Milk: This is a secretion produced by all mammals before it has been altered to into any other form.
Cholesterol: This is an alcoholic compound of complex structure that, in milk, is mostly found in the fat globules.
Lactation: This is the giving of milk by mammals.
Lobster: This is a hard shelled animal that lives on the bottom of the ocean near the shore.
Specific gravity of milk: This is related to its density. It is found by dividing the density of the substance by the
density of water at either 40C (39 oF) or 20 oc (68 0F).
Mammary glands: These are special glands found in all mammals. In female mammals the mammary glands
produce milk.
The Zoonoses: these deals with diseases that can be transmitted from animals to man and from man to
animals. It includes surveillance, prevention and control of such diseases.
Hygiene of food of animal origin: This involves the safe processing and handling of foods of animal origin in
manners fit for human consumption and these include meat, milk, eggs and fish products.
Environmental hazards and protection: Including waste disposal and management and pest control
Occupational hazards, trauma, allergies and control of animal population which may serve as disease
reservoirs.

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Meat Hygiene: This is the scientific concepts and procedures applicable to the processing of food animals in
such a way that the meat and meat products derived thereof are safe and wholesome for human and animal
use.
Antidote: a drug or other substance that antagonizes or abolishes the effect of a poison or toxin.
Blanching: treating vegetables, etc. with heat, e.g. steam or boiling water, briefy before freezing; it inactivates
enzymes altogether and reduces discoloration and nutrient loss
Canning: a process of preserving food by heating and sealing it in airtight container. The can is filled with food,
and air is pumped out of the space remaining at the top of the can to form a vacuum. The container is sealed,
heated in a cooker, and then cooled to prevent overcooking of the food inside. It is used to preserve a wide
variety of foods, including soups, sauces, fruits, vegetables, juices, meats, fish, and some dairy products.
Cathartic: a substance that aids bowel movement by exciting intestinal waves (peristalsis), increasing the bulk
of feces, making the feces soft, or adding slick fluid to the wall of the intestines.
Caustic substances: any substance that destroys living tissue, or causes burning or scarring, as silver nitrate,
nitric acid, or sulfuric acid
Cyanosis: bluish discoloration of the skin and mucous membranes from lack of oxygen
Endotoxin: a toxin produced within a micro-organism and liberated when the micro-organism disintegrates.
Enterotoxin: an exotoxin that acts on the intestine
Epidemic: the occurrence of a disease or diseases with a greater than normal (usual) rate of occurrence in a
population
Exotoxin: a toxin excreted by a microbe into the surrounding medium.
Hazard: a situation or thing that increases the chance of a loss from some danger that may cause injury or
illness
Hazardous waste: solid, liquid, or gas wastes that can cause death, illness, or injury to people or destruction of
the environment if improperly treated, stored, transported, or discarded. Substances are considered to be
hazardous wastes if they are ignitable, corrosive, reactive, or toxic.
Hygiene: practices necessary for establishing and maintaining good health
Intussesception: the sinking of one part of the bowel into the next, like a telescope effect
Leukemioid reactions:an abnormal condition resembling leukemia in which the white blood cell count rises in
response to an allergy, inflammatory disease, infection , poison, hemorrhage, burn or other causes of sever
physical stress.
Mycotoxins: compounds or metabolites produced by a wide range of fungi that have toxic or other adverse
effects on humans and animals
Outbreak: an epidemic referring to a more localized situation.
Pasteurization: the process of applying heat at certain degree for a specified period, usually immediately
followed by cooling, most often to milk or cheese to kill or slow the growth of harmful bacteria
Sanitation: the creation and maintenance of hygienic and healthful conditions
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Sitz bath: also called hip bath, literally (German) "seat" bath, a bath in which only the hips and buttocks are
soaked in water, saline or other solution
Spore: an inactive, resistant, resting, or reproductive body that can produce another vegetative individual under
favorable conditions
Syndrome: a constellation of symptoms and signs
Toxin: a chemical produced by living organisms that is poisonous to humans and animals
Milk Hygiene: Milk is the first natural food of all young mammals during the period immediately after birth. The
public health experts have defined milk as to be “the lacteal secretion of the mammary glands of a mammal,
practically free from cholesterol, obtained by the complete milking of one or more healthy cows which contains
not less than 8.25% milk solids-not-fat, and less than 3.25% milk fat.”
The public health reasons for the terms included in this definition are as follows: The food value of milk depends
upon its milk fat and milk solids-not-fat content. If either of these contents is reduced to below the range for
normal market milk, the proteins, carbohydrates, minerals and certain vitamins are also reduced.
Practical experience shows that 3.25% of milk fat and 8.25% of solids-not-fat are a reasonable minimum for
mixed herd milk.
Cholesterol tends to produce intestinal disturbances in children. For this reason, milk obtained within 15 days
before and 5 days after calving, the period during which cholesterol is produced, should be excluded.

Chemical composition of Milk

Milk is a complete food. It is the most nearly perfect food. It is not ‘the’ perfect food because it is not an entirely
dependable source of all vitamins (vitamins C and D) nor does it contain sufficient iron. Why milk deserves this
reputation is that it is the one food specifically prepared by nature for the young of mammals.
The composition of milk is extremely complex, consisting chiefly of water, protein in colloidal suspension,
lactose and fats in emulsion, inorganic salts in solution, vitamins, enzymes, gases and other substances.

Percentage composition of milk of different food animals

Physical Properties of Milk
The major physical properties of milk are color, specific gravity, freezing point and boiling point. These are
influenced by the composition of milk. They are also a great help in the processing and testing of milk for
adulteration. The milk pigments influencing the color of milk are:
• Carotene (Vitamin A) of the fat in the milk that gives a golden color.
• Riboflavin (B2) of the whey that gives a bluish color.
Normal, average milk has a specific gravity of 1.027 to 1.035. To determine roughly whether milk is adulterated
with added water or by skimming, its specific gravity is measured with the help of an instrument called a Q
lactometer, which is a type of hydrometer.

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Lactometer reading (Quevenne Lactometer) :
Correct reading of lactometer (L) is at 60 0 F (15.50c)
1. If L reading is above 600F, add 0.1 for each degree e.g. if L reads 30 at 68 0F, there is 80F (68-60) 0F therefore
correct reading at 680F is 30 + (8X0.1) = 30+ 0.8 = 30.8.
2. If L reading is below 60 0F, subtract 0.1 for each degree e.g. If L reads 29.5 at 53 0F there is 70F (60-53) 0F
therefore correct reading at 530F is 29.5 - (7X0.1) = 29.5- 0.7 =28.8.
NB: Add 0.1 Quevenne Degree for each degree F above 60 0F.
Subtract 0.1 Quevenne Degree for each degree F below 60 0F
Specific gravity of milk (S.G):
Therefore the milk is normal as its specific gravity is within the range 1.027-1.035.
Freezing point
Pure water freezes at 00c (320F). Since the freezing point of a dissolved substance is lower than the freezing
point of a solution, milk freezes at -0.550c (31.01 0F). As the freezing point of normal milk is constant, an
increase in freezing point indicates the presence of added water in the milk. To determine whether milk is
adulterated with added water, the freezing point is taken by the use of an apparatus called a “cryoscopy”. This
test is highly sensitive and even a very small amount of added water is easily detected.
Boiling point
Water boils at 1000c (2120F) while milk boils at 100.17 0C (212.30F) at sea level. A thermometer is used for
measuring the boiling point.
PH of Milk
Although pH is a chemical parameter of milk, it is discussed here for convenience. pH tells us whether the milk
is acidic or alkaline. Normal milk has a PH of 6.5 -6.8. To test the PH of milk, the following measuring devices
can be used
PH meter (accurate and sensitive) measurement,
PH colorimeter (gross measurement), and PH litmus paper (gross indicator)
Milk Products
Some of the common milk products that are made locally or commercially from whole milk are
Cream
A portion of milk containing not less than 18% milk fat, Cream may be taken from milk by “skimming “or
“separating”
Skimming is the process of removing manually the cream, which rises to the surface, after milk stands in a
container.
The remaining part of the milk is called skimmed milk.
Separating is the process of removing cream mechanically.
The remaining part is called separated milk.
Curd
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The coagulated part of milk, If milk is stands in a container for sometime at room temperature, it forms clots
called curds which are contained in a clear liquid called whey.
Whey:
This is the watery part of milk after separation of the curd from the whole milk. It contains protein, lactose,
minerals and salts.
Cheese
This is the clotting casein of milk. Cheese is made from separated milk or whole milk. The milk curd, after being
removed from the whey, is pressed into solids and through other processes and forms cheese.
Genuine cheese must contain no fat other than that obtained from milk.
Butter
This is the solidified milk fat or cream prepared by churning. The cream produced from milk is violently churned
up and shacken so that the fat globules are broken up and closed together into pieces of mass called butter.
Ghee
This is butter which has been heated and clarified. Butter is boiled over heat until the water is evaporated. It is
then strained and ghee is produced.
Margarine
This is used for breakfast to spread on bread or for cooking. It is usually made from animal or vegetable fat. Milk
or milk-products added to the margarine is only to give a buttery taste.

Milk-borne diseases
Milk is an excellent food for man but it is an ideal medium for the growth of micro-organisms. From the time milk
leaves the udder of the animal, unless adequate safeguards are maintained, it may receive bacteria and other
micro-organisms from the surroundings, for example the milker and other equipment used in milk processing,
storage and transportation.
Diseases resulting from infected carriers
• Typhoid and paratyphoid fever such as salmonella typhi and salmonella aratyphi.
• Tuberculosis (human) such as mycobacterium tuberculosis.
• Epidemic diarrhea
• Diphtheria
• Scarlet fever
Diseases transmitted from infected cows
• Tuberculosis (bovine) such as mycobacterium bovis
• Undulant fever (Brucellosis) such as brucella abortus
• Anthrax such as bacillus anthracis
• Q-fever such as coxiella burenti

15
• Mastitis (bovine) such as staphylococcus aureus
• Foot and mouth disease which is viral
Sanitary practices to be observed in producing safe milk
The main objective is to protect milk from external contamination such as animals, the milker and the
environment in which the milking is done.

Methods of making milk safe

Milk as secreted by the udder cells of a healthy cow is probably sterile, i.e. it contains no micro-organisms
capable either of souring the milk or causing disease. But when milk reaches its reservoir within the udder, and
particularly in passing through the teat of the udder and reaching the milking pail, the risk of picking up
deterious microorganisms steadily increases. Raw milk must undergo heat treatment to prevent not only its
rapid deterioration but also any risk of its conveying disease to the consumer. Heat treatment is generally most
satisfactory because it causes the minimum of change in the composition of flavors and acceptability of the
milk. Effective heat treatment does not necessarily entail the destruction of all micro-organisms originally
present but it accomplishes the destruction of any pathogens in the milk.
N.B. Milk produced under sanitary conditions still contains many bacteria. Therefore it must be treated properly
before consumption.
The most common method of treating raw milk is by applying heat.
There are at least five methods of treating milk.
Boling
This is the easiest and most practicable method of making milk safe in every home. As soon as raw milk is
produced or delivered it should be boiled.
Boiling is raising the temperature of the milk to boiling point and maintaining the milk at this temperature for a
few minutes. Then the milk should be immediately cooled. If it has to be stored the temperature should be
maintained below 100 c. Since these may be impracticable in a home, every care should be taken to keep the
milk as cool as possible> Preferably the milk should be consumed as soon as possible after cooling and not
stored for an extended period of time after it has been boiled and cooled.
Boiling of milk destroys all microorganisms except the spore formers but it changes the nutritive value of milk,
its flavors and palatability and appearance. However this disadvantage should be disregarded in favor of the
safety of boiled milk i.e. its freedom from disease-causing microorganisms. Boiling is technically difficult to
process on a large scale and is commercially uneconomical.
Pasteurization
The term pasteurization, named after Louis Pasture (1822-1895) the famous bacteriologist, was first devised to
be applied to other fluids, the main one being milk and used for controlling spoilage in wine and beer.
Afterwards pasteurization became popular.

16
Pasteurization of milk is a universally known method of rendering raw milk safe through controlled heat
treatment and can be defined as the process of heating every particle of milk and milk products to a
predetermined temperature and holding this temperature for a predetermined time.
Pasteurization of milk is not sterilization but it is a destruction of all pathogenic micro-organisms, a good number
of other non-pathogenic and non-spore forming bacteria and certain enzymes in the nutritive value and the
chemical nature of the milk.
Basically pasteurization of milk involves three essential steps:
• Heating raw milk to a predetermined temperature
• Holding at this temperature for a predetermined time
• Immediately cooling down to at least below 100C (500 F).
Therefore, the two most important variables are pasteurization temperature and the exposure or holding time.
At present there are at least three accepted methods of pasteurization of milk:
The holding or vat method
The holding or vat method, also known as the low temperature holding time process, is a method of holding the
milk in a vat (container) to a temperature of 630c (1450F) for 30 minutes. In this process milk is heated in a
large jacketed container by steam or hot water circulating in the interspaces of the vat or through a pipe coil in
the vat to a temperature of 1450F. In order to ensure a uniform temperature throughout the milk some method
of agitation is needed.
The milk is then immediately cooled to at least 100c (500F) or less in the same container, which holds the milk
or may be transferred through an outlet valve and piped into another cooler to be bottled.
There is a break in the operation between the holder vessel being emptied and another one being ready to be
filled.

The high temperature-short time method

This is a continuous process by which milk is rapidly brought to a temperature of 710c (1610F) and heated
continuously for 15 seconds.
During this process the milk has been preheated in the regeneration (heat exchanger) first and then its
temperature is brought rapidly up to about 1610
F and is held there through a holding tube for a period of 15 seconds, after which the milk is returned to the
regenerator. The milk is then passed into the cooler and finally to a bottle filling device.
During this process if milk is not properly pasteurized, it will not be passed into the cooler. It must then be
automatically returned back into the raw milk tank to be pasteurized.
The ultra-high temperature (UHT) method

17
In this process the milk is heated to at least 880C (1910F), held at this temperature for at least one second and
then immediately cooled to at least below 100C (500F).
This method has been developed very recently and is used only in a few developed countries because it
requires complex equipment and the highest levels of precision and handling.
Laboratory examination of milk
The laboratory examination of milk is one of the most valuable and necessary aids to the overall milk quality
control program. Without this service the safety and sanitary quality of milk is difficult to determine.
Although the environmental health worker may not personally conduct such tests, he or she must be able to
send samples to the laboratory and able to interpret the results of laboratory tests.
In order to make milk safe it may have to be handled with maximum care during milking, processing or storage.
Milk may also undergo pasteurization or other types of heat treatment. Regardless of this the condition of the
milk has to be checked at all stages. For example:
• It has to be cheeked for its bacteriological content just after milking to see the extent of the bacterial colony
• It also has to be checked after pasteurization to see if the process has inactivated all enzymatic activities.
Methylene-Blue Reduction Test
The purpose is to determine the quality of milk before pasteurization.
This test is particularly applicable to raw milk. The test involves determination of time required for the
disappearance of color when methylene blue thiocynate solution is added to raw milk.
In a test tube with 10 ml of milk add 1 ml of standard methylene blue solution. The sample is mixed and then
place either in a hot water bath or in an incubator at 350C -370C. Observations are made at intervals of 15-20
minutes for an 8 hour period to determine the time required for the disappearance of the blue in the sample .
Interpretation: Milk with a high bacterial content will decolorize the dye quite rapidly whereas milk with a low
bacterial content retains the blue color for several hours. On the basis of this test milk can be graded as follows:
Excellent: Very low bacterial count. Its decolorized time is about 8 hours i.e. not decolorized in 8 hours
Good: Low bacterial count. Decolorization time is 6-8 hrs i.e. decolorized in less than 8 hours but not less than 6
hours
Fair: High bacterial count. Decolorization time is below 2 hours i.e. decolorized in less than 2 hours
Poor: Very high bacterial count. Decolorization time is below
2 hours i.e. decolorized in less than 2 hours
Results of the test may be effectively used as a basis for improving the milk supplies, particularly milk intended
for pasteurization. This test, combined with field investigations, serves as an effective means of correcting
improper production methods and improving the general sanitary conditions of the dairy farm.
Resazurin Reduction Test
The purpose is to determine the sanitary quality of raw milk. This test is quite similar to that of the methylene
blue test, except with changes in color in a very short time. This test also undergoes a series of color changes

18
whereas methylene blue changes from blue to colorless. In a test tube with 10ml of milk add 1/10 (0.1ml) of
resazurin solution (0.05%). After mixing properly the sample is placed in a water bath or incubator at 350C-
370C. Observations for color changes are made at 15 minute intervals. The two most common applications of
the resazurin test are:
The one-hour test: In this test the color of the milk is compared after 1 hour at 370C with several exactly
described color standards.
The three hours (triple reading) test: In this test 3 readings are made at 1-hour interval to see changes in color.
Interpretation: Milk with a high bacterial count and other infections of the animal is detected quite sharply with
the resazurin test. A resazurin pink of 3 hours or longer represents a good quality of milk.
High-grade (acceptable) milk requires at least 3 hours.
Standard plate count (agar plat count)
The purpose is to estimate the bacterial population of the milk and dairy products prior to heat treatment.
In this test a 1ml portion of the milk sample is diluted with distilled water to give dilutions ranging from 1/10 to
1/1000. A 1 ml portion from the dilutions is then placed in a Petri dish/plate containing a growing media (milk
agar). This sample is incubated at 350C-370C for 48 hours. At the end of 48 hours a count of colonies
developing on the plates is done with help of a “Queven bacterial colony counter.”
Interpretation: The number of colonies counted multiplied by the dilution factor gives what is known as the
standard plate count (SPC) or the estimated number of bacteria per milliliter of sample. For example, if 30
colonies are counted in a Petri dish of 1/100 dilution, the SPC is 30x1000= 30,000.
The standard is as follows:
• Raw milk: 200,000 maximum acceptance
• Pasteurized milk: 30,000 maximum acceptance. .
The interpretation of the results is based upon the fact that the bacterial population in milk serves as an index of
sanitary quality i.e. a low bacterial population indicates correct handling and processing, whereas a high count
many indicate the reverse.
Coliform Test
The purpose is to determine the presence of organisms of coli form group in milk. It is used primarily to detect
contamination after pasteurization.
In this test the dilutions 10ml, 1ml, 0.1 ml from the milk sample are transferred into appropriate media and then
incubated for 48 hours at 370C. At the end of this period these preparations are observed for the presence of
gas (refer to water analysis for complete procedures).
Interpretation: A positive test on pasteurized milk indicates contamination after heat treatment. That is the
presence of coli form organisms in pasteurized milk is a signal for the source of contamination in the milk
processing plant.
Babcock test (fat test) the purpose is to determine the fat content of milk. after mixing well by shaking the raw
milk sample, take about 17.6 cc (ml) by using a pipette and fill it into a graduated babcock bottle. carefully add
19
to this bottle a 10cc. concentrated. without delay shake it for 3 minutes and then centrifuge the bottle at 1400f.
(if the milk sample is pasteurized add 7 cc more h2so4 to the 10cc already filled and shake it for 1 minute.) after
centrifuging stand it for 5 minutes and add to it hot water up to the base of the neck and centrifuge for 1 minute.
Take out the bottle from the centrifuge and put it on a hot water bath for some time and do the readings.
Interpretation: the fat which rises into the graduated neck of a special babcock bottle is measured directly with
the aid of a caliper or geometrical divider, the length of the fat column from the lower surface to the highest
point of the upper meniscus. results are expressed in percent.fat content (%) quality
Below 3 Poor
3-3.25 Fair
3.25-3.50 Good
Above 3.50 Excellent

Egg and Fish Hygiene

Egg Hygiene
A hen’s egg, although it is not a complete food for humans, is a complete food for a chicken embryo. A hen’s
egg weighs about 57 grams and its specific gravity (excluding the shell) is 1.048. The PH of an egg is 7.7.
An egg consists of three main parts:
The outer shell: This forms a hard protective layer that accounts for about 10% of the total weight of an egg. It is
porous and allows air exchange to the growing embryo and its color is mostly white.
The egg white (inside the shell): This is a viscous colorless liquid that accounts for about 60% of the total weight
of an egg and consists of protein, water, salts and vitamins.
The egg yolk (in the center): This is a thick yellow or orange emulsion that accounts for about 30% of the total
weight of an egg and consists of fat, protein, salts and vitamins.
Constituents of an egg
Protein: This is an average of 12.85% and eggs are a good source of protein.
Fat: This is an average of 11.15% and eggs are a fairly good source and fat is present in egg yolk.
Water: This is about 73.80% and the white egg holds most of the water.
Mineral salts: This is an average of 1.60%, an egg has a very small amount.
Eggs are deficient in carbohydrates, but rich in vitamin A, B2, D and E.
Causes of spoilage
An undamaged eggshell allows the passage of oxygen, carbon dioxide and water vapor through the pores. The
shell carries a vital membrane covering these pores but allows gaseous exchange.
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Microbes are hindered from passing through the shell. Although the shell is intact, simple manual handling may
destroy the membrane.
Microbes are then able to invade and infect the egg. Removal of the covering by washing with water also
permits the entry of microorganisms.
Some of the common defects found in eggs are:
Black or red spots: This is when on candling an egg red and black spots are seen in an egg yolk, which was
originally yellow.. If on candling the yolk is very dark the egg should be condemned.
Blood spots: This is when a drop of blood is detected in egg yolks through candling. If the spots are small, the
egg can be used immediately for cooking but if stored longer it will decompose.
Fishy taste: This is usually due to feeding materials. It can be also due to improper storage. If the taste is
pronounced the egg should be condemned.
Mold on shells: This is found mostly on cracked eggs. This defect is due to a poor storage system. Mold can
cause quick decomposition and the egg should be condemned.
Egg inspection
Eggs may be examined in various ways for freshness:
Shaking using hands: A fresh egg gives no sound when shaken and a stale (bad) egg makes a sound when
shaken.
Brine test or immersion in water: A fresh egg will sink in water or
10% salt solution. The 10% salt solution is prepared by dissolving 2 oz of salt in 1 part of water and stale (bad)
eggs will float in a solution.
Candling: This is projeting light through eggs. The eggs are held between the observer and a source of bright
light to detect the size of the air space and any other changes within the egg. When the egg is fresh it is
translucent, the yolk faintly seen and the air space is not more than a ¼ inch in depth. But when the egg is
stale, dark spots or blood spots are seen within the shadow of the yolk and the air space is more than ¼ of an
inch in depth.
Preservation of eggs
Eggs are preserved for a long time by preventing the entrance of air through their pores i.e. by smearing the
egg shell with wax, butter, lard or oil or immersing the egg in a solution of sodium silicate (glazing).
Silicate solution: Sodium silicate is added to water to form a solution. The eggs are immersed in, and covered
with, this solution.
Oil dipped: Eggs are dipped for a few seconds in tasteless clear mineral oil. Surplus oil is then removed and the
egg dries in 24 hours.
Lime water: A solution is made of 4 parts of slacked lime,1 part salt and 20 parts of water. This solution should
be mixed properly and stand for a week. The clear liquid is drained off and poured over the eggs.
Cold storage: Eggs are stored in cold storage usually a degree or so below the freezing point of water i.e. at
-1oc (30oF). The relative humidity should be 70-80%. Incorrect relative humidity may cause mold to form on the
21
eggs, so they should also be kept dry and well ventilated. If the storage humidity is too low this can lead to loss
of weight. If the storage humidity is too high this can encourage the growth of mold. The washing of eggs often
does more harm than good.

Fish hygiene
Fish are cold-blooded vertebrates that are their body temperature is close to and varies with that of atmosphere,
varying considerably in size and shape. When fish are brought out of water into air they quickly perish.
Fish can be divided in two classes:
Round fish: These are swimming fish, which live at varying depth from the surface of sea and possess darkly
colored dorsals but whitish ventral surfaces.
Flat fish: These live at the bottom of sea. They have asymmetrical bodies. They live on one side, usually the
left, which is white, the upper side being a brownish color.
Types of fish
White fleshed fish: These include haddock, cod, sole, turbot and whiting.
Red fleshed fish: These include salmon and trout.
Greasy fleshed fish: These include mackerel, sprats, herrings, sardines and eels.
Shell fish: These include crabs, lobsters, oysters and mussels.
2.2.2 Anatomy of Fish
It is essential that a slight knowledge of the anatomy of fish should be gained in order to facilitate fish
inspection.
Fins: Fish for their movement in water possess a number of limbs called fins:
• Dorsal fins that are situated along the back
• Ventral fins that are situated on the body
• Pectoral fins that are situated posterior to each gill and upon the shoulder.
• Anal fin that is situated underneath, near the anus.
• Caudal fin that is situated on the tail.
Skin: This is a layer of connective tissue to which scales are attached. The outer layer is called the epithelium.
Bones: A vertebral column passes down the middle of the body from the brain, long bones radiate from this
column. The skull is cartilaginous and contains organs of smell and hearing. The eyes possess spherical
crystalline lenses and protrude when newly caught or in water but collapse when exposed to the atmosphere.
Gills: Fish have gill flaps on each side of their heads adjacent to their jaws and opening into their pharynx.

Characteristics of fish
Fish freshness: The freshness of fish depends principally on its temperature and the time that has elapsed
since the death of the fish.

22
The bacterial living in the fish multiply more rapidly as the temperature rises. In this process some malodorous
compounds are produced. In addition the effect of a slight alteration in temperature becomes more noticeable in
the region just above the temperature at which fish freezes (-10C).
Fish spoilage: Fish that are unfit for human consumption can be subdivided into four categories:
• Those affected by diseases.
• Spoilage or putrefaction type
• Contamination (contaminated fish)
• Rancidity (high degree of offensive odor)
Putrefied fish are known by one or more of the following characteristic changes:
• The odor changes from fresh odor to sour, rancid or rotten
• The gills turn into a grayish or brownish color and become slimy
• The entrails (intestines) are decomposed. When not eviscerated, the digestive enzymes are frequently active
and soften the belly in a short time and it finally bursts.
• The belly and the surface of the outer flesh turns slimy and often shows yellowish or brownish discoloration.
The flesh becomes soft, loose and inelastic. It is easy to press the fingers through the belly.

Signs of freshness and the decomposition of fish

Fresh Stale
I. Eyes - full and bright Eyes - gray and sunken
II. Flesh - firm, solid and elastic when pressed Flesh - soft, strips form with fingers, flesh does not pit when
pressed bones, pits form when pressed with fingers
III. Scales - full and firm Scales -easily rubbed out
IV. Abdominal cavity - clean, not discolored Abdominal cavity - smelling and with reddish discoloration
V. Gills - clean, bright, not swollen Gills - gray, brownish slimy, swollen
VI. Fresh fish - will sink if placed in Stale fish - floats in water water.

Inspection of fish
• Check the condition of eyes, scales and flesh of the fish
• Check if gills are firm and elastic; test with fingers if any doubt exists
• Split the fish and examine backbone for decomposition. If bone is pink or red from end of the tail towards the
head, condemn/discard it
• Test the blood of the fish with the fingers; if the fish is stale there is a faint smell on the fingers
• Split down the lateral line and examine the backbone
• The abdominal cavity shows discoloration when the fish are stale.
Fish-borne diseases

23
The known diseases of fish are few and it is only a very small part of the vast harvest that is taken from water
that is affected. Generally speaking with the exception of one or two cases, the rest of the harvest produces no
ill health upon human beings.
Fish that to all appearances are healthy are sometimes responsible for symptoms of poisoning in people,
producing a slight fever and rash. They are afflicted with parasites. Some of the common diseases are:
Fish pox: This is caused by Myxosporidiea and affects fresh water fish.
Signs of the pox are located on muscles, skin and viscera. The flesh is soft, yellow and gelatinous and gives a
bitter taste.
Action: Affected fish should be condemned /discarded.
Salmon disease (plague): This is caused by bacillus salmonis pests and affects fresh and seawater fish.
Transmission is through abrasion or ulceration of the skin. Signs are the formation of white patches on sides,
belly and head ulcer formation.
Action: Fish of this nature is rarely seen in a market. They are unfit for human consumption.
Furunculosis: This is caused by bacillus salmonicida and affects fish in fresh water only as seawater destroys it.
Transmission is through skin contact. Signs are the formation of furriness and skin with several patches. When
the tissue is affected it extends deeply into the bones.
There are soft swellings, inflammation of the intestine and hemorrhages in peritoneum and liver.
Action: Fish with Furunculosis are unfit for human food and are rarely seen in a market since there is
decomposition on the flesh. Fish are rapidly killed through the spread of the disease.
Tuberculosis: This is caused by tubercle bacilli and affectes fish such as cod and turbot. The signs are lupitus-
like growths on skin near the tail (containing cheesy mater), soft yellow deposits in the liver, stomach and
intestines.
Action: Fish are unfit for human consumption.
Parasitic diseases: These are caused by diphylobothrium latum. And affect fresh water fish. Transmission is
through swallowing parasite larvae. Signs are found encysted in the muscles of fish.
Action: Fish affected with this parasite should be seized as being unfit for human food. It may be consumed if
sufficiently cooked.
Methods of fish preservation
Refrigeration: This is when fish is properly gutted and washed, then preserved using ice or other cooling
devices.
Drying: This is when fish are opened, cleaned and soaked in brine for several hours and left to dry in the open
air for several days.
Smoking: This is when fish are gutted, cleaned, sprinkled with salt and hanged to be smoked with the help of a
smoking fire such as saw dust or wood clippings.
Pickling: This is when a fish is gutted, cleaned and washed properly and finally placed in brine and pickled.
Salting: This is when a fish is gutted, cleaned and mixed with salt and packed into boxes or other containers.
24
Frying: This is when a fish is washed properly, filleted, skimmed and dipped in frying oil.
Canning: This is when a fish is gutted, cleaned and placed in brine.
After it is properly prepared it is put into a can to be cooked and finally properly sealed.

MEAT HYGIENE
Purposes of meat hygiene
The primary purpose of good meat hygiene practice is:
• To prevent the transmission of animal diseases to man
• To provide safe, wholesome meat products for human consumption
The secondary purpose is an economic aspect:
• The reduction of loss of meat and its by-products
• The prevention of animal disease transmission to other domestic animals
The tertiary purpose is due to the adulteration of carcass meat, which is not required by consumers other than
for food for animals:
• To prevent the sale and consumption of carcass meat, which is not demanded by consumer other than as
food for animals?
• To prevent the sale and consumption of meat that is inferior in value

Slaughterhouses
Traditional animal slaughtering
Raw meat is the most favoured food product enjoyed by many consumers, in spite of its ill effects. This type of
meat is mostly not produced in organized slaughterhouses and put out for sale in meat shops. Rather it is the
usual practice that the livestock is bought in the market through individual interest and choice. It is then brought
to their homes and put to slaughter where the meat is consumed according to the preferences of each family.
In social culture a sheep or goat is to be killed for individual family use at any time when they are in need or
during festivals or other occasions. Big animals such as a cow or an ox can be killed in an open place for a
number of families or group of related co-workers and be shared equally. In certain situations, such as a
wedding ceremony or other occasions, one or more cattle may be slaughtered in the area where the occasion is
taking place.
All these traditional practices may be acceptable from the deep rooted culture and spiritual belief of the society.
However many underestimate the direct or indirect ill health and economic ill-effects it gives to the consumer.
Some of the problems that may arise where open and indiscriminate slaughter of an animal takes place are:
• An immediate inspection by meat inspectors of animals when they are alive or killed is impossible
• The people who are included in killing and assisting in the handling of the meat will be the first victims of any
disease that may occur

25
• Since it is the usual practice that all the people who attend the animal slaughter will share and eat raw meat,
such as the tongue and a portion of tripe called “sember”, immediately after slaughtering they may contact
tapeworm
• The stunning and slaughtering practice may be incomplete and as a result a portion of the blood may remain
within the body of the animal and may lead to spoilage of the meat during storage
• The hygienic handling of meat during animal slaughter in open fields is at a minimum and the keeping quality
of the meat will be affected
• The handling of meat outside the slaughterhouse may reduce some essential meat products and/or wastage
of certain byproducts which normally require special collection and care for further processing to be converted
to valuable by-products
• The quality of hides and skins of ruminant animals that may be collected from rural and urban areas where
traditional slaughter practice is under taken are highly affected to the extent that their market value will be
diminished and unacceptable for industrial production
• Above all illegal and indiscriminate animal slaughter practice in a community will create an insanitary
environment that causes the breeding of flies, smell and nuisance to the nearby inhabitants.
To overcome the above and other related problems the fundamental principles of hygiene, as well as economic
considerations, demand that the slaughtering of animals for human consumption be carried out in
establishments especially designed and constructed for this purpose and kept under constant sanitary control.
Main features of slaughterhouses
The slaughterhouse or abattoir is a general term applied to an establishment engaged in killing livestock, or one
or more species, for human consumption. It varies in size from the back yard of a local butcher to the great
meat processing plants. In most countries slaughterhouses are either privately owned, depending on the local
need, or are large premises capable of providing slaughtering accumulation for an entire city and are
administered by the local authority.

Accommodation and facilities are required for the humane and hygienic slaughter of animals, the sanitary
handling of meat and meat products. There should be a provision of facilities for inspection and quality control,
readily available facilities for equipment cleaning and operators’ locker rooms as well as special and separate
rooms for the receiving of by-products, and animal lair age etc.
There are certain general principles to be considered in relation to the sanitary and economic standards for
construction and operation, once the essential preliminary administrative and planning decisions have been
finalized. Community involvement and acceptance in the planning stage is a prime factor with the technical
approval from the health sector. Based on these the main features to be considered in the design and
construction of slaughterhouses are:

Location and site

26
Locating will have to be decided under preliminary planning, that is from the already drafted town plan or future
expansion zone areas.
This should be legally approved by the designated agency who considers certain essential requirements such
as the transport and supply of livestock, final product disposal system and other aesthetic factors. The prime
consideration in connection with the building of any slaughterhouse is the site. The most important points to be
considered in the choice of site are:-
• Accessibility by road and rail for the transportation of animals, meat and other products as well as staff
workers.
• Availability of a safe and abundant water supply system preferably with a public pipe connection and on-site
water storage tanks holding at least one days consumption without interruption. The recommended water
requirement is a minimum of 100 liters and a maximum of 200 liters per day per adult bovine animal
• Proper and convenient final sewage and other waste disposal area and facilities
• Accessibility to electrical power
• The slaughterhouse should be freely exposed and if possible sited in the outskirts of town
• A naturally sloping area assists both in the disposal of sewage and storm water
• Availability of adequate space for future expansion possibilities
• The immediate environment should be safeguarded from all possible alternatives that may endanger the
health or safety of the inhabitants
Area and size
Depending on the need of the local community careful consideration must be given to the size of the site with
future possible expansion space for buildings and vehicle movement.
The size and design of the rural slaughterhouses are standardized to meet local needs and to satisfy their
operational objectives.
In such establishments a maximum 50 animals per day can be handled satisfactorily. This may occupy a plot of
about one acre of land for all purposes.
The urban type of slaughter house which handles all ruminant animals and pigs, a 100-200 units per day,
requires at least double the size of space in acres, while meat plants of larger capacity with a complete packing
operation, occupy at least 3 times of plot size of that of a normal rural slaughterhouse.
Design and main facilities
The overall layout of the buildings of the slaughterhouse depends on the size and operational capacity that it
undertakes, the environmental and climatic factors, such as prevailing winds, the land slope for both internal
and external drainage systems and the handling of the by-products for useful materials with minimum nuisance.
The construction of the building parts and surfaces should fulfill the sanitary requirements that satisfy the
essential housing standards.

