Global Antimicrobial Resistance Surveillance System (GLASS)

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The Profession of Dietetics. Archived from the original PDF on August 24, The minimum daily meal frequency is defined as: Infant and young child feeding list of publications. Galen thought that for a person to have gout , kidney stones , or arthritis was scandalous, which Gratzer likens to Samuel Butler's Erehwon where sickness is a crime. At the same time, they also require income security and protection to ensure that they will not suffer from income loss or lose their job because of pregnancy or maternity leave.

Global Antimicrobial Resistance Surveillance System (GLASS)

Types of Surveillance Systems

It occurs most frequently in areas where there is little iodine in the diet—typically remote inland areas where no marine foods are eaten. Although goitre assessment by palpation or ultrasound may be useful for assessing thyroid function, results are difficult to interpret once salt iodization programmes have started. The median urinary iodine concentration is considered the main indicator of iodine status for all age groups, because its measurement is relatively non-invasive, cost-efficient and easy to perform.

Since the majority of iodine absorbed by the body is excreted in the urine, it is considered a sensitive marker of current iodine intake and can reflect recent changes in iodine status.

Median urinary iodine concentrations have been most commonly measured in school children aged 6—12 years due to their easy access. During the neonatal period, childhood and adolescence, iodine deficiency disorders can lead to hypo- and hyperthyroidism. Serious iodine deficiency during pregnancy can result in stillbirth, spontaneous abortion and congenital abnormalities such as cretinism, a grave, irreversible form of mental retardation that affects people living in iodine-deficient areas of Africa and Asia.

Of even greater significance is the less visible, yet pervasive, mental impairment that reduces intellectual capacity at home, in school and at work. Cut-off values for public health significance in different target groups. Concentration cut-off values for public health significance. May pose a slight risk of more than adequate iodine intake in these populations.

Risk of adverse health consequences iodine-induced hyperthyroidism, autoimmune thyroid disease. Urinary iodine concentrations for determining iodine status deficiency in populations. Goitre as a determinant of the prevalence and severity of iodine deficiency disorders in populations. Iodine deficiency, list of publications. Global iodine status in and trends over the past decade.

In NLIS, it is used as a proxy for access to health services and maternal care. The indicator gives the percentage of live births attended by skilled health personnel in a given period. A skilled birth attendant is an accredited health professional—such as a midwife, doctor or nurse—who has been educated and trained to proficiency in the skills needed to manage normal uncomplicated pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of women and newborns for complications.

In developed countries and in many urban areas in developing countries, skilled care at delivery is usually provided in health facilities. Births do, however, take place in various other appropriate places, from home to tertiary referral centres, depending on availability and need. WHO does not recommend a particular setting for giving birth.

Home delivery may be appropriate for normal births, provided that the person attending the delivery is suitably trained and equipped and that referral to a higher level of care is an option, however this may lead to an overestimation of births attended by skilled personal as infants delivered outside of a health facility may not have their birth method recorded.

All women should have access to skilled care during pregnancy and at delivery to ensure the detection and management of complications. One woman dies needlessly of pregnancy-related causes every minute, representing more than half a million mothers lost each year, a figure that has improved little over the past few decades.

Another 8 million or more suffer life-long health consequences from the complications of pregnancy. The lack of progress in reducing maternal mortality in many countries often reflects the low value placed on the lives of women and their limited role in setting public priorities.

The lives of many women in developing countries could be saved by reproductive health interventions that people in rich countries take for granted, such as the presence of skilled health personnel at delivery. Improved sanitation facilit ies and drinking-water sources. What do these indicators tell us? These indicators are the percentage of population with access to an improved drinking-water source and improved sanitation facilities. How are they defined?

Improved drinking-water sources are defined in terms of the types of technology and levels of services that are likely to provide safe water. Improved water sources include household connections, public standpipes, boreholes, protected dug wells, protected springs and rainwater collection.

Unimproved water sources are unprotected wells, unprotected springs, vendor-provided water, bottled water unless water for other uses is available from an improved source and tanker truck-provided water.

Improved sanitation facilities are defined in terms of the types of technology and levels of services that are likely to be sanitary. Improved sanitation includes connection to a public sewers, connection to septic systems, pour-flush latrines, simple pit latrines and ventilated improved pit latrines.

Service or bucket latrines from which excreta are removed manually , public latrines and open latrines are not considered to be improved sanitation. Access to safe drinking-water and improved sanitation are fundamental needs and human rights vital for the dignity and health of all people. The health and economic benefits of a safe water supply to households and individuals especially children are well documented.

