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INTRODUCTION TO NUTRITION AND DIETETICS

5.1 Course Purpose

This course is intended to enable the trainee understand basic terminologies

used in the course and to gain more insight into the course

5.2 Expected outcomes

a) To be able to define various common terms that shall be used

throughout thecourse
b) To appreciate the evolution of nutrition and dietetics as a profession
c) To understand nutrition as a science
d) To gain knowledge about the roles of a nutritionist/dietician in the community

5.3 Content

Introduction: definition of terms e.g. Nutrition, nutritional status, nutrients,

RDAs, RDIs, serving, nutrition screening, invalid, convalescents etc,
History of nutrition and dietetics; Importance of nutrition and dietetics; An
introduction to dietetics as profession: educational requirements and career
opportunities-( clinical, community, sports, administrator, industrial
nutrition); orientation to the field of dietetics; role, responsibilities and
relationships within the professions; and interrelations with other health
professionals; Standards and ethics of professional conduct among
dieticians; modern dietetic practice; Skill and competencies in modern
dietetics; Opportunities for interaction with dietetics practitioners will be
offered; Relationship between nutrition and other fields; Roles of nutritionist
and dietitian, their similarities and differences; common nutrition problem
in the developing

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INTRODUCTION
Definition of terms
a) Nutrition:- this is the science of food, the nutrients and other substances
therein, their action, interaction and balance in relation to health and
disease, and the processes by which the organism ingests, digests, absorbs,
transports, utilizes and excretes food substances.
b) Dietetics:- combined science and art of regulating the planning, preparing
and serving of meals to individuals or groups under various conditions of
health and disease according to the principles of nutrition and management,
with due consideration for economic, social, cultural and psychological
factors. The science consists of knowledge of nutrition, food and the dietary
constituents needed in different states of health and disease.
c) Nutrients: - any chemical substances needed by the body for one or more
of the following functions: to provide heat or energy, to build and repair
tissues and regulate lifeprocesses.
d) Diet:- the usual foods and drinks regularly consumed. Diet can be used to
assess the nutrition status of a person. There are two types of diet
a. Normal diet: - this is the diet that supplies all the nutritional needs of
a normal, healthy individuals, with due consideration for age, sex,
activity and physiologicalneeds.
b. Therapeutic diet: - diet that is manipulated or modified to suit a
certain disease condition. Examples include low carbohydrate diet,
sodium free diet, high proteindiet, low fat diet etc.
e) Nutritional status: - status of the body resulting from the consumption and
utilization of nutrients. Clinical observations, biochemical analyses,
anthropometric measurements and dietary studies are used to determine this
state.
f) Nutritional deficiency: - condition of the body that may arise as a result of
lack of one or more nutrients in the diet or breakdown of one or more of the
bodily processes concernedwith nutrient utilization.
g) Nutrition screening: - process of identifying clinical characteristics known
to be associated with malnutrition in order to
h) identify persons at risk and plan appropriate nutrition therapy.
i) Nutrition assessment: - this is a comprehensive process of identifying and
evaluating thenutritional needs of a person using appropriate, measurable
methods.
j) Recommended daily allowances (RDA):- these are levels of intake of
essential nutrientsthat are adequate to meet the nutrient needs of practically
all healthy persons.
k) Reference daily intake: - the standard value for protein, vitamins and
minerals used innutrition labeling.
l) Invalids; - a person made weak or disabled by illness or injury
m) Convalescents; - a person who is recovering from an illness or medical
treatment

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n) Food; - this is any nutritious substance that people or animals eat or drink
or that plantsabsorb in order to maintain life and growth.

What is food?
Food consists of edible materials such as meat, breathe d and vegetables; it may

be raw (like fresh fruit, or cooked, processed or semi-processed. Food is a nutritious

substance eaten by us to maintain our vital life processes. It is a fundamental need,

a basic right and a prerequisite to good health. Food can be described in a number of

different ways. Here are some terms you will find useful:

Perishable food: food items that have a short storage life and will become spoiled

or contaminated if not preserved and handled properly, e.g. meat, eggs, milk, fruits,

vegetables and the like.

Non-perishable food: foods which are not easily spoiled or contaminated, e.g.

sugar and cereals. Wholesome food: food which is sound, clean and free from

harmful ingredients – it is suitablefor human consumption.

IMPORTANCE OF FOOD

1. Food for energy, growth and development

Food is needed to provide energy for movement, work and maintaining vital

functions of the body, e.g. the heart needs energy to circulate blood in our body.

