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NUTRITION :
WHAT TO EAT TO BE HEALTHY
This is a reprint from
WAere 'There Is No Doctor
( Indian adaptation )
Published by the
VOLUNTARY HEALTH ASSOCIATION OF INDIA
40, Institutional Area, South of l.l.T.
New Delhi 110016
125
CHAPTER
Nutrition:
What to Eat to Be Healthy
SICKNESSES CAUSED BY NOT EATING WELL
Good food is needed for a person to grow well,
work hard, and stay healthy. Many common sicknesses
come from not eating enough of the foods the body
needs.
A person who is weak or sick because he does not
eat the right foods, or does not eat enough, is said to
be poorly nourished—or malnourished. He suffers
from malnutrition.
Poor nutrition is the most common cause of the following health problems:
in anyone
in children
• failure of a child to grow or gain
weight normally (see p.349)
• slowness in walking, talking, or
thinking
• swollen bellies, thin arms and legs
• sadness, lack of energy
• swelling of feet, face, and hands,
often with sores or marks on the skin
weakness and tiredness
loss of appetite
anemia
sores in the corners of the mouth
painful or sore tongue
'burning'
• thinning or loss of hair, or loss of
its color or shine
• dryness of eyes, blindness
Although the f Mowing problems may have other causes, they are often caused
or made worse tv not eating well:
• diarrhea
ringing or buzzing in the ears
headache
• fits or convulsions in small children
• heavy pulsing of the heart
(palpitations)
bleeding or redness of the gums
• anxiety (nervous worry) and various
nerve or mental problems
nosebleeds
• cirrhosis (liver disease)
stomach discomfort
dryness and cracking of the skin
• frequent infections
126
Eating right helps the body resist sickness.
Not eating well may be the direct cause of the health problems just listed. But
in addition, poor nutrition weakens the body's ability to resist all kinds of
diseases, especially infections:
■ Poorly nourished children are much more likely to get severe diarrhea, and
to die from it, than are children who are well nourished.
■ Measles are especially dangerous in children who are malnourished.
* Tuberculosis is more common, and gets worse more rapidly, in those who are
malnourished.
• Cirrhosis of the liver, which comes in part from drinking too much alcohol,
is more common and worse in persons who are poorly nourished.
■ Even minor problems like the common cold are often worse and last longer
in persons who are poorly nourished.
Eating right helps the sick get well.
Not only does good food help prevent disease, it also helps the sick body fight
disease and become well again. So when a person is sick, nutritious food is
especially important.
Unfortunately, some mothers stop giving a child nutritious foods when he is
sick or has diarrhea—so the child becomes weaker, cannot fight off the illness,
and may die. Sick children need nutritious food! If a sick child will not eat,
encourage him to do so.
Often the signs of poor nutrition first appear when a person has some other
sickness. For example, a child who has had diarrhea for several days may develop
swollen hands and feet, a swollen face, purple spots, or peeling sores on his legs.
These are signs of malnutrition. The child needs more good food!
During and after any sickness, it is very important to eat nutritious food.
rw
EATING WELL
AND KEEPING
CLEAN
ARE THE
BEST
sg
/
GUARANTEES \ \
OF GOOD
HEALTH
\
\
,
127
The patches on this mother's arms are a sign of pellagra, a type of
malnutrition. She ate mostly one kind of food (maize) and not a mixture o'
different kinds of food such as beans, dark green leafy vegetables.
Because she was not eating well, her breasts did not produce milk for her baby.
As a result, he suffers from extreme malnutrition. The child was 2 years old when
tlhis picture was taken. He is very small and thin with a swollen belly, his hair is
tlhin, and probably he will be mentally slow (retarded) for the rest of his life.
To prevent this, mothers and their children must eat better.
128
FOODS OUR BODIES NEED TO STAY HEALTHY
To be healthy and strong our bodies need a balance of different nutritious
foods every day. At every meal we should eat something from each of these four
food groups:
1.
Staple foods:
Staple foods are cheap sources of energy and are also called energy foodsThey
are like wood for our fires. The harder a person works, the more energy foods he
needs. Our diet contains a lot of staple foods. But a diet of these foods alone, without
the foods in the other three groups, make our bodies weak.
Some examples of staple foods:
I1
cereals and grains - wheat, rice, jowar.maize. ragi
starchy foods - potatoes, sweet potatoes, tapioca.
starchy fruits - banana, bread fruit.
2.
Foods that give us extra protein:
Protiens are body building foods. They are necessary for proper growth, for
making healthy muscles, brains, and many other parts of our bodies.
Staple foods contain only half of the protein that our bodies need. To be healthy
our diet should contain at least one food from this group. To grow strong and
healthy, everyone should eat enough protein everyday.
129
Some examples of proteins:
Pulses
Peas, beans
Soyabean
Nuts
Groundnut
Dark green leafy vegetables
Soyabeans and groundnuts are high in protein. A handful of groundnuts eaten
everyday along with staple foods gives the body enough protein.