27
Floors: These should be impermeable, rough finished and hard with a non-slip material to avoid accidents,
easily cleanable and resistant to corrosion. They must always be in good repair and should have a well-graded
drainage system, giving a slope of 1 to 60 to the external drains.
Walls: These should be smooth and hard, of an impervious material up to a height of not less than 3 meters
from the floor and preferably reaching to the ceiling. If the splash height of the wall is 2 meters then remaining
portion of the walls should be lime washed. To avoid dirt that remains fixed in the corner edges between the
walls and the floor, this junction should be at a curve to facilitate washing and splashing and to remove dirt
easily.
Roof and ceilings: The top part of the building should be framed with preferably pre-fabricated iron rafters or
local materials such as eucalyptus tree or other materials which do not disintegrate. In all rooms used for edible
products the interior surface of the ceiling should be covered with a smooth and easily cleanable material. If it
requires a surface, which minimizes the deposit of dirt and dust on the inner roof, a thin cement lining or chip
wood materials should be used.
Lighting: An adequate natural or artificial lighting system must be provided throughout the establishment. The
natural lighting should be permitted to allow sufficient intensity of light through the normal windows or sidewall
openings to all workrooms where daylight operations are conducted; light inlet of an area approximately 25% of
the floor area is recommended. However since most slaughterhouses operate during the night, it is necessary
to install an efficient artificial light system to all the room and especially in those areas where maximum activity
and detailed inspection techniques are required. It is generally recommended that the overall intensity should
not be less than
50 foot - candles – at all inspection points
20 foot - candles – in all-purpose workrooms
10 foot - candles - in all other areas
All electrical line system should either be insulated and fixed in proper arrangement or most preferably buried
inside wall lines to prevent fire, accident and human contact. In addition protective shields should be fitted to all
artificial light lamps to minimize dust or insect deposits.
Ventilation: Adequate ventilation must be provided to prevent excessive heat, steam and condensation. Where
possible all wall spaces and air inlets should be properly screened to prevent the entrance of insects, birds and
other vermins. In case of urban type of slaughterhouses with or without meat packing processes the exchange
of air should be taken either naturally through open side windows and other roof vent systems or by means of
mechanical extraction fans. The efficiency of this ventilation process is determined by the proper design and
construction method. Properly installed screen mesh or doorways, well-spaced for the easy movement of
products, should be provided to supply light and air to the rooms.
Water supply and waste disposal: The mains water supply must be pure, safe and adequate for all purposes
and at a sufficient head pressure to reach all working areas. The continuous flow of water using rubber hoses
facilitates the washing of carcasses and all-purpose cleaning. To guarantee a continuous supply of water, an
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elevated tank, which holds sufficient for at least daily usage, should be provided in an accessible area. An
installation of hot water for the sterilizing of slaughtering tools is required for rural slaughterhouses.
Slaughter at all levels uses large quantities of water which eventually produce a significant amount of waste that
requires attention in its disposal. An inefficient waste disposal system may create possible pollution of
watercourses in the vicinity. To prevent such problems and to facilitate the disposal of the waste products within
the meat plant a simple and effective sewage disposal system should be arranged. The choice and design and
construction should be based on the type and size of the establishment and should include installations such as
septic tank, soakage pit, oxidation ponds, manure pits etc. Handling all waste content should reduce the amount
BOD to a minimum level in the effluent that finally will be absorbed into the surrounding surface area or joined
with local watercourses.
Drainage: In the proper design and construction of any slaughterhouse it is vital to handle all waste products
inside and outside the building. All animal waste, blood, offal content and other wash wastes should flow without
interruption into the final disposal system. These drains should be closed but their size and slope should be
carefully designed for their efficient operation. If these are not met the sanitary requirements will remain a
nuisance and may affect the edible products. Any drainpipe of whatever material it is made of should have
inspection chambers or gully traps at all possible line systems or connections. Regular inspection for
maintenance and cleaning should be practiced to avoid blockages and unsightly conditions.
A model slaughterhouse with or without a meat packing plant entails a varying number of buildings or sections.
The slaughterhouses in townships or rural areas of Ethiopia which are only limited to producing edible meat
products should have the following essential working parts:
Lairage
Slaughtering hall
Meat hanging and inspection hall
Gut and tripe compartment sink
Hide and skin shed
Employee’s dressing room
Office and store
Manure bay
Separated slaughtering place
Lairage: This is the accommodation provided for animals brought to the slaughterhouse before they are put to
be slaughtered. In here animals are kept to rest for a period of 12-24 hrs by providing them with water and
undisturbed resting conditions. For those animals needing isolation for observation grass should be available. In
addition ante mortem inspection is done during the resting period.
The main sanitary requirements for lairage construction are
• To be well spaced and large enough to accommodate at least one day’s slaughter and, depending on the
source of supply, a
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3 days collection of stock
• For the floor to be made of impermeable concrete and a non slippery material with a proper drainage system
• A divided partition for different animals and a separate lair toserve as a quarantine space for sick and
suspected animals
• To be easily accessible with a continuous pipe supply water trough
• For the passage from the lairage to the slaughtering hall to bebuilt to permit a one-by-one flow of animals
Slaughter hall: This is the place where the actual slaughtering is done followed by complete a bleeding process
and dressing. All blood and all external body parts are removed immediately to outside of the hall. In larger
meat plants separate slaughtering places for each type of animal may be required. The sanitary requirements
for the hall construction are
• For the internal walls and the floor structures to be smooth and washable
• For a sloppy drain to permit blood and wash waste to flow out easily
• For there to be properly installed meat-hanging chains with overhead rails
• Conveniently located running tap water with a well fastened washing hose
• For a on-site electrical steam boiler or sterilizer to be installed for slaughtering tools
Meat hanging hall: This is a place where all carcasses and organs are kept temporarily and serves primarily for
inspection. The entire sanitary requirements that are applied should be the same as in the slaughtering hall.
Gut and tripe compartment sinks: This is a separate unit conveniently attached to the outside the slaughtering
hall for initial separation and empting of stomachs and intestine contents for gut and tripe preparation. Since this
is a very important unit from a contamination point of view; it should be properly constructed and used.
The essential sanitary requirements and facilities for this unit are
• Impervious washing sinks with drained concrete slabs
• Running water taps with a continuous supply of water
• Properly built drainage systems throughout the final system
• Temporary waste contents collection container at close proximity
Hide and skin shed: This is a side walls open structure where after curing wet hides and skins of slaughtered
animals can be permitted to dry for about a week. The structure is designed and built for a capacity of at least
50 hides and 100 skins each day, seven days a week. After the curing the hides and skins are tied to a
strengthening frame made of wood and held in orderly arrangements to dry out in the open. Space or suitable
accommodation for the storage of hides and skins should be provided until they are collected by licensed
contractors.
Employee’s Dressing room: This is a place for the exclusive use of the employees who are directly engaged in
the slaughterhouse. This may have lockers for employees’ belongings and work clothing. Since most of the
animal slaughterhouse hours are at night the employers should have resting or sleeping facilities. Toilets with
an incorporated washing system must be provided.

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Office and store room; This is a small sized room strictly for administration and storing certain meat inspection
equipment nearer to the main gate, to permit a direct access to those who are authorized or to certain other
visitors. The meat inspector or veterinarian and a clerk will use this room.
Manure bay: This is a structure specially prepared to handle all animal stomach and intestine materials and the
manure part is collected to be loaded onto the transport vehicle. It is usually built in an elevated position to
facilitate the transfer of waste contents. This may be sited on the dirty side of the meat plant, either near to the
lairage area or the gut and tripe preparation vats. The final disposal of waste material must be carried out
without creating objectionable conditions.
Separate slaughtering for Muslims use: This is by itself a separate section, small in size but with complete parts
as in the Christian side.
Depending on the size and type of slaughterhouse additional facilities may be required for the work to be
carried out satisfactorily. In areas where the slaughter of animals rather than ruminants is to be carried out,
such as pigs, a separate slaughtering and scalding room is necessary. There are times where suspected
animals need special attention; it is then that a separate room for killing and the handling of the carcasses is
required. Side-by-side with this a condemned moot distracter unit should be available. If the meat produced in
the plant is to be used for packing or to remain in the place for an unlimited time the daily products need to be
stored without being spoiled. For this purpose a sizable cold storage room with a cooling system and all other
essential facilities should be provided close to the slaughtering hall section.
Essentials of slaughter
The traditional way of slaughtering food animals by any skilled individual is that after tightly tying the four legs,
the animal to laid flat on the ground and its neck is positioned for cutting. Depending on religions beliefs, a
prayer is recited and immediately using a sharp knife the throat is severing and the body bleeds to death.
The practice applied in slaughterhouses is adopted from traditional experiences with the exception that since
the number of animals attending for slaughter is large, one may not follow the same procedure as stated above.
Depending on the species and body strength, animals may not be so cooperative as to easily lie down and
bleed to death. They may instead struggle and reduce the efficiency of bleeding.
Every effort must be made to reduce the amount of stress on the animal prior to slaughter, carryout the
slaughtering without unnecessary suffering and the bleeding should be complete as speedily as possible.
Chief Method of slaughtering
In conventional slaughtering methods in most developed countries, it is normal practice to render the animal to
be killed without unnecessary suffering or cruelty, except in the Jewish and Muslim practices where the animal
is slaughtered without previous stunning.
There are three common choices of slaughtering methods

SLAUGHTERING WITHOUT PREVIOUS STUNNING:

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All food animals are killed by means of severing the main blood-vessel in the neck and thus bleeding to death.
This is a humane method of slaughtering because of slow bleeding to death and suffering of the animal. In this
method the animal’s throat is severed (cut) across the carotid arteries and jugular veins or it is stabbed in the
chest area or throat.

Bleeding is a procedure in the slaughter process which is performed by cutting jugular vein in the neck and
carotid artery in order to allow blood to drain from the carcass, resulting in the death of the animal from cerebral
anoxia. The extra blood in the tissues may lead to meat getting decomposed quickly. Incisions should be
therefore swift and precise. In poultry, sheep, goats and ostriches, the throat is cut behind the jaw.  

After successful bleeding, first the head is skinned, separated from the body, marked with the same number as
the body and then hung on hook for post mortem examination.

The first step in evisceration is to cut around the tied bung or rectum and free it completely from all attachments.
The breastbone is then cut along the midline up to its tip. Another cut is made from the cod or udder down the
midline into the breast cut.

Visual perception

First the carcass and visceral organs should be examined visually for any visible abnormalities. Examination is
done for any change of colour, atrophy, hypertrophy, neoplastic condition etc.
The organs are palpated for any change in consistency, sliminess or gelation, cyst, etc.
The organs are incised, if needed. This is done to examine any parasite inside organ, structural deformity etc.
These are done for confirmation and support the observation made by macroscopic examination. While
examining the organs of carcass, lymph node of adjoining area must be examined.

Puncture of the neck prior to bleeding (pitying):

The neck is punctured using a sharp knife especially prepared for this purpose. This is inserted through the first
cervical vertebrae, near the occipital bone. This causes damage of medulla oblongata, reduces breathing and
heart action and finally makes the animal unconscious.
Stunning prior to bleeding:
Use of this method is affected by a mechanically operated instrument and electricity or gas anesthesia without
any adverse effects on the condition of the meat or its products. This process is to put the animal into a state of
insensibility that lasts until it is slaughtered. The different techniques used in the stunning of animals are
• A striking instrument, such as a pole axe or any other appropriately hard tool, to blow on the forehead of the
animal which causes a fracture of the frontal bone and damages the cerebral brain
• Captive bolt pistol, with penetrating and non-penetrating types of bolts, which when shot to different sites of
the head of various animals cause unconsciousness as a result of brain damage
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• Electrical instruments,, using a pair of tongs having 60-80 volts of power, depending on the size and type of
animal. This method of stunning produces a better bleeding by passing an alternating current through the brain
or heart of the animal
• Anesthetic gas, such as carbon dioxide (CO2), is commonly applied to pigs by a special apparatus. Once the
pigs are exposed to the gas for a sufficient time it will render them insensible to pain until slaughtering. It is
important that with the correct concentration of 65-70% CO2, the period of exposure should be 45 seconds and
bleeding should take place within 30 seconds.
All the above methods of stunning are not applicable in all slaughterhouses in Ethiopian, but their choice is
worth considering especially in areas where high meat production is undertaken. Except where there are
objections on religious grounds, compulsory stunning prior to slaughter has now been enforced by legislations
in many countries. The ritual methods of slaughter vary from one religious sector to the other and all must be
respected according to the consumers’ need. In Ethiopia, as in other countries, there are three ritual methods of
slaughtering: Christian, Muslim and Jewish. In traditional ways of slaughtering these are strictly followed. In
public slaughterhouses Christians and Muslims kill animals either by previously stunning or directly by severing
the throat to complete bleeding by individuals of the respective faiths and in their designated areas. At present
even though there is no separate slaughterhouse for Jews the method of slaughtering is strictly followed from
the selection of the live animals to the correct applying of a knife across the neck to permit an acceptance of the
meat for Jewish food. The cutting of the throat is done, using a knife specially prepared by a rabbi, transversely
across the neck in one slash. If the knife receives any nick during the act of slaughter, the performance is
incorrect and thus the meat cannot be consumed by Jews.
Conditions of Bleeding
Bleeding is the process of draining out the blood from the animal’s body by severing the large blood vessels of
the neck. There are two main methods of bleeding; cutting of the carotid arteries and jugular veins by an
incision across the throat region, and by stabbing in the jugular furrow at the base of the neck. Whichever
method of bleeding is employed it should be as compete as possible. In general it should last for at least six
minutes and the amount of blood allowed to flow out should be the maximum. A healthy animal usually may
bleed well, while the ill ones may bleed badly in that most of the blood remains in the flesh. Imperfect bleeding
is an indication of illness, moribund, suffering from fever and other situations. The efficiency of bleeding has a
most important bearing on the subsequent keeping quality of the carcass. Efficiency of bleeding can be judged
by:
• In a badly bled carcass the left ventricle contains blood, and the lungs and the liver remains with a high blood
content
• In a badly bled carcass when the incision is made to the inter coastal muscles blood can be squeezed out
Rigor mortis
Rigor mortis or settling of the carcass is the process characterized by a hardening and contraction of all the
voluntary muscles and finally stiffening of the joints, some hours after death.
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Presence of rigor mortis is due to a chemical reaction. After death the muscles lose their extensibility when the
supply of the adenosine triphosphate (ATP) and glycogen is used up, or the lactic acid acts on the protein
muscles where coagulation of myosin in the body takes place, which finally causes settling.
The development of rigor mortis is influenced by
• The atmospheric temperature: Quick onset takes place in high temperatures and slows down in low
temperatures
• The health of the animal: Where in a fevered carcass rigor mortis is absent or scarcely noticeable
• The degree of muscular activity prior to slaughter: Where if the animal is subjected to stress and fatigue, rigor
mortis will appear and disappear quickly
• The pH of the carcass: This affects the quality and color of the meat. In freshly killed animal the pH value of
the meat is about 7.0 while in a properly set carcass it is about 5.5.
Methods of inspection
Proper meat inspection helps prevent the spread of meat-borne diseases and to produce a wholesome and
safe supply of meat for human consumption.
Inspection of meat has two aspects
• Examination of live animals on entry to the slaughterhouse, referred to as ante mortem inspection
• Examination of the carcass and organs after slaughtering referred to as postmortem inspection.
In situations where animals are so injured or sick to death, or those involved in serious accidents or potential
danger to life need not wait for ante mortem inspection but be immediately killed to save the meat. This is
referred to as emergency slaughter.
Ante mortem inspection
This is the most important process of examination, without which no adequate inspection of the carcass of the
meat is possible. Many diseases like rabies, anthrax and tetanus that may not produce visible lesions and any
evidence of abnormality can only be detected on ante mortem inspection. An animal showing signs of illness,
injury or exposed to sudden accident must be subjected to a thorough examination and follow-ups before taking
final action. Ante mortem inspection ought to be carried out solely by trained and certified inspectors.
Generally when examining live animals attention must be given to the following;
• Posture and movement
• Condition of hide and skin
• State of nutrition – fully developed or emaciated
• Reaction to external influences (environment)
• Feeding reaction – appetite, rumination, quality of droppings, etc,
• Breathing mechanisms - condition of the muzzle, nasal mucosa, respiration, etc,
• Anal opening, vagina or mammary gland.
Inspection of live Animals
Signs of health Signs of sickness
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1. Active and alert Inactive, dull and hanging head
2. Glossy (shiny) bright coat Rough, dull coat
3. Skin – loose and elastic Skin - sticky (tight skin)
4. Muzzle - moist and wet, cool Dry muzzle, warm
5. Clear bright eyes Dull, sunken and discharging eyes
6. Breathing – easy and regular Difficult, rapid and painful breathing
7. Feed and drink normally Loss of appetite, refusal of food
8. Normal temper Abnormal behavior
9. Normal dung Bloody diarrhea
10. Normal temperature Abnormal temperature
11. Remain in herd Separate from herd
12. General good body condition Emaciated body
Post-mortem examination
This is carried out immediately after the slaughter and if possible a follow up inspection is done from
slaughtering to dressing stages of the carcass. The most important requirement in conducting postmortem
examinations is that it should be carried out in a methodical manner, following a definite sequence. Experienced
inspectors can easily perform this. The main purpose of post-mortem examinations is to detect and eliminate
abnormalities and states of contamination by ensuring that the meat is fit for human consumption.
Routine post-mortem examinations must be carried out with care, in a hygienic manner and as much as
possible avoiding unnecessary cuts and mishandling. Any incision made should be done in a proper manner
that it will not impair the market value of the meat. If the carcass or organs require detail examination then
bacteriological examination needs to be done in detail for further examination in part or whole. All carcasses or
organs found to be free from disease and abnormal conditions and must be stamped as fit for human use and
those that are unfit should be condemned and immediately removed to a final disposal place.
Generally the method of postmortem examination recommended and adapted by most countries is as follows: -
Visual examination
• State of nutrition of the carcass
• Evidence of bruising or discoloration
• Efficiency of bleeding
• Abnormalities or swelling of bones, joints or muscles
• Signs of local and general edema
• Condition of pleura and peritoneum
• Check viscera as they are removed from the carcass
Palpation, incision and detailed visual examination
• Blood: color, clotting
• Head: eyes, pharynx, tongue, lips, sub-maxillary and retro pharyngeal lymph nodes
35
• Thoracic cavity: lungs, bronchial and medestinal lymph nodes, heart, diaphragm
• Abdominal cavity: stomach, intestine, spleen, liver, and kidneys
• Reproductive cavity: uterus and ovaries, testicles and penis, udder, supra mammary and inguinal glands
• Connective tissue: fat, bones, joints, tendons
• Muscles: mostly active muscles
• Lymph nodes: at all sites of the carcass
• Feet: internal condition
After a general examination the carcass, organs and viscera must be subjected to a detailed postmortem
examination for specific disease identification and judgment. Diseases vary in their severity, extent and spread
within the animal body. They may occur as an acute stage and actively affect the animals or may be a mild and
chronic type. In this case, judgment or action taken is the most difficult part of meat inspection. It is easy to
reject meat and to be on the safe side but it is not so easy to know what to pass as fit for consumption .
Meat-Borne Diseases
The most prevalent specific diseases that require attention are explained under the following classification:
• Bacterial: Such as bovine TB, anthrax, blackleg or tetanus
• Viral: Such as foot and mouth disease, render pest or rabies
• Parasitic: Such as tapeworm, liver fluke or hydatid disease
• Fungal: Such as actinomycosis
Bacterial Diseases
Tuberculosis: This is the infectious disease for most animals and humans and is characterized by the
development of tubercles in any part of the body. It is caused by mycobacterium tuberculosis. There are three
common types of tubercle bacilli affecting man and animals, the human (Mycobacterium tuberculosis), bovine
(Mycobacterium bovis) and avian (Mycobacterium avium). There is also a fourth type which affects fish. Most
sheep are very rarely attacked. The routes by which tubercle bacilli gain entrance to the body are respiration,
ingestion, inoculation and congenital and genital organs.
The tubercle bacilli when they enter the body of animals produce primary lesions in the respiratory or digestive
tract, followed by lesions in the associated lymph nodes. The specific reaction of the body tissues to the
multiplication of invading tubercle bacilli is manifested by a proliferation of the phagocyte cells at the point of
rest forming a nodule or “tubercle”. This primary infection is localized in the organs or associated lymph nodes
due to either breathing in the tubercle bacilli into the lungs or swallowing the bacilli with infected food or by
autoinfection.
Signs in live animals
• If the lungs are affected there is frequent coughing, breathing is rapid and difficult and in severe conditions
emaciation occurred

36
• If the pleura or peritoneum are affected then the coat becomes rough and dry, the skin hard and inelastic and
the body becomes highly emaciated
• If the udder is affected then the lymphatic glands become enlarged, ¼ of the organ is swollen and a small hard
tubercle is felt
Post-mortem examination
Inspect by touch and incision all surfaces of organs and associated lymph glands for tubercles
• Examine in detail by cutting the lymph nodes into slices
• If required use bacteriological examination
If during these inspection and examination processes lesions and tubercles are found in certain organs and
associated lymph nodes this is evidence of localized infection. If however the lesions and tubercles are
manifested over the entire carcass as milliary tuberculosis of lungs, multiple lesions, widespread infected
lymphatic glands, congenital tuberculosis and acute lesions this is evidence of generalized tuberculosis and
action is required to be taken.
Action to be taken:
• In a localized condition: Only the part or parts containing lesions are to be condemned. For example if the
head of an animal is affected then the head and tongue are seized and properly disposed of
• In a generalized condition: Where tuberculosis with emaciation or evidence of the above conditions is shown,
the entire carcass should be seized and totally destroyed.
Anthrax
Anthrax (spleen fever) is an infective disease of animals and man caused by spores forming bacteria called
Bacillus anthracis. It occurs in pre-acute, acute and chronic forms. The disease is worldwide in distribution
though often restricted to particular areas.
• Ingestion of flesh having the bacilli or its spores
• Contamination of wounds with bacilli or its spores
• Inhalation of bacilli or spores while working or handling in wool-sheep industry, tannery and hide and skin
markets.
The blood of animals with anthrax contains numerous bacilli and once the animal is open to bleeding under
favorable conditions in the open air where the presence of oxygen is sufficient, the bacilli will form spores. The
spores are not found in the living animals and are formed at temperatures in the range of 12-430c and when the
oxygen supply is adequate. The sporulating form Bacillus anthracis is more resistant to distractive influences
than the bacilli form. It is necessary to prevent the infusion of blood from all natural openings as well as other
parts of the carcass. However for bacteriological examination drops of blood from the tips of the animal’s ear or
from under the surface the tail may be taken with great care. A blood smear is prepared on a slide making a
normal staining laboratory procedure and then finally seen under a microscope. If positive, the bacilli appear
blue surrounded by definite purple capsules.
Signs in living animals
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In very acute cases animals become suddenly excited and fall dead.
The disease is sudden in its onset and is usually manifested by high fever, up to 420c, and death occurs within
48 hours of the onset of the illness. It may also has bloody diarrhea, dark red, tarry, unsaturated blood
discharged form the nose, mouth and anus.
In less acute cases generally the animal separates from the herd with a hanging head and is very hard to move
far. The body temperature rises up to 410c, giving a bloody urine and dung. The muscles tremble or quiver and
when hands are put over the body it shows crepitation of the skin .
Post-mortem examination
If the animal is killed and the body is opened without suspicion during the ante mortem examination or without
the knowledge of the people, the following should be checked carefully:
• Spleen: Seen as swollen, up to five times its normal size, changes to black tarry color. Spleen enlargement in
sheep is almost absent. In cross section it shows as a gray or white dot appearance
• Blood: The blood coming out from any opening of the animal’s body is thick and black tarry in color and it does
not clot easily.
Action to be taken:
The meat from anthrax-infected animals is dangerous to man although anthrax bacilli are readily destroyed by
gastric juices. The spores are resistant and may gain access to the system through abrasions of the mouth or
mucous membrane.
Therefore the following measures should be taken:
The carcass, including blood, hide, offal and internal organs, should be disposed of by burning, preferably by
incineration or using a strong fire. The whole carcass and any other parts of the body available at the spot
should be disposed of by burying in a pit. In preparing the pit the following points should be considered:
• Location: Choose a proper site for the burial place, one that should be away from sources of water and away
from any dwelling areas
• Depth of the pit: At least 2 meters
• Pit covering: The carcass and other contents should preferably be covered with quicklime, up to 1 foot on top
and 1 foot at the bottom of the body. Finally the pit should be covered with compacted earth material
• Fencing: This safeguards the burial place from wild animals.
Therefore it should be protected by proper fence
The place where the carcass and all other contents are laying must thoroughly treated with an appropriate
disinfectant. All slaughtering tools and articles used must be boiled and disinfected with a chlorine solution or
formaldehyde.
All persons handling the animal must wear gloves, apron and plastic boots. An antibiotics (penicillin) injection is
of great help for prophylactic treatment.
Black quarter, black leg or quarter leg

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Blackleg is a worldwide infectious disease of cattle and sheep. It is caused by bacteria called “clostridium
chauvoei”. It is a spore-former bacterium that results from soil infection, which affects animals that more
commonly grass feed than stall-fed. Blackleg spores are very resistant to destructive influences and may retain
their virulence for over 10 years in dried muscle and indefinitely in the soil.
Susceptible animals may be infected by inoculation or more commonly by the ingestion of spores in soil, dust,
grass and water.
Most often, young animals, between six months and two years of age are attacked. Black leg is not
communicable to man, man is immune.
Signs in living animals
Generally black leg is characterized by severe inflammation of muscles with toxocemia and high mortality. The
infection is followed by crepitate swellings as a result of gas formation when developed in the subcutaneous
tissue. During ante mortem inspection the following conditions are detected:
• Swelling on the shoulder, neck, legs, loins and thigh and crepitation over the swollen part is commonly present
• Manifested with high fever
• Death occurs within 24 hrs.
• Cause lameness, if the limbs are affected
Post-mortem examination
• Muscles: These become blackish red and edematous at the periphery of the swelling and have a spongy
appearance.
Above all it emits a rancid and unpleasant odor
• Lesion: If it is cut it gives off gas with a pus-like odor
• Visceral organs: The liver and kidneys show marked changes, being enlarged and congested.
Action to be taken
If a live animal is found affected with black quarter, slaughter of the animal is forbidden. If however after
slaughter the carcass and organs are found to be affected they should be rejected and disposed of properly
because the flesh of such animals is highly affected and spoiled to the extent that it gives off a rancid taste and
odor.
Tetanus (Lockjaw)
Tetanus is an acute, highly fatal and infective disease. It is caused by bacteria called “clostridium tetani”. All
animals can be affected, principally horses, sheep and cattle and rarely pigs. Tetanus organisms have their
natural habitat in the intestines of horses and other animals. They commonly exist in the top layers of the soil
which has specially been fertilized with manure. In animals it is caused by contamination with soil of open
wounds or the umbilical cord in newborn animals. In man contamination is by of wounds or penetration through
skin or mucus membrane. The organisms themselves do penetrate the blood, but remain at the site of
inoculation where they produce a very acute toxin, which cause the acute tetanus spasms, stiffness of the body
and finally death.
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Signs in living animals
The examination during ante mortem is incomplete by itself, but by taking specimens from the wound of the
animal or drawing blood from the body a bacteriological test is done to confirm the disease.
• At the site of inoculation the tissue becomes edematous.
• Causes muscular spasm in the muscles of the jaw (master muscle)
• Causes stiffness of the body, starting from the jaw and spreading to the legs
• Attacks the nerve cells of the spinal cord and brain.
Post-mortem examination
Since there is slight alteration internally, the post mortem examination is very difficult unless it is preceded by
ante mortem inspection.
Certain characteristic changes shown are:
• Slight pathological change may be observed in the heart, liver and kidneys
• The internal muscles may become soft and change color to grey
• The dead animals show evidence of asphyxia.
• The blood of the animal becomes dark red showing some tendency to clot.
Action to be taken
Since the whole carcass is to be affected because of the reaction of the body, the carcass and the organs must
be rejected as unfit for human consumption.

VIRAL DISEASES
Foot and Mouth disease
This is an acute, contagious, febrile disease caused by entrovirus and occurring in cloven-footed animals, such
as cattle, pigs, sheep and goats. The virus of the disease is most concentrated in the infective fluid from the
vesicles, which characterizes the infection. Grazing or stable animals with vesicles, while feeding and walking,
will have their blisters burst out and contaminate the pasture and grazing land with viruses that have been
discharged. These viruses will get access to other grazing animals through their feet when walking or their
mouthparts while feeding. Infection with the virus of the foot and mouth disease is rare in man and usually takes
a mild form. The disease can be spread by means of infected fodder, by meat affected by the disease and by
consuming milk from the infected cow.
Signs in living animals
• Excessive salivation as a result of affected mouthparts
• The principal locations of the vesicles or blisters are the membrane of the lips, muzzle, tongue and fibrous pad
• Lameness as a result of vesicles between the digit, at the base of the supernumerary digits, around the horns
and pairs of hooves
• Lesions in

40
Cattle: Found on the tongue, lips, dental pad, feet and udder. The size of vesicles or blisters is ½ to 2 inches
and they have a white clear appearance and contain a yellow fluid.
Sheep and goats: Found generally on the feet and seldom in the mouth, the lesions in these animals are
smaller than cattle ones.
Pigs: Found on the feet, inside the nasal septum and sometimes on the teat of the udder.
Action to be taken
Once the ante mortem inspection is done properly to identify the condition of the infection, the postmortem
examination is not necessary as a routine procedure, but for an overall check-up of the internal condition of the
lesions, it should be practiced.
In this case the whole carcass, organs, hide and teat of an animal suffering from foot and mouth disease must
be seized and destroyed and when need arises should be burnt properly. In addition thorough cleansing and
disinfection of all tools, materials and all places in contact should be done to safeguard any further
contamination of meat products.
Render Pest (Cattle Plague)
Render pest is an acute, infectious and febrile disease affecting particularly cattle, which when once introduced
spreads very fast and may lead to the almost complete extinction of animals over large areas. It is endemic in
Ethiopia as in other places. This disease also affects game animals. It is caused by viruses that are
characterized by inflammatory neurotic changes of the mucus membrane of the alimentary tract. The disease is
spread through direct contact or through water and grass contamination to other animals.
Signs in living animals
• If the animal is affected with the disease, it is dull looking and it stands with its head down with its back
hunched
• It has a high fever, 410c-420C.
• Onset of diarrhea with a black and smelly condition is frequent, which causes the animal to rapidly become
emaciated
• The animal loses its appetite and stops ruminating
• The mouth shows an acute inflammation of the mucous membrane, with its muzzle dry and eyes having a
discharge.
Post-mortem examination
• Inflamed patches are seen on lips and throat area
• Red streaks on the rectum are visibly
• Liver is enlarged and the gall bladder is distended
• The associated lymphatic glands are swollen
• Dehydration and emaciation of the carcass may be seen.
Action to be taken

41
Since it does not affect man but gives a poor quality meat and poor protein content, because of the high fever
and toxemic condition of the animal, the carcass and organs affected must be totally condemned and
destroyed. In areas where render pest is endemic, vaccination coverage is of great help preventing the spread
of the disease for fairly long time.
Rabies
Rabies (hydrophobia) is an acute, infective viral disease, which is usually transmitted by a bite from an affected
animal. Man is susceptible and is usually infected by a dog bite. Almost all carnivorous animals such as dogs,
wolves, hyenas, jackals etc are also susceptible and become infected through the bite of other rabid animals.
Signs in living animals:
Rabies has 3 stages of symptoms.
1st stage- Melancholic (depression)
• Normal temper changes to irritation and aggressiveness
• Animal tends to hide away, becomes uneasy and moves actively
• Is frightened of any noise heard
2nd stage- mania (madness)
• Excitability increases and wanders aimlessly
• Animal’s normal appetite is changed and attempts to eat strange articles
• Starts attacking other animals though man is rarely attacked
• Slight paralysis startes and the animal cannot swallow
3rd Stage- paralysis
• Larynx and pharynx are first attacked and the voice of the animal changes
• Muscles of mastication are affected and the eyes become paralyzed
• Continuous dripping of saliva starts
• Muscles of locomotion and breathing are affected
• Finally, when paralysis is complete, the animal dies of asphyxiation.
Post-mortem examination
Post-mortem examination of rabid food animals that have died or have been slaughtered reveals no diagnostic
lesions. The characteristic changes in the brain are only evident on microscope examination is negree bodies
are seen it is positive for rabies. The stomach contains little food and the gastro-intestinal mucosa may be
inflamed.
Action to be taken
Rabid animals for meat are unfit for slaughter because the handling of the meat of rabid animals is dangerous.
To safeguard the spread of rabies, the following control measures should be taken:
• Careful follow up of all suspected animals
• Destruction of all stray dogs
• Compulsory vaccination of all owned dogs by the veterinary office
42
• Control of wild animals
• Quarantine of any suspected animals for 10-14 days, if is the animal develops the symptom the person in
contact should start prophylaxis immediately.

PARASITIC DISEASES AND INFESTATION

The most important parasites in meat inspection are those which are transmissible to man by the consumption
of the flesh of affected animals or by coming into contact with such flesh. Other parasites, though not causing
diseases in man, may render such flesh or organs to deteriorate and therefore, be unfit for sale for human
consumptions. The three most common parasites of animals to be dealt here are: tapeworm, liver fluke and
echinococus.
Tape worms in humans
Tapeworms (cestodes) are parasites, when mature inhabitants of the intestines. The presence of numerous
tapeworms in the intestine may exert a deleterious effect and discomfort on the host. The adult tapeworm
possesses a head or scolex and a number of segments
(proglottids) which vary from three to many hundreds. Tapeworms exist in two stages, each resident in a
separate host, called the cysticercus’s (cyst) stage and the adult (matured) stage. The cysts are non-feeding,
immature stages are lodged in the muscles or other tissues and organs while in the adult form, the parasite
attains complete sexual development, in the intestine.
The two common tapeworms requiring attention in meat inspection are Tania saginata and Tania Solium.