Food is needed to repair and replace our body cells.

2. Social function of food

Food has always served an important function in the social interactions between

people. In Kenya many social occasions are centred on food. During the many

holidays, families prepare particular foods and drinks to celebrate the occasion.

Food is also served at social events such as weddings and funerals. On all of these

occasions, food indirectly serves as an instrument to develop social bonds and

relationships.

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3. Psychological function of food

In addition to nourishing the body and filling a need in our social life, Food satisfies

certain emotional needs. People who travel to or live in a new land often find

adjusting to the unfamiliar food and food customs a serious problem; they feel

anguish and a longing for their customary food. Food can also be used to express

feelings for example; the giving of food is a sign of friendship. Serving favourite

foods is an expression of special attention and recognition, and the withholding of

wanted foods can be a means of punishment.

Whatever the occasion or purpose for serving and eating food, special attention

must be paid to its handling at all stages to attain a good sanitary quality; otherwise

it could turn out to be a source of illness and dissatisfaction.

HISTORY OF NUTRITION AND DIETETICS

All recorded history shows that food has played an extraordinarily vital role in the
rise and growth or the fall and decline of nations because of its effect on health and
efficiency.
Since earliest times food have been considered in the light of both cause and cure of
disease, and few stories are more fascinating than the gradual evolution of the science
of nutrition from the maze of sage philosophy, countless fads and superstitions which
have grown up through the centuries.
Medical literature from the time of Hippocrates has been replete with advice for the
use of food in disease and as a measure to prevent disease. There was little true
understanding of what happened to food in the body until the science of physiology
explained the processes of digestion, circulation and respiration. On the other hand,
the careful observations of many people gradually led to much information which
proved to be fairly sound.
History of nutrition can be explained in three eras.

ROLES OF NUTRITIONIST AND DIETICIAN

Nutritionist is a professional who teaches or applies the science of nutrition for the
improvementof health and control of disease.

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Roles of nutritionist
1. Help us understand the function of foods, which supply our nutritional and
physiological need.
2. Know how to select foods to meet our need for nutrients from available
foods or basic food groups.
3. Educate understand the composition of food and the changes that occur
during preparation, so that these changes can be controlled to prepare
acceptable food productsto meet our body’s needs.
4. Help to learn the methods of food preparation which blend acceptability
with retention ofnutrients.
5. Play an important role in many areas of health care. They work closely with
patients, clients and a range of health care professionals to determine the
best possible nutrition program for individuals, group and communities.
6. They help plan a healthy diet that can help prevent disease.
7. Promotion of capacity building for adopting healthy eating habits and
healthy lifestyleand prevention of diet-related chronic diseases.
8. Together with communities, identify, plan, implement, monitor and
evaluate communitynutrition and health program
9. Do health and nutrition education and promotion.

Dietician
A professional who have an extensive knowledge about foods and human nutrition
and are uniquely qualified to provide medical nutrition therapy. Is a specialist who
translates the physician written order into practically in terms of foods, nutritional
products and formulas.
Roles
1. A dietician assess evaluates the patient nutritional status, formulate the
nutritional care plans and designs individualized meal patterns according
to patient food habits andtherapeutic need
2. Recommends appropriate formulas for enteral feeding and counsel patients
and family regarding any dietary modification mainly at the point of
discharge.
3. He also advices on nutritional effect on drug therapy due to the drug
interaction

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4. Evaluates patient response to the diet.

BRANCHES OF NUTRITION AS A SCIENCE

a. Clinical nutrition
Deals with the study of the relationship between food and a healthy body.
Morespecifically, it is the science of nutrients and how they are digested,
absorbed, transported, metabolized, stored and eliminated by the body.
Besides studying how food works in the body, nutritionist are interested in
how environment affects the quality and safety of foods and what influence
these factors have on health and disease. They Plan meals for hospital
patients and others who have special dietary needs.
b. Community nutrition
Involved in maintaining optimum nutritional health of the whole population
and high risk or vulnerable subgroups within the population. Emphasizes
health promotion and disease prevention but may include therapeutic and
rehabilitative services when these needs are not adequately addressed by
other parts of the health care system. Is often used to reflect the wide range
of delivery settings and sponsoring organizations for nutritional related
programs and services. Community nutrition services tend to be directed
to individualand groups in the community.
c. Research nutrition
It performs scientific research on food and human nutrition and work in
universities, medical research centers and food manufacturing plants.
d. Sport nutrition
It is a relatively new area of study involving the application of nutritional
principles to enhance sport performance
It is the application of eating strategies to promote good health and
adaption to training, to recover quickly after each exercise training session
and to perform optimally during competition.
e. Food science/ industrial nutrition
Applied science devoted to the study of food. It is the discipline in which
the engineering, biological and physical sciences are used to study the nature
of foods, the causes of deterioration, the principle underlying food
processing and the improvement of foods for the consuming public.