3.
Foods that give us extra energy:
Fats and sugars are concentrated forms of stored energy. Our bodies change fat
into sugar when more energy is needed. Always try to eat some fat or oil with each
meal.
Some examples of energy supplements are:
Fats - oil. butter, ghee, meat fat
130
Fat rich foods
nuts, oh seeds, paneer
J pAWfi y]
Sugars - white sugar, honey, jaggery
ESar
4.
Foods that contain a lot of vitamins and minerals:
Vitamins are protective foods. They help our bodies work properly. We become
sick if we do not eat foods with all the necessary vitamins.
Minerals are needed for making healthy blood, bones and teeth.
Some examples of vitamin foods are:
dark green leafy vegetables - spinach, drumstick leaves, amaranth
dark yellow vegetables - carrots, yellow pumpkins
other vegetables - tomatoes
131
fruits - papaya, amla. orange, mango, lemon
animal products - meat. eggs, chicken, fish, milk
WHAT IT MEANS TO EAT RIGHT
To eat right means to eat enough. But it also means to eat a balance of the
different foods the body needs. To be healthy a person needs to eat enough foods
from each of the food groups just described. Many people eat large amounts of
starchy energy foods like rice, maize, tapioca, or plantain, but not enough of body
building and protective foods like beans, peas, pulses, dark green leafy vegetables-.
and fruit. These people can be malnourished. To stay healthy, try and eat at least
one food from each group at each meal.
Malnutrition is often most severe in children, who need lots of nutritious food to
grow well and stay healthy. The two most common forms of severe malnutrition are
the following : KWASHIORKOR and MARASMUS
Neither kwashiorkor nor marasmus develops all at once. A child may already be
fairly malnourished and still show few signs. Agood way to check if a child is poorly
nourished is to measure the circumference around his upper arm.
132
Checking for Malnutrition : The sign of the Upper Arm
After 1 year of ige, any child whose upper arm
measures less than 13 cm around is malnourished, no
matter how ‘fa his feet, hands and face may look. If
the arm meas jres less than 12 cm. he is severely
malnourished.
Very often children who are given only breastmilk with
no other foods look fairly well nourished. But they are
on the border line of malnutrition. Even a minor illness
like cold or diarrhoea can make them malnourished.
1. This child was given only breast milk. This child felt sick with a minor
infection like cold
Infection
2. This chiid was given other foods along with breast milk. This child
was able to fight infection and so remained healthy.
Another good way to tell if a child is well-nourished or poorly nourished is to
weigh him once a month. A healthy well-nourished child gains weight regularly.
The weighing of Children and the use of the Road to Health Chart is discussed fully
in Chapter 21. page 343
Kwashiorkor.often first appears when a child has diarrhoea or another infection
like measles. It is seen most often in babies who are only breast fed and who are
given very little other food to eat.
This child with kwashiorkor has not been eating enough staple foods. He
'burns up’ the protein in the staple food and the breast milk to make energy.
Therefore he has no protein left to grow and make his body strong. This
child has Kwashiorkor. We call this wet malnutrition because his feet,
hands and face are swollen.
Because of swelling, and because he may even have some fat. the child with
kwashiorkor may look plump rather than thin. But his muscles are wasted. If you look
at his upper arms, you will find them surprisingly thin. This child needs more food.
WET MALNUTRITION
OR KWASHIORKOR
—from not eating enough protein—
DRY MALNUTRITION
OR MARASMUS
—from not eating enough—
Sometimes, a child does not eat enough of any kind of food. In other words he is
starved.
He has dry malnutrition, or marasmus. His body is small, very thin, and wasted. He
is little more than skin and bones. Thia child also needs more food.
Often a child may show the signs of kwashiorkor and marasmus at the same
time. His legs may be swollen as in kwashiorkor but his arms may be thin as in
marasmus. This child needs m'bre food.
Certain bulky foods like plantains (bananas), and roots (radish, tapioca,
turnip, etc.) have so much water and fibre in them that the child gets full
without getting enough food to meet his energy needs. His belly cannot holo
more, but he is still starving.
It is very important that such children eat at least 3 times a day, and also snack
between meals. Mixing a little vegetable oil with a child's food also helps. When
ever possible he should eat other less bulky, more nutritious foods-both energy
foods and proteins.
CHILDREN, LIKE CHICKENS,
SHOULD ALWAYS BE PECKING.
134
Prevention and treatment of malnutrition:
Both marasmus and kwashiorkor can be prevented or treated by eating a
balance of nutritious foods and by eating enough. For babies, breast milk is the
best complete food. Breast feeding should be continued as long as possible. Some
mothers breast feed their babies for 2 years or longer. After the first 4 to 6
months the baby should begin to get other nutritious foods in addition to breast
milk. This is discussed more fully on page 142
Children with kwashiorkor or marasmus need extra food. Eggs, milk, chicken,
meaj and fish are considered good food but are expensive. A mixture of
staple food and protein food should be given. To be easily digested, the
food should be well cooked and mashed. A little oil or fat can be added to
the food to increase the energy content of the food.