Both indicators are used to monitor progress towards the Millennium Development Goals. Water, Sanitation and Hygiene. World Health Statistics, Children aged 1 y ear immunized against measles. Estimates of vaccination coverage of children aged 1 year are used to monitor vaccination services, to guide disease eradication and elimination programmes and as indicators of health system performance.

Measles vaccination coverage is defined as the percentage of 1-year-olds who have received at least one dose of measles-containing vaccine in a given year.

In countries that recommend that the first dose be given to children over 12 months of age, the indicator is calculated as the proportion of children under 24 months of age receiving one dose of measles-containing vaccine. Measles is a leading cause of vaccine-preventable childhood deaths, and unvaccinated populations are at risk for the disease. Measles is a significant infectious disease because it is so contagious that the number of people who would suffer complications after an outbreak among nonimmune people would quickly overwhelm available hospital resources.

When vaccination rates fall, the number of nonimmune persons in the community rises, and the risk for an outbreak of measles consequently rises. Millennium Development Goals indicators database. This indicator reflects the percentage of women who consumed any iron-containing supplements during the current or past pregnancy within the last 2 years.

It provides information about the quality and coverage of perinatal medical services. Daily iron and folic acid supplementation is currently recommended by WHO as part of antenatal care to reduce the risk of low birth weight, maternal anaemia and iron deficiency.

However, despite its proven efficacy and wide inclusion in antenatal care programmes, its use has been limited in programme settings, possibly due to a lack of compliance, concerns about the safety of the intervention among women with an adequate iron intake, and variable availability of the supplements at community level.

This indicator is included as a process indicator in the core set of indicators for the Global Nutrition Monitoring Framework. The indicator is defined as the proportion of women who consumed any iron-containing supplements during the current or past pregnancy within the last 2 years. Data can be reported on any iron-containing supplement including iron and folic acid tablets IFA , multiple micronutrient tablets or powders, or iron-only tablets which will vary by country policy.

Improving the intake of iron and folic acid by women of reproductive age could improve pregnancy outcomes and enhance maternal and infant health. Iron and folic acid supplementation improve iron and folate status of women before and during pregnancy, in communities where food-based strategies are not yet fully implemented or effective.

Folic acid supplementation with or without iron provided before pregnancy and during the first trimester of pregnancy is also recommended for decreasing the risk of neural tube defects. Anaemia during pregnancy places women at risk for poor pregnancy outcomes, including maternal mortality and also increases the risks for perinatal mortality, premature birth and low birth weight.

Infants born to anaemic mothers have less than one half the normal iron reserves. Morbidity from infectious diseases is increased in iron-deficient populations, because of the adverse effect of iron deficiency on the immune system. Iron deficiency is also associated with reduced work capacity and with reduced neurocognitive development. Demographic and Health Surveys. Global Nutrition Monitoring Framework: Operational guidance for tracking progress in meeting targets for Children with diarrhoea receiving oral rehydration therapy.

This indicator is the prevalence of children with diarrhoea who received oral rehydration therapy. It is the proportion of children aged 0—59 months who had diarrhoea and were treated with oral rehydration salts or an appropriate household solution. The terms used for diarrhoea should cover the expressions used for all forms of diarrhoea, including bloody stools consistent with dysentery and watery stools, and should encompasses mothers' definitions as well as local terms.

Diarrhoeal diseases remain one of the major causes of mortality among children under 5, accounting for 1. As oral rehydration therapy is a critical component of effective management of diarrhoea, monitoring coverage with this highly cost—effective intervention indicates progress on an intermediate outcome indicator of the Global Nutrition Targets, prevalence of diarrhoea in children under 5 years of age.

Children with diarrhoea receiving zinc. This indicator reflects the prevalence of children who were given zinc as part of treatment for acute diarrhoea. Unfortunately, there are no readily available data on this indicator, which is maintained in the NLIS to encourage countries to collect and compile data on these aspects in order to assess their national capacity.

Measures to prevent childhood diarrhoeal episodes include promoting zinc intake. Diarrhoeal diseases account for nearly 2 million deaths a year among children under 5, making them the second most-common cause of child death worldwide.

The greater the prevalence of zinc supplementation during diarrhoea treatment, the better the outcome of treatment for diarrhoea.

WHO and the United Nations Children's Fund UNICEF recommend exclusive breastfeeding, vitamin A supplementation, improved hygiene, better access to cleaner sources of drinking-water and sanitation facilities and vaccination against rotavirus in the clinical management of acute diarrhoea and also the use of zinc, which is safe and effective.