Tania saginata (Cystecercus bovis)

The adult beef tape worm occurs in the small intestine of humans where the intermediate stage, cystecercus
bovis, is found in cattle.
The adult tapeworm measures from 3 -10m in length with a head or scolex having four suckers and a long
segment (proglottides). The life cycle of beef tapeworms takes place at two stages in a different host.
The stage of development that concerns in meat inspection is that part which takes place in cattle. The eggs
which are discharged contain an open fluid which may remain over the grass and will be ingested by cattle. In
time these hatch out in the intestine, penetrate the gut wall and reach the blood stream by which they are
carried to various parts of the animal body. The embryos that become attached to the muscles develop into
cysts- cysticercus’s bovis. These cysts remain active for some years in the muscles, which later undergo
degeneration, cassations and calcification. The most affected part of the body are the active muscles, namely
the masseter muscles, heart, tongue, inter-coastal muscles, shoulder and neck muscles, diaphragm, liver and
lungs and other muscles (Biceps and triceps).
Taenia solium (cystecercus cellulosae)
The adult tapeworm inhabits the upper part of the small intestine of man while the intermediate stage,
cysticercus cellulosae is found in pigs. The adult tapeworm is 2-6 m long, with a globular head less than 1mm in
43
diameter and segments. The life cycle of a pork tapeworm takes place in the same way as in a beef tapeworm,
where the cysts are formed in the pigs’ active muscles, namely the heart, diaphragm, tongue, neck, shoulder,
inter coastal and abdominal muscles.
During ante-mortem inspection of tapeworms in living animals, it is not easy to identify the signs and symptoms
of the disease. Therefore it is not done as a routine procedure. A meat inspector instead may have the
knowledge of the area from where the animals originate and this may give him a hint for a thorough examination
of the muscles during the postmortem examination.
Action to be taken
Since consuming meat raw or partially cooked meat with tapeworm cysts infects man, the following measures
should be taken:
• Localized infection, where the organs or part of the muscles are offered with only a few in number of cysts, the
only affected part has to be seized and disposed of properly.
• In generalized infection, where the cysts are found in most organs or parts of the muscles in a significant
number, the whole carcass should be condemned.
In order to save the meat there are certain practical measures that may be taken if they are properly handled.
Cysts in meat can be destroyed by adequate boiling or cooking, at least 140oF (600c), or cysts in meat can be
inactivated or killed by cold storage or deep refrigeration at temperature 200F (-6.60C) for 3 weeks or at a
temperature of 140F (-100C) of 2 weeks.
Liver Fluke (Fasciola Heptatica)
Fasciola heptatica is a common liver fluke that is responsible for the acute and chronic inflammation of the liver
and bile ducts. It is distributed almost universally throughout the world. It is usually flat, leaf shaped and pale
brown in color with an oral sucker. The parasite is 32 mm long and 8.4 -13 mm wide. The animals most
commonly affected are sheep and cattle. The life cycle of the parasite takes place in different hosts. The stage
of development in sheep or cattle is the part that concerns meat inspectors. The intermediate host, in which the
cycle of maturity takes place, is in the snails who favorably inhabit marshy areas. After the eggs are discharged
from the host they develop into meracidium and in a favorable condition they finally reach cercariae stage.
These cercariae settle on the blades of grass and other plants in the pasture where grazing animals eat them.
Within the animal intestine the liberated embryos finally reach the liver and develop into the adult flukes. Flukes
live in the liver and bile ducts of the animals, which then affects the organ.
In an acute case there is a condition of distinct swelling and congestion of the liver and bile ducts, as a result of
invasion of the liver by a large number of young flukes. In chronic cases, the liver become distorted, the bile
ducts enlarged, thickene and turn to a bluish color.
It is not necessary to make ante mortem inspection for liver fluke infestation. There is no indicative sign for the
infestation other than to know the areas from which the animals originated in the locality.
Post-mortem examination

44
Since the main organs that are affected the liver and lungs, external observation and incision to expose the bile
ducts can be done to check the organs. If the liver is infested with the flukes, they may be seen emerging when
the surface of the liver is pressed with both hands. The same way may also apply to the lungs.
Action to be taken
The organs, the liver and lungs if highly affected should be rejected and disposed of properly. Since liver fluke is
not transmissible to man by consumption of the meat, some parts of the meat may be saved if they are free
from infestation.
Hydatid disease (Echinococeus Granulocus)
This is the smallest of the tapeworms, about 3-9 mm in length and composed of a head or scolex and three or
four segments. Dogs are the definitive host, while man does not harbor the adult worm. The incidence of
echinococecus infection in an area can be determined from its level in dogs. The food animals affected are
cattle, sheep and pigs. Infection to man is only by contamination of water or vegetables with hydatid infection
and not by infected cystic meat. The life cycle of echinocoecus passes through the definitive host, the dog and
the intermediate host, the sheep or cattle. After the intermediate host ingests the fertile ova, the digestive juices
dissolve the capsules and the embryos penetrate through the walls of the small intestine passing into the portal
veins and are retained in the liver and on the parts of the body.
Once they reach the tissue muscles they form cysts. This cystic stage is known as echinocoeceus or hydatid
cyst. These organs with cysts when disposed of carelessly can be consumed by dogs and pass a cycle of
development in their body. The discharged feces of dogs may contaminate vegetables or water, and the cycle
continuous again.
The ante mortem inspection is not done to a identify hydatid disease condition, instead careful exploration is
done during post mortem examination.
Post-mortem examination
The organs most commonly affected are the liver, lungs, kidneys and spleen. Occasionally cysts are also found
in the heart, bones and muscular tissues. Liver is heavily infected and in the long run cyst degeneration takes
place through a process of cassation and calcification.
During the examination the cysts that form on the organs and other parts of the carcass should be checked
carefully.
Prevention: The cycle can be interrupted by having proper human waste disposal, by preventing dogs from
entering the slaughter place and if possible by boiling and the cooking of water.
Action to be taken
All affected organs and parts of the carcass are unfit for human consumption and so they should be condemned
and disposed of properly.
Other Measures:
• Condemned meat parts should not be disposed of anywhere but burnt or buried with care.
• Dogs should be prohibited from entering slaughterhouses or similar places, proper fencing is required
45
• Food and vegetables should be prevented from being contaminated with dog faeces.
Actinomycosis (Lumpy Jaw)
This is a chronic disease of cattle commonly known as “Lumpy Jaw”.
A fungus called “actinomyces bovis” causes it. Pigs are more affected than other animals. Actinomyces boviis is
responsible for actinomycosis of the bone in cattle and the main cause of udder actionmycosis in the pig. The
infection of bone may be regarded as the true from of actinomycosis, while infection of the softer tissues is
caused by actinobacililus, another bacterial species. In cattle the lesions of actinomycosis are usually confined
to the head, and may involve the jawbones to produce “lumpy Jaw”, the lower jaw is more affected than the
upper one. The bone part of the jaw is thickened and forms a honey-combed appearance on section.
Signs in living animals
• The lower jawbones are distinctly seen to be affected
• Some extended lesions may be seen in the head part
• Tongue ulceration, enlargement and hard formation takes place
• Pigs (sow’s) udder is affected.
Since the most affected parts of the head and other organs can be easily checked externally, there is no need
for a post mortem examination.
Action to be taken:
Affected organs, such as head, tongue udder, stomach or lungs, should be condemned.

FOOD-BORNE DISEASES
Significance and Brief Description of Food borne Diseases
Case Study
Learning Activity 1
It was during the period of drought and famine when people were getting displaced from a highly drought-
stricken village to other areas. Before the resettlement, they used to wait in groups in a nearby small town for
few days, or sometimes weeks. Among them, Fatuma, a 25-year old lady came to the nearby health center with
one day history of nausea, vomiting and watery diarrhea. She was one of the cooks for the group. On
examination, she looked weak with feeble pulse, fast pulse rate and her blood pressure was abnormally low.
Her tongue and mucosa were dry.
After appropriate laboratory investigations, she was given proper management and advice. The next morning
25 similar cases from the group came to the Health Center.
They were also given appropriate management, and advice. Staffs from the Health
Center supervised the temporary shelters of the displaced people and came up with the following report: there
were about 50 individuals living in four rooms within one compound; the houses were under construction with
multiple openings and dusty floors.

46
There was no toilet in the compound and it was observed that there were human excreta scattered all around.
Cooking and eating utensils were not clean and there was no appropriate storage for their food. Pipe water
supply was available in the compound; but the people fetched the water using wide mouthed buckets for
storage. Finally the staffs conducted appropriate intervention measures and no similar cases were seen
subsequently.
Answer the following questions related to the case study
1. What do you think is the source of Fatuma’s health problem?
2. What do you comment about the role of Fatuma in the transmission of this disease among the settlers?
3. What are possible interventions to prevent such occurrences in the future?
4. Could food be considered as a possible cause for this outbreak? Why?

Definition of Food borne diseases

“Food borne disease” is defined as a disease caused by agents that enter the body through the ingestion of
contaminated food. These agents may be infectious agents or toxic substances.
Epidemiology
Although food is a basic human need it can sometimes cause a number of illnesses arising from pathogenic
and toxic substances that find their way in to food through contamination or spoilage. Food borne illnesses have
significant impact worldwide including developed nations. For example, the Center for Disease Control and
Prevention (CDC/US) has made estimates that 76 million cases, more than 300,000 hospitalizations and 5000
deaths occur in a year in the US from food-borne diseases. In addition, 400 – 500 outbreaks are reported.
Epidemiologic data related to food-borne diseases are inadequate in Ethiopia. But it can be evidenced that
these are very common in the country because of many reasons including poverty, lack of awareness, poor
water supply, poor personal hygiene and environmental sanitation, etc.
􀂃 Helminthic infections were the second leading cause of outpatient visits
􀂃 Dysentery and different parasitic infections were also among the ten top causes of outpatient visits
􀂃 Dysentery was among the leading causes of hospital admissions and deaths
􀂃 The national average access to safe water was 28.4% (75.7% for urban and
19.9% for rural)
􀂃 National figure for safe excreta disposal was 11.5% (49.7% for urban and 3.9% for rural)
􀂃 Typhoid fever, acute diarrheal diseases, bloody diarrhea and anthrax were reported as some of the major
causes of outbreaks
Classification and Etiology of Some Food Borne Diseases
Food borne diseases are categories as food borne Invasive Infections, food borne toxicoinfections and food
borne poisonings/Intoxications depending on the responsible agent:

47
Food Invasive Infections are caused by microbes that invade bodily tissues and organs and are diseases whose
etiologic agents are viable pathogenic organisms ingested with foods and that can establish infection . They
included in this group are the viruses, parasitic protozoa, other parasites, and invasive bacteria
(e.g., Salmonella, Aeromonas, Campylobacter, Shigella, Vibrio parahaemolyticus, Yersinia  and enteric-
type Escherichia coli).
Toxicoinfections which are caused by infective organisms that are not considered invasive in nature, but are
capable of multiplication or colonization in human and produce toxins resulting in a disease condition. Included
in this group are: Vibrio cholerae, Bacillus cereus  (diarrheal-type), C. botulinum  (in infants), C. perfringens  and
verotoxigenic E. coli  (E. coli O157:H7 and others).
Food borne poisonings/ intoxications are caused by toxins produced by organisms which have grown to
sufficient numbers in the food product. Diseases arising from the ingestion of toxins released by
microorganisms, intoxications from poisonous plants or toxic animal tissues, or due to consumption of food
contaminated by chemical poisons. In general, intoxication is manifested more rapidly after consumption of
contaminated food (shorter onset time) than are infections. The primary bacteria causing food borne
intoxications include: C. botulinum, B. cereus  (emetic-type) and Staphylococcus aureus. Other non-bacterial
toxins that cause illness include:
Diagnosis of Food-borne Diseases
A variety of infectious and non-infectious agents should be considered in patients suspected of having a food-
borne illness. However, establishing a diagnosis can be difficult, particularly in patients with persistent or
chronic diarrhea, those with severe abdominal pain and when there is an underlying disease process. The
extent of diagnostic evaluation of food borne diseases can be based on clinical features (history and physical
examination), environmental assessment and laboratory investigations.
Clinical Assessment
History
A case history may be important clue in determining the sources and causes of the diseases and the type of
foods involved. Therefore, obtain the history regarding the following points.
􀂾 Where, when, and what has been consumed?
􀂾 How soon after consuming the food did the symptoms occur?
􀂾 Duration of the resultant illness,
􀂾 Whether the consumed food had an unusual odor or taste?
􀂾 Inquiry on whether any other person or individuals have consumed the same food.
􀂾 Did anyone else become ill from eating the same food?
􀂾 Any other evidence suggesting the cause of the illness.
Physical Examination
Proper thorough examination should be done on any patient suspected to have foodborne disease.

48
Environmental Assessment
It is important to conduct environmental assessment and collect environmental samples for suspected and
potential causes of food borne illnesses especially of outbreaks. The assessment may include survey of the
source of the outbreak with critical evaluation of:
􀂾 Source of the suspected food;
􀂾 How the food is prepared including cleanliness of table and kitchenware;
􀂾 Personal hygiene and health status of food handlers;
􀂾 Sanitation of the food preparation and service premises;
􀂾 Storage of the food before and after its preparation;
􀂾 Presence of potential or actual contaminants;
􀂾 Availability of safe and adequate water supply;
􀂾 Type and quality of food storage, and service equipment including food contact surfaces.
􀂾 Collect of samples from suspected food, dish wares, vomitus and stool of cases.
􀂾 Power failure before the outbreak and breakdown of refrigeration
Outbreaks and incidents of food poisoning and food borne infection require careful histories of the food vehicle,
with environmental studies of the areas of food production and preparation as far back as possible. Sites of
infection and areas of spread may include the farm of origin, dealers, markets, processing areas, wholesale or
retail outlets to catering establishments, restaurants and domestic kitchens. Transport conditions for live
animals and for food–stuffs may enhance spread also.
Laboratory Investigations
The laboratory investigations will help to identify the causative agents. These investigations include, on the
appropriate samples, macroscopic examination, microscopic examination, culture and biochemical tests,
serology and toxicological tests. Different biological specimens such as stool, blood, liver aspirate, duodenal
aspirate and muscle biopsy can be used for the investigation as applicable (16).
Macroscopic Examination
􀂾 Routinely examine fecal specimens and identify the physical characteristics of the stools (color, consistency,
presence of blood, and mucus).
􀂾 Identify grossly visible parasites (16).
Microscopic Examination
􀂾 The direct examination of stool specimen is essential to detect motile parasite, cyst and helminthes eggs.
Because only a few eggs and cysts are usually produced even in moderate and severe infection, concentration
technique should be performed.
􀂾 Gram stain on appropriate specimens to detect gram–positive and gram–negative bacteria.
Culture and biochemical tests
49
These can be done in areas where the facilities and expertise are present.
Serology
Serological technique most frequently used in laboratories are those that can be performed simply and
economically uses stable reagents, do not require special equipment and enable specimen to be tested
individually or in small number. Such techniques include agglutination test, flocculation technique and enzyme
immunoassay.
Toxicological Tests
Occasionally, the toxicology laboratory is asked to aid in the diagnosis of possible chemical intoxication by
taking blood or urine sample from the affected individuals.
General Management Approaches of Food-borne Diseases
The management approach to food-borne diseases depends on the identification of specific causative agent,
whether microbial, chemical or other. In addition determination of whether specific therapy is available and / or
necessary or not is very important issue to consider. The management interventions for food-borne diseases
may involve one or more of the following.
􀂾 Symptomatic and supportive therapy
􀂾 Specific antimicrobial, antitoxin, antidote, etc therapy
􀂾 Surgical therapy
Many episodes of acute gastroenteritis are self-limiting and require only fluid replacement and supportive care.
If an antimicrobial is required the choice should be based on:
􀂾 Clinical symptoms and signs
􀂾 Organism identified from specimens, and in higher centers, antimicrobial sensitivity can also be determined.
Prevention and Control of Food-borne Diseases
Prevention and control of food–borne diseases, regardless of the specific cause, are based on the same
principles:
1. Avoidance of food contamination
2. Destruction or prevention of contaminants
3. Prevention of further spread or multiplication of contaminants.
Specific modes of intervention vary from area to area depending on environmental, economic, political,
technology and socio cultural factors.
The preventive and control strategies may be approached based on the major site in the cycle of transmission
or acquisition where they are implemented. These involve the activities performed at: source of infection,
environment and host.
Source of infection
􀂾 Thorough cooking of raw.
􀂾 Thorough washing of raw vegetables with clean water
􀂾 Keeping uncooked animal products far separate from cooked and ready-to-eat foods.
50
􀂾 Avoiding raw milk or foods made from raw milk.
􀂾 Appropriate heat treatment of food items before consumption
􀂾 Active immunization of animals
􀂾 Inspection of food
􀂾 Sanitary disposal of human wastes
􀂾 Treatment of cases
􀂾 Washing hands, knives, cutting boards, etc. after handling uncooked foods.
􀂾 Avoiding contact with materials contaminated with pet excreta or soil.
􀂾 Decontamination of animal products, e.g., wool, goat hair
􀂾 Burying intact or cremating of infected animal carcasses.
􀂾 Isolation
􀂾 Recognizing, preventing, and controlling of infections in domestic animals, pets.
􀂾 Washing hands after contact with animals
􀂾 Management of food handlers and homemakers
􀂾 Treatment of carriers.
􀂾 Proper care for patients with food-borne illnesses.
􀂾 Avoidance of food from animals with obvious infection, e.g., mastitis in cows
􀂾 Treatment of infections in food handlers such as skin and throat infections
Environment
This involved stringent follow-up from production to consumption. Some of the interventions include:
􀂾 Freezing, salting, etc. of food items during storage
􀂾 Control of flies, rats, roaches
􀂾 Public education on environmental and personal cleanliness
􀂾 Surveillance of food establishments
􀂾 Avoiding contamination of food after cooking
􀂾 Maintenance of sanitary food area
􀂾 Proper handling and storage of leftover foods
􀂾 Kitchen cleanliness
􀂾 Safe canning at home
􀂾 Careful storage and use of chemicals (storage away from foods)
Host
􀂾 Active or passive immunization of susceptible hosts
􀂾 Health education on the above areas
“The Ten Golden Rules” of WHO for Safe Food Preparation
1. Choose foods processed for safety
2. Cook food thoroughly
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3. Eat cooked foods immediately
4. Store cooked foods carefully
5. Reheat cooked foods thoroughly
6. Avoid contact between raw and cooked food
7. Wash hands repeatedly
8. Keep all kitchen surfaces meticulously clean
9. Protect food from insects, rodents and other animals
10. Use safe water

Investigation of Outbreaks of Food-borne Diseases

Outbreaks of food-borne diseases can lead to deaths of many people within short periods, and hence their
timely detection and proper management could not be overstated. When the Health Team receives information
regarding an outbreak of a possible food-borne disease, action should start immediately. This action has to be
integrated from the outset since the investigation and management of any outbreak requires the concerted
effort of all health professionals concerned. In addition, being prepared beforehand for such outbreaks, by
collecting the necessary information on food-borne diseases and previous outbreaks (in the area in particular) is
important.
The objectives of investigating an outbreak of a food-borne disease can be summarized as:
􀂾 Identifying the causative agent responsible for the outbreak
􀂾 identifying the food items, handlers, etc. responsible for the outbreak
􀂾 Identifying and tracing the location of the source of the outbreak
􀂾 Determining the conditions and mechanisms that led to the contamination of the food item identified
􀂾 Limiting the impacts and arresting the progression of the outbreak
􀂾 Being able to use information obtained from the current outbreak for the prevention of subsequent outbreaks
The health team should do the following in addressing a possible food-borne disease outbreak:
􀂾 Obtain as detailed information as possible from all available informers, cases, care-takers, clinicians, etc.; this
involves interviewing of infected individuals, management, and food handlers; all the obtained information
should be systematically registered using prepared questionnaires.
􀂾 In collecting this information, attempt should be made to determine the mean incubation period of the
outbreak.
􀂾 The exact date and time at which the suspected food was consumed should be sought; and of those who ate
and did not eat the food, the number and proportion of those who got sick should be calculated in order to know
the attack rate. It will be helpful to have and keep a list of symptoms and signs during assessing these
individuals for the presence or absence of the suspected food-borne illness (nausea, vomiting, diarrhea,
abdominal pain, fever, headaches, etc.).

52
􀂾 One has to keep in mind that the association between illness and exposure for the suspected food does not
have to be “perfect”; in fact, this is rarely so because of different factors, one of which may be that the
implicated food may not be contaminated throughout; in addition, host susceptibility varies as does dosage (the
quantity consumed), and there may be errors in reporting food histories (faulty recall, uncertainty); there may
also be errors in recording.
􀂾 If the outbreak is large and it is not possible to interview all participants, a random sample should be selected
and questioned for symptoms and food exposure history.
􀂾 Develop a hypothesis based on the initial clinical features and other information obtained regarding the
probable food-borne disease in order to devise case management plans to treat the sick individuals.
􀂾 Tell informers and cases to retain or recover all suspected food items, the original containers and packages
􀂾 Collect specimens of suspected food, stool and vomitus from ill persons and send them to a reference
laboratory immediately for identification of the agent.
Obtain and use appropriate sampling equipment such as sterile containers and other apparatus.
􀂾 Visit the institution or place where the outbreak is suspected to have started.
During this visit, all members of the team should go and analyze the environment and other situations in a
systematic way; they have to keep records of all things observed.
􀂾 Analyze and interpret all the information collected using the different techniques outlined above and try to trace
the exact source of the food implicated
􀂾 Finally, take remedial actions, and inform the public on the prevention and control methods.
􀂾 Report the findings to the concerned authorities, and keep a document of it for future use from the experience
gained.
Summary of steps in the investigation of food-borne disease outbreak investigation
1. Verify the existence of an outbreak
􀂃 Compare the current number of cases with the past
Note: -consider seasonal variations
2. Verify the diagnosis
􀂃 Review clinical and laboratory findings
3. Describe the outbreak with respect to time, place and person
4. Prepare an epidemic curve
5. Calculate food-specific attack rates
6. Formulate and test hypotheses (by consulting with higher level health professionals).
7. Search for additional cases
8. Analyze the data
9. Make a decision on the hypotheses tested (by consulting with higher level health professionals).
10. Intervene and follow-up
11. Report the investigation
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12. Inform the public on the control and prevention of the outbreak
N.B: While investigating an outbreak the proper treatment and care for patients should not be ignored.

Learning Activity 2
Case study
There is a busy a busy cafeteria at a boarding school in the town of Bo. The boarding school accommodates
over 1200 students; and all are served in this same cafeteria. The cafeteria is located in front of the students’
dormitories in about a 50 meter distance. In most cases the direction of the wind blow is from the dormitories to
the cafeteria. The dormitories harbor toilets with a water flush design but as water is scarce it is not uncommon
to observe piles of human excreta with a buzzing population of flies feeding on the excreta. The campus
compound, though has some trees, is dusty. Water is a problem in the boarding school; but this is alleviated by
fetching water with trailer tankers from bore holes at a distance of about 20 KM. The water then is filled, for
storage, to open barrels or narrow mouthed jerry cans with plastic hoses pulled over the floors in the kitchen of
the cafeteria. The cafeteria lacks ample dishes but this is compromised by rotating the utensils to serve more
students. During this rotation the dishes are simply rinsed in a bowel of water before they are given to the next
user in the queue. However, after a session of service the utensils are finally washed for the next session in a
three-compartment manual dish washing system filled with cold water and at the first compartment having
detergents. The dishes are placed to drip and dry in perforated plastic racks placed on the floor for ease of
sliding over the floor. The floor of the kitchen is rough and usually wet. However, it is frequently cleaned to drain
but not usually mopped, as this is a tedious task.
The number of workers in the kitchen and cafeteria is enough to manage the required service. The majority are
manual workers with low skills who have been on the job for long periods of time. Hence, the management
assuming they have experience is reluctant to train them on proper food handling. The administration considers
this as a good strategy to minimize unnecessary cost.
The wastes including garbage from the kitchen and the cafeteria are given to pigs that scavenge around these
facilities. The sewage drains to underground sewers but there is frequent blockage that leads at times to
overflow. The overflows facilitate growth of green grasses surrounding the cafeteria. Moreover, this wastewater
is used to water vegetables planted in the backyard. It is common to smell odors arising from the garbage and
the wastewater. This is not given much attention by the school management as they consider it to be normal to
kitchens and cafeterias.
The campus clinic record shows that most students come with complaints of diarrhea.
The clinic head reports that mass diarrhea complaints are commonly observed but are usually not serious. As
the clinic is so busy, the staffs have no time to visit the cafeteria.
In addition, the head of the clinic believes that giving proper care to the sick is easier and better than wasting
time assessing the cafeteria.
Questions related to the above case study
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1. How do you judge the overall sanitation of this cafeteria?
2. What do you think are the potential sources of food contamination in this cafeteria?
3. How do you evaluate the dish handling and washing practice?
4. Do you think training of food handlers can address any problem related to food hygiene in the cafeteria? If so,
discuss on some of them.
5. Are the toilets of the students’ dormitories of any threat to the food hygiene in the cafeteria? How?
6. Do you think the storage of water is appropriate? If not, why and what improvements do you suggest?
7. What defects do you see with the construction of the floor of the kitchen?
Suggest for solutions.
8. If you were a student of this school, what role could you have played in improving the food service?

THE BASIC PRINCIPLES OF FOOD SANITATION:

The word sanitation is derived from the Latin word “sanitas”, meaning “health”. The word sanitation is not a
“dirty” word. Most owners or managers of food facilities want a clean operation. Sanitation is the application of a
science to:
􀂃 provide wholesome food handled in a clean environment by healthy food handlers,
􀂃 prevent contamination with microorganisms or toxic chemicals that cause food borne illness, and
􀂃 Minimize the growth of food spoilage microorganisms.
Because of lack of awareness on issues of sanitation, food borne diseases are among the major health
problems.
Food borne diseases are not limited to the activities of microbes or their products. Food borne diseases can
also be caused by a variety of chemicals that may lead to illness and deaths of people who may have
consumed foods contaminated by these chemicals.
An effective program of food sanitation has several benefits. To mention some:
a. Reduced public health risks
b. Improved product shelf life
c. Improved customer relations
d. Improved product acceptability
e. Reduce wastage
The basic principles for food sanitation to control food borne illnesses and outbreaks can be summarized to
three essential activities:
􀂾 Prevention of contamination of the food from microorganisms, their toxins or other chemicals of health hazard..
􀂾 Elimination / destruction of micro – organisms or their toxins
􀂾 Prevention of the growth of microorganism or the inhibition of toxin production
Different Stages and Processes at Which Food may be contaminated

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Pathogenic and toxic substances may find their way into food through contamination or through spoilage.
Contamination of food can be either from biological agents or chemicals. Biological agents in food that are of
concern to public health include bacteria, viruses, parasites, helminthes, protozoa, algae, and certain toxic
products they may produce. Similarly there are, many chemical contaminants too.
Stage Process Possible contaminant and vital areas of concern
Primary production Planting, rearing livestock, fishing Night-soil, garbage, pesticides, etc
Processing Freezing, canning Food-plant sanitation, personal hygiene of food handlers, additives, etc
Distribution Containers, trucks Sanitation of collection and delivery vehicles
Marketing Market, retail shop Expired goods, sanitation of premises and markets
Food preparation Home, restaurants Sanitation of food premises, personal hygiene of food handlers, etc.
Serving and consumption Home, restaurants Cleanliness of utensils, personal hygiene of consumers

Sources of contamination of food:

Food products are rich in nutrients required by microorganisms and may become contaminated. Major
contamination sources are:-
􀂾 Water: If a safe water supply is not used in processing and preparation of food it then becomes a source of
contamination of the food (chemical or biological agents).
􀂾 Sewage: Raw, untreated sewage can contain pathogens that have been eliminated from the human body, as
well as other materials including toxic chemicals from the environment. If raw sewage is used to irrigate
vegetable farms, it can be a source of food contamination.
􀂾 Air: Contamination can result from airborne microorganisms and chemicals in food processing, packaging,
storage, and preparation areas.
􀂾 Equipment: contamination of equipment used for processing, preparing or serving food occurs during
production (manufacture) and when the material is not properly cleaned.
􀂾 Food handlers: The hands, hair, nose, and mouth harbor microorganisms that can be transferred to food
during processing, packaging, preparation, and service by touching, breathing, coughing, or sneezing. Of all the
viable means of exposing microorganisms to food, employees are the largest contamination source.
􀂾 Adjuncts and additives: Ingredients (especially spices, flavoring and coloring agents, preservatives) are
potential vehicles of harmful or potentially harmful microorganisms and toxins.
􀂾 Insects and rodents: Flies, cockroaches and rodents are associated with living quarters, eating
establishments, and food processing facilities, as well as with toilets, garbage, and other filth. These animals
transfer contaminants to food through their waste products; mouth, fur, intestinal tract, feet, and other body
parts; and during regurgitation onto clean food during consumption.
􀂾 Soil: Soil may contain microorganisms as well as poisonous chemicals. These agents may get access to food
either due to direct contamination or through dusts.

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􀂾 Plants and plant products: Most of the organisms found in soil and water are also found on plants, since soil
and water constitute the primary sources of microorganisms to plants. Chemicals sprayed to plants are other
potential health risks.
􀂾Other animals’ bodies: From the intestinal tracts of animals, microorganisms find their way directly to the soil
and water. From there, they may find their way into plants, dust, utensils and/or food. Meat of animals can get
contaminated during slaughtering, cutting, processing, storage, and distribution. Other contamination can occur
by contact of the carcass with the hide, feet, manure, dirt, and visceral contents. Likewise drugs used to prevent
disease and promote growth in animals may also become potential risk for human health due to persisting of
these drugs in the meat or milk products.
􀂾 Others:
 Mistaken use of a toxic chemical in the preparation seasoning or sweetening of food or by children
believing it is a drink.
 Deliberate and malicious contamination of food by a person for some irrational reason
 Water polluted by chemicals from farm and or spraying food trees (4,6).
Transfer of contamination:
Before a food-borne disease can occur, food-borne disease transmission requires that several conditions be
met. There are two related models that illustrate the relationship among factors that cause food-borne diseases.
These are:
a. Chain of infection:
This is a series of related events or factors that must exist or materialized and be linked together before an
infection will occur. The infection chain emphasizes the multiple causations of food-borne diseases. The
presence of the disease agent is indispensable, but all of the steps are essential in the designated sequence
before food-bore diseases can result
b. Web of causation:
This is a complex flow chart that indicates the factors that affect the transmission of food-borne diseases. This
presentation of disease causation attempts to incorporable all of the factors and their complex
interrelationships.

Factors most commonly contributing to food-borne disease outbreaks

There are a number of factors that may lead to the occurrence of food-borne illness outbreaks. The major ones
are:
􀂾 Preparation of food more than half a day in advance of needs
􀂾 Storage at ambient temperature
􀂾 Inadequate cooling
􀂾 Inadequate reheating
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􀂾 Use of contaminated processed food (cooked meats and poultry, and the like)
􀂾 Undercooking
􀂾 Cross contamination from raw to cooked food from utensils, and unhygienic kitchen environment
􀂾 Infected food handlers or poor personal hygiene of food handlers
􀂾 Unsanitary dishware, utensils and equipment
􀂾 Improper food handling procedures such as unnecessary use of the hands during preparation and serving of
food
􀂾 Improper food storage that may lead to cross contamination by agents of diseases
(micro-organisms, poisonous chemicals), or exposure to moisture that may facilitate microbial growth
􀂾 Insects and rodents

Prevention and Control of Food-borne Diseases

In practical terms, safe food can be defined as food that, after being consumed, causes no adverse health
effects
To ensure high quality of the food supply a number of parties must play specific roles.
The main actors include the government, consumers, and the food industry. It is critical that preventive
measures for ensuring food safety should be given great attention to prevent and or reduce food borne
diseases. The following are possible preventive measures for ensuring food safety at various stages:
1. Production of raw materials:
To ensure safe food production, it is important to look at the agricultural level, where foods are initially
produced, and improve the hygienic quality of raw foods.
􀂃 By improving the conditions under which crops, fruits, vegetables and food animals are raised, the hygienic
quality of raw food products can be significantly improved.
􀂃 Use of both pesticides and fertilizers should be reduced as much as possible.
􀂃 Residue levels of toxic chemicals used to improve crop production should be systematically monitored.
􀂃 Prohibition of use of untreated sewage water for irrigation of vegetable fields is also an area of attention.

2. Food Processing:
Substantial losses of food by contamination and spoilage can be prevented through concerted inspection and
monitoring of food processing infrastructures. Inspection services are usually inadequate in our country. This
needs to be strengthened. A modern approach to food safety in food establishments is Hazard Analysis and
Critical Control Point (HACCP) system.
This is an attempt to make a significant impact on the prevention of food-borne diseases. The HACCP system
consists of a series of interrelated actions that should be taken to ensure the safety of all processed and

58
prepared foods at critical points during the stages of production, storage, transport, processing, preparation,
and service.
Definitions:
i. Hazard: Means the unacceptable contamination, growth or survival of microorganisms of concern to safety or
persistence in foods of microbial products (e.g. toxins, enzymes) or the presence of chemicals of a harmful level
of concentration or of a potential risk to health.
ii. Critical control Point: Is a location, practice, procedure, or process at or by which control can be exercised
overall or more factors that, if controlled, could minimize or prevent the hazard (4).
3. Food Preservation and Storage
The aim of food preservation is to eradicate or prevent the growth of harmful pathogens during manufacturing,
processing and preparation of food so that it will remain, safe to eat for longer periods of time.
Food Preparation in the Home:
The household is perhaps the most relevant place for developing strategies to combat food borne illness, as it is
the location where the consumers, can exert the most control over what they eat. Strategies that can be
employed at home include:
􀂃 Maintaining a clean and hygienic environment in the kitchen or other food preparation areas.
􀂃 Proper sanitation facilities, cleanliness of household members who prepare the food, and
􀂃 Control of pests.
􀂃 Keeping chemicals away from kitchens and areas of food preparation. If needed, use chemicals cautiously.
􀂃 Consumption of fresh food, or cooked food while still hot will not cause foodborne infection.
Many bacterial pathogens are able to multiply in food because of the temperature at which the food is stored.
Refer to figure 3.2.3 for the control of pathogenic bacteria by temperature.
Food preparation in the food service industry:
The consequences of improper food preparation in food services such as canteens and restaurants can be
much greater than that in the household, simply because a large number of individuals may be simultaneously
exposed to unsafe food items. Street foods are particularly prone to lapses in safe food preparation, hence
requiring stringent control measures. It is essential to have a quality control program (inspection) that will
ensure the maintenance of food product standards during all stages of handling, processing and preparation; it
must also be applied to all areas and equipment that come into contact with food and beverages.
The prevention and control strategies for food borne diseases emanate from the three basic principles. The
different methods for applying these principles are discussed below:
Methods to keep food safe
The primary objective of keeping food safe is to prevent food from acquiring injurious properties during
preparation, shipment, or storage. The principal methods and the techniques used to keep food safe include
temperature control (including pasteurization, cooking, canning, refrigeration, freezing and drying), fermentation
and pickling, chemical treatment and irradiation
59
a. Temperature control:
i. The use of high temperature:
Heat is one of the oldest methods of destroying microorganisms in food. Heat destroys many microorganisms /
pathogens and some forms of toxins produced, such as the toxin of Clostridium botulinum. Heat treatment may
involve the following techniques.
􀂾 Cooking / boiling / frying operations
􀂾 Blanching operations. Blanching is mild pre-cooking involving brief scolding by hot water or steam used to
reduce the bacterial load and insects on vegetable foods.
􀂾 Canning: This is the process of placing prepared (heat-treated) food in cans, exhausting the air from the cans,
sealing the cans, sterilizing the sealed can and cooling it.
􀂾 Pasteurization: A process of heat treatment of food that kills pathogenic microorganisms without destroying
taste, digestibility and nutritive value of food and milk. It also destroys some food spoilage microorganisms.
􀂾 Drying (Desiccation): Bacteria cannot multiply in the absence of water (moisture).
ii. The use of low temperature
Unlike high temperature, low temperature (cold) is not an effective means of destroying microorganisms and
toxins in foods except retarding their multiplication and metabolic activities there by reducing toxin production.
􀂾 Chilling (cold storage or refrigeration): is reducing food temperatures to below ambient temperatures. This is a
suitable temperature to preserve perishable food items that may get spoiled at freezing temperature.
􀂾 Freezing: This is a dehydration method because the water in the food is transformed to ice, thus rendering it
unavailable for microbial metabolic function.
Freezing temperature depends upon the kind of food and the intended storage time.
b. Fermentation and pickling:
In fermentation the food is transformed into an acid state based on the pH control principle. Some fermented
foods have high amount of alcohol, which is antimicrobial. Pickling on the other hand refers to the immersion of
certain foods in concentrated natural acid solution such as vinegar.

c. Chemical treatment:
This involves osmotic balance disturbance or direct actions of the chemicals on the microorganisms. Liquids
pass into or out of bacterial cells by the process of osmosis. Examples for osmotic actions are salting and
sugaring. Some other chemicals may destroy or inhibit growth of microorganisms in food. Examples include
application of nitrites and smoking.
d. Radiation: this is a process of exposure of the food to high- speed electrons to destroy microbial cells. Beta,
gamma or x-rays irradiate microorganisms in foods. A cell inactivated by irradiation cannot divide and produce
visible growth.
e. Other important methods /supportive procedures that facilitate the safety of food:
􀂾 Health education
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􀂾 Good personal and environmental hygiene
􀂾 Availability of safe, ample and convenient water supply
􀂾 Training of food handlers and managers
􀂾 Stringent inspection and control actions
􀂾 Legislative support (ordinances and codes), licensing
􀂾 Good-housekeeping practices including separate storage and care of toxic chemicals.
􀂾 Understanding about additives and restrictions of unauthorized use.
􀂾 Food equipment selection to avoid chemical poisoning arising from the material constituency and or coatings
of some food utensils.
􀂾 Avoidance and care of insecticide use in food processing and preparation areas.
Collection of food samples
The need for sample collection:
The following factors may determine the essentiality of sample collection in food borne disease outbreaks:
􀂾 For diagnosis of outbreak
􀂾 For epidemiological reasons
􀂾 For legal issues
􀂾 For preventive aims
􀂾 For implementing appropriate actions
Sampling Plan:
􀂾 Before instituting a food sampling plan, the following steps should be followed:
o Discuss the plan with laboratory personnel
o Determine the analytical capability of the laboratory
o Determine how sample is to be taken
o Decide how often and under what conditions sampling is to be done
Criteria for sample collection:
􀂾 Type of food
􀂾 Size of the lot to be sampled
􀂾 Representativeness of the sample
􀂾 Acceptance and rejection criteria
􀂾 Degree of hazard to human health
Types of tests done on food samples:
􀂾 Physical (organo-leptic) tests using the senses, e.g. smell, color, taste
􀂾 Bacteriological, e.g. culture
􀂾 Chemical/toxicological, e.g., tests on animals

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General Principles of Food Hygiene
Food Hygiene is the efforts made to safeguard food from becoming health hazard and to prevent early spoilage
and contamination caused by handling of the foods. It is the procedures applicable to the processing of food in
such a way that the products derived thereof are safe and wholesome for human use. The general principle of
food hygiene is to ensure that food products are safe, wholesome and fit for human consumption.
Fit for Human Consumption: Food which has been passed and appropriately branded by an inspector and in
which no subsequent changes have been found due to disease, decomposition or contamination.
It is important to note that there are three key elements in the above definition. In order for food to be classed as
fit for human consumption, it must be safe, wholesome and processed in a hygienic manner.
a) Safe: Food products must be free from any substance which may be harmful to man. Such include both
infectious agents and toxic substances or either endogenous or exogenous origin.
b) Wholesome: Food products must be free from defects which may be either endogenous diseases or
exogenous non-microbial contamination and adulterations.
Whereas the primary aim in a safe food product is to exclude harmful microbes from the food chain,
wholesomeness is much broader in that it implies that the food products must be generally free from both
microbial organisms, non-microbial contaminants and even religiously and aesthetically acceptable to the
consumer.
The criteria governing the wholesomeness of food products can be grouped as follows:
i) Such food products must be free from obvious defects including contamination with seemingly harmless
extraneous materials.
ii) Microbial contamination of such food products must not exceed levels which could adversely affect the shelf-
life of the products. The effect of microbial contamination on the keeping quality of food will depend on the type
of products and the storage methods.
iii) The attributes of such food products must conform to expected standards such as colour, taste and smell.
c) Hygienic processing: Food products processed in the manner to ensure compliance with the above
requirements and to protect those involved in the process from occupational hazards such as tuberculosis,
brucellosis, salmonellosis, leptospirosis among others.
Hygienic processing also implies that a production system is in place which does not create environmental
hazards to the public.
There are a number of other terms used in meat hygiene and many of these are defined in the legislation:
Edible products are defined as products that are fit for human consumption. This would include meat, certain
offal, casings, etc. from animals which have been examined and passed by an inspector:
Inedible products are defined as “meat products which are not fit for human consumption” and would include
such products as hoofs, horn hair, bone, bristle, blood, dew claws, hide and skin.