Other forms of malnutrition:
Among poor people the most common forms of malnutrition are marasmus
or kwashiorkor (due to either hunger or starvation). However, other forms of
malnutrition may result when certain vitamins and minerals are missing trom
the food people eat. For example :
□ Young children who eat no yellow or dark
green fruits and vegetables, or other foods rich
in vitamin A may develop night blindness, dry
eyes, and eventually go blind (see p. 271).
• Children who do not drink milk and whose
skin is almost never exposed to the sunlight may
become bowlegged and develop other bone
deformities (rickets). While this problem can be
corrected by giving the child milk and vitamin D
(found in fish liver oil), the easiest and cheapest
form of prevention and treatment is to be sure
sunlight reaches the child's skin.
• Persons who do not eat enough foods with
iron, such as dark green leafy vegetables, eggs, or
meat, may develop anemia (see p. 146)
SUNLIGHT IS THE BEST PREVENTION
AND TREATMENT OF RICKETS.
■ A number of skin problems (p.248h sores
on the lips and mouth (p.276), or bleeding
gums may come from not eating fruits, vegetables, and other foods containing
certain vitamins (see p.129) •
These and other problems related to nutrition are discussed more fully in this
and other chapters.
135
WiAYS OF EATING BETTER WHEN YOU
D(O NOT HAVE MUCH MONEY OR LAND
There are many reasons for hunger and poor nutrition. One reason is poverty.
Inn many parts of the world a few people own most of the wealth and the land.
TKhey may grow crops like coffee or tobacco, which have no nutritional value
a<nd sell them to make more money, or the poor may farm small plots of
borrowed land, while the owners take a big share of the harvest. The problem of
hiunger and poor nutrition will never be completely solved until people learn to
slhare with each other fairly.
But there are many things poor persons can do to eat better at low cost—and
Iby eating well gain strength to stand up for their rights. On pages w13 and w14
<of "Words to the Village Health Worker" you will find several suggestions for
achieving better nutrition. These include improved use of land through rotating
crops, contour ditches, and irrigation; also breeding fish, beekeeping, improved
grain storage, and planting family gardens. If the whole village or a group of
families works together on some of these things, a lot can be done to improve
nutrition.
When considering the question of food and land, it is important to remember
that a given amount of land can feed only a certain number of persons. If the
amount of land and other resources your family has is limited, it is wise to plan
ahead and only have the number of children that you can feed well. More children
may mean more hands to do work, but it does not necessarily mean more land to
work.
Hungry children do not work well, and many of them die.
Small family size is becomingjncreasingly important for good nutrition. Think
about this and plan ahead. A discussion of the balance between people and land
is found on page w16. For a discussion of family planning, see Chapter 20.
When money is limited, it is important to use it wisely. This means cooperation
and looking ahead. Too often the father of a poor family will spend the little bit
of money he has on alcohol and tobacco rather than on buying nutritious food, a
hen to lay eggs, or something to improve the family's health. Men who drink
together would do well to get together sometime when they are sober, to discuss
these problems and look for a healthy solution.
Also, mothers sometimes buy sweets for their children when they could
spend the same money buying milk, eggs, or other nutritious foods. This way
their children could become more healthy for the same amount of money.
NO
IF YOU HAVE A LITTLE MONEY
AND WANT TO HELP YOUR CHILD GROW STRONG:
DO NOT BUY HIM A SOFT DRINK OR SWEETSBUY HIM A COUPLE OF EGGS.
YES
136
BETTER FOODS AT LOW COST:
Many of the world's people eat a lot of staple and starchy foods, and not enough
foods rich in protein, vitamins, and minerals. This is because most of these 'better'
foods cost so much. Animal protein like milk and meat is very nutritious, but also
expensive. Animals also require more land for the amount of protein they provide
Most people cannot afford much food from animals. Some religions do not allow
people to eat meat. In fact, a poor family can usually get more protein and good
nutrition if they grow or buy plant foods high in protein, like beans,peas, lentils,
groundnuts, and dark green leafy vegetables,
rather than expensive animal
foods like meat and fish.
People can be strong and healthy
when most of their protein comes from plants.
Try to eat a variety of plant foods rather than mostly one or two. Different
plants supply the body with different proteins, vitamins, and minerals. For
example, beans and maize together meet the body's needs much better than either
beans or maize alone. And if other vegetables and fruits are added, this is even
better. If possible, eat a different vegetable each day.
Here are some suggestions for getting more
proteins, vitamins, and minerals at low cost.
I. Breast milk. This is the cheapest, healthiest,
and most complete food for a baby. The mother
can eat plenty of plant protein and turn it into
the perfect baby food—breast milk. Breast
feeding is not only best for the baby, it saves
money!