Specifically, zinc supplements given during an episode of acute diarrhoea reduce the duration and severity of the episode, and giving zinc supplements for days lowers the incidence of diarrhoea in the following months. Currently no data are available. The impact of zinc supplementation on childhood mortality and severe morbidity. Report of a workshop to review the results of three large studies. Geneva , World Health Organization, Children aged months receiving v itamin A supplements.

These indicators are the proportion of children aged months who received one and two doses of vitamin A supplements, respectively. The indicators are defined as the proportion of children aged months who received one or two high doses of vitamin A supplements within 1 year. Current international recommendations call for high-dose vitamin A supplementation every months for all children between the ages of 6 and 59 months living in affected areas.

The recommended doses are IU for month-old children and IU for those aged months. Programmes to control vitamin A deficiency enhance children's chances of survival, reduce the severity of childhood illnesses, ease the strain on health systems and hospitals and contribute to the well-being of children, their families and communities. The World Summit for Children set the goal of virtual elimination of vitamin A deficiency and its consequences, including blindness, by the year The critical role of vitamin A for child health and immune function also makes control of deficiency a primary component of efforts to improve child survival and therefore of the achievement of the fourth Millennium Development Goal, a two-thirds reduction in mortality of children under 5 by the year As there is strong evidence that supplementation with vitamin A reduces child mortality, measuring the proportion of children who have received vitamin A within the past 6 months can be used to monitor coverage with interventions for achieving the child survival-related Millennium Development Goals.

Supplementation with vitamin A is a safe, cost-effective, efficient means for eliminating its deficiency and improving child survival. Immunization, Vaccines and Biologicals. These indicators are the proportion of children aged months who received one or two doses of vitamin A supplements. The indicator reflects the proportion of babies born in facilities that have been designated as Baby-friendly. Proportion of births in Baby-friendly facilities is included as a process indicator in the core set of indicators for the Global Nutrition Monitoring Framework.

This indicator is defined as the proportion of babies born in facilities designated as Baby-friendly in a calendar year. To be counted as currently Baby-friendly, the facility must have been designated within the last five years or been reassessed within that timeframe. Facilities may be designed as Baby-friendly if they meet the minimum Global Criteria, which includes adherence to the Ten Steps for Successful Breastfeeding and the International Code of Marketing of Breast-milk Substitutes.

The Ten steps include having a breastfeeding policy that is routinely communicated to staff, having staff trained on policy implementation, informing pregnant women on the benefits and management of breastfeeding, promoting early initiation of breastfeeding, among others. The International Code of Marketing of Breast-milk Substitutes restricts the distribution of free infant formula and promotional materials from infant formula companies.

The more of the Steps that the mother experiences, the better her success with breastfeeding. Improved breastfeeding practices worldwide could save the lives of over children every year. National implementation of the Baby-friendly Hospital Initiative. Implementation of the Baby-friendly Hospital Initiative. Mothers of children months receiving counselling, support or messages on optimal breastfeeding. Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers.

Optimal practices include early initiation of breastfeeding within 1 hour, exclusive breastfeeding for 6 months followed by appropriate complementary with continued breastfeeding for 2 years or beyond. Even though it is a natural act, breastfeeding is also a learned behaviour. Virtually all mothers can breastfeed provided they have accurate information, and support within their families and communities and from the health care system.

This indicator has been established to measure the proportion of mothers receiving breastfeeding counselling, support or messages. The proportion of mothers of children months who have received counselling, support or messages on optimal breastfeeding at least once in the previous 12 months is included as a process indicator in the core set of indicators for the Global Nutrition Monitoring Framework.

The indicator gives the percentage of mothers of children aged months who have received counselling, support or messages on optimal breastfeeding at least once in the last year. Counseling and informational support on optimal breastfeeding practices for mothers has been demonstrated to improve initiation and duration of breastfeeding, which in has many health benefits for both the mother and infant.

Breast milk contains all the nutrients an infant needs in the first six months of life. Breastfeeding protects against diarrhoea and common childhood illnesses such as pneumonia, and may also have longer-term health benefits for the mother and child, such as reducing the risk of overweight and obesity in childhood and adolescence.

Breastfeeding has also been associated with higher intelligence quotient IQ in children. Salt iodization has been adopted as the main strategy for eliminating iodine-deficiency disorders as a public health problem, and the aim is to achieve universal salt iodization. While other foodstuffs can be iodized, salt has the advantage of being widely consumed and inexpensive. Salt has been iodized routinely in some industrialized countries since the s.

This indicator is a measure of whether a fortification programme is reaching the target population adequately. The indicator is a measure of the percentage of households consuming iodized salt, defined as salt containing parts per million of iodine. Iodine deficiency is most commonly and visibly associated with thyroid problems e.