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Condemned meat is defined as “meat and meat products which have been found be an inspector not to be fit
for human consumption”. All diseased and defective carcases or part of carcasses will be declared condemned
material by the inspector and severely contaminated products may also be included in this category.
Purposes of Food Inspection
Meat inspection is the sanitary control of slaughter animals and meat.
The aim of meat inspection is to provide safe and wholesome meat for human consumption. The responsibility
for achieving this objective lies primarily with the relevant public health authorities who are represented by
veterinarians and meat inspectors at the abattoir stage.
The Objectives of meat inspection programme can be broadly classified into two:
i) To ensure that only apparently healthy, physiologically normal animals are slaughtered for human
consumption and that abnormal animals are separated and dealt with accordingly.
ii) To ensure that meat from animals is free from disease, wholesome and of no risk to human health
Specifically, the purposes include:
i) To prevent unsanitary meat (i.e. self-dead animals, diseased meat, foetus etc.) from being released for
human consumption.
ii) To prevent post-mortem contamination of meat through unhygienic dressing of carcass, contamination during
washing with polluted water, contamination from human carriers of infectious diseases etc.
iii) To prevent the addition of dangerous drugs and chemicals to meat e.g. in canning.
iv) To prevent false or fraudulent practices with meat e.g. soaking of meat and rubbing of pale carcasses with
blood by butchers.
v) To detect outbreaks of infectious diseases among food animals.
Biological and Chemical Bases of Meat and Milk Hygiene
The basic need for meat and milk hygiene stems from the need to produce wholesome products that will
nourish and benefit the consumers rather than make them sick. The general belief is that in the developing
countries (Nigeria inclusive) the consumption of animal protein is far below the FAO recommended, premised
on low production of livestock and poultry for the teeming populace. It is then important that the “little” available
animal protein is fit for human consumption.
Several factors are responsible for the unwholesomeness of animal products amongst which are microbial and
chemical contaminants.
Microbial contamination
Bacteria are everywhere and can be regarded as common contaminants. The most common ways by which
bacteria and other micro-organisms contaminate meat and milk are usually from processing (slaughtering and
processing of meat and milk collection and processing) and post-abattoir handling of the products. This includes
transportation and storage of meat prior to and during sale.
Efforts must then be put in place for proper slaughtering and processing of food animals to limit the spread of
micro-organisms to the edible parts of the carcase (care must be taken to separate clean operations from dirty
63
operations) and also to avoid cross contamination of the carcase (water, slaughtering surface, meat handlers,
containers, vehicles etc).
Assurance of microbiological quality of foods relies on control of the fate of organisms in the food and its
environment.
Chemical Contamination
Drugs are the major chemical contaminants of meat and milk. In some other developing countries, veterinary
drugs can be easily purchased over the counter thereby subjecting them to abuse. These drugs may ultimately
end up in the food chain for human consumption as residues at undesirable levels constituting health risks to
the consumers.
Ante-mortem Inspection of Food Animals
Meat Inspection
This is “Expert supervision of the whole process of producing meat products with the object of providing
wholesome meat for human consumption and preventing danger to public health”.
There are 3 steps in Meat Inspection:
Ante-mortem Inspection is the examination of animals prior to slaughter to assess their suitability as a source of
products fit for human consumption (animals may be passed as being fit for slaughter for human consumption).

Diseases and abnormalities encountered in ante-mortem inspection

Judgment decisions at ante-mortem inspection

Post anti-mortem inspections, the animals can be subjected to any of the following three decisions.
�      Passed/Accepted/ Fit for slaughter: The animals free from any disease and normal can be directly
sent for slaughter.
�      Rejected/ Condemned/ Unfit for slaughter: Animals suffering from fever (106 oF or more), emaciated
or dead animals, immature or pregnant animals are considered unfit and not passed for slaughter.
Animals with established symptoms of diseases are not sent for slaughter.
�      Suspect: Animals falling under this category are those for which decision regarding fitness for
slaughter cannot be made at the ante-mortem inspection stage. The following possibilities exist under
these circumstances.

(a)   Slaughter under special precautions: Animals under suspect category if having symptoms of
diseases.
(b)   Delayed/Detained slaughter: If the animals require treatment, or have history of recent
treatment/vaccination, animals in febrile condition, fatigued and exited state may require
treatment before they are slaughtered.
(c)   Segregated slaughter: Such decisions are made under special conditions such as dirty stock
or animal suspected for some contagious diseases etc. Such animals are slaughtered at the

64
 end of the day�s kill or separately slaughtered and a thorough post- mortem examination is
performed.
(d)   Casualty and emergency slaughter: Casualty slaughter is required when an animal is not in
acute pain or immediate danger of death but affected with a more chronic condition like benign
superficial tumors, obturator paralysis and post- partum paraplegia etc. When an animal is in
acute pain or suffering from condition like, fractures, severe injuries, uterine prolapsed etc.,
where a delay in slaughter would be contrary to the animal welfare, then animals requires
emergency slaughter.

Post-mortem Inspection is the examination of carcasses and organs after slaughter to assess whether these
products are fit for human consumption.

Hygiene and Sanitation Inspection is the inspection of facilities, equipment and processes to assess whether
the production system is hygienic.
Meat inspection may be performed by various groups of people including Veterinarians, trained inspectors and
company quality control personnel.
The methods of meat inspection and the extent to which it is pursued in different countries depend on a number
of factors.
Meat Quality: can be defined as “A combination of traits that provides for an edible product that loses a
minimum of constituent, is free of spoilage and other abnormalities after processing and storage, is attractive
and appetizing, nutritious and palatable after cooking”.

PURPOSES OF MEAT INSPECTION

i) To prevent unsanitary meat from being released for human consumption i.e. self-dead animals, diseased
meat, foetus, etc.
ii) To prevent post-mortem contamination of meat through unhygienic dressing of carcass, contamination during
washing with polluted water, contamination from human carriers of infectious diseases etc.
iii) To prevent the addition of dangerous drugs and chemicals to meat e.g. in canning, Sodium nitrate is now
prohibited while
Sodium nitrite is recommended as the correct non-toxic level can determined.
iv) To prevent false or fraudulent practices with meat e.g. soaking of meat and rubbing of pale carcasses with
blood by butchers.
v) To detect outbreaks of infectious Diseases among food animals. The number of a certain disease detected
passing through the abattoir can indicate the incidence of the disease on the field. High incidence of a
scheduled disease must be reported to the Animal Health Division.

65
vi) To fulfil National and International regulations and laws on the meat trade. i.e. Meat edicts and decrees;
Meat for the USA and EEC markets have acceptable limits of chemical residues and nil tolerance for antibiotics
and cortisones.
The Objectives of Meat Inspection Procedure
a. To ensure that only apparently healthy, physiologically normal animas are slaughtered for human
consumption and that abnormal animals are separated and dealt with accordingly.
b. To ensure that meat from animals is free from disease, wholesome and of no risk to human health.
The objectives are achieved by ante-mortem and post-mortem inspection procedures and by hygienic dressing
with minimum contamination.
Pre-slaughter care, Handling and Transport of Meat Animals
It is not enough to produce healthy meat animals, it is equally important to ensure that these animals reach the
point of slaughter in sound condition. Pre-slaughter care and handling can markedly influence the quality and
quantity of meat. Ways of loading and unloading, means of transportation and average distance covered by the
animals from the point of product to the point of slaughter has a definite bearing on the keeping quality of meat.
Excited, stressed, fatigued, suffocated, bruised and injured animals are not expected to yield wholesome meat.
The underlying principles for pre-slaughter care, handling and transport of meat animals re:
i. To avoid unnecessary suffering of animals during transport
ii. To ensure minimum hygienic standards
iii. To prevent spread of diseases.
Handling of animals should conform to human standards at every stage. It will safeguard the animal welfare as
well as meat quality.
Rough handling of animals before slaughter can result in several physiological stress. Loading and unloading
operations have to be prompt. It is particularly important in hot weather when heat builds up in stationary trucks.

Transport of slaughter animals

Transport of animals by rail, truck or on the hoof must be carried out carefully to ensure the quality of the meat.
Prevention of damage during transport, ante-mortem inspection and rest before slaughter are therefore
essential. The main requirements are that:
i. The owner should be in possession of a movement permit
ii. During transportation care must be taken to guard the animals against fractures, bruises, lacerations, lack of
water and food.
Driving on Hoof
Cattle in developing countries are often driven over 800km, of about 48km per day, to reach consumer area. In
these circumstance, holding grounds are essential, to provide a daily intake of water, rest and fodder for the
animals in transit.
Road transport
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Single-decked Lorries are used for large animals, whilst sheep, goat and pigs can be transported in double-
deckers. Use of the same vehicles for large and small animals is not recommended. The Lorries should have
non-slip floors. The landing platform should be fitted with batons to prevent slippage. Where animals are
transported on winding roads, it is essential to round off the corners inside the vehicle as very often animals
suffocate due to persistent pressure from other animals. For long distance transport under tropical conditions, it
is essential that the lorry have a roof or a tarpaulin.
Rail transport
The floors of the rail wagons should be fitted with baton to prevent slippage and should have a roof. Adequate
ventilation is essential.
The division of the wagon into several compartments is advisable.
Entrance should be by a loaded ramp or collapsible door.
Air transport
Expensive, hence limited to small animals like pigs and possible poultry
Sea transport
This means of transportation is very useful in international cattle trade preferably within a limited geographical
area.
Minimum Requirements of Transporting Food Animals
The adverse effects of transport could be minimised with the following amenities and practices:
a) Loading must be done not more than one hour before departure time
b) Provision of adequate ramp to facilitate loading and unloading and prevent fractures and bruising.
c) The wagon or lorry should be properly ventilated and provided with roofing to protect animals from rain and
heat of the sun. The floor and sides must not be damaged; there should be no nail or sharp obstructions
projecting from the floor or wall.
d) Adequate bedding must be provided.
e) Avoid overcrowding by providing adequate space for each animal. The floor space for each animal depends
on size.
f) Provide adequate food and water when journey involves extremely long periods
g) Provide rest during journey, at least every 24hrs for cattle.
h) The vehicle must be kept clean and disinfected with any of steam or hot water, freshly prepared quicklime,
Lysol (2.5%), phenol (3%) formalin (1%).
Lairaging of Animals
Lairage serves as a resting ground for the tired and stressed animals.
Resting period depends on the length and mode of journey, animal species, age, condition. Undue holding is
also not advised.

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Lairages are pens for animals for immediate slaughter and should have direct access to the slaughter hall. They
serve the purposes of providing rest for animals while waiting for slaughter for at least 24hrs and not exceeding
72hrs, and also to provide place and facility to inspect the animals prior to slaughter.
Lairage should have adequate space to contain 3days supply of cattle and 2days supply of sheep, goats and
pigs. Provided with litter and drainage, provided with watering and feeding troughs, the feed of
animals should be however be withheld for 12-18 hours before slaughter, but ample supply of drinking water
should be made available during this period. This lowers the bacteria load in the intestine and facilitates easy
removal of the hide or skin during dressing of carcass. Stunning is made more effective and brightness of the
carcass is also improved. The lairage should also have facilities whereby diseased animals could be isolated.
Between the lairage and slaughterhouse, there should be facility to wash dirty animals before slaughter.
Effect of Transport on Meat Animals
a) Stress and Fatigue: These conditions are inevitable sequel to transportation and do have a bearing on meat
quality. These conditions may at times lead to shipping fever (pasturella) and transient tetany.
b) Loss of weight or shrinkage : Shrinkage takes place due to dehydration and depletion of muscle glycogen
during the period of journey. In general, it ranges from 3 to 10 percent depending on the conditions and duration
of transport.
c) Bruises, torn skin and broken bones : Bruises are noticed in most of the species due to transportation.
Muscular bleeding may occur especially in pigs.
d) Death: This may occur during long transportation especially where animals are not properly packed and
provided for.

Rest prior to slaughter

Animals transported by rail, road or hoof should not be slaughtered on the day of arrival but should be allowed
to rest in the lairage. The transporting vehicle, whether lorry or rail wagon should be subjected to thorough
cleaning with disinfectant immediately after discharging the animals
The quality and condition of the carcass and its storage depend greatly on the care taken prior to slaughter.
Nervous, tired and excited animals could have a raised temperature causing imperfect bleeding. Muscular
fatigue reduces glycogen content in the blood,which after slaughter changes into lactic acid, thus causing
favourable conditions for the growth of spoilage and food-borne bacteria. Tiredness and excitement also cause
penetration of bacteria from the intestinal tract to the meat.
The beating of animals, or brutal pulling and dragging prior to slaughter must be eliminated since in addition to
being cruel, it has and adverse effect on the muscle and hence economic value of the animal.

Ante-mortem Inspection of Food Animals

Definition

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This is the comprehensive examination of food animals destined to slaughter prior to slaughter. Ante-mortem
examination of meat animals for slaughter is very necessary in order to produce wholesome meat and
safeguard the health of the consumers.
This aspect of meat inspection should be conducted in the Lairage within 24 hours of slaughter and repeated if
slaughter has been delayed over a day.
Ante-mortem Inspection
Some of the major objectives of ante-mortem inspection are as follows:
i) To screen all animals destined to slaughter
ii) To ensure that animals are properly rested and that proper clinical information, which will assist in the
disease diagnosis and judgement, is obtained to reduce contamination on the killing floor by separating the dirty
animals and condemning the diseased animals if required by regulation.
iii) To ensure that injured animals or those with pain and suffering receive emergency slaughter and that
animals are treated humanely.
iv) To identify sick animals and those treated with antibiotics, chemotherapeutic agents, insecticides and
pesticides.
v) To require and ensure the cleaning and disinfection of trucks used to transport livestock.
Both sides of an animal should be examined at rest and in motion.
Ante-mortem examination should be done within 24 hours of slaughter and repeated if slaughter has been
delayed over a day.
Animals affected with extensive bruising or fractures require emergency slaughter. Animals showing clinical
signs of disease should be held for Veterinary examination and judgement. They are treated as “suspects” and
should be segregated from the healthy animals. The disease and management history should be recorded and
reported on an ante-mortem inspection card. Other information should include:
1. Owner’s name
2. The number of animals in the lot and arrival time
3. Species and sex of the animal
4 The time and date of ante-mortem inspection
5. Clinical signs and body temperature if relevant
6. Reason why the animal was held
7. Signature of inspector
Ante-mortem inspection should be carried out in adequate lighting where the animals can be observed both
collectively and individually at rest and motion. The general behaviour of animals should be observed, as well
as their nutritional status, cleanliness, signs of diseases and abnormalities. Some of the abnormalities which are
checked on ante-mortem examination include:
1. Abnormalities in respiration
2. Abnormalities in behaviour
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3. Abnormalities in gait
4. Abnormalities in posture
5. Abnormalities in structure and conformation
6. Abnormalities discharges or protrusions from body openings
7. Abnormalities colour
8. Abnormalities odour
Abnormalities in respiration commonly refer to frequency of respiration. If the breathing pattern is different from
normal the animal should be segregated as a suspect. Abnormalities in behaviour are manifested by one or
more of the following signs:
The animal may be
a. walking in circles or show an abnormal gait or posture
b. pushing its head against a wall
c. charging at various objects and acting aggressively
d. showing a dull and anxious expression in the eyes
An abnormal gait in an animal is associated with pain in the legs, chest or abdomen or is an indication of
nervous disease.
Abnormal posture in an animal is observed as tucked up abdomen or
the animal may stand with an extended head and stretched out feet.
The animal may also be laying and have turned along its side. When it s unable to rise, it is often called a
“downer”.
Downer animals should be handled with caution in order to prevent further suffering.
Abnormalities in structure (conformation) are manifested by:
a. swellings (abscesses) seen commonly in swine
b. enlarged joints
c. umbilical swelling (hernia or omphalo-phlebitis)
d. enlarged sensitive udder indicative of mastitis
e. enlarged jaw (“lumpy jaw)
f. bloated abdomen
Some examples of abnormal discharges or protrusions from the body are:
a. discharges from the nose, excessive saliva from the mouth, after birth
b. protruding from the vulva, intestine
c. protruding from the rectum (prolapsed return) or uterus
d. Protruding from the vagina (prolapsed uterus)
e. Growths on the eye and bloody diarrhea Abnormal colour such as black areas on horse and swine, red areas
on light coloured skin (inflammation), dark blue areas on the skin or udder (gangrene).

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An abnormal odour is difficult to detect on routine ante-mortem examination. The odour of an abscess, a
medicinal odour, stinkweed
odour or an acetone odour of ketosis may be observed.
Since many abattoirs in developing countries have not accommodation station or yards for animals, Inspector’s
ante-mortem judgement must be performed at the admission of slaughter animals.
General Guidance for Inspection of Meat
i. Carcasses, organs and viscera of all animals slaughtered for sale must be inspected at the time of slaughter
and dressing of the carcass and passed as fit only if they satisfy the basic hygienic conditions expected. When
diseases is obviously present in an advanced or generalized degree so as to make further inspection
unnecessary, the carcass and organs should be rejected forthwith.
ii. Animals to be slaughtered for emergency reasons, or suspected of being diseased at ante-mortem
inspection, should be kept apart from others and should be slaughtered in the casualty block where such blocks
exist. Where this is not possible, such animals should be slaughtered after killing of normal animals is
completed.
iii. Tools, implements and equipment must be kept clean before and after use.
iv. Inspecting officers and slaughter men shall have at least two knives so that replacement of a contaminated
knife is possible at any time. A contaminated knife must be cleaned and sterilized by boiling before further use.
v. Inspecting officers should incise selected organs and parts of the carcass. All incisions should be made, if
possible, in such manner as not to impair the market value of the carcass, organ or part. If the routine incisions
are not sufficient to reach a diagnosis the inspecting officer may incise other parts of the carcass as he may
deem to be necessary.
vi. When incising diseased parts of organs, the inspecting officer should avoid contaminating healthy parts of
the carcass and organs, the floor and abattoir equipment.
Ante-Mortem Examination Procedure
The disease and management history of the animals should be recorded and reported on an ante-mortem
inspection card with the following information:
a) Owner’s name
b) The number of animals in the lot and arrival time
c) Species and sex of the animal
d) The time and date of ante-mortem inspection
e) Clinical signs and body temperature if relevant
f) Reason why animal is held
g) Signature of inspector
Ante-mortem examination should be carried out in adequate lighting where the animals can be observed both
collectively and individually at rest and motion.
The examination should be carried out in two stages:
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Stage I
General Examination: Meat animals should be observed in the lairage during rest as well as in motion. The
general behaviour, reflexes, fatigue, excitement, gait, posture, evidence of cruelty, level of nutrition, clinical
signs of diseases or any other abnormalities should be closely observed.
Stage II
Detailed examination: Suspected or diseased animals should be segregated for detailed examination. Their
temperature, pulse rate and respiration rate should be recorded. Animals showing elevated temperature and
systemic disturbance should be detained for further inspection and treatment in the isolation pen.
Some of the abnormalities which are checked for are:
i. abnormalities in respiration
ii. abnormalities in behaviour
iii. abnormalities in gait
iv. abnormalities in posture
v. abnormalities in structure and conformation
vi. abnormal discharges or protrusions from body openings
vii. abnormal colour
viii. abnormal odour

Principles of Judgement in Ante-Mortem Examination

a) Fit for slaughter. Animals which are normal and free from any clinical signs of disease should be sent for
slaughter.
b) Unfit for slaughter. Highly emaciated, skin bound animals and those affected with tetanus or communicable
diseases like rabies etc. or diseases which cannot be treated should be declared unfit for slaughter.
c) Suspects. All suspected animals need further attention. Some animals with localized condition and recovered
cases should be passed for slaughter as suspect with instructions for careful post-mortem examination.
i. Detained animals. Some animals need to be detained for specified period of time for treatment of disease or
excretion of known toxic residues.
ii. Emergency slaughter. It is recommended in cases where the animal is in acute pain or is suffering from a
condition where any delay in slaughter would be contrary to the welfare of animal. It is done under strict
supervision so that there is no hazard to the consumer health. Such condition could be recent injuries, recent
fractures, tympany (bloat), prolapse of uterus etc.
Ante-mortem examination of meat animals is of prime importance from Public Health point of view. It is the
initial step in detection of any sign of disease, distress, injury etc. which helps in taking appropriate decision
before slaughter of animal. It should be done properly and systematically by Veterinarians, which will in turn
help in maintaining high standards of meat quality.

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Slaughtering and Handling of Meat
Slaughtering means putting the food animals to death and thereafter preparing the carcasses for human
consumption. The essentials in the slaughter of food animals are that it should not cause unnecessary suffering
to the animals and bleeding should be as efficient as possible. Besides, it should be safe for the handlers also.
Slaughter types
Home slaughter
In developing countries animals are often slaughtered at home, and this practice is likely to continue for many
years to come. Domestic slaughter of animals is not recommended. Instead, animals should be taken for
slaughter at an approved slaughter slab.
The assurance of clean, wholesome meat; the elimination of contamination of the premises of the owner with
blood or intestinal contents and the danger of diseases spreading to animals and man are the factors in favour
of using a slaughter slab. In slaughtering, a hole of about 50cm deep should be dug under the bleeding animal.
Dogs must be kept away from the slaughter place.
During all operations, utensils, hands and clothes should be as clean as possible. Only the slaughterer should
be allowed to touch the meat, while other people may only handle hides and intestinal contents.

Emergency slaughter
As an emergency, animals that have been hit by a vehicle, or have broken limbs, or have been gouged by
horns, or damaged in any other accidental way can be slaughtered on the understanding that slaughter takes
place immediately after the accident before the multiplication of pathogenic and other micro-organisms can start
and all broken, damaged or bruised bones or meat are considered as condemned and discarded as such.
Dry slaughtering
This occurs when all the operations: flaying, evisceration, splitting and dispatching are done without the carcass
coming into contact with water, either directly or through wet walls, floors or equipment. It must not however be
understood to mean that the premises are dirty or unwashed, on the contrary, strict pre-slaughter hygiene and
thorough cleaning and washing of the premises and equipment must be carried out after each slaughter
operation so that the next slaughter takes place in clean, dry premises. Care must be taken that meat does not
come in contact with intestinal contents, floors hides and skin and unsafe water.
In dry slaughtering, all operations are performed on the rail from the point of entry to exit. This however does
not interfere with strict meat inspection.
Muslim method of slaughter or Halal
When animals are to be slaughtered according to Muslim injunction, the meat produced thereof is known as
Halal meat. Such must follow the following principles:

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a) The animal must be healthy and conscious.
b) Slaughter should be quick, with a single stroke cut to the throat without inflicting suffering to the animal.
Stunning is not acceptable.
c) The animal should be slaughtered lying on the floor with its head facing Mecca. The neck of the animal is
severed by cutting the four major blood vessels (carotid arteries and jugular veins) with a sharp knife. The
spinal cord is left intact. So the nerve centres controlling the heart and lungs remain functional and an efficient
bleeding is ensured. It also enhances the keeping quality of meat.
d) The name of Allah be invoked during the slaughter
e) Since pig is regarded as unclean animal, and the consumption of pork is prohibited under the Muslim
injunction, it is not acceptable to slaughter pigs under the same roof as cattle, sheep or goats. Also, a meat
shop selling mutton, goat or beef slaughtered according to
Muslim rites cannot sell pork to non-Muslims.
Humane Slaughter of Food Animals
This is also known as scientific slaughter. Such a slaughter avoids unnecessary pain and cruelty to food
animals and ensures as complete bleeding as possible. It also ensures speed of operation and safety of the
personnel.
Stunning is a process employed to create a state of immobility or unconsciousness at the time of slaughter.
Immediately, the animal is hoisted and blood vessels on the neck are severed (sticking) to bleed the animal to
death. It is important to note that in stunning the animal is not killed but only made unconscious.
Stunning Techniques and Devices
They fall into three main categories:
1. Mechanical instruments. Instruments such as captive bolt pistol, percussion or stunner cause damage to the
brain so the animal immediately looses consciousness. Application point of captive bolt pistol differs with
species. In effective stunning, the animal immediately collapse followed by tonic spasms and then movements
of the hind legs.
2. Electrical stunning. It is conveniently employed in stunning of small ruminants, pigs and poultry. The
instrument carries electrodes by which alternating current is passed through the brain. Bleeding is very efficient
and the power consumption is extremely low. If the current remains low, missed shock may occur resulting in
paralysis of the animal, although it remains fully conscious. It affects the quality of meat besides compromising
the safety of the handler. On the other hand, too high a current may cause splash. It refers to the appearance of
petechial haemorrhages throughout the subcutaneous tissue in pigs. The capillaries get ruptured due to
excessive increase in blood pressure.
Signs of efficient electrical stunning include (a) hind-legs stretched out violently (b) fore legs stiff (c) head and
neck bent backward (d) cessation of respiration.
Advantages of this system include the following:
(i) saves manual labour and permits speedy operation
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(ii) humane because unconsciousness is immediately produced and the electrode is painless on application
(iii) no mutilation of any part of the animal, hence may be acceptable by certain religions.
Disadvantages include:
(i) blood splashing may occur
(ii) needs steady electricity
Chemical stunning. Carbon dioxide gas stunning is most suitable for pigs. Carbon dioxide is heavier than air
and can be contained in a tunnel. The gas blocks the nerve endings.
On exposure to gas, pigs become anaesthetised that are then shackled and bled.
Advantages of this method include:
(i) Bleeding is quite efficient since carbon dioxide stimulates respiration favouring blood circulation
(ii) There is no splashing because blood pressure is not increased.
(iii) Less dangerous than electrical and mechanical methods.

Disadvantages of this method include:

(i) the system is not fast and requires a lot of space.
(ii) animals have different sensitivity to carbon dioxide
Slaughter without previous stunning
These include Jewish slaughter and Moslem (Halal) slaughters.
These methods employ one stroke to cut the throat, severing altogether the trachea, oesophagus, blood
vessels and muscle except the cervical vertebrae and the vertebral artery and spinal cord within it.
Advantages
1. Proponents of the method claim that unconsciousness is attained immediately upon severing of the carotid
arteries, hence the method is humane.
2. Since breathing and heart action are not markedly reduced, bleeding is thought to be enhanced.
Disadvantages
1. Unconsciousness may be immediate because of the possible supply of blood to the brain through the
vertebral – condyloid anastomoses which remains intact. This circulation may be aided by the blocking of the
proximal ends of the severed carotid artery.
2. Stomach contents may be regurgitated and contaminate the tissues of the neck or aspirated to the lungs and
mixed with the blood.
Sticking or Bleeding of the Animal
It is important that bleeding should be done as soon as possible after stunning so as to minimise the
extravasation of blood into the organs and musculature. Blood pressure is markedly increased during the period
of stunning and unless the pressure is relieved immediately by bleeding the rush of the blood to the tissues
(splashing) occurs.
Bleeding can be done by any of the two methods:
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1. After hoisting on the overhead rail, carotid arteries and jugular veins of both sides are severed across the
throat region, caudal to the larynx.
2. On the floor, skin is incised along the jugular furrow and carotid artery and jugular vein of one side are
severed. The knife is then passed to the chest severing the anterior aorta and anterior venacava.
Sometimes, knife reaches too far in the chest puncturing the pleura and the blood may be aspirated into the
thoracic cavity. This blood adheres to the parietal pleura especially the posterior edges of the ribs. This
contamination of lungs is called back bleeding or oversticking .
It requires to be washed immediately
Dressing of Slaughter Animal
Dressing techniques and sequence of dressing operations vary from place to place and are very much
influenced by the equipment and facilities available in the abattoir. The present trend in organized abattoirs is
towards line dressing whereby once the animal has been hoisted to the bleeding rail, it is not lowered to the
floor till the entire dressing operation is completed. The carcass is conveyed by gravity or power driven along an
overhead rail. Equipment such as brisket saw, hock cutter, hide puller, bone cutter etc. facilitate the dressing.
The process includes the opening of the carcass, flaying, evisceration, splitting, inspection and despatch.
1. Flaying: This is the removal of the hide and skin of cattle (buffalo), sheep and goat.
2. Dehairing: The removal of hair and bristles of pigs. This can be done by hand or by dehairing machine.
Plucking or
Defeathering is the removal of feathers of poultry. This can be done by 2 methods (a) Dry method whereby the
feathers are plucked after destroying the nerve centre behind the brain with a knife. (b) Wet method: here,
scalding tank with water is heated to 1300F is used to loosen the feather and facilitate plucking.
3. Evisceration: Removal of the viscera from the carcass.
Dressing of Cattle
1. After stunning, the animal is hoisted by one leg to theoverhead rail. It is brought above bleeding trough or
gully and an incision is made just in front of sternum cutting the main blood vessels.
2. Bleeding is done into a specially built bleeding trough which carries the blood into a blood-collecting tank.
Complete bleeding is essential as blood is an excellent medium for multiplication of bacteria throughout the
carcass.
3. A cut is made across the larynx, the oesophagus is tied off and the head is skinned and detached at the atlas
joint.
4. Now the forelegs (shanks) are removed.
5. The hind legs are skinned and removed while the carcass is hung by tendons on the spreader.
6. Deskinning (flaying) is carried forward from hind and forequarters and hide is now pulled with the help of a
hide puller.
7. Brisket is now opened along with the midline and the pelvic cavity is opened along the abdominal cavity.
Evisceration commences and plucks as well as viscera and removed. A careful cut releases the viscera which
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are separated into “thoracic viscera”: lungs, heart, liver, spleen and the pouch which includes stomach and
intestines. The thoracic viscera are hung on hooks over the viscera inspection table or on special edible offal
carries attached to overhead rails. This is done without delay. The intestinal contents should not be allowed to
spill over the carcass and the floor of the slaughter hall. The testicles, penis and tail should be removed and not
allowed to contaminate the carcass. The mammary gland should also be removed without it being punctured.
8. Now the carcass is sawn into two halves along the vertebral column.
9. Spray washing of the carcass. The carcass is then inspected and from the inspection line the carcass is
transferred to the chilling room.
Dressing of Sheep and Goat
1. Every effort should be made to ensure that dirt is not carried on the hair/wool into the slaughter place.
2. After stunning, the animal is hoisted to overhead rail and an incision is given in the jugular furrow near the
head severing both carotid arteries.
3. The forelegs are knuckled and a cut is made to the front, the forelegs are removed at knee.
4. The neck and cheeks are skinned along with the shoulder.
The throat is opened up and oesophagus is tied.
5. The hind legs are knuckled and a cut is made to the root of the tail. The legs are skinned.
6. The skin is incised in the middle of the bell and skinning proceeds towards the flank. Now skin is pulled down
over the backbone and base of the head.
7. The head and hind legs are removed. Treatment and the use of the head depend on different customs in
various countries.
8. A small cut in the abdomen is extended to the brisket and the breast bone is also split.
9. The pluck and viscera are removed. Kidney and its fat are left in the carcass. Under conditions where a
sheep/goat gantry hoist does not exist, all processes should be carried out on a skinning cradle.
10. Spray washing of the carcass is done followed by transfer to the chilling room.
Dressing of Pig
1. Sticking (Killing). After stunning, the pig is hoisted to the overhead rail. An incision of 5 to 10cm is made at
the mid - point of neck facing breast bone. The knife is inserted in this incision at an angle of 450 and is forced
down and back at least 12 – 15 cm to a point below the front of the breast bone. The knife is given a slight twist
before it is withdrawn.
Care should be taken not to insert the knife into the chest cavity.
2. Bleeding.
3. Scalding; the animal is dropped in the scalding tank maintained at a temperature of 60 -620C for about 6
minutes.
4. Scrapping or Dehairing. Raise the animals on the overhead rail and pull off the dew claws and toes while hot.
Scrap the loosened hair with the help of a hog scrapper or dull knife hindquarter downwards. Then rinse the
carcass with warm water.
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5. Singeing. It is done with the help of a blow lamp in which a high temperature is achieved and all the
remaining hair is burnt. Besides, singeing sterilizes the cuticle and firms up rind giving it a better appearance
and keeping quality.
6. Removal of head. Done at atlas joint before the carcass is opened
7. Evisceration. Viscera is removed and examined.
8. Splitting of the carcass
9. Final inspection of head and carcass.
10. Spray washing of carcass and transfer to the chilling room.

Post abattoir Handling of Meat

Transportation of meat from the slaughter place to the butchers’ shop
The aim of hygienic procurement, slaughter and dressing is to ensure that inspected meat derived from healthy,
properly slaughtered animals reaches the consumer clean, unspoiled and in a wholesome state, free from
danger of infection or intoxication.
Great care should be exercised in the method used for transporting meat from the place of slaughter to the
place of sale. Unhygienic transport, exposing the meat to heat, dust and bacterial contamination can nullify all
the measures taken at the most hygienic slaughter facility and properly constructed and operated butcher’s
shop. Where the output is large, special meat-carrying vehicles insulated, metal lined and if possible, equipped
with hooks for hanging the meat is recommended. Care should be taken to ensure that carcass meat is not
mixed with tripe or other offal.
Refrigeration of Carcasses
The carcasses with identification numbers after complete washing and inspection are brought to the chilling
room where they are kept for about 24hrs to bring the pH below 6. The carcasses should be as dry as possible.
The aim of chilling is to retard the bacterial growth during the post-mortem changes to extend the shelf-life of
the meat.
The temperature of the chilling room should be between 2 oC and 4oC.
The chilling room should always be kept clean and the carcasses hung on the rails. The chillers should not be
overloaded and spaces should be left between carcasses for the cold air to circulate, otherwise cooling will be
insufficient and carcass surface will remain wet for rapid bacterial growth.
Personal Hygiene and Cleanliness
For production of clean and wholesome meat, personal hygiene and attitude of the workers towards clean
habits are very important.

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Personnel with clean hands, clothing and good hygienic practices are absolutely essential to the production of
high quality meat.
All clothing should be clean and in good repair. No person working with meat should wear any kind of jewellery,
badges or button that may come loose and accidentally fall on the product. All persons working with exposed
meat should have their nail cut, hair cut or under control either completely covered with a clean cap or confined
by hairnet to prevent the hair from falling into the product. Safety devices such as aprons and mesh gloves must
be clean and in good repair. All unsanitary practices should be avoided by meat handlers.
No one should smoke or use tobacco anywhere in the plant area.
When handling meat, scratching the head, placing fingers in and around the nose or the mouth, sneezing or
coughing on the product, should never occur. Staff should guard against contaminating the product from
localised infection or sores.
Hands should be washed frequently to remove all visible soiling.
Liquid disinfectant, soap and paper towels should be made available.
Post Mortem Examination
Definitions
Post Mortem Inspection is the examination of carcases and organs after slaughter to assess whether these
products are fit for human consumption.
Edible products are products that are fit for human consumption. This would include meat, certain offal, casing
etc. from animals which have been examined and passed by an inspector.
Inedible products are meat products which are not fit for human consumption and would include such products
as horn, hair, bone, bristle, blood.
Condemned meat is meat and meat products which have been found by an instructor not to be fit for human
consumption. All diseased and defective carcasses or part of carcasses will be declared condemned material
by the inspector and severely contaminated products may also be included in this category.
Routine post mortem examination of a carcass should be carried out as soon as possible after the completion of
dressing in order to detect any abnormalities so that products only conditionally fit for human consumption are
not passed as food. All organs and carcass portions should be kept together and correlated for inspection
before they are removed from the slaughter floor.
Post mortem inspection should provide necessary information for the scientific evaluation of pathological lesions
pertinent to the wholesomeness of meat.