2. Eggs and chicken. In many places eggs are
one of the cheapest and best forms of animal
protein. They can be mixed with foods given to
babies who cannot get breast milk. Or they can
be given along with breast milk as the baby
grows older.
Eggshells, ground up well and mixed with food,
can provide needed calcium for pregnant women
who develop sore, loose teeth or muscle cramps.
Chicken is a good, often fairly cheap form of
animal protein-especially if the family raises its
own chickens.
137
3. Liver, heart, kidney, and blood.
These are especially high in protein,
—-vitamins, and iron (for anemia) and
=are often cheaper than other meat.
—Also fish is often cheaper than other
■imeat, but is just as nutritious.
In certain parts of India, dried fish is
—very cheap. This is very good.
■•especially for mothers who are breast
-(feeding.
•4.
Rice wheat and other grains.
'They are more nutritious if they are not
polished. Moderately polished rice.
and whole wheat contain more
vitamins than the white, over-polished
product. Parboiling causes an
important vitamin present in the husk
to move deep into the grain. Parboiled.
hand-pound rice is better than the raw.
polished rice
6. Dried maize (corn) when soaked in
slaked lime before cooking, allows
more of the vitamins (niacin) and
protein to be used by the body.
Ragi and bajra. These are very rich
in minerals, especially calcium and
iron. They are cheaper than rice or
wheat, and are also more nutritious.
These can be used instead of rice or
wheat for a good diet.
6.
A mixed cereal diet is better than
just one cereal. Different cereals
supply the body with different proteins.
A mixture of different cereals will
supply the body with all the protein it
needs.
7.
8. Beans and other legumes (peas,
lentils, etc.) are a good cheap source
of protein, especially soyabeans and
winged beans. If allowed to sprout
before cooking and eating, they are
higher in vitamins. Baby food can be
made from beans by cooking them well.
138
peeling off their skins, and mashing
them.
Beans, peas, and other legumes are
not only a low-cost form of protein.
Growing these crops makes the
soil richer so that other crops will
grow better afterwards. For this
reason, crop rotation is a good idea
(see p. w13).
9. Dark green leafy vegetables have
a modest amount of protein, some iron
and a lot of vitamin A. The leaves of
sweet potatoes, beans and peas, and
pumpkins are especially nutritious.
They can be dried, powdered, and
mixed with babies’ gruel (Kanji) to
add to the protein and vitamin
content.
Light green leafy vegetables like
lettuce and cabbage contain very little
protein or vitamins. In terms of
nutritional value, they are not worth
growing.
1 0 The green leaves of root vegetables
like radish, tapioca, have more proteins than the
radish or tapioca root which is more commonly
eaten. Tapioca leaves contain seven times as much
proteins and more vitamins than the root. If eaten
together with the root, they have more value at no
additional cost. The young leaves are best.
1 1 Cook vegetables, rice and others foods in little
water. Cut the vegetables just before cooking. Do
not over cook. This way fewer vitamins and minerals
are lost. Besure to drink the leftover water, or make it
into a soup. Add a little tamarind to the cooking
vegetables. This way fewer vitamins are lost
Fresh vegetables have more nutrientsthan old, stale
ones.
h i uni
139
1 2. Many wild fruits and berries are rich in
vitamin C as well as natural sugars. They can
provide a good vitamin and food supplement.
(Be sure to eat only those which are not
poisonous.)
13 . Cooking in iron pots or putting a piece of
old iron or rusty horseshoes in the pan when
cooking beans and other foods adds iron to fooc
and helps prevent anemia.
1 4 Jaggery contains a lot of iron as it is made in iron
pots. Use this instead of the commonly used white
sugar.
WHERE TO GET VITAMINS:
IN PILLS, INJECTIONS, SYRUPS-OR IN FOODS?
Anyone who eats well gets all the vitamins he needs. It is always better to eat
well than to buy vitamin pills, injections, syrups, or tonics.
Sometimes nutritious foods are scarce. If a person is already poorly nourished,
he should eat as well as he can and perhaps take vitamins besides.
In almost all cases vitamins taken by mouth work as well as injections, cost less,
and are not as dangerous. Do not inject vitamins! It is better to swallow them—
preferably in the form of nutritious foods.
If you buy vitamin preparations, be sure they have all the vitamins and
minerals commonly lacking in starchy diet.
These are:
Niacin (niacinamide)
Vitamin B-j (thiamine)
Vitamin B2 (riboflavin)
Iron (ferrous sulfate, etc.J-especially for pregnant women and persons with
anemia___________________________________________________________
140
In addition, certain people need extra:
Folic Acid (folicin), for pregnant women
Vitamin A
Vitamin C
(ascorbic acid)
for small children
Vitamin D
Vitamin Bg (pyridoxine), for small children and persons taking medicine for
tuberculosis
Calcium, for children and nursing mothers who do not get enough calcium in
foods such as milk and cheese, or foods prepared with lime
THINGS TO AVOID IN OUR DIET
A lot of people believe that there are many kinds of foods that will hurt them
or that they should not eat when they are sick. They may think of some kinds of
foods as 'hot' and others as 'cold', and'not permit hot foods for 'hot' sicknesses or
cold foods for 'cold' sicknesses.