Consumption of iodized salt increased in the developing world during the past decade: This means that about 84 million newborns are now being protected from learning disabilities due to iodine-deficiency disorders. Monitoring the situation of women and children.

Sustainable elimination of iodine deficiency disorders by Micronutrient deficiencies, iodine deficiency disorders. Population with less than the minimum dietary energy consumption. This indicator is the percentage of the population whose food intake falls below the minimum level of dietary energy requirements, and who therefore are undernourished or food-deprived.

The estimates of the Food and Agriculture Organization of the United Nations FAO of the prevalence of undernourishment are essentially measures of food deprivation based on calculations of three parameters for each country: The average amount of food available for human consumption is derived from national 'food balance sheets' compiled by FAO each year, which show how much of each food commodity a country produces, imports and withdraws from stocks for other, non-food purposes.

FAO then divides the energy equivalent of all the food available for human consumption by the total population, to derive average daily energy consumption. Data from household surveys are used to derive a coefficient of variation to account for the degree of inequality in access to food. Similarly, because a large adult needs almost twice as much dietary energy as a 3-year-old child, the minimum energy requirement per person in each country is based on age, gender and body sizes in that country.

The average energy requirement is the amount of food energy needed to balance energy expenditure in order to maintain body weight, body composition and levels of necessary and desirable physical activity consistent with long-term good health.

It includes the energy needed for the optimal growth and development of children, for the deposition of tissues during pregnancy and for the secretion of milk during lactation consistent with the good health of the mother and child. The recommended level of dietary energy intake for a population group is the mean energy requirement of the healthy, well-nourished individuals who constitute that group.

FAO reports the proportion of the population whose daily food intake falls below that minimum energy requirement as 'undernourished'. Trends in undernourishment are due mainly to: The indicator is a measure of an important aspect of food insecurity in a population. Sustainable development requires a concerted effort to reduce poverty, including solutions to hunger and malnutrition.

Alleviating hunger is a prerequisite for sustainable poverty reduction, as undernourishment seriously affects labour productivity and earning capacity. Malnutrition can be the outcome of a range of circumstances. In order for poverty reduction strategies to be effective, they must address food access, availability and safety. Rome, October The State of Food Insecurity in the World Economic growth is necessary but not sufficient to accelerate reduction of hunger and malnutrition. FAO methodology to estimate the prevalence of undernourishment.

FAO, Rome, 9 October Infant and young child feeding. The recommendations for feeding infants and young children 6—23 months include: The caring practice indicators for infant and young child feeding available on the NLIS country profiles include: Early initiation of breastfeeding. This indicator is the percentage of infants who are put to the breast within 1 hour of birth.

Breastfeeding contributes to saving children's lives, and there is evidence that delayed initiation of breastfeeding increases their risk for mortality.

Infants under 6 months who are exclusively breastfed. This indicator is the percentage of infants aged 0—5 months who are exclusively breastfed. It is the proportion of infants aged 0—5 months who are fed exclusively on breast milk and no other food or drink, including water. The infant is however, allowed to receive ORS and drops and syrups containing vitamins, minerals and medicine.

Exclusive breastfeeding is an unequalled way of providing the ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process, with important implications for the health of mothers. An expert review of evidence showed that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants.

Breast milk is the natural first food for infants. It provides all the energy and nutrients that the infant needs for the first months of life. Breast milk promotes sensory and cognitive development and protects the infant against infectious and chronic diseases. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses, such as diarrhoea and pneumonia, and leads to quicker recovery from illness.

Breastfeeding contributes to the health and well-being of mothers, by helping to space children, reducing their risks for ovarian and breast cancers and saving family and national resources. It is a secure way of feeding and is safe for the environment. Infants aged 6—8 months who receive solid, semisolid or soft foods.

WHO recommends starting complementary feeding at 6 months of age. It is defined as the proportion of infants aged 6—8 months who receive solid, semisolid or soft foods. When breast milk alone no longer meets the nutritional needs of the infant, complementary foods should be added. This is a very vulnerable period, and it is the time when malnutrition often starts, contributing significantly to the high prevalence of malnutrition among children under 5 worldwide.

Children aged 6—23 months who receive a minimum dietary diversity. This indicator is the percentage of children aged 6—23 months who receive a minimum dietary diversity. As per revised recommendation by TEAM in June , dietary diversity is present when the diet contained five or more of the following food groups: Children aged 6—23 months who receive a minimum acceptable diet. This indicator is the percentage of children aged 6—23 months who receive a minimum acceptable diet.