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The activities include the development of new food products, design of

processes to produce these foods, choice of packaging material, shelf-life
studies, and sensory evaluation of the product with panel or potential
consumers as well as microbiological and chemical testing.
FACTORS AFFECTING HUMAN DIETARY REQUIREMENTS
1. Age
Children have a higher metabolic rate than adults and so require more
energy and also need to eat the correct amount and type of food to support
growth.

2. Sex
Men require more energy, hence calories, because they have a higher
metabolic rate than women due to their relatively greater muscle mass.
Women require more iron than men to replenish their iron store due to the
loss during menstruation.
3. Pregnancy and Lactation
A woman who is pregnant or breastfeeding has different nutrition
requirement to that of one who is not. This is to support both the mother and
the baby hence their nutritional requirement increases.
4. Physiological status( state of health/illness)
Nutrition requirement vary depending on whether someone is healthy or ill.
Some illnesses require increase of specific nutrients and others requires
reduction of nutrients. For example a burn patient requires an increase in
protein.
5. Activity level
An athlete will need a different nutrition requirement to that of an office
worker. Exercise improves metabolic efficiency and hence increases nutrient
requirement.

FACTORS AFFECTING HUMAN DIETARY CHOICE

1. Money
The amount of money one has will affect the type of food that he or she will
buy.
2. Availability of food
One can only be able to buy or eat foods that are in season.

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3. Personal lifestyle
A person can choose what to eat depending on his or her lifestyle. For
example there are some people who do not consume meat that is they are
vegetarians because of their lifestyle.
4. Time
Time factor is an important consideration when it comes to food
preparation. A person who is very busy will tend to choose foods that are
easy to prepare and that cook faster.
5. Nutrition knowledge

If one has nutrition knowledge he or she will choose food that provides the
recommended daily allowance compared to someone who does not have this
knowledge and will only take food to feel satisfy.

PRINCIPLES AND GUIDELINES OF PLANNIG A HEALTHY DIET

1. Adequacy- the diet provides sufficient energy and nutrients enough to
meet the energyrequirements of an individual
2. Balance- consuming enough food of each type
3. Kilocalorie control- amount of energy obtained from food should be
balanced with theamount of energy required in the body to sustain its
metabolic and physical activity.
4. Nutrient density-select foods that deliver most nutrients for the least food
energy.
5. Moderation- consuming in moderation foods that are rich in fats and sugar
but with lownutrient value.
6. Variety- select foods from each food group and vary choices within each
food group.

NUTRIENTS
A nutrient is any chemical substance needed by the body for one or more of
the followingfunctions:-
• To provide heat/energy
• To build and repair tissues
• Regulate life processes.
Nutrients can be grouped as macronutrients or micronutrients. Macronutrients are
needed in the body in a relatively large amount and these include carbohydrates,

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proteins, fats and oil, fibres and water. Micronutrients are needed in a less amount
in the body. They include minerals and vitamins.
CARBOHYDRATES
Contain carbon, hydrogen and oxygen. It is identified as starch and sugar. It is an
essential nutrient provided entirely by plant food. It is the major source of energy
for the body and dietary fibre.
Storage forms of carbohydrates
In wheat rice and potatoes it is stored inform of starch while in the sweet pea,
banana and fruits its stored in form of sugar. In green maize it is stored as sugar and
in dry maize as starch. In green banana it is stored as starch while in ripe bananas
as sugars.

Carbohydrates are divided into saccharides: Monosaccharide and disaccharides are

known as simple sugars. Polysaccharides are simple sugar. Natural occurring
monosaccharides include glucose, fructose and galactose.
Glucose is the most important major source of energy for the tissues and central
nervous system. It is the only form of carbohydrate that is freely transported in the
blood thus known as blood sugar.
Hypoglycemic is a condition of having less glucose in the blood. Hyperglycemic is
a condition of having more glucose in the body.