Change in pH

Decrease in pH due to lactic acid formation is accompanied by various exothermic reactions such as anaerobic
glycolysis. pH changes from physiological pH i.e 7.2-7.4 to ultimately post-mortem pH i.e 5.3-5.5 in 24 hrs.

Change in temperature

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Temperature of animal increases from 37.6-39.0C This is the reason why animal cools slowly during
refrigeration as a result of continuous production of heat.

Change in proteins

Due to the change in pH and high temperature, colour of meat changes and water holding capacity (WHC) also
decreases. Sarcoplasmic proteins get denatured and attached to the surface of myofilament, which produces
change in meat colour which becomes light.

Change in water holding capacity

Water holding capacity is the function of respective proteins which binds with water. In pre-rigor stage meat
possesses a high water holding capacity but later it decreases during first hour following death of animals.
Lowest water holding capacity is found at its iso-electric pH i.e. 5.3-5.5

Conversion of Muscle into Meat (Rigor Mortis)

The most important change that occurs in postmortem muscle is the development of rigor mortis, means
stiffness of the muscle. The primary cause of onset of rigor is post mortem decline in the level of ATP. The
process takes from 7-24 hrs depending on the species; however it is linked with the rate of depletion of ATP in
muscle.
Professional and technical knowledge must be fully utilized by:
1. viewing, incision, palpation and olfaction techniques.
2. classifying the lesions into one of two major categories – acute or chronic
3. establishing whether the condition is localized or generalized, and the extent of systemic changes in other
organs or tissues.
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4. determining the significance of primary and systemic pathological lesions and their relevance to major organs
and systems, particularly the liver, kidney, heart, spleen and lymphatic system.
5. co-ordinating all the components of ante mortem and post mortem findings to make a final diagnosis.
6. Submiting the samples to the laboratory for diagnostic support, if abattoir has holding and refrigeration
facilities for carcasses under detention.
Carcass Judgement
Trimming or condemnation may involve:
1. Any portion of a carcass or a carcass that is abnormal or diseased.
2. Any portion of a carcass or a carcass affected with a condition that may present a hazard to human health.
3. Any portion of a carcass or a carcass that may be repulsive to the consumer.

Localized versus generalized conditions

It is important to differentiate between a localized and a generalized condition in the judgement of an animal
carcass. In a localized condition, a lesion is restricted to a certain area or organ. Systemic changes associated
with a localized condition may also occur. E.g. jaundice caused by liver infection or toxaemia following
pyometra.
In a generalized condition, the animal’s defence mechanisms are unable to stop the spread of the disease
process by way of the circulatory or lymphatic systems. The lymph nodes of the carcass should be examined if
pathological lesions are generalized. Some of the signs of a generalized disease are:
1. Generalized inflammation of lymph nodes including the lymph nodes of the head, viscera and/or the lymph
nodes of the carcass.
2. Inflammation of joints.
3. Lesions in different organs including liver, spleen kidneys and heart.
4. The presence of multiple abscesses in different portions of the carcass including the spine of ruminants.
Generalized lesions usually require more severe judgement than localized lesions.
Specific Indication rendering carcass Unfit for human consumption
The following diseases and conditions may result in the declaration of meat or carcass as unfit for human
consumption.
- Actinobacillosis (generalized)
- actinomycosis (generalized)
- Anemia (advanced)
- Anthrax - Metritis (generalized)
- Black leg - Odour(abnormal or sexual)
- Botulism - Edema (generalized)
- Brucellosis (acute) - Pericarditis (acute septic)
- Severe bruising - Peritonitis (acute diffuse septic)
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- BSE - Pleurisy (acute diffuse septic)
- Caseous lymphadenitis (generalized)- Pneumonia (acute septic)
- Cysticercus ovis (generalized) - Pyaemia
- Decomposition (generalized) - Rabies
- Enteritis - Sarcocysts (generalized)
- Fever - Septicemia
- Foot and Mouth Disease (FMD) - Stillborn/Unborn
- Glanders - Swine erysipelas (acute)
- Jaundice - Tetanus
- Malignant Catarrhal fever - Toxemia
- Mastitis (acute septic) - Trichinellosis
- Melanosis (generalized) - Tuberculosis (generalized or with emaciation)
- Tumors (malignant or multiple)- Uremia
-Viraemia
Routine Post Mortem Examination Cattle
Head: The gums lips and tongue should be inspected for lesions of necrosis, stomatitis, actinomycosis,
Actinobacillosis; the tongue being palpated from dorsum to tip for the latter disease. Incisions of internal and
external masticatory muscles for Cysticercus bovis should be made parallel to the lower jaw. Retro pharyngeal,
sub maxillary and parotid lymph modes should be incised for Tuberculosis lesions. The tonsils, of cattle and
pigs frequently harbor tuberculosis bacilli and should always be examined and removed as unfit for food.
Sheep and goats
Vesicles and ulcers: These are commonly encountered in foot and mouth disease and Orf (contagious pustular
dermatitis)
Judgment: Partial condemnation of the affected parts.
Parasitic disease: Oestrus ovis larvae are deposited in the nostrils of sheep and invade the nasal cavity where a
chronic catarrhal inflammation develops.
Judgment: Condemnation of affected head.
Pigs
Abscesses: Cases of abscesses should always be subject to a further inspection and examination for pyaemia
Atrophic rhinitis: This is a chronic condition in pigs the cause of which is not fully known.
Pneumonia is often found in animals suffering from atrophic rhinitis
Judgement: In the absence of systematic changes, the affection may be regarded as a local one, with
condemnation of the head only. Cysticercosis: Cysticercus cellulose is frequently found in the tongue and
masticatory muscles of pigs in countries where parasite is commonly found.
AFFECTIONS OF THE LIVER
Cattle
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The liver is an important indicator of acute infectious diseases being one of the first organs to show
macroscopic changes and if the animal survives, it is the last organ to return to normalcy.
1. Cloudy Swelling: At Post Mortem (PM) the liver will appear enlarged and so will the portal lymph nodes. The
enlargement can be recognized by rounded edges of the organ and the bulging of the cut surface. Furthermore,
the color of the organ becomes dull and grayish and the consistency softer than normal. The liver is said to be
friable and have a parboiled appearance.
Petechial hemorrhages may at the same time be scattered on the surface of the liver and in the liver tissue
itself.
Judgment: Total condemnation, as it is a sign of systemic disease.
2. Fatty change:
At PM the liver will be enlarged with a uniform light yellow color and a consistency like soft dough. In case
where no pathological factors can explain the fatty change it must be regarded as physiological.
Judgment: Total condemnation in case of pathological fatty change.
3. Amyloid degeneration: This condition is secondary to some chronic diseases such as tuberculosis or
suppurations. Affected livers are enlarged with rounded edges, pale and heavy with a rubber-like consistency. It
is often part of a generalized amyloidosis with Amyloid degeneration also in the kidneys, spleen and mucous
membrane of the intestine.
Judgment: Local or total condemnation depending on the general condition of the animal.
4. Necrosis: is death of tissue, which is still part of the living body.
Judgment: Total condemnation if the condition is accompanied by systemic changes, otherwise local
condemnation.
5. White nodules on the liver surface: This may sometimes appear as grey-brownish discoloration and small
grey-white foci scattered on the surface of the liver.
Judgment: Local condemnation
6. Tuberculosis: The liver may be affected by tuberculosis in three different ways
Judgment: Local condemnation of the liver, if it only effects the liver, otherwise total condemnation of the
carcass if the lungs, intestines, and head are also involved
7. Abscesses/Purulent hepatitis:
In most cases, the liver abscesses are localized, however, the condition often result in pyaemia.
Judgment: When localized abscesses are present in the liver, without systemic involvement, the liver can be
condemned and the carcass passed.
Parasitic diseases:
a. Hydatid cyst: The cysts are usually found in the liver and lungs, but occasionally in other organs. The size of
the cysts usually ranges from that of a pea up to the size of a tennis ball. Many of the cysts show degenerative
changes in which the fluid disappears and the cavity becomes filled with a yellowish-green caseous material
which often undergoes calcification.
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Judgment: The liver must be condemned and destroyed in order to break the life cycle of the parasite. The liver
and the other organs should be checked for cysts.
b. Cysticerous tenuicollis: The larvae migrating leave a tortuous tract of red soft material. They may also be
seen as grayish white tortuous cords in the liver tissue.
Judgment: The liver should be condemned if several cysts and/or tortuous cords are present. .
c. Cysticercus bovis: Lesions and judgment as above
d. Fascioliasis: Their presence in the bile ducts leads to an inflammation, which results in a considerable
thickening of the walls of the ducts. Calcification of the walls often occurs.
Judgment: Local condemnation of the affected liver
8. Melanosis: In the liver appears as black spots of unequal size scattered on the surface of, and in the liver
tissue itself.
Judgment: In cases of extensive discoloration, condemnation of the liver. In cases where only a few spots are
present they should be trimmed off and the liver passed.
9. Cirrhosis: The consistency of the liver will become firm due to the fibrous tissue and may appear grayish in
color.
Judgment: This depends on the original cause
10. Icterus or Jaundice: Seen as yellowish discoloration of the liver
Judgment: Total condemnation in case of systemic involvement, otherwise local condemnation.
Sheep and goat
Most of the diseases mentioned in connection with liver affections of cattle are found in sheep and goats, with
the judgment being the same
Pig
“Milky spot” livers: The migrating larvae of Ascaris suum pass the liver where some are caught in the capillaries,
characterized by irregular white spots on the liver surface. These spots are known as “milky spots”, and they
consist of fibrous tissues.
Judgment: In cases where it is possible, the liver should be trimmed.

BASIC CONSTRUCTION PRINCIPLES OF FUNCTIONAL ABATTOIR

Abattoir: any establishment where specified animals are slaughtered and dressed for human consumption and
that which is approved registered and/or listed by the authority for such purposes.
A competent authority: the official body charged by the government with the control of meat hygiene, including
setting and enforcing regulatory meat hygiene requirement.
Lairage: a place that provides temporary housing for animals prior to slaughter.
Isolation pens: special pens in which animals can be held, separated from their congeners to facilitate
Veterinary inspection or treatment.

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Consideration for location of an Abattoir
 Size of the area
 Range of operations
 Target market(s) to be covered by the abattoir
 Other consideration in determining the size of the area is capital (funds available for the
project).
 Distance from the cattle and meat markets where purchase of live animals can be made and
meat can be sold.
 Availability of electricity.
 Water source/supply.
 Access road
 An abattoir must not be sited close to residential:
 to avoid environmental pollution and the adverse effect on people’s health.
 It also prevents accidents from moving animals
 It must not be close to a latrine
 It must be located away from factories to avoid smoke or dust which can cause contamination
of meat and meat products.
 It should have adequate space for lairage, areas for digging pits for condemned meat, for tripe
and hide treatment facilities and also for future expansion.
 The whole slaughter facility complex should be fenced
General Principles of Abattoir Design and Construction
The design of abattoir varies from situation to situation. There can be no single blue print for all the situations.
The guiding principle should be to provide all related services under hygienic conditions at lowest cost. In
general, the following basic guidelines should receive serious consideration:
There should be provision of an area for the containment of animals prior to slaughter
1. The operational facilities should be so designed and located that a clear demarcation exists between clean
and unclean sections. Workrooms, structures and equipment should be designed and constructed to allow for
effective cleaning and monitoring of hygienic status.
2. Facilities for personnel should include changing rooms, toilets with hand-washing and drying facilities,
showers and a separate room for eating and drinking.
3. Suitable conditions must be provided for the preparation and storage of meat.
4. A maintenance program must be followed to ensure that facilities and equipment meet the required
standards.
The abattoir should have the following essential facilities:
a) Resting place for animals before slaughter
b) Ante-mortem examination
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 c) Humane slaughter
d) Flaying, dressing and washing of the carcases.
e) Hanging carcasses and edible offals.
f) Handling by products.
g) Inspection of meat and disposal of condemned carcasses or part thereof.
h) Staff welfare

Lairage
The lairage provides temporary housing for the animals prior to slaughter and it’s design should take into
account the following needs; animal welfare, maintaining cleanliness and separation of sick or “suspect”
animals. It must be designed and constructed to allow the following physical activities:
Animal activities Human activities
Eating Ante-mortem inspection
Drinking Sorting
Lying and resting Cleaning and disinfection
Comfortable movement
The key elements in the design of a lairage are:
- Sufficient light for satisfactory ante-mortem inspection.
- Floors that drain easily and do not compromise the cleanliness of animals’ coat
- No sharp objects that could injure animals.
- Isolation pen available for the containment of sick or “suspect” animals, with separate drainage.
- Physical separation of lairage (dirty area) from the area where edible products are produced.
Equipment for hygienic and efficient slaughtering
All equipment used in the slaughterhouse should be durable and made from easily sterilized material. Its size
should be in relation to the function it performs.
 Overhead rails with the following accessories:
 overhead rollers
 beef trees sheep carriers
 pig shackles
 extension chains for beef quarters
 hooks for beef quarters
• Pipe-made dressing rails
The basic equipment used in the different slaughter procedures are as follows:
• Hand tools :
o stunning pistol,
o sticking and skinning knives,
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o axe/meat and bone cutting saws/choppers.
• Floor rings
• Skinning cradles
• Visceral inspection table and hook rail
• Pig scalding vat and dressing equipment
• Sanitation equipment
o Sterilizer
o Dirt –removing carts
• First-Aid Materials
DISPOSAL AND TREATMENT OF ABATTOIR EFFLUENT
Abattoir Effluent
• the outgoing water from the abattoir environment containing waste materials
• are highly nitrogenous, biologically degradable
• with relatively high concentrations of suspended and dissolved solids, fats, scraps, blood, gut contents,
detergents, hair and hide scraps.
• some of these materials can be recovered and may eventually be useful materials.
The load or concentration of organic matter is measured in terms of biochemical oxygen demand (BOD) and is
expresses as ppm or mg/litre.
• The BOD is the amount of oxygen required to decompose the organic matter completely by aerobic biological
action in certain period at 20oC.
• While the BOD of normal domestic sewage is 250 – 300 ppm (mg/litre),
• that of abattoir effluent is between 1600 and 2000ppm (about 5 to 6 times the BOD of normal domestic waste).
• abattoir effluent thus has a high potential for polluting the water courses,
• it is then important that on-site treatment of the effluent is carried out before the effluent is connected to the
municipal sewer line.
General Principles of Treatment
Although there are several systems of effluent treatment, the basic principle involves
• screening of solids, removal of fat particles
• decomposition of organic matter by bacteria either aerobically or anaerobically in the tanks or ponds.
• The entire process can be carried out in two stages.
o In the first stage, gross solid particles suspended solids and fat particles are separated (physical
process/treatment).
o In the second stage, remaining organic matter is subjected to biodegradation (biochemical process).
In general, abattoir effluent treatment involves the following steps:
i. Physical Processes
• Screening.
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• Sedimentation
ii. Biological Process
The aim of the biological process is to remove the organic component in the effluent where it cannot be
removed by physical methods.
• Aerobic Pond System.
• Anaerobic System.
iii. Chemical Process
iv. Treatment of Manure Laden Effluent
UTILIZATION OF ANIMAL BY-PRODUCTS
Animal by-products refer to the parts of the food animal not used for food by man. In liberal terms, animal by-
products include every part of a slaughtered animal except the dressed carcass.
MILK HYGIENE
Milk hygiene is the safety and quality assurance program for milk and diary products that cover the whole diary
chain from farm to table, so that milk and milk products derived thereof are wholesome and fit for human
consumption.
Milk is the normal lacteal secretion from domesticated animals produced from one or more milking, without
either addition thereto or extraction such animals include cow, goat, camel and buffalo.
Milk products are products exclusively derived from milk and other substances necessary for the manufacture of
such product, provided that these substances are not intended to take the place in part or in whole of any milk
constituent.
Whole milk: milk as is drawn from the cow.
Skimmed milk: milk from which part of the fat has been removed. It may be sweetened with sugar.
Ice cream: this is frozen mixture of various diary products, sweeteners, stabilizer and various flavourings.
Butter: this is fairly solid yellow milk fat brought together by a form of agitation called churning.
Milk composite products: these are milk products in which milk is an essential part added to other food items,
but these other food items are not intended to take the place of any milk constituent.
Composition of milk
Water 87.25%
Milk fat 3.75%
Milk sugar (lactose) 4.70%
Protein (casein, lacto albumin) 3.40%
Ash (Nacl, Potassium chloride, Potassium citrate) 0.75%
Vitamins and others 0.15%
Sources of Milk Infection and Contamination
• Infection of milk by disease organisms can be derived from the dairy animal itself, the human handler, or the
environment (including the milk utensils).
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• these organisms can be excreted through the udder directly into the milk, or originate from the skin and
mucous membrane of the animal or milkier and contaminate the milk and milk utensils.
• one of the most important extraneous sources of contamination is water used in the processing plant.
The essential requirements are
• to maintain udders free from infection (mastitis),
• manage cows so that udders and teat are clean,
• milk them in such a way that minimises bacterial contamination,
• store milk in clean containers at temperatures which discourage bacterial growth until cooled.
Hygiene in Milk Production
• Milk should be protected against direct or indirect contact with any source of external contamination during all
the steps of milking, collection and transport.
• Particular care should be taken to avoid the direct physical contact of milk with unclean surfaces such as those
of milking utensils, udders teats and the hands of milkier.
Milk Pasteurization
• Pasteurization is the process of heating of milk to such temperatures and such periods of time as are required
to destroy any pathogen that may be present,
• whilst causing minimal changes in composition, flavour and nutritive value
• Pasteurization helps in destroying pathogenic organisms and a majority of pathogenic organisms and a
majority of nonpathogenic ones,
• it also inactivates the enzyme phosphatase, which is abundantly present in raw milk.
• Thus, if a phosphatase test is carried out immediately after pasteurization and it gives a positive result, it is an
indication that the milk has not been properly pasteurized.
PRESERVATION OF MEAT
MEAT PRESERVATION
 The basis for meat preservation is to prevent the meat from microbial attack and prolong the storage life of the
meat.
 Basically, preservation methods are designed to make conditions unfavourable for these organisms to grow.
 This is achieved by extreme heat or cold, deprivation of water and oxygen, excess of saltiness and increased
acidity of the substrate.
 The methods based on these principles include
o dehydration,
o salt curing,
o chemicals,
o irradiation,
o chilling and freezing
o heat processing
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Physical Changes in Stored Meat
Meat undergoes the following superficial changes as a result of storage
i. Shrinkage: Shrinkage means loss of weight as a result of evaporation of water from meat surface.
ii. Swelling: This means condensation of water vapour on meat brought from a cold store into ordinary room
temperature.
iii. Loss of Bloom: Bloom is defined as colour, texture and general appearance of carcass surface. This is
caused by excessive intake of water, dehydration or undue oxidation.
Dehydration
To achieve best results, meat should be pre-cooked at temperatures below 70oC. Low fat meats dry more
rapidly and they are more easily rehydrated. Dehydration does not affect the gross chemical composition of
meat. However, dehydrated meat reabsorbs water only to about 60% of the original moisture content.
Salt curing
This is a method of preserving meat with the use of brine solution.
Brine solution contains the following:
Water 4.50 Litres
Salt 1.02 kg
NaNO3 or KNO3 21.25g
Sugar (optional) 56.75g
The action of salt curing on meat can be preservative or bacteriostatic.
a) Preservative action
b) Bacteriostatic action
Smoking
Smoke is produced as a result of anaerobic distillation of wood followed by partial oxidation. If the oxidation is
complete, there will be production of water and oxygen and not smoke, since wood’s main components are
cellulose (50%), hemicellulose (25%) and lignin (25%) which all contains carbon, oxygen and hydrogen.
Smoke contains well over 200 compounds of which are aldehyde, phenols, acetate and resins. These
compounds prevent oxidative activities, provide flavour for the meat and have germicidal effect.
Smoking is the process of allowing smoke produced from natural wood, twigs, heather or the fruits of trees to
act on the surface of meat and meat products. During smoking the smoke is transferred to the product through
the process of absorption, adhesion, condensation, diffusion, dissolution and deposition.
There are many methods of producing smoke these include; smouldering of wood, by friction, steam, gas
pyrolysis, vibratory feeder and liquid smoke production.
Action of smoke on texture, flavour and colour of meat
Texture: The effect of smoke on texture meat depends on the relative humidity and the smoke temperature. At
relative humidity of 65 –

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70%, the surface of the meat will be dry. During smoking, as temperature increases from 49oC to 82oC, the
meat protein coagulates and the meat is toughened.
Colour: The surface colour of well-smoked meat is light golden yellow to dark brown shades. The colour varies
with the type of wood burnt, the density of smoke and the temperature of the smoke.
Flavour: The smoky taste in smoked meat product is as a result of the phenolic fraction of smoke. The type of
wood can also affect the flavour, soft woods give acrid flavours.
Chemical preservatives
Antibiotics: these have been used to preserve and improve the keeping quality of beef carcases, poultry and
fish. These antibiotics are added to water in a proportion of 5 to 40ppm and the meat is dropped into the treated
water. Alternatively, the antibiotic is added to ice in amounts of 2 – 5ppm and the fish (or meat) is transported in
the treated ice. The storage life of such treated meat, poultry and fish is considerably increased.
Disadvantages of this method include
1. Antibiotics are not effective against yeasts and moulds
2. These antibiotics may occur as residues in the meat which when consumed may be hazardous to the health
of the consuming populace.
3. The widespread use of antibiotics in food encourages the appearance of antibiotic-resistant strains among
pathogenic bacteria present.
4. There is the danger that producers may tend to depend more on drugs than good hygienic practices.
Cold storage
Chilling
Chilling involves refrigerating meat to temperature just above freezing point. This temperature must be
maintained throughout the meat until it is delivered to the consumer. Meat will not keep for a long time unless it
is proper chilled. In chilling, care should be taken to prevent meat from being frozen as meat upon thawing
develops characteristics which are considered not so desirable than those possessed by chilling. Quick chilling
of carcase is necessary in order to prevent the growth of spoilage organisms. This process is achieved by rapid
circulation of air at low temperature (1 to 2oC or as low as -7oC) and controlled humidity. Chilling of some of the
thicker muscles is sometimes accelerated by the injection of liquid carbon dioxide into the muscle.
Freezing
Meat has no definite freezing point because of its complex structure.
Freezing meat at very low temperature, the quality of the meat is retained better.
In freezing meat, the internal temperature of the meat should be reduced to -18oC. To store already frozen
meat, the air temperature must be equal to or less than -14oC and this will kept the meat for 9months and
above. Pork should be stored at -18oC and will keep well for 6months. There should be proper spacing of
boxed meat or meat products as they are placed in the freezer between layer boxes and between boxes in the
individual layers.

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To transport frozen meat and prevent thawing during transportation, the vehicle and cargo space should be
capable of a maximum air temperature of 10 oC.
Food Irradiation
Food irradiation is a physical means of food treatment by exposing food either pre-packed or bulk to gamma
rays, x-rays or electrons, in a special room and for a specific duration of time to achieve a desired aim.
Technically, gamma rays can be produced from radioisotope sources e.g. 60Colbat or 37Cesium. Foods treated
with ionizing radiation are safe for human consumption. It has been shown that it is not possible to activate or
induce radioactivity in any food material passed through irradiator regardless of the length of time of radiation
exposure, hence toxicological testing of foods so treated is no longer required. Gamma rays kill micro-
organisms in meat without a significant rise in the temperature of the product. However, the resultant chemical
changes in the irradiated product have been found to change the aroma and odour of such product.

INTRODUCTION TO CEREAL GRAINS, LEGUMES AND OILSEEDS, STRUCTURE AND COMPOSITION OF

CEREAL GRAINS, LEGUMES AND OILSEEDS

 Introduction

India has reached to a level of self-sufficiency in the production of cereals, pulses and oilseeds after the green
revolution. Cereals are plants which yield edible grains and include rice, wheat, corn, barley, and oats. Cereal
grains are the fruit of plants belonging to the grass family ( Gramineae). Cereal grains provide the world with
majority of its food calories and about half of its protein. They are also good source of micronutrients such as
calcium, iron and vitamins of group B. Cereals are staples and are consumed in large quantities by majority of
population in the world either directly or in modified form as major items of diet such as flour, bran and
numerous additional ingredients used in the manufacture of other foods. Asia, America, and Europe produce
more than 80 percent of the worlds cereal grains. Cereals are easy to store because of low moisture content,
easy to handle and providing variety to the diet. The principle cereal grains grown in India are wheat, rice, corn,
sorghum and barley.

Legumes are next to cereals as an important source of proteins. They are flowering plants having pods which
contain bean or peas. There are basically two groups of legumes. First is high-protein high-oil group like
soybean, groundnut, lupine, etc. which are mainly used for processing and contains high protein (~ 35%) and oil
content (15- 45%). The second group comprises the moderate- protein low-oil types like cowpea, gram, pea,
lentil etc. India is one of the largest pulse growing countries in the World. Different pulses grown in India are
chickpea (bengal gram/chana), pigeon pea (tur/arhar), green gram (moong), black gram (urad), lentils (masur).

Oilseeds have become an increasingly important agriculture commodity, with a steady increase in annual
production worldwide. Oilseeds are seeds which contain high oil content and are widely grown as a source of

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edible oil. Major oilseeds grown in India are groundnut, cottonseed, mustard, rapeseed, soybean, sunflower and
sesame seed. The coconut (copra) is also an important oilseed.

Cereal grains are not only low in protein but also deficient in certain essential amino acids, especially lysine.
Legumes as well as many oilseeds are rich in lysine, though relatively poor in methionine. Edible oilseed meals
obtained from oilseeds are rich in proteins and have been used to improve the nutritional properties of cereal
products such as infant food and food for school going children in most of the countries in world.

Rice

Rice (Oryza sativa, Linn.) crop originated in Asia and has been a staple food there since the Ice Age in Sierra
Leone. It is staple food for more than half of the World’s population

Corn

Corn or Maize (Zea mays, L) is native to the America. Corn originated in Mexico, evolving from the wild grass
Teosinte.

Barley

Barley (Hardeum vulgare L.) is among the most ancient of the cereal crops. The original area of cultivation has
been reported to be in the Fertile Crescent of the Middle East, in present day Lebanon, Iran, Iraq, and Turkey.

Structure of Cereal Grains

Cereal grains are the fruit of plants belonging to the grass family ( Gramineae). Botanically, cereal grains are a
dry fruit called a caryopsis.

The caryopsis fruit has a thin, dry wall which is fused together with the seed coat. The seed portion of cereals
consists of: a seed coat or testa (bran), storage organ or nutritive reserve for the seed (endosperm), and a
miniature plant or germ. The aleurone layer which is just below the seed coat, is only a few cells thick, but is
rich in oil, minerals, protein and vitamins. Starch and protein are located in the endosperm which represents the
bulk of the grain and is sometimes the only part of the cereal consumed. Starch granules range in size from 3-8
m in rice; 2-30 m in corn, and 2-55 m in wheat.

Chemical Composition of Cereals

Rice and wheat are most important cereals forming part of human food. The major constituents of the principal
cereals are: Cereal grains consist of about two third carbohydrates, mainly in form of digestible sugars and
starches. These grains are also an important source of several other nutrients such as protein, calcium, iron,
vitamin B complex and dietary fiber. Cereal grains contain 10-14% moisture, 58-72% carbohydrate, 8-13%
protein, 2-5% fat and 2-11% indigestible fiber. They also provide about 300-350 kcal/100 g of grains. Cereals
are deficient in vitamins A, D, B12 and C.

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Structure of Legumes

The term pulses is limited to crops harvested solely for dry grain, thereby excluding crops harvested green for
food mainly as vegetables (peas, beans, etc.), crops used mainly for oil extraction (e.g. soybean and groundnut)
and leguminous crops for sowing purpose (e.g. seeds of clover and alfalfa). A legume is a plant in the family
Fabaceae (or Leguminosae), or a fruit of these specific plants. A legume fruit is a simple dry fruit that develops
from a simple carpel and usually dehisces (opens along a seam) on two sides. A common name for this type of
fruit is a pod. Well-known legumes include peas, beans, lentils, black gram, green gram, soy and groundnut.

Pulses all have a similar structure, but differ in color, shape, size, and thickness of the seed coat. Mature seeds
have three major components: the seed coat, the cotyledons, and the embryo

Composition of Pulses

Pulses contain carbohydrates, mainly starches (55-65 percent of the total weight); proteins, including essential
amino acids (18-25 percent, and much higher than cereals); and fat (1 - 4 percent). The remainder consists of
moisture, fiber, minerals and vitamins.  

Structure of Oilseeds

Oil seeds are mainly used for extraction of edible oil. Oilseeds crops grown in India are groundnut, rapseed,
mustard, soybean, sunflower, sesame, castor, safflower, niger and linseed. Oilseeds are made up of three basic
parts: the seed coat, the embryo, and one or more food storage structures. The seed contains two pieces of
cotyledons that function as food reserve structures. The seed coat is marked with a hilum or seed scar. The
basic function of the coat is to protect the embryo from fungi and bacterial infection.

Composition of Oilseeds

Proximate composition of various oilseeds

RICE QUALITY AND GRADING STANDARDS

Cooking/eating quality indicators

Cooking and processing characteristics of the rice are the factors of primary importance in rice eating areas of
the world. Milling, cooking and processing qualities are the fundamental components of quality that determine
and establish economic value of rice. Upon cooking, long grain rice is dry and fluffy with individual grains,
whereas medium and short grain types are moist and chewy with grains that tend to stick or clump together.
Major cooking quality parameters are discussed hereunder.

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 Special grades are provided for the specific qualities or conditions of rice that affect marketability. These special
grades:

1        Rough rice: Parboiled rough rice, Smutty rough rice, Weevily rough rice
2        Brown rice: Parboiled brown rice and Smutty brown rice for processing
3        Milled rice: Parboiled milled rice, Undermilled milled rice

MILLING OF WHEAT

Wheat flour milling is a process that consists of controlled breaking, reduction and separation, Wheat flour
milling involves three basic processes:

i).     Grinding: Fragmenting the grain or its parts

ii).   Sieving: Classifying mixtures of particles based on its particle size
iii).  Purifying: Separating bran from endosperm particles based on their terminal velocity, by means of air currents.
ALTED MILK FOODS
Malted Milk Food until recently, and Malt Based Foods at present are perhaps the only barley-based processed
foods. Interestingly, this value-added food is most popular among children and therefore, it is no wonder these
products represent among a rapidly growing milk-food market. Barley malt is major ingredient of malted milk
foods and malt-based foods. Malted milk food is a product made by combining whole milk with the liquid
separated from a mash of ground barley & wheat flour in such a manner as to secure full enzymic action of the
malt extract, and reducing the mixture to dryness by desiccation. It may also contain added sodium chloride,
sodium / potassium bicarbonate. India is among the world’s biggest market for malt- milk based food products.
Malted- milk food products market in India has been growing in the range of 5 to 8 per cent for the last ten
years.

Historical Background

Malted milk food was developed in 1883 by William Horlicks of Racine, Wisconsin, and the product was
commercially marketed in 1887. William Horlicks undertook the research at the request of some physicians for
developing a baby food containing milk solids and cereal solids. This product received the attention of the
medical professionals and the consumers due to its convenience, nutritive value, digestibility and palatability.

According to FSSA (Food Standard Safety Act) malted milk food means the product obtained by mixing whole
milk, partly skimmed milk or milk powder with the wort separated from a mash of ground barley malt, any other
malted cereal grain and wheat flour or any other cereal flour or malt extract with or without addition of flavouring
agents and spices, emulsifying agent, eggs, protein isolates, edible common salt, sodium or potassium
bicarbonate, minerals and vitamins and without added sugar in such a manner as to secure complete hydrolysis
of starchy material and prepared in a powder or granule or flake formed by roller drying, spray drying, vacuum

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drying or by any other process. It may contain cocoa powder. It shall be free from dirt and other extraneous
matter. It shall not contain any added starch (except natural starch present in cocoa powder) and added non
milk fat. It shall not contain any preservative or added colour. Malted milk food containing cocoa powder may

BISCUIT MAKING
Baking industry is the most stable sector in the food manufacturing industries. The principal basis for most
products in this range is wheat flour. Addition of water and various other ingredients give us variety of products
like cookies, crackers, cakes, pastries and biscuits. Biscuits are flat, crisp, baked good, whereas cookies are
softer and thicker. Cracker means biscuits of a low sugar and fat content, frequently bland or savory. These
types of flour confections are palatable, easy to carry and don’t require further preparation before consumption
and thus they are considered as staple snacks.

Characteristics

Biscuit is a low moisture bakery product. Moisture content of biscuit is typically below 4% depending upon its
weight, thickness and shape. Biscuit dough can be made from soft wheat flour with a high amount of sugar (25-
55%) and shortening (20-60%). They are classified based on the way the dough is placed on the baking band
e.g. rotary molded, wire-cut, cutting machine, etc.

CANNED LEGUME PRODUCTS

Pulses are generally consumed in the form of Dal. Processing of pulses is important in improving their nutritive
value. The processing methods used are soaking, germination, decortications, cooking and fermentation.

Soaking

Soaking in water is the first step in most methods of preparing pulses for consumption. Soaking reduces
antinutritional factors present in pulses. Soaking reduces the oligosaccharides of the raffinose family, which are
responsible for flatulence after pulse consumption. Soaking also reduces the amount of phytic acid in pulses.

Fermentation

The processing of food pulses by fermentation increases their digestibility, palatability, and nutritive value.
Soybean is very valuable pulse whose protein approaches the quality of animal protein. However, it cannot be
directly used as food because of the anti-nutritional factors present in it. The anti-nutritional factors can be
eliminated by fermentation process. The common examples of fermented product are idli and dosa (blend of
fermented black gram and rice). This fermentation process improves the availability of essential amino acids.

Germination

Germinated legumes are also occasionally used as traditional legume foods. Sprouting causes partial
breakdown of starch and proteins and contributes to the better digestibility. Sprouting also improves flavour of

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the legume. Sprouted legumes can also be used as a ready-to-use marketable product. Sprouting causes
hydrolysis of the oligosaccharides, also responsible for causing flatulence of legumes.

Puffing

Puffed legumes are cheap and popular food for the common man. Puffing and toasting of pulses is practiced all
over the country. The flavour and light texture of the product makes it popular among all age groups. These
products are traditionally used as snacks. Puffing is effected by manual or mechanical roasting of conditioned
legumes in hot sand. The increase in size is 1.5 to 2 times of its original size.  Bengal gram and peas are best
suitable for puffing. The puffing expansion during roasting is maximum in Bengal gram which is most popular for
puffing.

The grains are first soaked in water for short duration (1-3 minutes), mixed with sand heated to 250�C and
toasted for 15-25 seconds with agitation. After sieving off the sand, the grains are dehusked between a hot
plate and a fast rotating rough roller. The yield of puffed product is about 65-70% by weight.