Proportion of children aged months who receive a minimum acceptable diet is included as a process indicator in the core set of indicators for the Global Nutrition Monitoring Framework.

The composite indicator of a minimum acceptable diet is calculated from: Dietary diversity is present when the diet contained four or more of the following food groups: The minimum daily meal frequency is defined as: A minimum acceptable diet is essential to ensure appropriate growth and development for feeding infants and children aged 6—23 months.

Without adequate diversity and meal frequency, infants and young children are vulnerable to malnutrition, especially stunting and micronutrient deficiencies, and to increased morbidity and mortality. Source of all infant and young child feeding indicators. Infant and Young Child Feeding database.

Infant and young child feeding list of publications. Global Nutrition Monitoring Framework. Children with diarrhoea receiving oral rehydration therapy and continued feeding. This indicator is the prevalence of children with diarrhoea who received oral rehydration therapy and continued feeding.

It is the proportion of children aged months who had diarrhoea and were treated with oral rehydration salts or an appropriate household solution and continued feeding. As oral rehydration therapy is a critical component of effective management of diarrhoea, monitoring coverage with this highly cost-effective intervention indicates progress towards the child survival-related Millennium Development Goals.

Health expenditure includes that for the provision of health services, family planning activities, nutrition activities and emergency aid designated for health, but excludes the provision of water and sanitation.

Health financing is a critical component of health systems. National health accounts provide a large set of indicators based on information on expenditure collected within an internationally recognized framework. Polysaccharides are often referred to as complex carbohydrates because they are typically long, multiple branched chains of sugar units. Traditionally, simple carbohydrates are believed to be absorbed quickly, and therefore to raise blood-glucose levels more rapidly than complex carbohydrates.

This, however, is not accurate. Dietary fiber is a carbohydrate that is incompletely absorbed in humans and in some animals. Like all carbohydrates, when it is metabolized it can produce four Calories kilocalories of energy per gram.

However, in most circumstances it accounts for less than that because of its limited absorption and digestibility. Dietary fiber consists mainly of cellulose, a large carbohydrate polymer which is indigestible as humans do not have the required enzymes to disassemble it.

There are two subcategories: Whole grains, fruits especially plums , prunes , and figs , and vegetables are good sources of dietary fiber. There are many health benefits of a high-fiber diet. Dietary fiber helps reduce the chance of gastrointestinal problems such as constipation and diarrhea by increasing the weight and size of stool and softening it. Insoluble fiber, found in whole wheat flour , nuts and vegetables, especially stimulates peristalsis ;— the rhythmic muscular contractions of the intestines, which move digest along the digestive tract.

Soluble fiber, found in oats, peas, beans, and many fruits, dissolves in water in the intestinal tract to produce a gel that slows the movement of food through the intestines. This may help lower blood glucose levels because it can slow the absorption of sugar. Additionally, fiber, perhaps especially that from whole grains, is thought to possibly help lessen insulin spikes, and therefore reduce the risk of type 2 diabetes. The link between increased fiber consumption and a decreased risk of colorectal cancer is still uncertain.

A molecule of dietary fat typically consists of several fatty acids containing long chains of carbon and hydrogen atoms , bonded to a glycerol. They are typically found as triglycerides three fatty acids attached to one glycerol backbone.

Fats may be classified as saturated or unsaturated depending on the detailed structure of the fatty acids involved. Saturated fats have all of the carbon atoms in their fatty acid chains bonded to hydrogen atoms, whereas unsaturated fats have some of these carbon atoms double-bonded , so their molecules have relatively fewer hydrogen atoms than a saturated fatty acid of the same length.

Unsaturated fats may be further classified as monounsaturated one double-bond or polyunsaturated many double-bonds. Furthermore, depending on the location of the double-bond in the fatty acid chain, unsaturated fatty acids are classified as omega-3 or omega-6 fatty acids.

Trans fats are a type of unsaturated fat with trans -isomer bonds; these are rare in nature and in foods from natural sources; they are typically created in an industrial process called partial hydrogenation. There are nine kilocalories in each gram of fat. Fatty acids such as conjugated linoleic acid , catalpic acid, eleostearic acid and punicic acid , in addition to providing energy, represent potent immune modulatory molecules.

Saturated fats typically from animal sources have been a staple in many world cultures for millennia. Saturated and some trans fats are typically solid at room temperature such as butter or lard , while unsaturated fats are typically liquids such as olive oil or flaxseed oil. Trans fats are very rare in nature, and have been shown to be highly detrimental to human health, but have properties useful in the food processing industry, such as rancidity resistance. Most fatty acids are non-essential, meaning the body can produce them as needed, generally from other fatty acids and always by expending energy to do so.

