PUBLIC HEALTH NUTRTION THE CONCEPT OF HEALTH

Public Health – the science and art of preventing disease,  The World Health Organization (WHO) defines HEALTH
prolonging life, and promoting health through organized as a state of complete physical, mental, and social well-
community. being, not merely the absence of disease.
 “Ecological viewpoint”
Public Health Nutrition – theory and practice of nutrition;  “anatomic integrity”
approach focuses on promotion of nutrition.  Ability to perform personally valued family, work and
community roles.
Public Health Nutrition Program – planned nutrition activity in  Ability to deal with physical, biological, and social stress.
the community.

Community – a group of people who are in a particular space, Determinants of Health

shared values, interact within social system. 1. Biology (sex, race, age, other hereditary factors)
2. Lifestyle (PA, diet, hobbies, use of drugs, religion, SP,
Policy – a course of action chosen by public authorities to medcare, stress mgnt)
address the problem. 3. Living, Working, and Social Conditions (housing,
education, occ, incm, soc net, soc econ stat)
Programs – instruments used by community nutritionist. 4. Community conditions (climate and geo, water suppl,
health, med, soc serv, political/gov)
Epidemiology- study of disease distribution within the 5. Background conditions (national foo, nut policy, national
population. min wage, cul belfs, Cul val, adv, media msgs, food dis
sys).
Nutritional epidemiology- application of epidemiological
techniques to understanding causes of disease in population.
NATURE OF PUBLIC HEALTH
 Charles Edwars Winslow, American bacteriologist,
proponent of PH, define health as the science and the art
of preventing disease, prolonging life, promote physical
health and efficiency through organized community
efforts of sanitation of the environment.
 Nutrition as a science is objective.
 PHN gives emphasis to disease prevention and promote
well-being.
  Community-based approach enable programs/interven o If not effective, drug therapy can recommend
to reach large number of people. o Strategies are aimed at self-care for people w/
 Individuals and communities in environments need to be chronic disease
healthy.
 Health care is basic to health.  Tertiary Prevention (TP): Treatment and Rehabilitation
 PHN is thought of as “going upstream’. o Involves treatment and rehab, reduced amount of
 PHNP are cooperative social efforts. ↑ disability caused by disease
o Includes diabetes, kidney, angina
o Prevent further disability, any secondary
PREVENTION STRATEGIES IN PUBLIC HEALTH conditions that may result from health problems
3 LEVELS: o Ex: MNT for renal patient, Nut ed (vitamins & min
 Primary Prevention (PP): Health Promotion suppl), feeding strat to prev HIV/AIDS, cardiac
o Strategies is encourage individuals, families and rehab (diet exercise, stress mngnt)
communities ways to reduce risk factors with o Goal: restore indv through rehab to an “optimal”
disease and injury. level.
o Methds: provide info to public, reach consumers
daily to promote nut intervention, provide CORE FUNCTIONS OF PUBLIC HEALTH
motivation for food services to serve ↓ fat, cal, Na.  Assessment, Policy Development and Assurance
To endorse more complete food and nut labeling.  Ten essential PH services identified by US Institute of
o Ex: Nut & weight mangt classes in comm center Med
for adults, environmental changes to provide nut 1. Monitor health status to identify com health prob.
choices in school caf vend machine. Campaigns to 2. Diagnose & investigate health prob and hazrds in
↑ avail of fruits and veg from farmer markets. com.
3. Inform, educate & empower people about health
 Secondary Prevention (SP): Risk Appraisal and Risk issues.
reduction 4. Mobilize com partnership to identify and solve
o Risk appraisal and screening to emphasize early health prob.
detection and diag of disease. 5. Develop policies and plans
o Begins where patho may occur 6. Enforce laws and regulation to ensure safety
o Encompasses diagnostic services (screening, 7. Link people to needed personal health services
surveillance, clinical) (Adults: over 65, disabilities, diab)