They may also avoid some foods which they think have PITHAM (see p30)0r. they
may believe that many different foods are bad for a mother with a newborn child.
These beliefs may do more harm than good. Often the foods people think they
should avoid when they are sick are the very foods they need to get well.
A sick person has even greater need for body-building foods than a healthy
person. We should worry less about foods that might harm a sick person and think
more about the foods that help make him healthy—for example: fruit, vegetables,
milk, meat, eggs, and fish. As a general rule:
The same tooas that are good for us when we are healthy
are good for us when we are sick.
141
■ Alcohol causes or makes worse diseases of the liver, stomach, and nerves. It also
causes social problems.
■ Smoking can cause chronic (long-term) coughing or lung cancer and other
problems (see p.1 78 ). Smoking is especially bad for people with lung diseases like
tuberculosis, asthma, and bronchitis, and for pregnant woman
■ Too much greasy food, hot spices, or coffee can cause stomach ulcers and other
problems of the digestive tract.
■ Too much sugar and sweets spoils the appetite, rots the teeth, can cause heart
problems, and may be part of the cause of intestinal cancer. However, some sugar
may help give needed energy to a very sick person or poorly nourished child.
A few diseases require not eating certain other foods. For example, people with
high blood pressure, certain heart problems, or swollen feet should use little or no
salt. Too much salt is not good for anyone. Stomach ulcers and diabetes also
require special diets (see p. 149)
THE BEST DIET FOR SMALL CHILDREN
THE FIRST2 TO 4 MONTHS OF LIFE:
For the first 2 months give the baby
mother's milk and nothing else.
Breast milk is the best and purest rood for babies. It is better than any baby
food or formula you can buy. If you give tne baby only breast milk during the
first 2 to 4 months, this helps protect him against diarrhea and many infections.
If the mother's breasts ao not make enough milk:
♦ The mother should drink a lot of water or other liquids. The more liquid she
drinks the more milk she will produce.
142
• The mother should eat better. Foods with proteins and vitamins— beans, dark
green leafy vegetables, papaya, garlic, meat. milk, cheese, eggs, and dried fish
will help her make more milk for her baby.
If the mother's breasts do not give any milk:
♦ Have her drink a lot of liquids and eat better. Let the baby suck her breasts
often. Sometimes her breasts will begin to make milk.
♦ If this does not work, give the baby some other type of milk—like cow's milk,
goat's milk, canned milk. A little sugar may be added to whatever kind of milk the
baby is given.
Note: whatever type of milk is used, always add some boiled water. Here are two
examples of correct formulas:
2 parts cow's milk ■
1 part boiled water.
1 teaspoon sugar
1 Part buffalo's milk
3 parts boiled water
1 teaspoon sugar
to*
If non-fat (skimmed) milk is used, add a tablespoon of cooking or vegetable oil to the i.
formula.
♦ Always boil the milk and water. It is safer to feed the baby with a cup and
spoon than to use a baby bottle. Baby bottles and nipples are difficult to keep
clean and cause many infections, including diarrhea (see p.185 ). If a bottle is
used, both it and the nipple should be boiled each time before the baby is fed.
BOTTLE FEEDING IS DANGEROUS. IT CAN KILL YOUR BABY.
If there is not enough money to buy milk for the baby, make a porridge from rice.
cornmeal, or other cereals. If possible add to this some skinned beans, pulses or
other protein. These should be well mashed and given as a liquid.
WARNING: Cornmeal or rice water alone is not nutritious enough for a baby.
The baby will not grow properly or walk or speak on time. He will get sick
easily and may die. THE BABY MUST HAVE A MIXTURE
DIFFERENT FOODS.____________________________________ __________________
FROM 4 MONTHS TO 1 YEAR OF AGE:
1.
Continue to give the baby breast milk, if possible until he reaches 2 years of age.
2.
When the baby is 4 months old. start giving him other foods as well. These foods
need to be well cooked and mashed. Often when the baby first tastes such food, he
spits if out. It tastes strange to him because he has not eaten it before. But the
143
mother should keep feeding him this food. He will soon got used to it and enjoy it. In
expensive. nutritious feedings can be made by combining at least one food from
each of the following groups:
Staple foods
Protein foods
Concentrated
energy foods
Foods with vitamins
and minerals
wheat
rice
ragi
jowar
bajra
potato
tapioca
pulses
peas
beans
groundnuts
soybeans
dark green leafy
vegetables
animal products
like milk, eggs, fish
meat
fats
oils
cheese
butter
ghee
jaggery
honey
white sugar
dark greenleafy vegetables
fruits
animal products
like milk. eggs. meat.
fish
These are some examples of balanced feeding using foods from each group.