However, in humans, at least two fatty acids are essential and must be included in the diet. An appropriate balance of essential fatty acids— omega-3 and omega-6 fatty acids —seems also important for health, although definitive experimental demonstration has been elusive. Both of these "omega" long-chain polyunsaturated fatty acids are substrates for a class of eicosanoids known as prostaglandins , which have roles throughout the human body.

They are hormones , in some respects. The omega-3 eicosapentaenoic acid EPA , which can be made in the human body from the omega-3 essential fatty acid alpha-linolenic acid ALA , or taken in through marine food sources, serves as a building block for series 3 prostaglandins e. The omega-6 dihomo-gamma-linolenic acid DGLA serves as a building block for series 1 prostaglandins e. An appropriately balanced intake of omega-3 and omega-6 partly determines the relative production of different prostaglandins, which is one reason why a balance between omega-3 and omega-6 is believed important for cardiovascular health.

In industrialized societies, people typically consume large amounts of processed vegetable oils, which have reduced amounts of the essential fatty acids along with too much of omega-6 fatty acids relative to omega-3 fatty acids.

Moreover, the conversion desaturation of DGLA to AA is controlled by the enzyme deltadesaturase , which in turn is controlled by hormones such as insulin up-regulation and glucagon down-regulation.

The amount and type of carbohydrates consumed, along with some types of amino acid, can influence processes involving insulin, glucagon, and other hormones; therefore, the ratio of omega-3 versus omega-6 has wide effects on general health, and specific effects on immune function and inflammation , and mitosis i. Proteins are structural materials in much of the animal body e.

They also form the enzymes that control chemical reactions throughout the body. Each protein molecule is composed of amino acids , which are characterized by inclusion of nitrogen and sometimes sulphur these components are responsible for the distinctive smell of burning protein, such as the keratin in hair. The body requires amino acids to produce new proteins protein retention and to replace damaged proteins maintenance.

As there is no protein or amino acid storage provision, amino acids must be present in the diet. Excess amino acids are discarded, typically in the urine.

For all animals, some amino acids are essential an animal cannot produce them internally and some are non-essential the animal can produce them from other nitrogen-containing compounds. About twenty amino acids are found in the human body, and about ten of these are essential and, therefore, must be included in the diet. A diet that contains adequate amounts of amino acids especially those that are essential is particularly important in some situations: A complete protein source contains all the essential amino acids; an incomplete protein source lacks one or more of the essential amino acids.

It is possible with protein combinations of two incomplete protein sources e. However, complementary sources of protein do not need to be eaten at the same meal to be used together by the body. Water is excreted from the body in multiple forms; including urine and feces , sweating , and by water vapour in the exhaled breath.

Therefore, it is necessary to adequately rehydrate to replace lost fluids. Early recommendations for the quantity of water required for maintenance of good health suggested that 6—8 glasses of water daily is the minimum to maintain proper hydration. Most of this quantity is contained in prepared foods. For healthful hydration, the current EFSA guidelines recommend total water intakes of 2.

These reference values include water from drinking water, other beverages, and from food. The EFSA panel also determined intakes for different populations. Recommended intake volumes in the elderly are the same as for adults as despite lower energy consumption, the water requirement of this group is increased due to a reduction in renal concentrating capacity.

Dehydration and over-hydration - too little and too much water, respectively - can have harmful consequences. Drinking too much water is one of the possible causes of hyponatremia , i. Pure ethanol provides 7 calories per gram. For distilled spirits , a standard serving in the United States is 1.

A 5 ounce serving of wine contains to calories. A 12 ounce serving of beer contains 95 to calories. Alcoholic beverages are considered empty calorie foods because other than calories, these contribute no essential nutrients. The micronutrients are minerals , vitamins , and others.

Dietary minerals are inorganic chemical elements required by living organisms, [70] other than the four elements carbon , hydrogen , nitrogen , and oxygen that are present in nearly all organic molecules. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Some are heavier than the four just mentioned, including several metals , which often occur as ions in the body.

Some dietitians recommend that these be supplied from foods in which they occur naturally, or at least as complex compounds, or sometimes even from natural inorganic sources such as calcium carbonate from ground oyster shells.

Some minerals are absorbed much more readily in the ionic forms found in such sources. On the other hand, minerals are often artificially added to the diet as supplements; the most famous is likely iodine in iodized salt which prevents goiter.