o For people w/ cholesterol introduce to therapeutic 8. Assure competent ph and personal healthcare
lifestyle changes workplace
 9. Evaluate effectiveness, accesbility and quality of  Identify key nutrition related problem
personal and population based health services  Set goal
10. Research for new insights and inov solutns to  Define objective goals
health problems.  Create quantitive
 Develop program
Three Public Health approaches  Implement program
1) Socio-ecological approach  Evaluate program
 Upstream approach
2) Lifestyle approach ROLES OF PUBLIC HEALTH NUTRITIONIST OR COMMUNITY
 Disease prevention or midstream approach WORKER
3) Biological Approach 1. Assessor of people’s nutrition and nutrition related
 Downstream or medical problems
2. Community organizer
Community Nutrition – is broader and encompasses any 3. Program planner
nut program which targets community, regardless it is 4. Program implementer
funded by gov or priv group 5. Community/group facilitator
Public Health- refers to community-based programs 6. Informer, educator, communicator
conducted by government agency. 7. Researcher
Nutrition epidemiology supports PHN, provides 8. Mediator
scientific basis for development of evidence on which ph 9. Program administrator
action can be implemented. 10. Program evaluator
o Goal: to inform PHN a population approach to 11. User of research and information
prevent illness and promote health through
nutrition. KNOWLEDGE AND SKILLS :
Health Promotion define as any process enables indv or Policy, Planning and administration
comm to increase control over determinants of their Biostatistics (collecting, compiling, analyzing, reporting)
health. Epidemiology (understand health and disease)
o Building healthy public policy Environment science (understand biological and chemical)
o Create supportive environment Research skills, Management, Communication, Education
o Dev personal skills of the public
o Reorienting health serv
o Strengthening community actions National Nutrition Policies
 Guided by results of food and health surveys, give
THE PUBLIC HEALTH NUTRITION CYCLE information on distribution of foodstuff.
  Exogenous factors- from outside (natural environment,
Methods of Acquiring Information man-made, behavioral)
1. Nutrition Assessment - measurement of indicators of  Endogenous factors- from within (values, beliefs,
dietary status. attitudes, and knowledge)
2. Nutrition Monitoring – assessment of dietary at
intermittent times, detect changes in dietary. MALNUTRITION PROBLEMS IN PHILIPPINES
3. Nutrition surveillance- continuous assessment of 1. PROTEIN-ENERGY MALNUTRITION (PEM)/ PROTEIN-
nutritional status ENERGY UNDERNUTRITION (PEU)
4. Nutrition screening- system identifies specific  Lack of protein and energy in diet
individuals for nutrition or public health intervention.  Common in infancy/childhood and elderly
 ET: Primary (inadequate food intake)
Secondary (low food ingestion, inadeq nut abs,
MALNUTRITION ↑nut req, ↑ nut losses)
 Lack or absolute deficiency or excess of essential o Poverty, Ignorance, Social problems, Cul and
nutrients. Social Practices, Biological, Environmental.
 Forms of Malnutrition: o Metabolic disruptions – caused by severe nutrient
1. Undernutrition- inadequate quantity of food, deficit complications or inadeq treatment.
micronutrient deficiency.
o Types: growth failure, wasting or edema, Clinical Forms of Acute Malnutrition
stunting, micronutrient deficiency  Marasmus or Wasting
2. Overnutrition- excessive quantity of food o “skin and bones” appearance
3. Specific deficiency- results from relative lack or absolute o Thin “old man” face
deficiency of an individual nutrient. o Front view: ribs easily seen, skin upper arms lose
4. Imbalance- disproportion among essential nutrients and thighs
 Acute Malnutrition (wasting or weight loss) Back view: ribs and shoulder is seen, flesh missing
 Chronic Malnutrition (stunting) from buttocks “baggy pants”
o Class: Moderate acute malnutrition (MAM)
Severe acute malnutrition (SAM)
Body measurements: (MUAC & Weight-for-
Height)

ECOLOGY OF MALNUTRITION
 Ecology- relationship of man to his environment or
factors influence man in what he does.