4 to 6 months
6 months to 1 year
water in which dal and green leafy vegetables have
been boiled and cooked with a little jaggery and milk.
well cooked dal mashed and mixed with a mashed
chapati or mashed rice
well cooked green leafy vegetables.
mashed bananas, papaya, or other ripe fruits.
half boiled egg yolk mixed with a little milk.or
mashed chappati. Porridge made of dalia. wheat.
ragi. jowar and other staple foods.
rice mashed, chappati mixed with dal. green leafy
vegetables, milk. egg. potato, etc. ripe fruits.
CAUTION: The time when children are most likely to become
malnourished is between 6 months and 1 year of age. It is dangerous
because they often do not show any signs of malnutrition. Even a mild
infection like a cold can makethemseverely malnourished. They must
be given more food.
For children of this age to be healthy we should:
KEEP FEEDING THEM BREAST MILK,
FEED THEM OTHER NUTRITIOUS FOODS ALSO,
BOILTHE WATER THEY DRINK, AND
KEEP THE CHILDREN AND THEIR SURROUNDINGS
CLEAN.
144
A small child has a small stomach. He cannot eat a lot of food at one
3.
time. So feed him often. Give him as much food as possible. By six months.
a baby should eat five to six times a day.
ONE YEAR AND OLDER:
After a child is 1 year old, he can eat the same foods as adults, but should also
drink milk whenever possible.
Try to give the child foods with plenty of proteins, vitamins, iron, and minerals
(as shown on p. 1 28 and 129) every day, so that he will grow up strong and
healthy.
Children and candy: Do not accustom small children to eating candy and
sweets or drinking soft drinks. When they have too many sweets, they no longer
want the foods that are better for them. Also, sweets are bad for their teeth.
However, when food supply is limited, adding a little sugar and vegetable oil to
milk or other food may allow children to make fuller use of the protein in the
food they get.
THE BEST DIET FOR CHILDREN
145
HARMFUL IDEAS ABOUT DIET
1 The diet of mothers after giving birth:
In many areas there is a dangerous popular belief that a woman who has just
had a baby should not eat certain foods. This folk diet—which forbids the new
mother some of the most nutritious foods and permits her to eat little more than
rice or chappati with a watery curry-makes the mother weak and anemic. It may
even cause her death, by lowering her resistance to hemorrhage and infection.
After giving birth a mother needs to eat
the most nutritious foods she can get.
In order to fight infections or bleeding and to produce enough milk for her
child, a new mother should eat plenty of body-building foods like beans, eggs,
chicken, milk products, meat, fish, fruits, and vegetables. None of these foods will
harm her; all bring better health.
2. It is also not true that oranges, guavas, or other fruits are bad for a person
who has a cold, the flu, or a cough. In fact, fruits like oranges and tomatoes have
a lot of vitamin C, which may help fight colds and other infections.
3. It is not true that certain foods like spices, or guavas cannot be eaten
while taking medicine. However, eating fat or spices when one has a disease of the
stomach or other parts of the digestive system may make things worse—whether
or not one is taking medicines.
146
HEALTH PROBLEMS RELATED TO WHAT PEOPLE EAT
Special diets are the best prevention ana treatment for certain diseases. Here
are some of these diseases:
ANEMIA
A person with anemia has thin blood. This happens when blood is lost or
destroyed faster than his body can replace it.
A diet lacking meat, dark green leafy vegetables, and other foods rich in iron
can cause anemia or make it worse. If a child is not given other foods along
with breast milk after 6 months of age, he can get anemia.
Other causes of anemia are :
• hookworm infection
* dysentry
■ malaria and
• blood loss from - lungs as in tuberculosis
- stomach as in peptic ulcer
- anus as in piles
- large wounds
Women can also get anemia due to:
" increased loss during monthly periods
' repeated abortions
* many children without spacing.
*
white fingernails
147
* Weakness and fatigue
* If anemia is very severe, face and feet may be swollen, the heart beats
faster and the person may have shortness pf breath. The finger nails are flat,
and sometimes there is spooning of nails. To test this, put a drop of water on
a finger nail; if it remains there without roiling off, there is spooning of nails.
Treatment and prevention of anemia:
• Eat foods rich in iron. Bajra and ragi have good amounts of iron. Green
leafy vegetables, especially spinach, amaranth, beans and peas have a lot of
iron. Jaggery has iron as it is made in iron pots. Meat. fish, chicken, eggs
arehigh in iron. Liver is specially high.
♦ If foods rich in iron are hard to get, or if the anemia is severe, the person
should take iron (ferrous sulfate pills, p. 424). This is especially important for
pregnant women who are anemic. For nearly all cases of anemia, ferrous sulfate
tablets are much better than liver extract or vitamin B12- As a general rule, iron
should be given by mouth, not injected, because iron injections are dangerous.