FIBRE
This is a portion of a plant that resists digestion thus remain undigested in the
intestine. Dietary fibre is divided into soluble and insoluble.
a. Soluble fibre

Dissolve in water to form a gel which slows the rate at which food passes
the large intestine thus increasing absorption. It also bits cholesterol from
bile preventing its reabsorption and circulation in the blood thus lowering
the cholesterol level. It is found infruits, grain and legumes.
b. Insoluble fibre
Found in vegetables, wheat and brand. It tends to absorb water and increases
in bulk contributing to the volume of stool. This helps to maintain
gastrointestinal movement keeping food moving in the gastrointestinal truct

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hence preventing constipation, colon cancer and weakening of intestinal

wall hence preventing diverticulosis.
Sources of carbohydrates
1. Cereals and grains e.g. maize, rice and wheat.
2. Roots and tubers e.g. potatoes and cassava
3. Sugars and sugary foods.
Functions of carbohydrates
• It is the least expensive source of energy with glucose as the main source.
• They spare protein, because in absence of carbohydrates protein is changed
into energy.
• They spare the body by providing the energy
• They are source of sweetness. They make food palatable increasing food
intake.
• Source of dietary fibre.
Carbohydrate loading
An adult man stores about 340 grams of glucose which is enough to last for about
half a day. However by manipulating diet, association with exercise the capacity
can be increased a procedure known as carbohydrate loading. In certain disease
conditions the energy requirement increases above normal. Carbohydrate loading
therefore can be used to meet the increased energy requirement.
Effects of carbohydrate free diet
• Rapid lose of body weight
• Inability of the body to prevent protein breakdown to provide energy
leading to furtherweight lose
• Blocking the uses of fats as a source of energy.
• Accumulation of incomplete products of fats metabolism leading to
ketosis caused byketone bodies.

PROTEIN
Protein is made up of carbon, hydrogen, oxygen and nitrogen which is the key thing
and radicalwhich can either be a sulphur or phosphorus.
Protein can be divided into:-
• Protein of high biological value (first class protein). This include protein
from animalsources and soya bean
• Protein of low biological value (second class protein). Include protein from
plant sourcesexcept soya bean

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Factors affecting protein utilization

1. Amino acid imbalance- varying the food and eating good quality protein.
2. Caloric inadequacy- if caloric intake drop amino acids are used as a source of
energy
3. Body injury- more amino acids are needed for repair of worn out tissues
4. Emotional stress in form of fear and anger. They increase secretion of
epinephrineleading to nitrogen loss.
Role of protein in human body
There are five functional groups of protein
i. Structural roles (muscles, collective tissue skeleton, skin, nails and hair).
ii. Transport proteins- this combine with other substances in the blood
stream fortransport and include the albumin, haemoglobin and
ceruloplasm.
iii. Antibodies immunoglobulin produced by white blood cell.
iv. Peptide hormonis control the bodies function by controlling or
regulating the synthesis or activities of hormones and enzymes. Those
of nutritional important include insulin and parathyroid hormones.
v. Enzymes regulate chemical process in the body. They are protein
structures that combine selectively with other molecule in the cell to
catalyze physiological changes

LIPIDS
Lipids are water insoluble organic substances but dissolve in inorganic
substance e.g. ether.Dietary lipids are composed of two major compounds: -
glycerol and fatty acids.
The chemical structures of fatty acids
Fatty acid can either be saturated or unsaturated.
a. Saturated- fats from animals. The carbon chains are longer. They are high in
cholesterol
b. Unsaturated- have atleast one double bond. They are solid at room
temperature.
c. Polyunsaturated- they are lipid at room temperature. The degree of
saturation expressesthe health value of fat. Polyunsaturated are the better
option.
Hydrogenation:- it is a process of adding hydrogen to unsaturated fatty acid to

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solidify them atroom temperature e.g. margarine.

Roles of fats
• They are source of energy
• Fats constitute the cell membrane
• They insulate the body organs
• They protect certain body organs e.g. liver, kidney etc. holding them in
position that isthey are shock absorbers
• Fats are carrier of fat soluble vitamins
• They make food palatable increasing food intake.