EGG: STRUCTURE, COMPOSITION AND QUALITY

Egg is a complete food consumed throughout the world. Eggs of various birds may be eaten however eggs of
hen and duck are most commonly consumed. Egg protein contains all the essential amino acid and has got
highest biological value. Thus egg proteins are considered by the WHO to be the reference protein, to which all
other proteins are compared. An average weight of hen egg is about 2 ounce i.e. 57g
Structure and Composition of the Egg
Whole Egg can be divided into three major components
1. Shell             
2. Egg white   
3. Egg yolk     
Composition of Egg
Composition of egg
Water Fat
Component % % Protein % % Ash %
Whole egg 100 65.5 11.8 11 11.7
Egg white 58-60% 88 11 0.2 0.8
Egg yolk 31-33% 48 17.5 32.5 2
9 �
Shell 12%        
Shell

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It is the Outer covering of Egg, contributes to 9 � 11% of the whole egg weight. 94% of the egg shell is
composed of calcium carbonate. It Acts as a barrier against harmful bacteria and other contaminants. Shell has
got numerous pores on its surface, permitting moisture and carbon dioxide to move out and oxygen to move in
as egg ages. Strength of the shell indicates the quality of the egg and strength is influenced by mineral and
vitamin content of the hen’s diet, mainly calcium, phosphorous and Vitamin D. Inside surface of the Shell is
lined by a mucous layer also known as protective layer called cuticle or bloom. Cuticle preserves the freshness
of the egg by blocking the pores on the shell.
Egg white
It is also known as Egg albumin, it contributes to about 65% of the egg�s liquid weight. It contains more than
half of the egg�s total protein. Egg white becomes thin as an egg ages because protein changes in character.
Hence fresh eggs sit up tall and firm in the pan while older ones tend to spread out. As the egg ages, carbon
dioxide escapes out, so the albumin becomes more transparent than the fresh ones
Egg yolk
The yolk or yellow portion makes up to about 33% of the liquid weight of the egg. It contains all of the fat in the
egg and about 45% of total egg proteins.
Structure of the Egg      

     Source: USDA

Factors affecting quality of egg
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 1.      Age of the egg
2.      Storage atmosphere
3.      Temperature of storage
4.      Relative humidity
5.      Pre-treatments given before storage
Testing the quality of egg
1.      Water test: this test is based on the principle of density. Eggs are simply dropped into water. Good
quality eggs sink to bottom and poor quality ones float. Loss in weight is due to dehydration and thus
increased air cell size.
2.      Sensory test: Cracked, smelly, rough surface indicates poor quality
3.      Candling test: This is the most commonly used test to determine the spoilage of egg. The egg shell is
porous and allows the light to pass through. The eggs to be tested are placed in front of sharp, bright light
and assessed for following factors
a.       Cracks on the shell
b.      Air cell size and position
c.       Albumin and yolk position and firmness
d.      Presence of any blood clot  or foreign elements in the egg
Quality checks and storage of egg
Like any other food product, Eggs start deteriorating soon after it is laid. So it is very important to check the
quality of the egg before its consumption. Good quality egg should possess following qualities once it is broken.
1.      Yolk is firm and stands up in the centre of white
2.      Egg white forms a definite ring around the yolk and thick white holds its shape
3.      No blood spots are present
4.      No bad odour
Changes occur in egg during storage
1.      Increase in the size of air cell due to loss of moisture
2.      Increased pH due to escape of carbon dioxide. pH increases from 7.6 to 9.7
3.      Percentage of thin white increases, thus egg white loses its shape and runs easily.
4.      Water passes from white to yolk, thus fluid content of yolk increases.
Indicators to Determine Spoilage in Eggs
1. White index:
            White index = Height of thickest egg white portion/Egg diameter
            Range: 0.08 - 0.1
2. Yolk Index
            Yolk index = Height of Yolk/Yolk width

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             Range: 0.35 - 0.45
3. Hough’s Unit (HU)
Commonly used index to check the egg quality
            HU = Height of thick white/weight of Egg
For good quality egg HU is 72 and above and HU about 30 to 60 indicates poor quality.
4. Air cell size should be 2-3cm
Preservation of the Shell Eggs
Eggs can be preserved by 4 different methods
Wet immersion method
In this method only infertile, fresh, good quality eggs should be used
Lime sealing method
In this method saturated solution of lime water is used. Eggs are held in lime water for 14 -16hr, during
immersion CO2 released from the egg combined with lime to form calcium carbonate which deposits and seals
shell pores. Then it is removed and stored at room temperature. Such eggs can be stored for 3 -4 weeks at
room temperature
Water glass method
10% solution of sodium silicate is commonly called water glass. In this method Water should be boiled and
cooled to 24 26C, to remove the dissolved CO 2�, before the addition of calculated amount of sodium silicate.
Eggs are kept overnight and then removed and stored at room temperature.
FISH
Fish is a source of valuable animal protein and is now considered as a health food. This has resulted in
increased consumer demand. Indian fisheries and aquaculture provides nutritional security to the human food
and contributes to the agricultural exports and engages very large number of people in different activities. India
is the 3rd largest fish producing nations (after Chine and Indonesia) in the world with the production of 7.3 million
MT (FAO 2007). Presently, fisheries and aquaculture contribute 1.10 % to the national GDP, and 5.30 % to
agriculture and allied activities, while the average annual value of output during the Tenth Five Year Plan
Classification of fisheries
Fisheries can be broadly categorized into two types - fin fisheries and non-fin fisheries. Fin fisheries means
fisheries of true fishes, whereas non-fin fisheries is the fisheries of organisms other than true fish like prawn,
crab, lobster, mussel, oyster, sea cucumbers, frog, sea weeds, etc.
Fin fisheries can be further categorized into two types capture fisheries and culture fisheries.
Functions of the fish market
Fish markets are bridges between producers and consumers. The following are the functions of the market.
1.      All types of fishes are brought together for selling.
2.      Transportation of fishes

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 3.      Storage of fishes
4.      Business problems can be solved
5.      Fishes can be graded here
6.      Money transactions take place in markets
7.      Time and distance is saved.
Types of markets
Based on the marketing place, production importance and products, the markets can be classified into the
following types.
1.      Whole sale market: More amounts of fish comes to this market, then distributed to other types of
markets. Whole sale market can be grouped into two types,
a.   Primary whole sale market: More amount of sale of fish takes place in this market. Collection of
the fishes from surrounding places and selling the fish to wholesalers takes place. These types of
markets are found either in a village or a place covering a group of villages or towns or cities.
These are known as shandies.
b.    Secondary whole sale market: These are also called as gunjs. The fishes are brought from the
primary whole sale markets and sold to the wholesalers.
2.      Terminal markets: The fishes are sold to the retailers or consumers or to the agents.
3.      Retail markets: The fishes are sold to the consumers by the retailers or wholesalers.
4.      Fairs: These are found temporarily during festival times or in fairs. The fishes are sold directly to
consumers.
Fish, however, is more susceptible to spoilage than certain other animal protein foods, such as meat and eggs.
To prevent spoilage of fish, some form of preservation is necessary. Preservation means keeping the fish, after
it has landed, in a condition wholesome and fit for human consumption for a short period to few days or for
longer periods of over few months.
Methods of Preservation
Preservation for short duration
Chilling
This is obtained by covering the fish with layers of ice. Ice is effective for short term preservation such as is
needed to transport landed fish to nearby markets or to canning factories, etc. Here autolytic enzyme activities
are checked by lowering the temperature.
Preservation for long time
When the preservation is required for a long period of time, the fishes are passed through the cleaning, gutting
and conservation and storage.
Cleaning and gutting

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During cleaning, the caught first are fish washed thoroughly in cold, clean water to remove bacteria, slime,
blood, faeces, and mud, etc. from the body surface of the fish. It is being done under proper sanitary conditions.
Large fishes are gutted (i.e. all the internal organs or viscera are removed) and the body cavity is washed.
Conservation and Storage
Conservation is necessary to keep the dead fish in fresh condition for quite a long time. This is achieved by
employing any one of the methods like freezing, drying, salting, smoking and canning.
Freezing
Freezing means removal of heat from the body. To check the enzymal, bacterial action and putrefaction it is
preferred to store the fish under lower temperatures. When fish is intended to be stored for a long period, quick
freezing is preferred which inhibits bacterial action. During quick freezing every part of the product comes within
the range of 0 to -5C. Properly frozen fish at -20C retains its physical properties and nutritive values for a year
or more and is almost as good as fresh fish. There are three ways effecting quick freezing:
a)      Direct immersion of fish in the refrigerating medium,
b)      Indirect contact with the refrigerant through plates
c)      Forced convection of refrigerated air directed at heat transfer surfaces.
In general different methods of freezing are adapted through sharp freezer, air blast freezer, contact plate
freezer, immersion freezing, liquid freon freezing, liquid nitrogen freezing, fluidized bed freezer, cryogenic
freezing, etc. Among the various types of quick freezing plants installed in India the carrier air blast type is
widely used. The air blast freezer is in the form of a tunnel and heat transfer is affected rapidly by the circulation
of air. The temperature used ranges from 0 to -30 0C and air velocity varies from 30 to 1050 meters/min.
Freeze drying
This is modified deep freezing, completely eliminating all chances of denaturation. The deep frozen fish at
-200C is then dried by direct sublimation of ice to water vapour with any melting into liquid water. This is
achieved by exposing the frozen fish to 140 0C in a vacuum chamber. The fish is then packed or canned in dried
condition. The product is quite fresh looking in appearance, flavour, colour and quality.
Salting
Salting is a process where the common salt, sodium chloride, is used as a preservative which penetrates the
tissues, thus checks the bacterial growth and inactivates the enzymes. Some of the factors involved in salting of
fish which play an important role are purity of salt, quantify of salt used, method of salting and weather
conditions like temperature, etc.
During the process the small fishes are directly salted without being cleaned. In the medium and large sized fish
the head and viscera are removed and longitudinal cuts are made with the help of knives in the fleshy area of
the body. Then the fish is washed and filled with salt for uniform penetration through flesh. Large fishes like
sharks are cut into convenient sized pieces. Generally, sardines, mackerels, seer fishes, cat fishes, sharks and
prawns are used for salting.

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Dry salting and wet salting and are the methods employed in salting of fish.
a)   Dry salting
In this process the fish is first rubbed in salt and packed in layers in the tubs and cemented tanks. The salt is
applied in between the layers of fishes in the proportion of 1:3 to 1:8 salt to fish. The proportion of salt to fish
varies with the fish since the oily fish require more salt. At the end of 10 - 24 hours the fishes are removed from
the tubs and washed in salt brine and dried in the sun for 2 or 3 days.
b)  Wet salting
The cleaned fish are put in the previously prepared concentrated salt solution. It is stirred daily till it is properly
picked. With large sized fishes, longitudinal slits are made in the flesh to allow penetration of salt. After pickling
for 7-10days, the salty water that oozes out from the fish is allowed to drain off. This can be stored upto 3-
4months.
Smoking
In this method, landed fish is cleaned and brined. It is then exposed to cold or hot smoke treatment. In cold
smoking, first a temperature of 38 0C is raised from a smokeless fire. After this heating, cold smoke at a
temperature below 280C is allowed to circulate past the fish. In case of hot smoking, first a strong fire produces
a temperature around 130 0C.This is followed by smoking at a temperature of 40 0C. The smoke has to be wet
and dense. Good controls are necessary over density, temperature, humidity, speed of circulation, pattern of
circulation and time of contact with fish of the smoke. The phenol content of the smoke acts as an antiseptic
and it also imparts a characteristic colour and flavour. For making fire and smoke, only hard wood (Conifer
wood, Saw dust etc.) are used.
Canning
Canning is a method of preservation in which spoilage can be averted by killing micro-organisms through heat.
Oily fish are the most suitable for canning. Salmon, tuna, sardine, herring, lobster, shrimp, etc. are canned. The
raw material should be processed properly since it contains most dangerous Clostridium botulinum which
should be destroyed. There are some other heat resistant bacteria like Clostridium sporogenes which can be
eliminated at a temperature of 5 - 6 times more than Clostridium botulinum. It needs a temperature of 1200C for
4 minutes or at 1150C for 10 minutes to kill them in large numbers.

Canning is done by putting cleaned dressed and cut fish into a saline solution. The cans holding the fish and the
saline are then double seamed under vacuum. Thereafter, sterilization of cans takes place at 121 0C for 90min
under steam pressure. Sterilization is followed by cooling of the cans under room temperature by running water.
Drying
Drying involves dehydration i.e. the removal of moisture contents of fish, so that the bacterial decomposition or
enzymic autolysis does not occur. When moisture contents reduce upto 10%, the fishes are not spoiled
provided they are stored in dry conditions. Fish drying is achieved either naturally or by artificial means. In

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natural drying the fishes after being caught are washed and dried in the sunshine. In artificial drying the killed
fishes are cleaned, gutted and have their heads removed. They are then cut lengthwise to remove large parts of
their spinal column, followed by washing and drying them mechanically.

Value Added Fisheries Products

Value addition is one of the most practical ways to increase the profitability in fish processing and sale in
domestic as well as international markets. It is also becoming a market requirement as the wholesale traders,
retail outlets and finally the consumers are on the lookout for fish products that require minimum preparation.
Some of the value added fish products are Fish sausages, Fish fillets, Fish cutlets, dehydrated fish products,
Fish pickles, Fish flakes/wafers, Fish noodles.

NUTRITIONAL DISORDERS / DISEASES / DEFICIENCIES

As we start another semester into the world of nutritional disorders and health, our focus will be in
demonstrating that nutritional science is an evolving field of study, continually being updated and supported by
research, studies, and clinical trials. As the semester progresses with establishing this fact through lectures,
discussions, and the incorporated seminar series, students confidence will be strengthened in nutritional
science as a true guide to our eating habits, an advisory base for our target clients, grounds for confirming or
revolting cultural-traditional-taboo beliefs around food and nutrition and health. In essence, the primary goal of
this course is to provide students with information backed by nutritional science, and with a variety of resources
that use scientific information / evidence necessary to make sound nutritional choices to optimize health and
help prevent disease. The course lectures will cover and show that there are many conditions and deadly
diseases that can be prevented by good nutrition. You will also learn about the many other determinants of our
food choice, health and disease, how the powerful tool of scientific investigation / data collection is used to
design dietary guidelines, and recommendations that promote health and prevent disease.

Defining Nutrition, Health, and Disease

The word nutrition first appeared in 1551 and comes from the Latin word ‘nutrire’, meaning “to nourish.” Today,
we definenutrition1as the sum of all processes involved in how organisms obtain nutrients, metabolize them,
and use them to support all of life’s processes. Nutritional science is the investigation of how an organism is
nourished, and incorporates the study of how nourishment affects personal health, population health, and
planetary health. Nutritional science covers a wide spectrum of disciplines. As a result, nutritional scientists can
specialize in particular aspects of nutrition such as biology, physiology, immunology, biochemistry, education,
psychology, sustainability, and sociology.

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Your ability to wake up, to think clearly, to communicate, to hope, to dream, to go to school, to gain knowledge,
to go to work, to earn a living, and to do all of the things that you like to do are dependent upon one factor—
your health. Good health means you are able to function normally and work hard to achieve your goals in life.
For the next few minutes, take some time to view snapshots of the insides of the refrigerators of American
mechanics, doctors, school teachers, hunters, short order cooks, college students, vegans, and more.

Public Health and Disease Prevention

Disease is defined as any abnormal condition affecting the health of an organism, and is characterized by
specific signs and symptoms. Signs refer to identifying characteristics of a disease such as swelling, weight
loss, or fever. Symptoms are the features of a disease recognized by a patient and/or their doctor. Symptoms
can include nausea, fatigue, irritability, and pain. Diseases are broadly categorized as resulting from pathogens
(i.e., bacteria, viruses, fungi, and parasites), deficiencies, genetics, and physiological dysfunction. Diseases that
primarily affect physical health are those that impair body structure (as is the case with osteoporosis), or
functioning (as is the case with cardiovascular disease). Mental illnesses primarily affect mental and social well-
being.
The foods we eat affect all three aspects of our health. For example, a teen with Type 2 diabetes (a disease
brought on by poor diet) is first diagnosed by physical signs and symptoms such as increased urination,
thirstiness, and unexplained weight loss. But research has also found that teens with Type 2 diabetes have
impaired thinking and do not interact well with others in school, thereby affecting mental and social wellbeing.
Type 2 diabetes is just one example of a physiological disease that affects all aspects of health—physical,
mental, and social.
Food
Industrialized countries are bombarded with television programs that show where to find the best dinners,
pizzas, and cakes, and the restaurants that serve the biggest and juiciest burgers. Other programs feature
chefs battling to prepare meals, and the top places to burst your belly from consuming atomic chicken wings
and deli sandwiches longer than a foot. There are also shows that feature bizarre foods from cultures around
the world. How do you use the information from TV, media popular network food shows to build a nutritious
meal? You don’t—these shows are for entertainment. The construction of a nutritious meal requires learning
about which foods are healthy and which foods are not, how foods and nutrients function in our body, and how
to use scientific resources.
Importance of Food to Man (Human Beings)
As stated in the definition above, food is important to man to fulfil:
 Satisfy hunger & satiety
 Religious needs (after fast food needs)
 Our natural physiological, biological, and nutritional needs

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 To build up tissues, repair worn out tissues, provide energy, provide halt for warmth, maintain body
processes, protect the body from diseases, stay alive, be healthy
 Sensorial quest (appetite, aroma, color/appearances, likes and dislikes/revolting etc.)
 Entertainment or to celebrate our identity / culture or traditions (naming ceremonies, weddings,
traditional societies, funerals etc)
 A sense of love, caring and sharing - Famine / disaster times, families/individuals struggling with food
needs, special occasions such as birthdays, weddings etc.)
KEY TAKEAWAYS

• Nutrition - Science of food, the nutrients and other substances within food, their actions and interactions and
balance in relation to health and disease.

• Nutrition security - Appropriate quantity and combination of inputs such as food, health services and
caretakers time needed to ensure an active and healthy life at all times for all people.

• Malnutrition - Malnutrition includes a wide range of clinical disorders resulting from an unbalanced intake of
energy, protein as well other nutrients. It can present as under or over nutrition.

• Protein-Energy-Malnutrition (PEM) - Protein-Energy-Malnutrition is a clinical syndrome present in infants and

children as a result of deficient intake and/or utilization of food especially the lack of appropriate quality and
quantity, and balance protein and calories in the diet.

Health is defined as “a state of complete physical, mental, and social well-being, and not merely the absence of
disease or infirmity.” Disease is defined as any abnormal condition that affects the health of an organism, and
is characterized by specific signs and symptoms. • Disease affects all three aspects of the health triangle. •
Good nutrition provides a mechanism to promote health and prevent disease. • Diet-related conditions and
diseases include obesity, Type 2 diabetes, cardiovascular disease, some cancers, and osteoporosis.

Nutritional Disorder / Deficiency / Disease

Primary nutritional deficiency is one of the most basic types of malnutrition, and occurs in people who do not
have enough nutrients in their diet. Malnutrition is one of the most prevalent causes of infant mortality, with
about 10 children dying of malnutrition each minute. Primary nutritional deficiency is generally reversible when
the person begins eating enough nutritious food.
Primary nutritional deficiency typically occurs because a person doesn't get enough of certain vital nutrients.
Since your body requires a steady supply of different nutrients, primary nutritional deficiencies can affect your
organs, tissues and bone. Some common conditions of malnutrition include: fatigue, dizziness, decaying teeth,
swollen gums, poor immune function, slowed reaction times, poor growth, muscle weakness, learning problems,
bloated stomach, osteoporosis etc. Unlike secondary malnutrition, primary nutritional deficiency can generally
be resolved by eating foods or taking supplements to provide the missing nutrients.

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Primary vs. Secondary
Secondary malnutrition occurs when the body’s ability to absorb nutrients is limited by a condition or illness.
These conditions can include celiac disease, cystic fibrosis, lactose intolerance, pancreatic insufficiency and
pernicious anemia. Additionally, organ failure can reduce your body’s ability to absorb nutrients from the foods
you eat. To reduce your risk of primary nutritional deficiency, simply adopt a balanced diet rich in nutritious
foods, including whole grains, leafy greens, fruits and lean proteins. Most adults can get enough of the required
nutrients while following a diet with 2,000 calories per day. One way of reducing your risk of primary nutritional
deficiency is to limit empty-calorie foods such as soft drinks and candy, which add calories but have no
significant nutritional value.
Adequate nutritional support is most essential for infants, adolescent children and pregnant women. Each of
these requires a stable supply of vitamins, minerals and other nutrients to support exponential growth of tissues
or organs. Children with primary nutritional deficiency can develop a condition called marasmus, characterized
by a thin body and stunted growth. Children deficient in protein can develop an enlarged liver, edema or
delayed development as a result of a serious condition called kwashiorkor. Folic acid deficiencies in pregnant
women can lead to birth defects and other adverse conditions. Lastly, many minerals and nutrients - such as
vitamin D plays a crucial role in bone formation, and can result in rickets and osteomalacia in adults with
nutritional deficiencies.
Nutritional Disease – is any of the nutrient-related diseases and conditions that cause illness in humans. They
may include deficiencies or excesses in the diet such as obesity and eating disorders, and chronic diseases
such as cardiovascular disease, hypertension, cancer, and diabetes mellitus etc. Nutritional diseases also
include developmental abnormalities that can be prevented by diet, hereditary metabolic disorders that respond
to dietary treatment, the interaction of foods and nutrients with drugs, food allergies and intolerances, and
potential hazards in the food supply.

Nutrient Deficiencies - Although the so-called diseases of civilization - for example, heart disease, stroke,
cancer, diabetes and other eating disorders etc., will be covered in this course, the most significant nutrition-
related disease is chronic undernutrition, which plagues more than 925 million people worldwide. Undernutrition
is a condition in which there is insufficient food to meet energy needs; its main characteristics include weight
loss, failure to thrive, and wasting of body fat and muscle. Low birth weight in infants, inadequate growth and
development in children, diminished mental function, and increased susceptibility to disease are among the
many consequences of chronic persistent hunger, which affects those living in poverty in both industrialized and
developing countries.
1. Nutritional deficiencies, known as malnutrition, are the result of your body not getting enough of the
nutrients it needs.
2. Children are more at risk for serious complications due to nutritional deficiencies than adults.

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 3. You can prevent nutritional deficiencies by making sure you get enough nutrients from your diet. You
should talk to your doctor and dietitian to help make any decisions on dietary changes and before
taking any nutritional supplements.
The body requires many different vitamins and minerals that are crucial for both development and preventing
disease. These vitamins and minerals are often referred to as micronutrients. They aren’t produced naturally in
the body, so you have to get them from your diet.

A nutritional deficiency occurs when the body doesn’t absorb the necessary amount of a nutrient. Deficiencies
can lead to a variety of health problems. These can include problems of digestion, skin problems, stunted or
defective bone growth, and even dementia. The amount of each nutrient you should consume depends on your
age. In the United States, many foods that you buy in the grocery store (such as cereals, bread, and milk) are
fortified with nutrients that are necessary to prevent nutritional deficiency. But sometimes your body is unable to
absorb certain nutrients even if you are consuming them.

NUTRIENT DEFICIENCIES
Macronutrient deficiency refers to a lack of the nutrients required in large amounts for normal growth and
development. Macronutrients "carbohydrate, protein, and fat" are essential for health, growth, healing, and
immune function. Too little or too much of any of these macronutrients may result in poor health and a variety of
diseases. In the past, research on nutrition and disease frequently focused on the problems caused by diets
that provided too little nutrition. However, eating too much has become a far greater threat to health in
developed countries and in many developing nations as well.

Macronutrients include:
 Carbohydrates
 Protein
 Fat
Protein-Energy Malnutrition (PEM) is a common macronutrient deficiency that occurs when children consume
insufficient amounts of protein and energy (carbohydrates and fat) to meet the body’s needs.
Conditions that can result from PEM include:
 Wasting (very low weight-for-length/height)
 Stunting (very low length/height-for-age)
Malnutrition is the impaired function that results from a prolonged deficiency - or excess of total energy or
specific nutrients such as protein, essential fatty acids, vitamins, or minerals. This condition can also result from
fasting and anorexia nervosa; persistent vomiting (as in bulimia nervosa) or inability to swallow; impaired
digestion and intestinal malabsorption; or chronic illnesses that result in loss of appetite (e.g., cancer,

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AIDS). Malnutrition can also result from limited food availability, unwise food choices, or overzealous use of
dietary supplements.

Chronic undernutrition manifests primarily as protein-energy malnutrition (PEM), which is the most common

form of malnutrition worldwide. Also known as protein-calorie malnutrition (PCM), PEM is a continuum in which
people - all too often children - consume too little protein, energy, or both. At one end of the continuum is
kwashiorkor, characterized by a severe protein deficiency, and at the other is marasmus, an absolute food
deprivation with grossly inadequate amounts of both energy and protein.
An infant with marasmus is extremely underweight and has lost most or all subcutaneous fat. The body has a
“skin and bones” appearance, and the child is profoundly weak and highly susceptible to infections. The cause
is a diet very low in calories from all sources including protein, often from early weaning to a bottled formula
prepared with unsafe water and diluted because of poverty. Poor hygiene and continued depletion leads to a
vicious cycle of gastroenteritis and deterioration of the lining of the gastrointestinal tract, which interferes with
absorption of nutrients from the little food available and further reduces resistance to infection. If untreated,
marasmus may result in death due to starvation or heart failure.
Kwashiorkor, a Ghanaian word meaning the disease that the first child gets when the new child comes, is
typically seen when a child is weaned from high-protein breast milk onto a carbohydrate food source with
insufficient protein. Children with this disease, which is characterized by a swollen belly due to edema (fluid
retention), are weak, grow poorly, and are more susceptible to infectious diseases, which may result in
fatal diarrhea. Other symptoms of kwashiorkor include apathy, hair discoloration, and dry, peeling skin with
sores that fail to heal. Weight loss may be disguised because of the presence of edema, enlarged fatty liver,
and intestinal parasites; moreover, there may be little wasting of muscle and body fat.

Kwashiorkor and marasmus can also occur in hospitalized patients receiving intravenous glucose for an
extended time, as in when recovering from surgery, or in those with illnesses causing loss of appetite
or malabsorption of nutrients. Persons with eating disorders, cancer, AIDS, and other illnesses where appetite
fails or absorption of nutrients is hampered may lose muscle and organ tissue as well as fat stores. Treatment
of PEM has three components. (1) Life-threatening conditions—such as fluid and electrolyte imbalances and
infections—must be resolved; (2) Nutritional status should be restored as quickly and safely as possible; rapid
weight gain can occur in a starving child within one or two weeks; (3) The focus of treatment then shifts to
ensuring nutritional rehabilitation for the long term. The speed and ultimate success of recovery depend upon
the severity of malnutrition, the timeliness of treatment, and the adequacy of ongoing support. Particularly
during the first year of life, starvation may result in reduced brain growth and intellectual functioning that cannot
be fully restored.
Children may be at increased risk for PEM for several reasons, including:
 Lack of food
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  Poor quality food
 Gastrointestinal illness (e.g. parasites)
 Illnesses which cause malabsorption
 Poor sanitation
 Chronic illness, including hepatitis, kidney disease, lung disease and heart defects

Wasting

Wasting is defined as very low weight for length/height. It typically results from acute malnutrition that occurs
due to a calorie deficit. This can be due to low calorie intake and/or poor quality of food. Wasting results from a
rapid weight loss or failure to gain weight due to infection or inadequate dietary intake. When a child
experiences a severe calorie deficit, the first body compartment to be affected is fat stores, before length or
head growth. This results in a child who is much too light for his or her frame and obviously undernourished-
looking. In extreme cases of wasting, children are at an increased risk of death.

Symptoms
Wasting is a major indicator of malnutrition. Children with wasting may present the following symptoms:
 Recent, drastic weight loss
 “Thinness”
 Low muscle and fat mass
 Fatigue
 Non-healing wounds
Children who are underweight due to chronic malnutrition may exhibit both stunting and wasting.
Causes
Wasting may be a result of short or long term conditions such as:
 Acute starvation
 Poor food quality
 Infection resulting in weight loss
 Chronic food shortage

Diagnosis

Wasting is measured by the weight-for-height index. It is considered to be present when weight-for-height is

more than two standard deviations below the World Health Organization standard.

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Treatment

Wasting is readily reversible once conditions improve. Recovering a normal body composition requires the
intake of larger quantities of energy, proteins, and nutrients needed for the synthesis of muscle and fat tissue.
However, if children with acute or severe malnutrition are re-fed too fast, they may develop a life-threatening
condition called “refeeding syndrome.”

Stunting

Stunting is very low height for age. It is the failure to reach one’s genetic potential for height. The lack of
nutrients – often combined with chronic infection and/or stress – can affect the child’s length more than weight.
In these cases, kids will be small but might look chubby because their fat stores are disproportionately
distributed across an even shorter body frame.

Symptoms

Children with stunting may present the following symptoms:

 Short for age
 Child appears young for his or her age
 Low weight for age
 Appears chubby (disproportionate fat mass related to height)
 Bone growth is delayed
Wasting and stunting can present in mixed forms.

Causes

Stunting develops over a long period due to a combination of some or all of the following factors:
 Not enough protein in proportion to total calorie intake
 Hormone changes triggered by stress (cortisol, for example)
 Frequent infections early in life
The development of stunting is a slow, cumulative process and does not necessarily mean that the current
dietary intake is inadequate. The growth failure may have occurred in the past.

Diagnosis

Stunting is measured by the height-for-age index. A child is considered to be “stunted” when height-for-age is
more than two standard deviations below the World Health Organization standard.

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Treatment

Children who are stunted may benefit from additional quantities of nutrients needed for both bone and lean
tissue growth; however, a specific nutritional plan should be developed in conjunction with a child’s pediatrician
and dietitian.

Impact of Malnutrition on Health and Development

Malnourished children experience developmental delays, weight-loss and illness as a result of inadequate
intake of protein, calories and other nutrients. Because orphaned and institutionalized children may experience
one or several macronutrient and micronutrient deficiencies, they are at risk for a variety of short-term and long-
term complications.

Short-Term Implications

Because so much development occurs in the first few years of life, nutrient deficiencies can have major short-
term implications in young children.

Immune Implications

Malnourishment can greatly compromise a child’s immune system, making them more susceptible to infectious
diseases. Particularly in institutions where there are poor sanitary practices, children are vulnerable to infections
from other children or caregivers. In particular, zinc, iron and vitamin A are commonly associated with
weakened immune function.

Growth Implications

Nutrient deficiencies and gastrointestinal infections commonly co-occur in orphans. A child may contract an
infection due in part to poor nutritional status. In turn, a gastrointestinal infection places the child at even greater
risk for nutrient deficiencies because nutrients are unable to be absorbed properly. Consequently, nutrient
deficiency combined with infection can cause growth retardation. Additionally, a deficiency in one nutrient may
lead to a deficiency in another nutrient. Malnutrition not only impacts growth in the short term, but can also limit
total bone growth. Additionally, children classified as low height-for-age (stunted) may never be able to regain
lost growth potential if they continue to live in a nutritionally deprived situation.

Long-Term Implications

The short-term implications of malnutrition eventually give way to long-term complications, such as growth and
cognitive delays.

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Cognitive Implications

Malnutrition negatively effects brain development causing delays in motor and cognitive development, such as:
 Attention deficit disorder
 Impaired school performance
 Decreased IQ scores
 Memory deficiency
 Learning disabilities
 Reduced social skills
 Reduced language development
 Reduced problem-solving abilities

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Protein

Protein supports the growth and maintenance of the body. The amino acids that make up proteins are used
for building DNA, cell membranes, hormones, receptors, brain chemicals, and many other molecules in the
body. Protein is also the second largest source of stored energy (second to fat cells) because of the large
amount of muscle that is a steady source of amino acids

The Food and Nutrition Board of the National Academy of Sciences has determined that nine amino acids
are essential for health. These cannot be manufactured in significant quantities by the body and must be
obtained from the diet. The essential amino acids are (9):
Isoleucine Leucine Lysine
Methionine phenylalanine Threonine
Tryptophan Valine Histidine
During growth and in various diseases, several other amino acids (including arginine, cysteine, glutamine,
glycine, proline, and tyrosine) are also considered essential because the body cannot produce enough of
them on its own.
 Too much protein can be harmful: Although a deficiency of dietary protein is clearly harmful, many
chronic diseases may be caused or worsened by too much protein, particularly animal protein. These
diseases include: osteoporosis, kidney stones, kidney failure, gout, and possibly certain cancers. Food
from plant sources supply protein in the amount and quality appropriate for all ages.
 Protein requirements are increased in certain conditions: As noted above, severe illness may cause
protein deficiency. These illnesses include liver and kidney diseases, burns, severe infections, and
major surgery.

Carbohydrates
Carbohydrate is the main energy source in the human diet, providing 50 percent or more of total calories in
the form of starches and sugars. Carbohydrate–containing foods can be classified in several ways:
 Simple vs. Complex Carbohydrate. The term simple carbohydrate refers to single
(monosaccharide) and double (disaccharide) sugar molecules. Common monosaccharides include
glucose and fructose, while common disaccharides include sucrose (table sugar). Examples of
foods high in simple carbohydrate include table sugar, fruit, and milk.

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Glucose  Fructose Sucrose
C6H12O6 C6H12O6 C12H22O11

A complex carbohydrate refers to multiple sugar molecules linked together by chemical bonds
(polysaccharides, or “starch”). The health benefits of carbohydrate–containing foods are largely limited to
those rich in complex (rather than simple) carbohydrate. Examples of foods high in complex carbohydrate
include grains, legumes, starchy vegetables, pasta, and breads. Starches are complex carbohydrates that
include cellulose, an important source of dietary fiber.

Cellulose
 Refined vs. Unrefined Carbohydrates. Refining is a process by which the outer bran coating of
grains is removed. In this process, brown rice is converted to white rice, for example, or whole
wheat is converted to white flour. As a result, the food loses most of its fiber content. Note that a
food can be rich in complex carbohydrate but also be refined. White rice and white bread, for
example, are refined grain products, but retain their complex carbohydrate.
 Glycemic Index. The glycemic index is a scale used to describe the effects carbohydrate–rich
foods have on blood sugar levels. The glycemic index of a food is determined by feeding a portion
of carbohydrate to healthy people after an overnight fast. Blood sugar is tested every 15 to 30
minutes over two hours, and the result is compared with that of feeding participants the same

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 amount of pure glucose. Foods that are lower on the glycemic index tend to raise blood sugar more
slowly than foods with a higher glycemic index.

These distinctions between various kinds of carbohydrate are clinically important. Diets high in sugars and
refined carbohydrate may cause high blood sugar and increased triglycerides levels (the chemical form of
fat in the blood).

Diets that are high in carbohydrate and fiber and low in fat and cholesterol are particularly helpful for the
prevention and treatment of several diseases, including obesity and weight–related diseases, such as
diabetes and hypertension.
Fats
Foods contain combinations of saturated and unsaturated fats*. Saturated fat is found in high quantities in
dairy products, eggs, and meats, for example, while vegetable oils are particularly high in unsaturated fats.
Unsaturated fats are either monounsaturated (found in olive and canola oils) or  polyunsaturated (found in
nuts, seeds, and seed oils).
Only two kinds of fats are essential, and both of these are polyunsaturated. They have important roles as
parts of cell membranes and as signaling molecules. The essential fatty acids include linoleic acid (an
omega–6 fatty acid) and alpha–linolenic acid (an omega–3 fatty acid). They are called “essential” because
they are not produced by the body and must be obtained through the diet or supplementation. Essential
fatty acids are converted into hormone–like chemicals called eicosanoids. These chemicals play significant
roles in the immune system, inflammation, blood clotting, and many other functions. A healthy balance of
eicosanoids occurs when a relatively large amount of omega–3 fats is consumed, compared with omega–6
or other fats.

The Need to Limit Fat

Of all the macronutrients, fats have the greatest potential to cause disease when consumed in excess.
Reducing saturated fats, in particular, is important in controlling cholesterol levels. Generally speaking, fatty
foods provide few nutrients. Other than essential fatty acids, vegetable oils provide vitamins E and K, which
can be obtained from other sources. Ideally, fats should not be added to meals; rather, they should be
consumed in modest amounts as part of healthy foods that provide essential nutrients.