♦ If the anemia is caused by dysentery (diarrhea with blood), hookworm,
malaria, or another disease, this should also be treated.
♦ If the anemia is severe or does not get better, seek medical help. This is
especially important for a pregnant woman.
Many women are anemic. This is often because they do not eat enough foods
rich in iron to replace the blood they lose during menstrual periods or with child
birth. Anemic women run a greater risk of miscarriage and of dangerous
bleeding in childbirth. For this reason it is very important that women eat beans,
dark green vegetables, and as much meat, chicken, and eggs as possible, especially
during pregnancy. Family planning—allowing 2 to 3 years between pregnancies—
lets the woman regain strength and make new blood (see Chapter 20).
HIGH BLOOD PRESSURE
High blood pressure can cause many problems, such as heart disease, kidney
disease, and stroke. Fat people are especially likely to have high blood pressure.
Signs of high blood pressure:
• frequent headaches, mostly at the back of the head, and especially
when getting up in the morning.
• pounding of the heart and shortness of breath
with mild exercise
• weakness and dizziness
occasional pain in the left shoulder and chest
148
All these problems may also be caused by other
diseases. Therefore, if a person suspects he has high
blood pressure, he should see a health worker and
have his blood pressure measured.-------------------------- »
A BLOOD
PRESSURE CUFF
for measuring
blood pressure
What to do to prevent or care for high blood pressure:
♦ Overweight people should lose weight (see below)
♦ Fatty foods, and foods with a lot of sugar or starch should be avoided.
Always use vegetable oil instead of butter or ghee. Sunflower oil is the
best.
♦ Food should be prepared and eaten with little or no salt.
♦ When the blood pressure is very high, the health worker may give medicines to
lower it. Many people can lower their blood pressure by losing weight if they
are fat (see below), and by learning to relax.
OVER WEIGHT
To be very fat is not healthy. Too much fat helps
cause high blood pressure, heart disease, stroke, gall
stones, diabetes, arthritis in legs and feet, and other
problems.
Fat people snould lose weight by:
♦ not eating greasy, fatty, or oily foods.
♦ not eating sugar or sweet foods.
♦ getting more exercise.
♦ not eating too much of anything, especially
starchy foods, like corn, bread, potatoes, rice, tapioca etc.
Fat people should noteat more than one chappati ora handfulof rice with
■each meal. However, they can eat more fruit, vegetables and lean meat.
To lose weight, eat only half of what you now eat.
149
DIABETES
Persons with diabetes have too much sugar in their blood.
The signs of diabetes are:
And in severe cases:
continual thirst
urinating often and a lot
unexplained tiredness
itching and long-term skin
infections Like boils
weight loss
numbness or pain in the hands
or feet
sores on the feet that do not
heal
loss of consciousness
Increased appetite.
All of these signs may be caused by other diseases, too. In order to find out
whether a person has diabetes, his urine should be tested to see if there is sugar
in it.
One way of testing the urine is to boil 8 drops of untne with 5 ml of a special
liquid called Benedicts Solution. Boil for two mihutes. If the person is
diabetic, the colour of the solution will change from blue to green, yellow or
red. If the colour of the solution remains blue, then the person is not
diabetic.
Another way of testing the urine is to use special paper strips (for example
uristix.) If those change colour when dipped in the urine, then the person is
diabetic. These special paper strips are very expensive.
You will also notice that ants collect on the urine of a diabetic person.
When a person gets diabetes after he is 40 years old, it can often be best
controlled without medicines, by eating correctly. The diabetic person's diet is
very important and must be followed carefully for life.
The diabetic diet.Fat people with diabetes should lose weight until their
weight is normal. Diabetica must not eat any sugar or sweets. They
should eatfoods high in protein (dark green leafy vegetables, beans, nuts.
eggs, fish, lean meat, etc.) and low in starch. They should avoid foods like
rice, maize, wheat, potato, tapioca, and fruits like banana, apple,
breadfruit, jackfruit, etc.
Some diabetic persons—especially the young—need special medicine (insulin).
In case of severe diabetes, a health worker should be consulted.
STOMACH ULCERS, HEARTBURN, AND ACID INDIGESTION
Acid indigestion and 'heartburn' often come from eating too much heavy or
greasy food or from drinking too much alcohol. These make the stomach produce
extra acid, which causes discomfort or a 'burning' feeling in the stomach or mid
chest. Some people mistake the chest pain called 'heartburn' for a heart problem
rather than indigestion.
An ulcer is a chronic sore in the stomach or small intestine, caused by
too much acid. It can be recognised by a chronic, dull (sometimes sharp)
pain in the pit of the stomach. Often the
150
pain lessens when the person eats food or drinks
milk. The pain gets worse 2 or 3 hours after
eating, if the person misses a meal, or after he
drinks alcohol or eats fatty or spicy foods. Pain
is often worse at night.