MINERALS
These are inorganic substances required in small amount in the body and they are
essential forthe normal functioning of the body. They occur naturally and must be
taken in the diet.
General functions of mineral
1. Needed for coagulation/ clotting of blood
2. For bone formation
3. Transmission of nerve impulse
4. For biochemical reaction
5. We need them for iron in the haemoglobin
6. Need to maintain fluid and acid base balance
7. Are needed for absorption e.g. magnesium
8. Needed for muscles contraction
9. For proper functioning of immune system

CALCIUM AND PHOSPHORUS

Absorption of calcium increases with age. Calcium and phosphorus are deposited
on the teeth and bones. A normal body has got 10mg of calcium per 1000ml of
blood. This is what is taken up by the cell and used for other body function such as
nerve transmission, muscle contraction, blood clotting, and synthesis of enzymes
and hormones especially those involve in digestion and production of saliva.
Dietary sources of calcium
Milk, sea food, green leafy vegetable, eggs, milk product and ripe banana
Situation in which calcium is prescribed
• In pregnant women

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• People who are lactose intolerance because they cannot take calcium in milk
• People who are old age
Note that drugs reduce the amount of calcium absorbed. The presences of other
nutrients such as lactose, protein and vitamin D increase the absorption of calcium.
The paratoid hormonesdecrease calcium absorption.
Deficiency
• Stunted growth
• Rickets in children
• Osteomalacia for adults
• Osteoporosis
Calcium Rigor- this is where muscles cannot contract due to too much calcium.
Too muchcalcium leads to deposition of much calcium causing kidney stones.
Much calcium reduces the absorption of iron and zinc. Too much calcium affects
the metabolism and absorption of vitaminK.

IRON
Two billion people in the world suffer from iron deficiency thus anemia. The red
color in theblood is the iron in haemoglobin.
Function
• Iron has the oxygen carrying capacity in the blood through haemoglobin
• Iron involve in the production of energy
• Needed in the formation of red blood cell
• Iron helps in arresting free radical preventing oxidation. It is
an anti-oxidantSources include organ meat, dark green vegetables,
beans, eggs, fish and poultry.

IODINE
Require by the thyroid gland to syntheses thyroxin. They deficiency causes:-
1. Goiter- it is the second commonest deficiency disease caused by goitrogens.
2. Mental retardation- where the brain does not develop
3. Growth retardation- someone does not grow as expected

VITAMINS
They are chemically unrelated organic substances. They are required by the body

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in small amount for it normal physiological functioning but are not synthesized by
the body a part from vitamin D.
Vitamins can either be fat soluble these include A, D, E and K or water soluble
including C andB groups.
VITAMIN A
Is a generic descriptor for compounds with biologically active retinal and some pro-
vitamin carotene. It is measured in retinal equivalent (R.E) or international units
(IU). The active substances are insoluble in water and vitamin A is discovered by it
ability to prevent night blindness.

Sources include green, yellow and bright colored vegetables, liver, oily fish, daily
product, eggs, poultry and yellow fruits.
Vitamin A is needed for cell development especially for the epithelial tissue, the
cornea of the eye, mucus membrane, nasal lining, gastrointestinal lining and skin.
Vitamin A is necessary for vision. It is also required for cell differentiation
The deficiency of vitamin A therefore causes incomplete synthesis leading to
scaling of the epithelial membrane leading to a condition called keratinization
Hypervitaminosis of vitamin A
This is a result of too much intake of vitamin A and this causes irregular thickening
of some long bone and abnormal development of the foetus. However toxicity from
dietary sources is rare and therefore supplementation before or during pregnancy
should be done with caution.

THE FIVE MAJOR FOOD GROUPS

Eating a variety of foods promotes good health and prevents deficiency diseases
1. The first major group is breads, cereals and other grain products. Foods in
this group include carbohydrates, vitamins of B group and folic acid. There
is also fibre, iron, magnesium and zinc.
2. Fruit and vegetables
Fruits and vegetables are the basic sources of vitamins and most mineral
salts. They provide dietary fiber and add color, flavor and texture to the diet.
Citrus fruits, melon andbarriers are rich in vitamin C.
Deep yellow fruit and vegetable are rich in vitamin A. All fruits have folic
acid, potassium and magnesium.
Dark green vegetables are rich in vitamin A, C, riboflavin and folic acid,

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iron, calcium, magnesium and potassium.

Pulse vegetables are rich in vitamin B complex, iron, magnesium, zinc and
potassium.
3. Milk, cheese, yoghurt and other products
These are good sources of calcium and protein of high biological value and
vitamin B12and vitamin A if fortified.
4. Meats, poultry, fish and alternatives

They are main sources of protein of high biological value, they provide
niacin, vitamin B12, B6, iron, phosphorus, zinc, fats and cholesterol.
Alternatives include beans/legumes and peanut butter.
5. Fats, sweets and alcoholic beverages
They are packed in group called empty calories because they contain very
few nutrients. Their consumption should be minimized. Sugar in soda and
soft drinks are not encourage but from fruit is encouraged. Alcoholic
beverages are discouraged and should be avoided for it inhibits the
absorption of vitamin B complex.

