Practical Nutritional Practice Analysis

Vitamin deficiency in food can cause different health deficiencies like Pellagra, Scurvy, Rickets among others. Most of these negative health outcomes are evidenced in the staple diet of those in the developing and poor countries. We shall understand some diets that cause these deficiencies in this essay.

Pellagra

The characteristics of Pellagra are mental afflictions, diarrhea, and dermatitis. Inadequate quantity of nicotinic acid in the diet that causes niacin deficiency in the body causes Pellagra. Over dependence on maize is an observed cause of Pellagra. Though Maize contains Niacin, it cannot be absorbed in the body in the raw form. It has to be passed through alkaline hydrolysis to be absorbed by the body. Jowar also contains adequate quantities of Niacin. However, the presence of leucine in jowar inhibits the process of absorption of niacin. Additionally, chronic alcoholism is one known cause of lack of ability to absorb of niacin (through poor nutritional habits and thereby malabsorption) and drug-induced pellagra may be through Isoniazid (Karthikeyan & Thappa, 2002). Table1 below lists the causes leading to pellagra.

Inadequate diet

Jowar diet

Maize diet

Malnutrition

Malabsorption

Crohn's disease

Subtotal gastrectomy

Gastroenterostomy

Jejuno-ileitis

Chronic alcoholism

Metabolic derangement

Carcinoid syndrome

Hartnup's disease

Drug-induced

Ethionamide, azathioprine, chloroamphenicol, phenytoin, pyrazinamide, 5-fluroracil, 6-mercaptopurine, INH

Table 1. Causes of Pellagra (Adopted from Karthikeyan & Thappa, 2002)

Thus pellagra can be attributed to major reasons and hence categorized as Primary and Secondary Pellagra. Primary pellagra is caused due to insufficient niacin absorption in the body owing to dietary constraints (hence appearing in people living in impoverished conditions). Secondary Pellagra, on the other hand is the incapability of the body to process niacin in a productive way that may be caused by drug usage like azathioprine, isoniazid; Prolonged diarrhoea or Chronic alcoholism; Gastrointestinal illnesses like ulcerative colitis; Hartnup disease; carcinoid tumors or Liver Cirrhosis (Karthikeyan & Thappa, 2002).

Scurvy

Scurvy is a disease owing to deficiency of vitamin C It is characterized by swollen and bleeding gums and by opening up of healed wounds. This condition was initially seen in sailors who lacked adequate vitamin C foods. Lack of vitamin C in food or inability to absorb it (ascorbic acid consumption) may cause scurvy. In present times, the main causes of scurvy could be anorexia, famine, ignorance or restrictive diets driven by allergies or just food fads, or having problems ingesting food. The most dominant cause of Scurvy can be attributed to abnormal collagen synthesis caused due lack of vitamin C (Olmedo, Yiannis, Windgassen & Gornet 2006). Amongst the main causes of are habits like alcoholism or dependency on drugs or Smoking -- it reduces the body's capability to absorb Vitamin C in addition to mental issues like anorexia nervosa -- this an eating disorder characterized by over-concern about weight gain and so taking extreme measures like the smallest quantity of food possible. Some health related problems like complicated mental health problems like schizophrenia and severe depression and nausea inducing treatments like chemotherapy or conditions limiting digestion like ulcerative colitis and Crohn's disease or in women Pregnancy or breastfeeding might also cause vitamin C deficiency as they are in need of additional supply, and hence Scurvy (Olmedo et al., 2006).

Rickets

Rickets is caused most dominantly by Vitamin D deficiency in the diet. The growing child is most affected in this disease, which is characterized by a failure of normal mineralization of the epiphyseal growth palate. Regions where the ultraviolet b radiation (required for synthesis of Vitamin D) from sunlight cannot reach the ground are the most affected by this deficiency. Pregnant mothers are affected by this deficiency first, followed by the feeding period when the baby receives insufficient vitamin D from mother's milk. In addition, in such regions, the clothing may cover the whole body thereby avoiding sunshine (Allgrove & Mughal, 2014).

2. Eating Disorders

Irregular eating habits characterize Eating Disorder (ED). The reasons causing it could include, among other things, distress and irrational self-image concerns about body shape and weight. ED may comprise of either very less eating leading to undernourished body or excessive eating, both of which can negatively affect well-being of both males and females. ED is categorized most commonly as Anorexia nervosa, Bilumia Nervosa and Binge Eating Disorder (BED). The people suffering from ED often fall prey to unhealthy conditions like depression and substance abuse and become a cause of further aggravation of ED and deteriorating health of those afflicted.

Anorexia Nervosa

Anorexia Nervosa is a condition of an ED patient who is overtaken by excessive fear of gaining body weight and shape. This fear leads to refusal to adequate and healthy diet necessary for a healthy and a well-nourished body. It is observed that such individuals may often have a clearly underweight body in spite of which their obsession with weight and shape persists, causing an unhealthy condition. Such a condition is further driven by poor communication, familial discord or pressures to look slim and shapely. This type of ED individuals dominate the personality traits following exaggerated perceptions about weight and shape concerns and indulge in food purging and stopping short of adequate nourishment. Such individuals are obsessed with weight and shape issues, live a conformist, and constricted life (Vitousek & Manke, 1994). Individuals of this disorder may exercise excessively, restrict food intake and even resort to self-induced vomiting out of irrational concerns. Continued refusal to healthy nourishment leads to a condition where the body reacts by slowing down the metabolic processes to conserve energy. The body additionally is deprived of vital nourishment. Such Individuals are compulsive slow eaters and chew food to the point of exaggeration to ensure limited eating (Obadina, 2014).

Bulimia Nervosa

A less dominant type of ED manifests as Bulimia Nervosa. Here the afflicted individual displays mental instability and impulsiveness. Similar to Anorexia, such individuals may report different characteristics and mannerisms. However, the commonality between the two is that of onset at a young age, incidence of depression and stress leading to denial and deprivation of self-report. Mental Instability is a common factor in all variants of ED and Bulimia Nervosa patients also exhibit such symptoms. An additional concern is that the weight gain may lead to additional physiological problems, thereby making treatment a delicately balanced exercise for such individuals (Vitousek & Manke, 1994).