Vitamins and Minerals

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Micronutrient deficiency is a lack of essential vitamins and minerals required in small amounts by the body
for proper growth and development. Micronutrients include, but are not limited to:
 Vitamins A, B, C and D
 Calcium
 Folate
 Iodine
 Iron
 Zinc

The usual cause of nutritional deficiencies is a poor diet that lacks essential nutrients. The body stores
nutrients, so a deficiency is usually caught after it’s been without the nutrient for some time. A number of
diseases and conditions — including colon cancer and gastrointestinal conditions — can lead to an iron
deficiency. Pregnancy can also cause a deficiency if the body diverts iron to the fetus.
However, there are some general symptoms you might experience, including:
 pallor (pale skin)
 fatigue
 weakness
 trouble breathing
 unusual food cravings
 hair loss
 periods of lightheadedness
 constipation
 sleepiness
 heart palpitations
 feeling faint or fainting
 depression
 tingling and numbness of the joints
 menstrual issues (such as missed periods or very heavy cycles)
 poor concentration

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 Selected Nutrient-Deficiency Diseases

Disease (and key Symptoms Foods Rich in Key Nutrient

Nutrient involved)
Xerophthalmia blindness from chronic eye infections, poor liver, fortified milk, sweet potatoes, spinach,
(Vitamin A) growth, dryness and keratinization of epithelial greens, carrots, cantaloupe, apricots
tissues
Rickets weakened bones, bowed legs, other bone fortified milk, fish oils, sun exposure
(Vitamin D) deformities
Beriberi nerve degeneration, altered muscle pork, whole and enriched grains, dried
(Thiamin) coordination, cardiovascular problems beans, sunflower seeds
Pellagra diarrhea, skin inflammation, dementia mushrooms, bran, tuna, chicken, beef,
(Niacin) peanuts, whole and enriched grains
Scurvy delayed wound healing, internal bleeding, citrus fruits, strawberries, broccoli
(Vitamin C) abnormal formation of bones and teeth
Iron-deficiency decreased work output, reduced meat, spinach, seafood, broccoli, peas,
Anemia (Iron) growth,increased health risk in pregnancy bran, whole-grain and enriched breads
Goitre enlarged thyroid gland, poor growth in infancy iodized salt, saltwater fish
(Iodine) and childhood, possible mental retardation,
cretinism
Source: Gordon M. Wardlaw, Perspectives in Nutrition 

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 Deficiency Symptoms and Signs
Symptom or Sign Possible Nutritional Deficiency Other Possible Causes

General Symptoms and    

Appearance

Fatigue Protein-energy, iron, magnesium, potassium, Many physical illnesses including hypothyroidism,
vitamins B1, B12 and other B vitamins and cardiac failure, anaemia, chronic fatigue syndrome
vitamin C    and depression                                                    

Loss of appetite Zinc Many chronic illnesses

Pica eating non-nutritive General malnutrition and possibly iron, calcium, Normal in infants under 2 years of age, pregnancy
substances zinc, vitamins B1 – thiamine, B3 – niacin, C and especially in young women, mental illness
D

Loss of taste Zinc Common cold, many nasal disorders

Cold intolerance Iron        Hypothyroidism, anaemia and reduced cardiac

output

Pale appearance due to Iron, folate and vitamin B12 Excessive bleeding and haematological disorders
anaemia               

Carotenoderma – yellow Protein-energy and zinc      Dietary carotenoid excess especially in women,
discolouration of the skin hypothyroidism
noticeable on the face
and trunk

Diffuse Protein-energy Addison’s disease and  haemochromatosis

hyperpigmentation

Muscle wasting e.g. Protein-energy                                       

clothes appear too big,
loss of limb musculature

Loss of height and Calcium and vitamin D                      Increasing age and disease- related osteoporosis
excessive curvature of

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the spine

Skin    

Itchy skin – pruritus Iron Many skin diseases, liver disease

Dry Essential Fatty Acids or multiple nutritional Old age, skin conditions e.g.
skin                                                
deficiencies eczema                                                 

Red scaly skin in light- Vitamin B3                                           Excessive sun-exposure in red/fair haired individuals
exposed areas light-exposed areas            

Excessive bruising Vitamin C Old age, trauma and blood disorders

Haemorrhage or redness Vitamin C  

around hair follicles         

Bleeding into a joint or Vitamin C Various blood disorders

other unusual bleeding

Plugging of hair follicles Vitamin C  

with keratin or coiled hairs

Fine downy hair on torso Protein-energy.  Typical of Persistent anorexia  

– lanugo nervosa

Mouth    

Sore Iron, vitamin B12, B2, B3 and possibly other B Excessively hot drinks and oral disease
tongue                               vitamins

Cracking and peeling Vitamin B2 – riboflavin Excessive exposure to cold or windy weather
of     skin on the lips

Cracking at the corners of Iron, vitamin B2 – riboflavin possibly other B Poorly fitting dentures, eczema infection with
the vitamins candida albicans
mouth                           

Recurrent mouth ulcers Iron, vitamin B12, folate and possibly other B Coeliac disease, Crohn’s disease recurrent herpes

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 vitamins  and oral disease

Enlarged veins under the Vitamin C Smoking and old age

tongue with micro-
haemorrhages

Smooth, shinny and sore Iron, vitamin B12 and folate  

tongue: atrophic glossitis

Head, Face and Neck    

Scalp hair loss      Iron        Any scalp disease, alopecia from other causes

Dandruff                              Essential
               fatty
                               
acids and biotin Fungal infection of scalp

Redness at the sides of Vitamin B2 –riboflavin, vitamin B6 and zinc Seborrhoeic dermatitis
the nose

Redness or cracking at Vitamins B2 or B6  

the outer angle of the
eyes

Goitre Iodine deficiency is likely if goitre is present in > Adolescence, pregnancy and various forms of
20% of population – endemic goitre                thyroid disease

Hands and Nails    

Nails - brittle or flaking Iron        and possibly essential fatty acids Poor circulation and old age

Nails - upturned or spoon- Iron        Psoriasis or other diseases of the nail bed
shaped nails

Carotenoderma – yellow Protein-energy and zinc      Dietary carotenoid excess especially in women,
discolouration of the skin hypothyroidism
noticeable on the palms

Musculo-skeletal    

Muscle pains and cramps Magnesium, potassium, sodium, vitamin B1 Muscle or neurological disease, polymyalgia

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 and vitamin D if there is hypocalcaemia rheumatica and hypocalcaemia

Calf muscle pain after Vitamin B1 – thiamine       Torn muscle, peripheral vascular disease and
minimal exercise                  myopathy

Excessive calf muscle Vitamin B1- thiamine Torn muscle, thrombosis

tenderness

Walking with a waddling Vitamin D and resultant Osteoarthritis of the hips or disease of the hip-girdle
gait                                myopathy                             muscles

Difficulty getting up from a Vitamin D and resultant myopathy Arthritis of the hips or knees, diseases of the nerves
low chair or climbing the or muscles
stairs or weakness of
shoulder muscles

Bowed legs Vitamin D - rickets in childhood Paget’s disease and syphilis

Twitching of facial Calcium and vitamin D if hypocalcaemia or Hypocalcaemia for other reasons e.g.
muscles when tapping on severe magnesium deficiency       hypoparathyroidism
the facial nerve in front of
the ear: Chvostek’s sign

Eyes    

Poor night vision Zinc, vitamin A and possibly vitamin B2 - Retinal disease
riboflavin

Conjunctival dryness Vitamin A Old age and Sjogren’s syndrome

Gastrointestinal    

Diarrhoea Vitamin B3 Irritable bowel syndrome, malabsorption, infective

diarrhoea and many other causes

Constipation Dehydration, fibre, potassium, magnesium and Irritable bowel syndrome, diverticulosis, cancer of
folate the colon

Neurological    

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Restless legs Iron or folate Various neurological disorders, pregnancy,
rheumatoid arthritis, and renal failure

Burning feet syndrome Vitamin B2 –riboflavin Early peripheral neuropathy

Loss of balance when Vitamin B12 and possibly vitamin B3 Many neurological disorders affecting the
standing upright with feet cerebellum, spinal chord or peripheral nerves
together and the eyes
closed: Romberg’s test

Loss of vibration Vitamin B12 and possibly vitamin B3 Increasing age and peripheral neuropathy
sensation in the lower
limbs

Peripheral neuropathy – Vitamins B1, B12 and possibly B3, B6 and Diabetes and many other causes
numbness, tingling, folate and very rarely copper (following
disordered sensation, gastrointestinal surgery or excess zinc
pain and or weakness in ingestion).  Relative lack of essential fatty
the hands or feet acids.

Unsteady movement or Vitamin B1, vitamin E and Coenzyme Q10 Alcohol, hypothyroidism and many neurological and
walking (cerebellar inherited disorders
ataxia)

Mental State    

Depression                         Vitamins C, B1, B3, B6, B12, folate, biotin and Mental illness, stress and as a consequence of
    possibly the essential fatty acids physical illness

Irritability                             Folate Alcoholism, deprcssion and personality disorder

                 

Poor Iron, vitamins B1, B12, folate and possibly Depression, stress, lack of sleep, alcohol, dementia,
concentration              essential fatty acids anaemia, hypothyroidism and many other diseases

Cardio-vascular    

Heart failure Vitamin B1 – thiamin and any deficiency Coronary, valvular and myocardial disease

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 causing anaemia

Palpitations Potassium and magnesium and any deficiency Coronary, valvular and myocardial disease
causing anaemia

Iron Deficiency

In iron deficiency, the amount of iron stored away for later use is reduced as indexed by a low serum ferritin
level, but has no effect on the iron needed to meet the daily needs of an individual. If the body requires
increased iron (due to a rapid growth spurt, for example), a person with inadequate stored iron has no
reserves to use. When the body lacks sufficient iron to make adequate hemoglobin, red blood cells cannot
transport adequate oxygen to tissues throughout the body. This can cause iron-deficiency anemia, an
advanced stage of iron deficiency. Iron is also critical for normal cardiac and skeletal muscle function and is
a key component of enzymes involved in the development of the brain. 
Iron is a micronutrient that is essential to the structure of every cell in the body, but particularly red blood
cells (hemoglobin), which transport oxygen in the blood to tissues in the body. In addition, iron is also a key
component in proteins in muscle tissue and is critical for the normal development of the central nervous
system. Iron deficiency is the most common form of malnutrition worldwide. A lack of iron in the diet results
in iron deficiency. The most commonly recognized condition associated with iron deficiency is anemia. Iron
is the most widespread nutritional deficiency worldwide is iron deficiency. Iron deficiency can lead
to anemia, a blood disorder that causes fatigue, weakness, and a variety of other symptoms.  In most
cases, iron deficiency is asymptomatic. However, children with severe anemia may display the following
symptoms:
 Fatigue and weakness
 Pale skin and hair loss
 Shortness of breath
 Headache and lightheadedness
 Cold hands and feet
 Inflammation or soreness of tongue
 Brittle or spoon-shaped nails
 Unusual cravings for non-nutritive substances such as ice, dirt, or pure starch (a condition known
as “pica”)

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  Poor appetite (especially in infants and children)
 Irritability
 Difficulty thinking
 Rapid heartbeat
Iron is an essential mineral and it is a main component of red blood cells, where it binds with hemoglobin
and transports oxygen to cells. There are actually two types of dietary iron:

 Heme iron: This type of iron is very well absorbed. It is only found in animal foods, and  red
meat contains particularly high amounts.
 Non-heme iron: This type of iron is more common, and is found in both animal and plant foods. It is
not absorbed as easily as heme iron.
The best dietary sources of heme iron include:
 Red meat: 3 ounces (85 g) of ground beef provides almost 30% of the RDI.
 Organ meat: One slice of liver (81 g) provides more than 50% of the RDI.
 Shellfish, such as clams, mussels and oysters: 3 ounces (85 g) of cooked oysters provide roughly
50% of the RDI.
 Canned sardines: One 3.75 ounce can (106 g) provides 34% of the RDI.
The best dietary sources of non-heme iron include:
 Beans: Half a cup of cooked kidney beans (3 ounces or 85 g) provides 33% of the RDI.
 Seeds, such as pumpkin, sesame and squash seeds: One ounce (28 g) of roasted pumpkin and
squash seeds provide 11% of the RDI.
 Broccoli, kale and spinach: One ounce (28 g) of fresh kale provides 5.5% of the RDI.

Risk Factors

The following can put children at risk for iron deficiency or anemia:
 Poor maternal health – especially a mother with iron deficiency anemia herself
 Blood loss in the stools due to intestinal parasites
 Inability to absorb iron
 Lack of iron in the diet
 Low birth weight

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  Bottle-feeding with formula not iron-fortified and drinking milk rather than formula in the first year
 Tea drinking
 Iodine Deficiency
Iron is rich in foods such as:
 Meats, poultry and fish
 Fortified cereals and oatmeal
 Legumes (e.g. soybeans and lentils)
 Leafy greens
 Seeds (e.g. sesame and pumpkin)

Treatment

Oral iron supplementation can be used for both prevention and treatment of iron deficiency anemia. Oral
iron supplements are usually best absorbed by an empty stomach. However, because iron can irritate a
child’s stomach, supplements may need to be taken with food. A source of vitamin C, like a citrus juice,
enhances iron absorption. It usually takes several months of iron supplementation to correct the iron
deficiency.

Calcium Deficiency

Calcium is one of several nutrients required for strong, healthy bones. However, it’s important to not overdo
it on calcium supplements. Calcium needs to be balanced with vitamin D, K2, and magnesium, or else it
can do more harm than good. Lack of balance between these nutrients is why calcium supplements have
become associated with increased risk of heart attack and stroke.

Calcium helps your body develop strong bones and teeth. It also helps your heart, nerves, and muscles
work the way they should. A calcium deficiency often doesn’t show symptoms right away, but it can lead to
serious health problems over time. If you aren’t consuming enough calcium, your body will use the calcium
from your bones instead, leading to bone loss.

Calcium deficiencies are related to low bone mass, weakening of bones due to osteoporosis, convulsions,
and abnormal heart rhythms. They can even be life-threatening. Postmenopausal women experience
greater bone loss due to changing hormones and have more trouble absorbing calcium. The best sources
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of calcium are dairy products such as milk, yogurt, cheese, calcium-set tofu, and small fish with bones.
Vegetables like kale and broccoli also have calcium, and many cereals and grains are calcium-fortified.

For example, if you have too much calcium and not enough magnesium, your muscles will tend to go into
spasm, and this has consequences for your heart in particular. Excessive amounts of calcium without
enough magnesium can lead to a heart attack and sudden death. You also need vitamin K2 to optimize
calcium’s benefit. The biological role of vitamin K2 is to remove calcium from areas where it shouldn’t be
(such as in your arteries and soft tissues), and shuttle it into the appropriate areas (such as your bones and
teeth). One of the best ways to achieve healthy bones is by consuming a diet rich in fresh, raw whole foods
that maximize natural minerals so that your body has the raw materials it needs to do what it was designed
to do. It's more likely your body can use calcium correctly if it's plant-derived calcium. Good sources include
raw milk from pasture-raised cows (who eat the plants), leafy green vegetables, the pith of citrus fruits,
carob, and wheatgrass, to name a few.

Vitamin A Deficiency
Vitamin A is an essential fat-soluble vitamin that is important for maintaining healthy skin, teeth, bones, cell
membranes, and vision. Vitamin A, like vitamin D, is also essential for your immune system. It’s a precursor
to active hormones that regulate the expression of your genes, and vitamin A and D work in tandem. For
example, there is evidence that without vitamin D, vitamin A can be ineffective or even toxic. But if you’re
deficient in vitamin A, vitamin D cannot function properly either, so a balance of these two vitamins is
essential.
Unfortunately, we do not yet know the optimal ratios between these two vitamins, which is why it’s best to
get them from food and sun exposure, rather than relying on supplements. It’s also important to understand
the difference between retinol and beta-carotene. Both are important forms of vitamin A, but it can be very
difficult to get sufficient amounts of vitamin A from beta-carotene alone. Unless your intestinal health is top
notch, and you eat your veggies with healthy fat, getting your vitamin A in the form of retinol from organic
animal products is your best bet, and here’s why:
 Retinol is preformed vitamin A, found in animal products such as grass-fed meat and poultry, liver,
fish, and raw organic dairy products like butter. This is the form of vitamin A your body can actually
use.

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  Beta-carotene is pre-vitamin A, found in plant foods like fruits and vegetables. In order for your
body to actually use beta-carotene, it must first convert it into retinol, and to do this, you need to
have a well-functioning digestive tract and sufficient bile produced by your gallbladder. Specific
enzymes are also needed to break down the carotene for the conversion into retinol to occur.

According to the WHO, a lack of vitamin A is the leading cause of preventable blindness in children.
Pregnant women who are deficient in vitamin A have higher maternal mortality rates as well. For newborn
babies, the best source of vitamin A is breast milk. For everyone else, it’s important to eat plenty of foods
that are high in vitamin A. These include:
 Eggs
 Green vegetables, such as kale, broccoli, and spinach
 Orange vegetables like carrots, sweet potatoes, and pumpkin
 Reddish yellow fruits, like apricots, papaya, and peaches
 Milk and butter
 Liver
 Fish (e.g. herring, sardines, and tuna)

Sources of beta-carotene include:

 Spinach
 Carrots
 Oranges
 Sweet potatoes
Other symptoms of vitamin A deficiency include:
 Dry eyes
 Eye inflammation
 Dry skin
 Dry hair
 Broken fingernails
 Decreased resistance to infections

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Risk Factors

 Low dietary intake of vitamin A, retinol and beta carotene

 Diet low in animal sources of pre-formed vitamin A
 Iron deficiency
 Vitamin B12 Deficiency

Treatment

The night blindness associated with vitamin A deficiency can be reversed with treatment. Total blindness,
however, cannot be treated. Treatment for vitamin A deficiency includes:
 Oral and injectable supplementation
 Food fortification
 Increasing consumption of vitamin A-rich foods, both animal and fruits and vegetables

Vitamin D Deficiency
Vitamin D deficiency can lead to abnormalities in bone development and a condition in children called
rickets.
Vitamin D is a fat-soluble vitamin naturally produced in the body. It is essential to the absorption of calcium
for proper bone development and function. Vitamin D is found in:
 Cod and cod liver oil
 Egg yolks
 Milk and butter
 Salmon and shrimp
 Fortified cereals

Vitamin D deficiency can cause rickets, a deficiency disease of infants and children in which bones are not
mineralized. In rickets, bones become soft and may bend, distort, and/or fracture. Rickets is one of the
most common childhood diseases in many developing countries. 
Foods with vitamin D include:
 fish liver oils
 fatty fish

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  mushrooms
 egg yolks
 liver

Children with Vitamin D Deficiency, or rickets, may present the following symptoms:
 Bone pain or tenderness
 Skeletal deformity, including bowed legs, windswept knees, boxy forehead, abnormal curvature of
the spine, and/or breastbone projection in the chest
 Dental problems, including defects in tooth structure, increased chance of cavities, poor enamel,
and delayed formation of teeth
 Increased tendency for fractures, especially greenstick fractures
 Poor growth in height or limbs
 Muscle spasms

Risk Factors

 Prolonged lack of direct exposure to sunlight

 Lack of Vitamin D and calcium in the diet

Treatment
Generally speaking, your best bet is to get your vitamin D level tested twice a year. Based on the
evaluation of healthy populations that get plenty of natural sun exposure, the optimal range for general
health appears to be somewhere between 50 and 70 ng/ml. As for how to optimize your vitamin D levels, I
firmly believe that sensible sun exposure is the best way, although vitamin D-rich foods and D3
supplements may also be necessary if you cannot get adequate sun exposure year-round.

Treatment of rickets involves:

 Vitamin D supplementation
 Increasing dietary intake of calcium, phosphates, and vitamin D
 Daily exposure to small amounts of sunlight (15 minutes/day for lighter skinned children; longer for
darker skinned children)
 Special braces to position the bones (severe cases)
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  Surgery (very severe skeletal deformities)

Vitamin B12 Deficiency

Vitamin B12 is a water-soluble vitamin that exists in several forms. Vitamin B12 is needed for proper red
blood cell formation and the maintenance of healthy nerve cells. It is also essential to making DNA, the
genetic material in cells. Vitamin B12 deficiency results from inadequate dietary intake or impaired
absorption. Vitamin B12 is found in fortified cereals and found naturally in foods that come from animals,
including fish. Vitamin B12 (cobalamin) is known as the energy vitamin. Your body requires it for a number
of vital functions, including energy production, blood formation, DNA synthesis, and myelin formation. The
two ways you become deficient are through a lack of vitamin B12 in your diet, or through your inability to
absorb it from the food you eat. Most oral supplements tend to be ineffective, as vitamin B12 is poorly
absorbed. Good sources of B12 include:
 Meat
 Poultry
 Eggs
 Milk and milk products
Vitamin B12 deficiency can be asymptomatic, but typical symptoms present can include:
 Fatigue and weakness
 Diarrhea
 Loss of appetite
 Pallor
 Sore mouth and tongue
 Shortness of breath
 Irritability and depression
 Sleep disturbances
 Psychosis
 Megaloblastic anemia

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Serious cases of vitamin B12 deficiency can cause damage to the nervous system, called subacute
combined degeneration of the spinal cord, with the following symptoms:
 Numbness and tingling of extremities
 Disturbed coordination
 Ataxic gait

Risk Factors

 Low dietary intake of vitamin B12

 Impaired absorption of vitamin B12
 Intestinal parasites such as tape worm or giardiasis
 Pernicious anemia
 Folate Deficiency

Treatment

Vitamin B12 deficiency can be treated by:

 Supplements: oral pills, under the tongue pills, liquid, nasal sprays, or injection
 Increased consumption of animal products

Vitamin E
Vitamin E is particularly important for your brain health, but it also helps support normal cholesterol levels,
and protect against free radical damage and the normal effects of aging. Recent animal research warns
that vitamin E deficiency may actually cause brain damage, while studies have also found that
supplementation with it may help delay the loss of cognitive function in people with Alzheimer’s disease.
You can tell what you're buying by carefully reading the label.
 Natural vitamin E is always listed as the "d-" form (d-alpha-tocopherol, d-beta-tocopherol, etc.)
 Synthetic vitamin E is listed as "dl-" forms
The best way to ensure that your body is getting the full spectrum of vitamin E, in a form your body can
beneficially use, is to make smart dietary choices. Good dietary sources of vitamin E include nuts, such as
hazelnuts, almonds, walnuts, and pecans; seeds such as sunflower seeds; olive oil; legumes; and green
vegetables, such as spinach and broccoli.

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General Treatment of Nutritional Deficiencies / Disorders

Treatment for a nutritional deficiency depends on the type and the severity of the deficiency. Your doctor
will find out how severe the deficiency is, as well as the likelihood of long-term problems caused by the lack
of nutrients. They may order further testing to see if there is any other damage before deciding on a
treatment plan. Symptoms usually fade when the correct diet is followed or supplemented. If you eat a
balanced, whole-food diet like the one described in my nutrition plan, you’re probably getting adequate of
the vitamins and minerals your body needs to function. If not (and this applies to the majority of the U.S.
population), there’s a good chance you may be lacking important nutrients.
Even if you do eat well, how and where your food was grown can also influence your nutritional intake. Soil
quality, storage time, and processing can significantly influence the levels of certain nutrients in your food.
Your age and certain health conditions (digestive issues and others) can also impact your body’s ability to
absorb the nutrients in your food. Unfortunately, in many cases nutrient deficiencies can be difficult to
assess, and you may not develop symptoms until the deficiency has become quite pronounced.

Dietary Changes

A doctor may advise you on how to change your eating habits in the case of a minor deficiency. For
example, anemia sufferers should include more meat, eggs, poultry, vegetables, and cereals. A doctor may
refer you to a dietitian if your deficiency is more severe. They may recommend keeping a food diary for a
few weeks. When you meet with the dietitian, you’ll go over the diary and identify changes you should
make. Typically, you will meet with the dietitian regularly. Eventually, you may have a blood test to confirm
that you’re no longer deficient.

NUTRIENT TOXICITIES

Excessive nutrients can lead to obesity. The nutrients you take in each day not only give you energy to
carry out your activities but also provide biological and chemical molecules to support your health.
Balancing your daily nutrients assures you have sufficient material to meet your needs but not so much it
negatively impacts your well-being. Excessive nutrients can, over time, lead to unwanted weight gain, affect
your metabolic processes and increase your risk of nutritional toxicities.

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Nutrients that do not supply calories to your diet can be dangerous if you take in too many of them. Fat-
soluble vitamins are especially prone to causing adverse effects because you store them in your adipose
tissue. Toxic levels of vitamin A, for example, can cause birth defects, while too much vitamin D can
increase your blood level of calcium and eventually cause calcium deposits in your soft tissues. Minerals
can also accumulate to toxic levels and cause problems. For instance, excess dietary calcium may lead to
kidney stones, and it affects the absorption of phosphorus, iron, zinc and magnesium. High sodium intake
can impact your cardiovascular system, too much copper can cause liver damage and excess manganese
can result in neurotoxicity.

Exceeding the government set tolerable upper limits can be a problem. "There is a reason for the tolerable
upper limits that needs to be respected. Research has shown at which levels nutrients can cause potential
problems, and these numbers take into account all sources of vitamins and minerals from food, fortified
food and supplements..

Water-Soluble Vitamins and Nutrients

Because water-soluble vitamins and nutrients dissolve in water, the continuous supply your body needs
calls for a steady daily intake, from the foods you eat, from the supplements you take, or from a
combination of foods and supplements. Vitamins C, B12, thiamin, niacin, riboflavin, tryptophan, pantothenic
acid, biotin, and folic acid are all classified in the water-soluble category.

Water-soluble nutrients work best when you get them in the proper amounts. When you eat or take more
than your body needs, the body adapts by absorbing just what it needs, and then it usually excretes the
excess in your urine -- but not always.

"Certain water-soluble vitamins in excess can cause problems, such as too much vitamin B6 can cause
nerve problems, too much niacin can cause flushing, and excess vitamin C can cause kidney stones,"
Frechman observes. Excess folic acid may also mask a vitamin B12 deficiency, which is more common in
people over age 50.

Fat-Soluble Vitamins

Vitamins A, D, E, and K are the fat-soluble vitamins. Unlike water-soluble vitamins, these vitamins dissolve
in fat and are stored in body tissues. Because they are stored, over time they can accumulate to dangerous

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levels and can lead to a condition called hyper-vitaminosis, meaning excess amounts of a vitamin in the
body, if more than the recommended amount is taken.

"Too much vitamin A, D, or K can lead to increased levels that are unhealthy and can cause health
consequences," says Frechman. She adds that too much vitamin A can lead to  birth defects, and too high
levels of vitamin E may increase the risk of hemorrhaging. Excess vitamin K can lessen or reverse the
effect of blood thinner medicines and prevent normal blood clotting.

Weight Gain

Maintaining your weight depends on both your food intake and your activity level. Taking in as many
calories as you burn allows you to stay at your current weight, but, if you routinely consume more calories
than you need, you will increase your body fat. Carbohydrates, proteins and fats all contribute calories to
your diet, with carbs providing your primary fuel source. However, once your energy needs are met, excess
carbohydrates can convert to fatty acids for storage in your adipose tissue. Your dietary proteins and fats
supply amino acids and fatty acids to your body, and, once the requirements for these nutrients are met,
the excess can also convert to fat tissue

Metabolism

Excessive protein intake can impact several aspects of your metabolism. For example, consuming greater
levels of this nutrient than your body needs can affect insulin sensitivity and potentially increase the risk of
developing diabetes. High dietary protein is contraindicated if you have kidney disorders, and it may be
associated with the onset of renal cancer. It may also cause calcium to be leached into your urine, affecting
bone health, or predispose you to metabolic acidosis. In this condition, your body’s protein synthesis
decreases while protein breakdown accelerates. Gout is another condition associated with excessive
protein intake and exacerbated by alcohol intake.

Hyponatremia

Water can be an overlooked nutrient, yet it is essential for your body to function properly. Although taking in
too little water can cause dehydration and even life-threatening effects, overloading on water can be
equally damaging. Hyponatremia is a condition in which your tissues are flooded with so much water it
dilutes the sodium surrounding your cells. In its mild form it can cause headache, muscle cramps and
fainting, but the condition can rapidly escalate, leading to seizures, brain damage and even death

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The Risks of Fortified Foods Combined With Supplements

Fortified foods are another way people get additional nutrients. Historically, fortified foods were the way
Americans filled some nutrient voids. Public health concerns over nutrient deficiencies led to production
practices like adding iodine to salt, grains enriched with B vitamins and iron, and milk fortified with vitamins
A and D.

But the combination of whole foods, supplements, and fortified foods raises safety concerns with experts.
Eating fortified foods while also taking supplements can cause a person's diet to exceed safe upper levels
and potentially lead to a toxic buildup.

DIET AND CHRONIC DISEASES / DISORDERS

1. OBESITY
Obesity is a serious and rising health epidemic in the world over, and it is estimated that in the US alone,
nearly 93 million Americans are affected by obesity and that number is predicted to climb to 120 million
within the next five years.
The definition of obesity varies depending on what one reads. Generally speaking, overweight and obesity
indicate a weight greater than what is considered healthy. Obesity is a chronic condition defined by an
excess amount of body fat. A certain amount of body fat is necessary for storing energy, heat
insulation, shock absorption, and other functions.
Another school of thought defines ‘Obesity’ as a condition that is associated with having excess of body fat,
defined by genetic and environmental factors that are difficult to control when dieting.

Another school states that ‘Obesity’ means having too much body fat. It is different from being overweight,
which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both
terms mean that a person's weight is greater than what's considered healthy for his or her height. Obesity
occurs over time when you eat more calories than you use. The balance between calories-in and calories-
out differs for each person. Factors that might affect your weight include your genetic makeup, overeating,
eating high-fat foods, and not being physically active. Being obese increases your risk of diabetes, heart
disease, stroke, arthritis, and some cancers. If you are obese, losing even 5 to 10 percent of your weight
can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh
200 pounds.

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Classification of Obesity
There are various classifications of obesity. You may have heard various terms such as “severe obesity” or
also “childhood obesity,” readily used by physicians and the public.
a. What is Severe Obesity?
A person is classified as being severely obesity when their Body Mass (BMI) is greater than 40, or they
are more than 100 pounds over their ideal body weight. Additionally, individuals who have a BMI of
35 or greater with an existing co-severeity (i.e. diabetes, hypertension, etc.) are also classified as
severely obese. Severe obesity has many of the same causes and some similar risks as obesity,
but you will find that they differ mostly with treatment strategies. There are an estimated 9 million
Americans who are affected by severe obesity in our country.

b. How Severe Obesity is Measured

Like, obesity, severe obesity is most commonly calculated using BMI. BMI is a measurement used
to indicate obesity and severe obesity in adults. BMI is calculated by dividing a person’s weight in
kilograms by his or her height in meters squared. An adult with a BMI of 40 or greater is considered
obese. Additionally, an individual is considered severely obese with a BMI of 35 or greater, with an
existing co-severeity. Once you find your measurement, you will want to find your weight
classification that is accompanied on the BMI chart or calculator. Knowing your BMI is a good
starting point in addressing your weight. If you find you are in an unhealthy range, you will want to
talk with your doctor to address this issue.There is not a separate BMI chart used for men and
women. Both sexes use the same chart to measure obesity. In addition, the same classifications of
obesity apply to both men and women.

c. Risks Associated with Severe Obesity

Many obesity-related conditions accompany severe obesity. Once an individual is considered
severely obese, these conditions become serious health risks. These obesity-related conditions
also negatively impact the quality of life for individuals and their family members affected by severe
obesity. The most common severe obesity-related diseases include:High Blood Pressure, High
cholesterol, Diabetes, Heart disease, Stroke, Gallbladder disease, Osteoarthritis, Sleep apnea and
respiratory problems, Some cancers (endometrial, breast, and colon)

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 d. Causes of Severe Obesity
Severe obesity is a complex issue and has many causes. It is a serious disease that needs to be
prevented and treated. Like obesity, the causes of severe obesity are widespread, but target three
main contributors: behavior, environment and genetics.

Prevalent Health Conditions / Risks Associated with Obesity?

The most prevalent obesity-related diseases or conditions include:
 Insulin Resistance
 Type 2 Diabetes
 High blood pressure
 High cholesterol
 Heart disease / Heart Attack and Congestive Heart failure
 Stroke
 Gallbladder disease
 Osteoarthritis
 Sleep apnea and respiratory problems
 Some cancers (endometrial, breast, and colon)

 Insulin Resistance - Insulin is necessary for the transport of blood glucose (sugar) into the cells of
muscle and fat (which is then used for energy). By transporting glucose into cells, insulin keeps the
blood glucose levels in the normal range. Insulin resistance (IR) is the condition whereby the
effectiveness of insulin in transporting glucose (sugar) into cells is diminished. Fat cells are more
insulin resistant than muscle cells; therefore, one important cause of insulin resistance is
obesity. The pancreas initially responds to insulin resistance by producing more insulin. As long as
the pancreas can produce enough insulin to overcome this resistance, blood glucose levels remain
normal. This insulin resistance state (characterized by normal blood glucose levels and high insulin
levels) can last for years. Once the pancreas can no longer keep up with producing high levels of
insulin, blood glucose levels begin to rise, resulting in type 2 diabetes,thus insulin resistance is a
pre-diabetes condition.

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 Type 2 (Adult-Onset) Diabetes - The risk of type 2 diabetesincreases with the degree and duration
of obesity. Type 2 diabetesis associated with central obesity; a person with central obesity has
excess fat around his/her waist, so that the body is shaped like an apple.Diabetes is a life-long
disease marked by high levels of sugar in the blood. It can be caused by too little insulin (a
hormone produced by the pancreas to regulate blood sugar), resistance to insulin, or both. Among
those diagnosed with type 2 (non insulin-dependent) diabetes, 67 percent have a BMI greater than
27 and 46 percent have a BMI greater than 30. Nearly 17 million people in the U.S. have type 2
diabetes, accounting for more than 90 percent of diabetes cases. An additional 20 million have
impaired glucose tolerance, sometimes called pre-diabetes, which is a strong risk factor for
developing diabetes later in life. An estimated 70 percent of diabetes risk in the U.S. can be
attributed to excess weight.

 High Blood Pressure (Hypertension) - Hypertension is common among obese adults. A Norwegian
study showed that weight gained increased blood pressure in women more significantly than in
men. Blood pressure is measured in millimeters of mercury (mm Hg). Hypertension (high blood
pressure) is when your blood pressure frequently goes over 140/90 mm Hg. About 1 in every 5
adults in the U.S. has high blood pressure. High blood pressure occurs more often in men than in
women. In addition, African Americans are affected almost twice as much as Caucasians. The
prevalence of hypertension in overweight U.S. adults is 22.1 percent for men with a BMI greater
than 25 and less than 27; 27.0 percent for men with a BMI greater than 27 and less than 30; 27.7
percent for women with a BMI greater than 25 and less than 27; and 32.7 percent for women with a
BMI greater than 27 and less than 30.

 High Cholesterol (hypercholesterolemia) - Lipid disorders are when you have excess fatty
substances in your blood. These substances include cholesterol and triglycerides. Having a lipid
disorder makes you more likely to develop arteriosclerosis and heart disease. The prevalence of
high blood cholesterol (greater than 240 mg/dL) in overweight U.S. adults is 19.1 percent for men
with a BMI greater than 25 and less than 27; 21.6 percent for men with a BMI greater than 27 and
less than 30; 30.5 percent for women with a BMI greater than 25 and less than 27; and 29.6
percent for women with a BMI greater than 27 and less than 30.

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 Stroke (cerebrovascular accident or CVA) - A stroke occurs when a blood vessel (artery) that
supplies blood to the brain bursts or is blocked by a blood clot. Within minutes, the nerve cells in
that area of the brain are damaged, and they may die within a few hours. As a result, the part of the
body controlled by the damaged section of the brain cannot function properly.

 Heart Attack -Heart disease is any disorder that affects the heart’s ability to function normally. The
most common cause of heart disease is narrowing or blockage of the coronary arteries, which
supply blood to the heart. A prospective study found that the risk of developing coronary artery
disease increased three to four times in women who had a BMI greater than 29. A Finnish study
showed that for every 1 kilogram (2.2 pounds) increase in body weight, the risk of death from
coronary artery disease increased by 1%. In patients who have already had a heart attack, obesity
is associated with an increased likelihood of a second heart attack.

 Congestive Heart Failure – heart attack / heart failure

 Cancer. Obesity has also been linked to cancer of the colon in men and women, cancer of the
rectum and prostate in men, and cancer of the gallbladder and uterus in women. Obesity may also
be associated with breast cancer, particularly in postmenopausal women. Fat tissue is important in
the production of estrogen, and prolonged exposure to high levels of estrogen increases the risk
of breast cancer. Obesity is a major health crisis in our country. There are several obesity-related
health conditions that are associated with obesity. These conditions often lead to a decreased
quality of health and life of those affected. Below you will find a list of obesity-related conditions. It
is important to talk with your doctor about these conditions.
Cancer involves the uncontrolled growth of abnormal cells that have mutated from normal tissues.

 Gallbladder Disease: Gallbladder disease includes inflammation, infection, stones, or obstruction of

the gallbladder.

 Heartburn: Heartburn is a painful burning sensation in the esophagus, just below the breastbone.
The pain often rises in your chest and may radiate to your neck or throat. The relationship between

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 heartburn and obesity is not quite clear, but can be linked to frequent heart burning sensation from
congestion, indigestion, poor metabolism and other related factors.

 Osteoarthritis: Osteoarthritis is a chronic disease causing deterioration of the joint cartilage (the
softer parts of bones which cushion their connections to each other) and formation of new bone
(bone spurs) at the margins of the joints.

 Psychological Depression: Depression may be described as feeling sad, blue, unhappy, miserable,
or down in the dumps. Most of us feel this way at one time or another for short periods. True
clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration
interfere with everyday life for an extended time.

 Sleep Apnea: Sleep apnea is a condition characterized by episodes of stopped breathing during
sleep. For more information on sleep apnea, click here.

Causes of Obesity / Factors that Influence Obesity?