Many elements are essential in relative quantity; they are usually called "bulk minerals". Some are structural, but many play a role as electrolytes. Many elements are required in trace amounts, usually because they play a catalytic role in enzymes. Vitamins are essential nutrients, [70] necessary in the diet for good health. Vitamin D is an exception, as it can be synthesized in the skin in the presence of UVB radiation , and many animal species can synthesize vitamin C. Vitamin deficiencies may result in disease conditions, including goitre , scurvy , osteoporosis , impaired immune system, disorders of cell metabolism, certain forms of cancer, symptoms of premature aging, and poor psychological health , among many others.

Phytochemicals such as polyphenols are compounds produced naturally in plants phyto means "plant" in Greek. In general, the term is used to refer to compounds which do not appear to be nutritionally essential and yet may have positive impacts on health. To date, there is no conclusive evidence in humans that polyphenols or other non-nutrient compounds from plants have health benefit effects.

While initial studies sought to reveal if nutrient antioxidant supplements might promote health, one meta-analysis concluded that supplementation with vitamins A and E and beta-carotene did not convey any benefits and may in fact increase risk of death. Vitamin C and selenium supplements did not impact mortality rate. Health effects of non-nutrient phytochemicals such as polyphenols were not assessed in this review. Animal intestines contain a large population of gut flora. In humans, the four dominant phyla are Firmicutes , Bacteroidetes , Actinobacteria , and Proteobacteria.

Bacteria in the large intestine perform many important functions for humans, including breaking down and aiding in the absorption of fermentable fiber, stimulating cell growth, repressing the growth of harmful bacteria, training the immune system to respond only to pathogens, producing vitamin B 12 , and defending against some infectious diseases.

There is not yet a scientific consensus as to health benefits accruing from probiotics or prebiotics. Carnivore and herbivore diets are contrasting, with basic nitrogen and carbon proportions vary for their particular foods. Many herbivores rely on bacterial fermentation to create digestible nutrients from indigestible plant cellulose, while obligate carnivores must eat animal meats to obtain certain vitamins or nutrients their bodies cannot otherwise synthesize.

Plant nutrition is the study of the chemical elements that are necessary for plant growth. Some elements are directly involved in plant metabolism. However, this principle does not account for the so-called beneficial elements, whose presence, while not required, has clear positive effects on plant growth.

A nutrient that is able to limit plant growth according to Liebig's law of the minimum is considered an essential plant nutrient if the plant cannot complete its full life cycle without it. There are 16 essential plant soil nutrients, besides the three major elemental nutrients carbon and oxygen that are obtained by photosynthetic plants from carbon dioxide in air, and hydrogen , which is obtained from water. Plants uptake essential elements from the soil through their roots and from the air consisting of mainly nitrogen and oxygen through their leaves.

Green plants obtain their carbohydrate supply from the carbon dioxide in the air by the process of photosynthesis. Carbon and oxygen are absorbed from the air, while other nutrients are absorbed from the soil. These hydrogen ions displace cations attached to negatively charged soil particles so that the cations are available for uptake by the root.

In the leaves, stomata open to take in carbon dioxide and expel oxygen. The carbon dioxide molecules are used as the carbon source in photosynthesis. Although nitrogen is plentiful in the Earth's atmosphere, very few plants can use this directly. Most plants, therefore, require nitrogen compounds to be present in the soil in which they grow. This is made possible by the fact that largely inert atmospheric nitrogen is changed in a nitrogen fixation process to biologically usable forms in the soil by bacteria.

Plant nutrition is a difficult subject to understand completely, partially because of the variation between different plants and even between different species or individuals of a given clone. Elements present at low levels may cause deficiency symptoms, and toxicity is possible at levels that are too high. Furthermore, deficiency of one element may present as symptoms of toxicity from another element, and vice versa. Canada's Food Guide is an example of a government-run nutrition program.

Produced by Health Canada , the guide advises food quantities, provides education on balanced nutrition, and promotes physical activity in accordance with government-mandated nutrient needs. Like other nutrition programs around the world, Canada's Food Guide divides nutrition into four main food groups: Dietary and physical activity guidelines from the USDA are presented in the concept of MyPlate , which superseded the food pyramid , which replaced the Four Food Groups.

Department of Health and Human Services provides a sample week-long menu that fulfills the nutritional recommendations of the government. Governmental organisations have been working on nutrition literacy interventions in non-primary health care settings to address the nutrition information problem in the U.

The FNP has developed a series of tools to help families participating in the Food Stamp Program stretch their food dollar and form healthful eating habits including nutrition education. It is designed to assist limited-resource audiences in acquiring the knowledge, skills, attitudes, and changed behavior necessary for nutritionally sound diets, and to contribute to their personal development and the improvement of the total family diet and nutritional well-being.