NOTE
People should choose several serving from each of the first four group, except from
group five. Agood diet should:-
a. Contain adequate starch, energy and fibre especially whole grain. The diet
should avoidtoo much fat especially saturated fats and cholesterol.
b. Avoid too much salt
c. Alcoholic beverages must be taken in moderation if they must be taken.

RELATIONSHIP BETWEEN NUTRITION AND OTHER FIELDS

1. Nutrition and medicine
• There have been conceptual trends in the thinking about nutrition in
medicine and health. The first was the concept of deficiency- that an
insufficient amount of a critical nutrient can cause disease.

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• As an extension of malnutrition is the recognition that certain

disease states or
situations come with increased nutritional requirement. Example
when battling cancer individuals typically have significantly
increased nutritional and caloric demand.
• Excess nutrition- meaning getting too much of something in our diets
is also a risk
factor for diseases. Here the focus is on macronutrients example too
much of the wrong kind of fat is a risk factor for cardiovascular
diseases.
• The other concept that has been added to the scientific approach to
nutrition is the
recognition that specific nutrients may decrease the risk of
developing certain diseases and may even treat an existing disease.
2. Nutrition and sociology
• Sociology involves the study of how people relate to each other as
well as how the institutions of society affect behavior and attitude.
Other disciplines like anthropology have much longer history of
research into food and culture.
• Food studies have been an integral part of both rural sociology and
medicine sociology. For rural, food have been central in the studies
of agriculture and technological changes.
• For medical, food and nutrition are now recognized as important
factor in the study of health and wellness
• Sociologists examine how our nutritional habits are based on
cultural identity, gender, race, ethnicity and social class.
3. Nutrition and research
• Without the work of research very little of our present nutrition
knowledge would be available. Since technology is increasing and
new health problems are coming up, there is need to improve the
area of nutrition to manage and prevent these health problem. This
can be done through the work and knowledge of research.
4. Nutrition and education
• Education knowledge help the nutritionist convey nutrition

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information to the community in a manner easily understood through

nutrition education. Education also incorporate the nutrition
information in their syllabus in school enables the students to gain
the knowledge of nutrition even as they grow-up.
CURRENT AWARENESS OF NUTRITION IN KENYA
1. Fortification
Addition of one or more nutrients such as vitamins, minerals and amino
acids to food so that it contains more of the nutrients than were originally
present. In Kenya example include fortification of blue band with vitamin
A, some maize flour have also been fortified with vitamin A.
2. Public awareness
This is making the people to be aware of nutrition hence increasing nutrition
knowledge to help deal with nutrition related problems. This is done through
nutrition education.
3. Diabetes
This is a metabolic disease due to absolute or relative insulin deficiency.
Diabetes mellitus is a common clinical condition. About 10% of the total
population and about 1/5th of persons above the age of 50, suffer from this
disease. Nutrition is very important in managing diabetes.
4. Cancer
It is common term for a malignant cellular growth that tends to spread due
to the inability of the DNA to normal physiologic stimuli. The observation
that cancers of the stomach and liver are prevalent types is of interest, as
these organs are directly involved in nutrientutilization.
In addition, certain substances found in foods are carcinogenic. Among
these are aflotoxin of moldly peanuts, polyphenols in teas, excess selenium
in the diet and toxic substances developed in overheated fats.
Studies on dietary factors in relation to cancer prevention include the
following: vitamins A, C, E and selenium, which are antioxidants, protect
the DNA from electron seeking compounds so that it is not altered. Dietary
fibers are recommended because they bind carcinogens.
5. Obesity

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An individual is considered obese when the body weight is 20% or more

above the desirable weight. Obesity and overweight are on the rise in
Kenya. Like several public health challenges, it should be tackled and
prevented early as envisioned in the WHO global strategy on diet, physical
activity and health.
6. HIV/AIDS
The HIV/AIDS epidemic poses an inescapable challenge to the world at
large and Africa in particular. A massive effort is needed to cushion the
impact of the epidemic, and nutritional care and support should be
integral elements of any action taken.
Undernutrition is common
among people living with HIV/AIDS.

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