There are many causes that directly and indirectly contribute to obesity. Behavior, environment and
genetics are among the main contributors to obesity. The Centers for Disease Control has identified these
three as the main causes to the complexity of the obesity epidemic. On the other hand, the balance
between calorie intake and energy expenditure determines a person's weight. If a person eats more
calories than he or she burns (metabolizes), the person gains weight (the body will store the excess energy
as fat). If a person eats fewer calories than he or she metabolizes, he or she will lose weight. Therefore the
most common causes of obesity are overeating and physical inactivity . Ultimately, body weight is the result
of genetics, metabolism, environment, behavior, and culture.
Other Factors Associated With Obesity?
 Ethnicity - Ethnicity factors may influence the age of onset and the rapidity of weight gain. African-
American women and Hispanic women tend to experience weight gain earlier in life than
Caucasians and Asians, and age-adjusted obesity rates are higher in these groups. Non-Hispanic
black men and Hispanic men have a higher obesity rate then non-Hispanic white men, but the
difference in prevalence is significantly less than in women.

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  Childhood Weight -. A person's weight during childhood, the teenage years, and early adulthood
may also influence the development of adult obesity. For example,
 being mildly overweight in the early 20s was linked to a substantial incidence of obesity by age
35;
 being overweight during older childhood is highly predictive of adult obesity, especially if a
parent is also obese;
 being overweight during the teenage years is even a greater predictor of adult obesity.
 Hormones - Women tend to gain weight especially during certain events such
as pregnancy, menopause, and in some cases, with the use of oral contraceptives. However, with
the availability of the lower-dose estrogen pills, weight gain has not been as great a risk.
The following two methods are simple and straightforward:
 Skin Calipers - This method measures the skinfold thickness of the layer of fat just under the skin
in several parts of the body with calipers (a metal tool similar to forceps); the results are then used
to calculate the percentage of body fat.
 Bioelectric Impedance Analysis (BIA) - There are two methods of the BIA. One involves standing
on a special scale with footpads. A harmless amount of electrical current is sent through the body,
and then percentage of body fat is calculated. The other type of BIA involves electrodes that are
typically placed on a wrist and an ankle and on the back of the right hand and on the top of the
foot. The change in voltage between the electrodes is measured. The person's body fat percentage
is then calculated from the results of the BIA. Early on, this method showed variable results. Newer
equipment and methods of analysis seem to have improved this method. Health clubs and weight-
loss centers often use the skin caliper or bioelectric impedance analysis method; however, these
can yield inaccurate results if an inexperienced person performs them or they are used on
someone with significant obesity.

What About Weight-For-Height Tables?

Measuring a person's body fat percentage can be difficult, so other methods are often relied upon to
diagnose obesity. Two widely used methods are weight-for-height tables and body mass index (BMI). While
both measurements have their limitations, they are reasonable indicators that someone may have a weight
problem. The calculations are easy, and no special equipment is required.

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What Is The Body Mass Index (BMI)?
BMI
BMI is a measurement used to indicate obesity and morbid obesity in adults. BMI is calculated by dividing a
person’s weight in kilograms by his or her height in meters squared. An adult with a BMI of 30 or greater is
considered obese. BMI is a number calculated by dividing a person’s weight in kilograms by his or her
height in meters squared. BMI is used in determining obesity. Below, enter the correct information in the
fields to calculate your BMI. A BMI chart is also provided to determine the correct classification. Remember,
there is no perfect method to measuring weight status. It is important to talk with a healthcare professional
about your weight. Once you find your measurement, you will want to find your weight classification that is
accompanied on the BMI chart or calculator. Knowing your BMI is a good starting point in addressing your
weight. If you find you are in an unhealthy range, you will want to talk with your doctor to address this issue.
There is not a separate BMI chart used for men and women. Both sexes use the same chart to measure
obesity. In addition, the same classifications of obesity apply to both men and women.

The body mass index (BMI) is a now the measurement of choice for many physicians and researchers
studying obesity. The BMI uses a mathematical formula that accounts for both a person's weight and
height. The BMI measurement, however, poses some of the same problems as the weight-for-height
tables. Not everyone agrees on the cutoff points for "healthy" versus "unhealthy" BMI ranges. BMI also
does not provide information on a person's percentage of body fat. However, like the weight-for-height
table, BMI is a useful general guideline and is a good estimator of body fat for most adults 19 and 70 years
of age. However, it may not be an accurate measurement of body fat for bodybuilders, certain athletes, and
pregnant women.

The BMI equals a person's weight in kilograms divided by height in meters squared (BMI = kg/m 2). To
calculate the BMI using pounds, divide the weight in pounds by the height in inches squared and multiply
the result by 703.
It is important to understand what "healthy weight" means. Healthy weight is defined as a body mass index
(BMI) equal to or greater than 19 and less than 25 among all people 20 years of age or over. Generally,
obesity is defined as a body mass index (BMI) equal to or greater than 30, which approximates 30 pounds
of excess weight.

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 The World Health Organization uses a classification system using the BMI to define overweight and
obesity.
 A BMI of 25 to 29.9 is defined as a "pre-obese."
 A BMI of 30 to 34.99 is defined as "obese class I."
 A BMI of 35 to 39.99 is defined as "obese class II."
 A BMI of or greater than 40.00 is defined as "obese class III."

The table below has already done the math and metric conversions. To use the table, find the appropriate
height in the left-hand column. Move across the row to the given weight. The number at the top of the
column is the BMI for that height and weight.

BMI (kg/m2) 19 20 21 22 23 24 25 26 27 28 29 30 35 40
Height (in.) Weight (lb.)
58 91 96 100 105 110 115 119 124 129 134 138 143 167 191
59 94 99 104 109 114 119 124 128 133 138 143 148 173 198
60 97 102 107 112 118 123 128 133 138 143 148 153 179 204
61 100 106 111 116 122 127 132 137 143 148 153 158 185 211
62 104 109 115 120 126 131 136 142 147 153 158 164 191 218
63 107 113 118 124 130 135 141 146 152 158 163 169 197 225
64 110 116 122 128 134 140 145 151 157 163 169 174 204 232
65 114 120 126 132 138 144 150 156 162 168 174 180 210 240
66 118 124 130 136 142 148 155 161 167 173 179 186 216 247
67 121 127 134 140 146 153 159 166 172 178 185 191 223 255
68 125 131 138 144 151 158 164 171 177 184 190 197 230 262
69 128 135 142 149 155 162 169 176 182 189 196 203 236 270
70 132 139 146 153 160 167 174 181 188 195 202 207 243 278
71 136 143 150 157 165 172 179 186 193 200 208 215 250 286
72 140 147 154 162 169 177 184 191 199 206 213 221 258 294
73 144 151 159 166 174 182 189 197 204 212 219 227 265 302
74 148 155 163 171 179 186 194 202 210 218 225 233 272 311
75 152 160 168 176 184 192 200 208 216 224 232 240 279 319
76 156 164 172 180 189 197 205 213 221 230 238 246 287 328

Table Courtesy of the National Institutes of Health

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Below is a table identifying the risk of associated disease according to BMI and waist size.

Disease Risk* Relative to Normal Weight and Waist Circumference

Men 102cm (40 in) or Men > 102cm
BMI (kg/m2) Obesity Class Less Women 88cm (40 in)Women > 88cm
(35 in) or less (35 in)
Underweight < 18.5
Normal weight 18.5 - 24.9
Overweight 25.0 - 29.9 Increased High
Obesity 30.0 - 34.9 I High Very High
Obesity 35.0 - 39.9 II Very High Very High
Extreme Obesity 40.0 + III Extremely High Extremely High
* Disease risk for type 2 diabetes, hypertension, and CVD.

Dietary carbohydrates are not the problem in obesity. In some Asian cultures, for example, where
carbohydrate foods such as rice are the predominant food, people are relatively thin and heart disease and
diabetes rates are lower than they are in Western cultures. With OBESITY, what matters in weight control
is the ratio of food energy (calories) consumed to energy expended, over time.

Height-weight tables as a reference for healthy weights have been supplanted by the parameter known as
the body mass index (BMI). The BMI estimates total body fat, although it is less sensitive than using a

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skinfold caliper or other method to measure body fat indirectly. The BMI is defined as weight in kilograms
divided by the square of the height in metres: weight ÷ height 2 = BMI. In 1997 the WHO recommended
international adoption of the definition of a healthy BMI for adult women and men as between 18.5 and
24.9. A BMI lower than 18.5 is considered underweight, while a BMI of 25 to 29.9 denotes overweight and
30 or higher indicates obesity. Definitions of overweight and obesity are more difficult to quantify for
children, whose BMI changes with age.

Waist Circumference
Waist circumference is a less-common method used to measure obesity in an individual. This simple
measurement indicates obesity and morbid obesity in adults by measuring your waist. To find your waist
circumference, wrap a tape measure around the area above your hip bone and below your rib cage.
For females, a waist circumference of 35 inches or greater is considered unhealthy. For men, a waist
circumference of 40 inches or greater is considered unhealthy. There is not a classification chart or various
ranges used with this method to determine obesity. Only the simple thresholds for men and women noted
above apply.
Treatment and Management of Obesity
A healthful eating plan for gradual weight loss in adults will likely contain about 1,200 to 1,500 kilocalories
(kcal) per day, probably accompanied by a balanced vitamin and mineral supplement. A desirable weight
loss is about one pound per week from fat stores (as opposed to lean tissue), which requires an energy
deficit of 3,500 kcal, or about 500 kcal per day. Consuming less than 1,000 kcal per day is not
recommended; a preferred approach would be to increase physical activity, which has the added benefit of
helping to maintain lean tissue. Individuals who are severely obese and unable to lose weight may, after
medical consultation, consider weight-loss medications that suppress appetite or decrease nutrient
absorption or even surgery to reduce the volume of the stomach or bypass it altogether. Carbohydrate-
restricted diets, very-low-fat diets, and novelty diets—those in which one food or food group is emphasized
—may result in weight loss but generally fail to establish the good dietary and exercise practices necessary
to maintain the desired weight, and weight is often regained shortly after the diet is stopped.

Prevention and Risk Factors

 Screening for and Determine Management of Obesity in Adults
 Aim For a Healthy Weight 

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  Balance Food and Activity 

Treatments and Therapies

 How Are Overweight and Obesity Treated?
 Weight Control
 Weight Loss Surgery

What To Do About Obesity

However, it is important to note that treating severe obesity often takes a more aggressive approach, which
includes bariatric surgery.
Behavior Modification and Physical Activity
As discussed above, behavior plays a large role in obesity. Modifying those behaviors that may have
contributed to developing obesity is one way to treat the disease. A few suggested behavior modifiers
include:
  Changing eating habits
  Increasing physical activity
  Becoming educated about the body and how to nourish it appropriately
  Engaging in a support group or extra curricular activity
  Setting realistic weight management goals
Commercial Programs - Participating in a non-clinical program or commercially operated programs is
another form of treatment for obesity. Some programs may be commercially operated, such as a privately
owned weight-loss chain. Counselors, books, Web sites or support groups are all ways you can be involved
in a non-clinical weight-loss program.
Physician-Supervised Weight-loss - Physician-supervised weight-loss programs provide treatment in a
clinical setting with a licensed healthcare professional, such as a medical doctor, nurse, registered dietitian
and/or psychologist. These programs typically offer services such as nutrition education, pharmacotherapy,
physical activity and behavioral therapy.
Commercial Programs - Participating in a non-clinical program or commercially operated program is
another form of treatment for severe obesity. Some programs may be commercially operated, such as a
privately owned weight-loss chain. Counselors, books, Web sites or support groups are all ways you can be
involved in a non-clinical weight-loss program.

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Bariatric Surgery - Bariatric surgery is a treatment for severe obesity and should be reserved as the last
resort. There are various surgical options to choose from when considering bariatric surgery. In order to
qualify for surgery, individuals must have a BMI of 40 or greater, or a BMI more than 35 and an existing
weight-related co-severeity, such as diabetes or hypertension. Deciding if surgery is right for you, as well as
choosing which surgical option is best for you is a decision to be made by you and your doctor. 
2. DIABETES MELLITUS and METABOLIC DISORDERS
Diabetes mellitus is a group of metabolic disorders of carbohydrate metabolism characterized by high blood
glucose levels (hyperglycemia) and usually resulting from insufficient production of the
hormone insulin (type 1 diabetes) or an ineffective response of cells to insulin (type 2 diabetes). Secreted
by the pancreas, insulin is required to transport blood glucose (sugar) into cells. Diabetes is an important
risk factor for cardiovascular disease, as well as a leading cause of adult blindness. Other long-term
complications include kidney failure, nerve damage, and lower limb amputation due to impaired circulation.
Type 1 diabetes (formerly known as juvenile-onset or insulin-dependent diabetes) can occur at any age but
often begins in late childhood with the pancreas failing to secrete adequate amounts of insulin. Type 1
diabetes has a strong genetic link, but most cases are the result of an autoimmune disorder, possibly set
off by a viral infection, foreign protein, or environmental toxin. Although elevated blood sugar is an
important feature of diabetes, sugar or carbohydrate in the diet is not the cause of the disease. Type 1
diabetes is managed by injections of insulin, along with small, regularly spaced meals and snacks that
spread glucose intake throughout the day and minimize fluctuations in blood glucose.

Type 2 diabetes (formerly known as adult-onset or non-insulin-dependent diabetes) is the more common

type of diabetes, constituting 90 to 95 percent of cases. With this condition, insulin resistance renders cells
unable to admit glucose, which then accumulates in the blood. Although type 2 diabetes generally starts in
middle age, it is increasingly reported in childhood, especially in obese children. Genetic susceptibility to
this form of diabetes may not be expressed unless a person has excess body fat, especially abdominal
obesity. Weight loss often helps to normalize blood glucose regulation, and oral antidiabetic agents may
also be used. Lifestyle intervention (e.g., diet and exercise) is highly effective in delaying or preventing type
2 diabetes in high-risk individuals.

Migration studies have shown that urbanization and adoption of a Western diet and habits can dramatically
increase the rate of type 2 diabetes. For example, a high prevalence of the disorder is seen in

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the Pima Indians of Arizona, who are sedentary and eat a high-fat diet, whereas prevalence is low in a
closely related group of Pimas living a traditional lifestyle—physically active, with lower body weight and a
diet that is lower in fat—in a remote, mountainous region of Mexico. Type 2 diabetes is a serious health
problem among Native Americans and other ethnic minorities in the United States. Worldwide, the
prevalence of type 2 diabetes has increased sharply, along with the rise in obesity.

Specific treatment plans for diabetics are designed after individual medical assessment and consultation
with a registered dietitian or qualified nutrition professional. The therapeutic diet, which has changed
considerably over the years, focuses on complex carbohydrates, dietary fibre (particularly the soluble type),
and regulated proportions of carbohydrate, protein, and fat. Because heart disease is the leading cause of
death among diabetics, saturated fatty acids and trans-fatty acids are also restricted, and physical activity
and weight control are strongly encouraged. Older dietary recommendations restricted sugar in the diabetic
diet, but recent guidelines allow a moderate intake of sugars, so long as other carbohydrates are reduced
in the same meal. Diet and exercise are also used to manage a condition known as gestational diabetes,
which develops in a small percentage of pregnant women and usually resolves itself after delivery, though
such women are subsequently at increased risk of developing type 2 diabetes.

3. TOOTH DECAY

Dental caries (tooth decay) is an oral infectious disease in which bacteria, primarily Streptococcus mutans,

in the dental plaque metabolize simple sugars and other fermentable carbohydrates into acids that dissolve
tooth enamel. Dental plaque (not to be confused with the lipid-containing plaque found in arteries) is a
mass of bacteria and sticky polymers that shield the tooth from saliva and the tongue, thereby facilitating
decay. All dietary forms of sugar, including honey, molasses, brown sugar, and corn syrup, can cause tooth
decay; fermentable carbohydrates in crackers, breads, cereals, and other grain products, as well as milk,
fruits, and fruit juices, also have cariogenic (decay-causing) potential. Eating sugary or starchy foods
between meals, especially sticky foods that stay on the teeth longer, increases the time that teeth are
exposed to destructive acids. Artificial sweeteners are not cariogenic, and xylitol, a sugar alcohol used in
some chewing gums, is even cariostatic, i.e., it reduces new tooth decay by inhibiting plaque and
suppressing decay-causing bacteria. Putting an infant to sleep with a bottle, especially one containing juice
or other sweetened beverages, milk, or infant formula can lead to a condition called “baby bottle tooth
decay.”

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4. HEARTBURN and PEPTIC ULCER

When gastric contents, containing hydrochloric acid, flow backward from the stomach, the lining of the
esophagus becomes inflamed, leading to the burning sensation known as heartburn. Occasional heartburn
(also known as acid indigestion) is a common occurrence, typically precipitated by eating certain foods.
However, some people experience heartburn regularly, a condition known as gastroesophageal reflux
disease (GERD). Individuals with GERD are advised to limit their intake of alcohol and caffeine, which relax
the lower esophageal sphincter and actually promote reflux, as well as their intake of fat, which delays
gastric emptying. Chocolate, citrus fruit and juices, tomatoes and tomato products, spearmint and
peppermint oils, and certain spices may aggravate heartburn, but these foods do not appear to cause the
condition.

5. BOWEL CONDITIONS and DISEASES

Constipation, a condition characterized by the difficult passage of relatively dry, hardened feces, may arise
from insufficient dietary fibre (roughage) or other dietary factors, such as taking calcium or iron
supplements, in addition to daily routines that preclude relaxation. Straining during defecation can also
contribute to diverticulosis, small outpouchings in the colonic wall, which may become inflamed
(diverticulitis) and present serious complications. Another possible consequence of straining is
hemorrhoids, swollen veins of the rectum and anus that typically lead to pain, itching, and
bleeding. Constipation can usually be treated by eating high-fibre foods such as whole-grain breads and
cereals, drinking sufficient amounts of water, and engaging in regular exercise. By drawing water into
the large intestine (colon), fibre—especially the insoluble type—helps form a soft, bulky stool. Eating dried
fruits such as prunes, which contain a natural laxative substance (dihydroxyphenylisatin) as well as being
high in fibre, also helps stimulate the bowels. Although laxatives or enemas may be helpful, frequent use
may upset fluid, mineral, and electrolyte (salt) balances and interfere with vitamin absorption. Any
persistent change in bowel habits should be evaluated by a physician.

In contrast to constipation, diarrhea—loose, watery stools, and possibly an increased frequency of bowel

movements—can be a cause for immediate concern. Acute diarrhea of bacterial origin is relatively common
and often self-limiting. Other common causes of acute diarrhea include viral infections, parasites, food
intolerances or allergies, medications, medical or surgical treatments, and even stress. Regardless of

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cause, drinking fluids is important for treating a temporary bout of diarrhea. However, if severe and
persisting, diarrhea can lead to potentially dangerous dehydration and electrolyte imbalances and requires
urgent medical attention, especially in infants and children. Prolonged vomiting presents similar risks.

Disease Prevention and Treatment

Chronic diseases — such as heart disease, stroke, cancer, diabetes and arthritis — are the leading causes
of death and disability in the U.S., according to the Centers for Disease Control and Prevention. Poor
nutrition is one of the four modifiable health risk behaviors responsible for chronic disease development
and severity.

Prevention is the most effective, affordable way to reduce risk for and severity of chronic disease. The
Department of Health and Human Services' National Prevention and Health Promotion Strategy is based
on four pillars of prevention: building healthy and safe communities; expanding quality preventive services
in both clinical and community settings; empowering people to make healthy choices; and eliminating
health disparities. Our members are leaders in delivering preventive services.
As secondary and tertiary prevention, medical nutrition therapy is an effective disease management
strategy that lessens risks from chronic disease, slows disease progression and reduces symptoms. Cost-
effective interventions that produce a change in personal health practices are likely to lead to substantial
reductions in the incidence and severity of the leading causes of disease in the U.S.

Academy members are committed to improving the health of racial and ethnic populations through effective
nutrition policies and programs that eliminate health disparities. Racial and ethnic minorities are in poorer
health, suffer worse health outcomes, and have higher morbidity and mortality rates. Through Academy
members' research, teaching and community outreach to provide nutrition services, the disparity margin
can be narrowed.

EATING DISORDERS and STARVATION

EATING DISORDERS
Eating disorders such as anorexia nervosa and bulimia nervosa are serious health problems reflecting an
undue concern with body weight. Girls and young women are most vulnerable to the pressures of society to
be thin, although boys and men can also fall prey to these disorders, which have lifelong consequences

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and can even be fatal. The incidence of eating disorders has risen during the last 50 years, particularly in
the United States and western Europe.

Anorexia nervosa is characterized by low body weight, propensity for drastic undereating, intense fear of
gaining weight or becoming fat (despite being underweight), and a distorted body image. Consequences
include impaired immunity, anemia, and diminished digestive function. Without intervention, a state of semi-
starvation similar to marasmus may occur, requiring hospitalization and even force-feeding to prevent
death. Treatment usually requires a coordinated approach, with the participation of a physician,
psychiatrist, dietitian, and possibly other health professionals.

Bulimia nervosa is thought to be more prevalent than anorexia nervosa, and both disorders may even occur
in the same person. In bulimia nervosa recurrent episodes of “binge eating” are followed by a form of
purging, such as self-induced vomiting, fasting, excessive exercise, or the use of laxatives, enemas, or
diuretics. Treatment usually involves a structured eating plan. Young athletes often restrict energy intakes
to meet weight guidelines and body-image expectations of their sport. Females are most affected, but male
athletes, such as gymnasts, wrestlers, boxers, and jockeys, are also vulnerable. Intense training among
young female athletes, coupled with food energy restriction, often results in amenorrhea (failure to
menstruate for at least three consecutive months) and bone loss similar to that at menopause. Calcium
supplementation may be required.
NUTRITION STARVATION
Starvation, widespread or generalized atrophy (wasting away) of body tissues either because food is
unavailable or because it cannot be taken in or properly absorbed. See nutrition.

FOOD-DRUG INTERACTION
Drugs may interfere with or enhance the utilization of nutrients, sometimes leading to imbalances. A
common example is the increased loss of potassium that results from the use of certain diuretics to treat
high blood pressure. Nutrient absorption can also be affected by drugs that change the acidity of the
gastrointestinal tract, alter digestive function, or actually bind to nutrients. For example, regular use of
laxatives, antacids, or mineral oil can reduce nutrient absorption and over time may lead to deficiency.
Elderly individuals who take multiple medicines are particularly at risk of impaired nutritional status.

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On the other hand, foods can alter drug absorption or interact with drugs in undesirable ways, resulting in
drug ineffectiveness or toxicity. For example, protein and vitamin B 6 interfere with the effectiveness of
levodopa, used to treat Parkinson disease. Tyramine, an amino-acid derivative found in certain aged
cheeses and red wines, may cause hypertension in individuals being treated for depression with
monoamine oxidase (MAO) inhibitors. Grapefruit juice contains unique substances that can block the
breakdown of some drugs, thereby affecting their absorption and effectiveness. These drugs include certain
cholesterol-lowering statins, calcium channel blockers, anticonvulsant agents, estrogen, antihistamines,
protease inhibitors, immune-suppressants, antifungal drugs, and psychiatric medications. Eating grapefruit
or drinking grapefruit juice within a few hours or even a few days of taking these medications could result in
unintended consequences.
Vitamin and mineral supplements and herbal products can also interact with medicines. For example, one
or more of the supplemental antioxidants studied—vitamin C, vitamin E, beta-carotene, and selenium—may
blunt the effectiveness of certain drugs (e.g., high-dose niacin, when used in combination with statins) in
raising HDL cholesterol levels and improving cardiovascular health. Also, the herbal supplement  St. John’s
wort can alter the metabolism of drugs such as protease inhibitors, anticlotting drugs, and antidepressants,
and it can reduce the effectiveness of oral contraceptives.

FOOD ALLERGIES and INTOLERANCES

A true food allergy involves an abnormal immunologic response to an otherwise harmless food component,
usually a protein. In the case of antibody-mediated (immediate hypersensitivity) food allergies, within
minutes or hours of exposure to the allergen, the body produces specific immunoglobulin E antibodies and
releases chemical mediators such as histamine, resulting in gastrointestinal, skin, or respiratory symptoms
ranging from mild to life-threatening. Much less common are cell-mediated (delayed hypersensitivity) food
allergies, in which a localized inflammatory process and other symptoms may not start for up to a day.
Adverse food reactions that do not involve the immune system, aside from foodborne infection or
poisoning, are called food intolerances or sensitivities. Most common of these is lactose intolerance, which
is a genetically determined deficiency of the enzyme lactase that is needed to digest the milk sugar,
lactose.

Milk allergy and lactose intolerance are distinct conditions that are often confused. Only about 1 percent of
the population has a true allergy to the protein in cow’s milk. Milk allergy is found most often in infants,

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whose immune and digestive systems are immature. On the other hand, much of the world’s population,
except those of northern European descent, is to some degree lactose intolerant after early childhood.
Undigested lactose reaching the large intestine can cause abdominal discomfort, flatulence, and diarrhea.
Lactose-intolerant individuals can often handle with little or no discomfort small quantities of dairy products,
especially yogurt or other milk products containing the bacterium Lactobacillus acidophilus; alternatives are
the use of lactose-hydrolyzed milk products or lactase tablets or drops, which convert lactose to simple,
digestible sugars.

Celiac disease (also known as celiac sprue, non-tropical sprue, or gluten-sensitive enteropathy) is a

hereditary disorder in which consumption of wheat gluten and related proteins from rye and barley is not
tolerated. Recent studies indicate that oats may be safe if not contaminated with wheat. Celiac disease,
which may be a type of cell-mediated food allergy, affects primarily individuals of European descent and
rarely those of African or Asian descent. It is characterized by inflammatory damage to the mucosal cells
lining the small intestine, leading to malabsorption of nutrients and such symptoms as diarrhea, fatigue,
weight loss, bone pain, and neurological disturbances. Multiple nutritional deficiencies may ensue and, in
children, growth is impaired. The disorder is often associated with autoimmune conditions, particularly
autoimmune thyroid disease and type 1 diabetes. Although celiac disease can be life-threatening if
untreated, patients can recover if gluten is eliminated from the diet.

Other adverse reactions to foods or beverages may be drug effects, such as those caused by caffeine or
alcohol. Certain foods, such as ripened cheese, chocolate, red wine, and even ice cream, trigger
headaches in some individuals. Food additives that can cause reactions in susceptible people include
sulfite preservatives, used in some wines, dried fruits, and dried potato products; nitrate and nitrite
preservatives, used in processed meats; certain food colorants, particularly tartrazine (also known as FD&C
Yellow #5); and the flavor enhancer monosodium glutamate (MSG). Some adverse reactions to food are
purely psychological and do not occur when the food is served in a disguised form.

Nearly any food has allergenic potential, but foods that most commonly cause antibody-mediated allergic
reactions are cow’s milk, eggs, wheat, fish, shellfish, soybeans, peanuts, and tree nuts (such as almonds,
walnuts, and cashews). Depending on processing methods, edible oils and other products derived from

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these foods may still contain allergenic protein residues. Severely allergic people may react to extremely
small amounts of an offending food, even inhaled vapours.

Studies differ significantly as to the percentage of adults and children who have true food allergies.
However, most seem to agree that few adults (about 2 to 5 percent) and slightly more children (roughly 3 to
8 percent) are affected. Most children outgrow food allergies, particularly if the offending food is avoided for
a year or two. However, food allergies can develop at any time, and some allergies, such as those to
peanuts, tree nuts, and shellfish, may be lifelong. Common symptoms of antibody-mediated food allergy
include tightening of the throat, swelling of the lips or tongue, itchy lips, wheezing, difficulty breathing,
headache, nasal congestion, skin rash (eczema), hives, nausea, vomiting, stomach cramps, diarrhea and,
in severe cases, life-threatening anaphylactic shock. People susceptible to anaphylaxis are advised to carry
a syringe loaded with epinephrine at all times and to seek emergency medical care if an allergic reaction
begins.

Food allergies are often hard to document, even by physicians trained in allergy and immunology. Blood
tests for antibodies to specific allergens, skin tests, and even an elimination diet, in which suspect foods are
eliminated from the diet and then added back one at a time, may not be definitive. The most conclusive
diagnostic test is a so-called double-blind food challenge, in which neither doctor nor patient knows whether
a suspect food or a harmless placebo is being given; however, these controlled clinical tests are expensive
and time-consuming.

Labels are important for identifying hidden ingredients in packaged foods, although they are often imprecise
and cannot be relied on naively. For example, even if a product is labeled as nondairy, a listing of casein,
caseinate, or whey indicates the presence of milk protein. Peanuts may be found in unlikely foods, such as
chili, stew, processed meats, oils, flours, cream substitutes, and desserts.

TOXINS IN FOODS
Edible skins of fruits and vegetables are rich in vitamins, minerals, and fibre; however,  pesticide residues
and other environmental contaminants are typically more plentiful in the outer layers of these foods.
Pesticides also tend to accumulate in the fat and skin of animals. Intake of toxic substances is reduced by

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consuming a wide variety of foods; washing fruits and vegetables carefully; and trimming fat from meat and
poultry and removing skin from poultry and fish. Even organic produce requires thorough washing: it may
not have synthetic chemicals, but mold, rot, fecal matter or other natural substances can contaminate it at
any point from field to market. Peeling helps reduce these unwanted chemicals and microbes, although
valuable nutrients will be lost as well.

A greenish tinge on potatoes, although merely the harmless substance chlorophyll, indicates that the
natural toxicant solanine may be present. Solanine builds up when a potato is handled roughly, exposed to
light or extremes of temperature, or is old. Symptoms of solanine poisoning include diarrhea, cramps, and
headache, although many damaged potatoes would have to be eaten to cause serious illness. Peeling
away green areas or removing sprouts or the entire skin (despite its high nutrient content) reduces solanine
intake.

Swordfish and shark, as well as tuna steaks, may contain high levels of methylmercury (which remains
after cooking) and should be avoided by pregnant women. Nonbacterial toxins in seafood include
scombrotoxin (histamine) in spoiled fish, which can result in a severe allergic reaction when
eaten; dinoflagellates(microscopic algae), associated with the so-called red tide, which can cause paralytic
shellfish poisoning when consumed; and ciguatera, found in certain warm-water reef fish.( See also fish
poisoning; shellfish poisoning.)

Natural toxins in some species of mushrooms cause symptoms ranging from gastrointestinal upset to
neurological effects, even hallucinations. Most mushroom fatalities are due to consumption of amatoxins
in Amanita phalloides, the mushroom species known as the death cap, which, if not lethal, can cause
lasting liver and kidney damage. As there are no antidotes for mushroom poisoning, and identification of
mushroom species by inexperienced mushroom pickers is often imprecise, consumption of wild
mushrooms is not advised.

YOUR DAILY FOOD CHOICES MAKE A BIG DIFFERENCE IN YOUR HEALTH

Your food choices each day affect your health — how you feel today, tomorrow, and in the future. Every
good food and liquid contains some important nutrition that your organs and tissues need to properly work
effectively. Without good nutrition, your body is more prone to disease, infection, fatigue, and poor

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performance. Children with a poor diet run the risk of growth and developmental problems and poor
academic performance. Without good nutrition, you don’t have good health, and without your health, you
don’t have a life.
The term nutrition comes from the Latin word nutrire, meaning “to nourish.”  Nutrition could be define as
the sum of all processes involved in how organisms obtain nutrients, metabolize them, how the body
breaks food down (catabolism) and repairs and creates cells and tissue (anabolism). Health on the other
hand as define by World Health Organization (WHO) in 1946, “is a state of complete physical, mental, and
social well-being and not merely the absence of disease or infirmity”. The earlier a person starts to eat a
healthy and balanced diet, the more likelihood to stay healthy.
Good nutrition provides energy: Foods such as carbohydrates give energy to function properly throughout
the day. In fact, muscle glycogen is an important element to helping you maintain your energy levels
throughout your day. Glycogen (stored carbohydrates) is important to have in your body before working out.
They will be an energy supply and not only enable you to achieve better fat loss results, but also help your
overall physique.
Good nutrition provides the building blocks of muscle: When you eat foods that contain protein, they are
broken down in the body as amino acids. These amino acids are then used to build and repair any muscle
tissue. This means you will be able to recover at a faster rate than if you were not to consume protein.
Every tissue in your body is made up of protein and it is important to consume enough through your diet to
replenish it. Protein is also needed to help your immune and nervous system.
Improve endurance: The right nutrients needs that supply the body heighten endurance. This is especially
important if you are an athlete or your hobbies are physical in nature, but even casual fitness buffs should
care about endurance. The more you are able to do the better you feel. When you can push yourself longer
and harder during a workout you will experience greater benefits. Proper nutrition makes exercise as
beneficial as possible.

Build Immunity: Eating right makes you stronger in terms of fitness, but it also strengthen other things about
your body like the ability to fight off illness. When you have a nourished body it is better able to defend itself
against sickness. Good nutrition improves your immunity, so you suffer from fewer minor illnesses.
Disease Prevention: Obesity is not the only nutrition-related cause of disease onset and progression. Too
much or too little of certain nutrients can also contribute to health issues. For instance, a lack of calcium in
your diet can predispose you to developing osteoporosis, or weakening of your bones, while too much

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saturated fat can cause cardiovascular disease, and too few fruits and vegetables in your nutrition plan is
associated with an increased incidence of cancer.
Decreased risk of heart disease and diabetes: Diets that are high in saturated fats and processed foods
can lead to being overweight, which increases a person’s risk for getting type II diabetes and heart disease.
By increasing the amount of healthy fats and decreasing unhealthy fats and processed foods, the body is
better able to regulate its blood sugar levels and weight is reduced, which decreases the risk factors for
developing certain obesity related diseases.
Helps you combat existing disease: In addition to the minor ailments you avoid when you are eating right,
you are also able to ward off serious diseases that have yet to occur, and manage those from which you
currently suffer. Nutrition helps you improve your immunity and gives you the strength to battle your current
ailments and recover from illness or injury. Some research has shown a vegetarian diet is helpful for those
battling fibromyalgia (chronic pain, stiffness and tenderness of muscles, tendons and joints).
Blood Sugar Control: Sugary foods cause spikes in your blood sugar. If you consume too many sugary
foods like white breads and concentrated fruit juices, over time you can develop Type 2 diabetes.
Heart Health: High-fat foods cause high cholesterol and a buildup of plaque in your arteries. It’s a known
fact that this can lead to stroke, heart attack or heart disease. Eat healthy fats, like those found in nuts to
get the fat you need without the plaque buildup.
Deceased Cancer Risk: Fruits and vegetables are full of antioxidants that help neutralize the damaging
cells known as free radicals. Free radicals are highly unstable and can lead to cancerous cells. Antioxidants
create a stable cell environment.

Improved health and wellness: Swapping unhealthy foods for healthy foods can improve your health and
wellness by increasing the strength of your bones and teeth, improving your energy levels and mental
clarity, decreasing your weight, improving your sleep and reducing your risk for high blood pressure and
diabetes.
Healthy bones and teeth: Calcium and Vitamin D are needed to maintain healthy bones and teeth. Calcium
is what helps build and regenerate bones and teeth, while Vitamin D is needed in order to help the body
absorb the calcium. Both of these nutrients can be gotten by consuming low-fat milk and dairy products and
consuming dark green leafy vegetables.
Weight control and reduction: A diet that is full of fruits, vegetables, lean proteins and whole grains can help
you lose, maintain or control your weight. The fiber in fruits, vegetables and whole grains will keep you

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fuller for longer while proteins will provide you with cellular support. In addition to the quality of the foods
you consume, the quantity matters when considering good eating habits. Taking in the same number of
calories as you burn ensures your weight remains steady over time. Consuming more than you burn, on the
other hand, results in weight gain as your body converts extra calories to fat tissue. A healthy meal plan
without excess calories helps you not only feel better but can prolong your life.
Improved Sleep: Individuals often report better sleep once they’ve improved their diets. This is due to
consuming higher-quality foods that require less filtering by the body to remove toxins.
Increases cognitive function and mental clarity: One of the first benefits of a healthy diet is increased
energy and mental clarity. This is because the body is finally getting all the macro and micronutrients it
needs to function properly and rejuvenate it on a cellular level. Research shows children who eat healthy
perform better in school. The entire public school meals program is built around this premise. A starving
brain is incapable of learning, while a well-fed brain exposed to proper nutrition performs at optimum levels.
Improves quality of life: Overall, good nutrition is the key to a happy, healthy life. When you feed your body
well it responds well. Improving your diet might not solve all of the problems you face in life, but it will surely
make you better able to deal with those problems and leading a healthy lifestyle. Improve your well-being,
Satisfy hunger, satiety, sensorial quest, sense of love; caring, sharing and enjoyment of a healthy diet can
also be one of the great cultural pleasures of life.

Homeostasis: Water is important for life and is necessary every day. A person needs about eight cups of
fluid per day. When it is very hot, while working, sweating or suffering from diarrhoea, vomiting or fever, a
person needs to drink even more to replace the water that has been lost. Nutrients also aid in the regulation
of bodily processes, like blood pressure and digestion.

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