Launched in , this program promotes lifelong healthful eating patterns and physically active lifestyles for children and their families. It is an interactive educational program designed to help prevent childhood obesity through classroom activities that teach children healthful eating habits and physical exercise.

Nutrition is taught in schools in many countries. In England and Wales , the Personal and Social Education and Food Technology curricula include nutrition, stressing the importance of a balanced diet and teaching how to read nutrition labels on packaging. In many schools, a Nutrition class will fall within the Family and Consumer Science or Health departments. In some American schools, students are required to take a certain number of FCS or Health related classes.

Nutrition is offered at many schools, and, if it is not a class of its own, nutrition is included in other FCS or Health classes such as: In many Nutrition classes, students learn about the food groups, the food pyramid, Daily Recommended Allowances, calories, vitamins, minerals, malnutrition, physical activity, healthful food choices, portion sizes, and how to live a healthy life.

In the US, Registered dietitian nutritionists RDs or RDNs [89] are health professionals qualified to provide safe, evidence-based dietary advice which includes a review of what is eaten, a thorough review of nutritional health, and a personalized nutritional treatment plan. They also provide preventive and therapeutic programs at work places, schools and similar institutions.

Certified Clinical Nutritionists or CCNs, are trained health professionals who also offer dietary advice on the role of nutrition in chronic disease, including possible prevention or remediation by addressing nutritional deficiencies before resorting to drugs. These Board Certified Nutritionists typically specialize in obesity and chronic disease.

In order to become board certified, potential CNS candidate must pass an examination, much like Registered Dieticians. This exam covers specific domains within the health sphere including; Clinical Intervention and Human Health. The study found that health literacy increases with education and people living below the level of poverty have lower health literacy than those above it.

Another study examining the health and nutrition literacy status of residents of the lower Mississippi Delta found that 52 percent of participants had a high likelihood of limited literacy skills. Systems that can automate the process of identifying adverse drug events, are currently being used, and are being compared to traditional written reports of such events. Issues in regard to healthcare improvement are evolving around the surveillance of medication errors within institutions.

Syndromic surveillance is the analysis of medical data to detect or anticipate disease outbreaks. According to a CDC definition, "the term 'syndromic surveillance' applies to surveillance using health-related data that precede diagnosis and signal a sufficient probability of a case or an outbreak to warrant further public health response.

Though historically syndromic surveillance has been utilized to target investigation of potential cases, its utility for detecting outbreaks associated with bioterrorism is increasingly being explored by public health officials. The first indications of disease outbreak or bioterrorist attack may not be the definitive diagnosis of a physician or a lab.

Syndromic surveillance systems monitor data from school absenteeism logs, emergency call systems, hospitals' over-the-counter drug sale records, Internet searches, and other data sources to detect unusual patterns.

When a spike in activity is seen in any of the monitored systems disease epidemiologists and public health professionals are alerted that there may be an issue. An early awareness and response to a bioterrorist attack could save many lives and potentially stop or slow the spread of the outbreak.

The most effective syndromic surveillance systems automatically monitor these systems in real-time, do not require individuals to enter separate information secondary data entry , include advanced analytical tools, aggregate data from multiple systems, across geo-political boundaries and include an automated alerting process.

A syndromic surveillance system based on search queries was first proposed by Gunther Eysenbach , who began work on such a system in More flu -related searches are taken to indicate higher flu activity. The results closely match CDC data, and lead it by 1—2 weeks. The results appeared in Nature. Influenzanet is a syndromic surveillance system based on voluntary reports of symptoms via the internet.

Residents of the participant countries are invited to provide regular reports on the presence or absence of flu related symptoms. The system has been in place and running since in the Netherlands and Belgium. The success of this first initiative led to the implementation of Gripenet in Portugal in followed by Italy in and Brasil , Mexico , and the United Kingdom in Some conditions, especially chronic diseases such as diabetes mellitus , are supposed to be routinely managed with frequent laboratory measurements.

Since many laboratory results, at least in Europe and the US, are automatically processed by computerized laboratory information systems, the results are relatively easy to inexpensively collate in special purpose databases or disease registries.

Unlike most syndromic surveillance systems, in which each record is assumed to be independent of the others, laboratory data in chronic conditions can be theoretically linked together at the individual patient level. If patient identifiers can be matched, a chronological record of each patient's laboratory results can be analyzed as well as aggregated to the population level.

Nutrition Landscape Information System (NLiS)