If the ulcer is severe, it can cause vomiting,
sometimes with blood. Stools with blood from
an ulcer are usually black, like tar.
Prevention and treatment:
♦ Eat foods that heal ulcers instead of tnose which irritate them:
These cure ulcers:
These do no harm:
These make ulcers worse:
boiled milk
cheese
cream
oats
bananas
all boiled vegetables
boiled or poached eggs
boiled potatoes
alcoholic drinks
coffee
cigarettes
spices and pepper
greasy food
♦ Milk is one of the best medicines for ulcers of acid indigestion. If the ulcer is
severe, drink a glass of milk every hour for the first few days and eat only things
listed in the first column above (those which cure ulcers). In a few days, when the
pain lessens, begin eating things in the center column (those which do no harm).
For a few months, it is a good idea to drink some milk with each meal and also in
mid-morning, in the afternoon, and again before going to bed (6 times a day).
♦ Antacids, such as milk of magnesia or magnesium and aluminum hydroxide
(p.416), also help fight stomach acid and cure ulcers. If pain is severe, an
antispasmodic may help (see p. 41 5)
♦ Even after the ulcer is cured the person should never eat or drink.any of
the things in the right-hand column aoove (those which make ulcers worse), as
these may cause the ulcer to return. If possible, he should keep taKing antacids
or milk at bedtime
When to consult a health worker:
* if the pain does not go away, or becomes worse, even after eating the
foods in the first column above (those which cure ulcers)
• if the person starts vomiting blood
■ if the stools becme black like tar .
• if there is a sudden severe pain followed by signs of peritonitis (see P i o8)
151
THESE TWO MEN HAD STOMACH ULCERS
This man ate these foods:
This man ate, smoked, and drank
and got worse.
It is important to cure an ulcer early. Otherwise it may lead to dangerous
bleeding or peritonitis. Ulcers usually get better if the person is careful with
what he eats and drinks. Anger, tension, and nervousness make ulcers worse.
Learning to relax and keep calm will help. Continued care is necessary to prevent
the ulcer from returning.
Better still, avoid ever getting an ulcer by eating wisely, not drinking much, and
not smoking.
CONSTIPATION
A person who has hard stools and has not had a bowel movement for 2 or more
days is said to be constipated. Constipation is often caused by a poor-diet
(especially not eating enough fruits, green vegetables, or foods with natural fiber)
or by lack of exercise.
Drinkina more water arid eating more fruits, vegetables, and foods with natural
fiber like tapioca or wheat bran is better than using laxatives. Older people may
need to walk or exercise more in order to have regular bowel movements.
A person who has not had a bowel movement for 3 or more days, if he does not
have a sharp pain in his stomach, can take a mild salt laxative like milk of
<v\
magnesia. But do not take laxatives often.
----------------:-------------- .-'WUNever use strong laxatives or purgatives—
zespecially if there is stomach pain.
------------------
l/r~ ’
>
‘-ho
•
..tinU
152
GOITER (A SWELLING OR MASS ON THE THROAT)
A goiter is a swelling or a large mass on the throat that results from
abnormal growth of a gland called thyroid. Most goiters are casued by
lack of iodine in the diet This is very common in hilly regions.
Somehmes. a lack of iodine in a pregnant woman's diet can cause
babies-to die or be born mentally slow and /or deaf (cretinism, p-365 )
This can happen even though the mother does not have a goiter.
How to prevent or cure a goiter and prevent cretinism:
Everyone living in hiliy areas or in areas where goitre is common should
use iodized salt. Use of iodized salt prevents the common kind of goiter
and will help many goiters go away. (Old, hard goiters can only be removed
by surgery k ut this is not usually necessary.)
If it is not possible to get • 'dized sab, use tincture of iodine Put 1 drop in a
glass of water each aay ana drink. BE CAREFUL: Too much tincture of iodine
is poisonous. Drink only 1 drop a day. Keep the bottle where children cannot
reach it. Iodized salt is much safer.
Most home cures for goiter do not do any good. However, eating crab and
other seafood can do some good because they contain iodine. Mixing a little sea
weed with food also adds iodine. But the easiest way is to use iodized salt.
HOW TO KEEP FROM GETTING A GOITER
153
LATHYRISM
This disease is caused by eating large amounts of the pulse called
kesari dal. Kesari dal needs very little water to grow and so grows well in
dry areas. It is cheaper than other pulses.
Kesari dal is grown in parts of Madhya Pradesh. Uttar Pradesh, ana
Bihar. Often, it is given as wages in these areas So the disease is found
mostly m persons working as labourers.
Lathyrism affects the nervous system. First, the affected person is
unable to stretch his legs The stiffness slowly increases until the person
is unable to walk Finally his lower limbs become completely paralyzed.
Once the signs start appearing, there is no treatment for this disease
How to prevent lathyrism:
These methods help rn reducing the amount of poisonous substance
present in kesari dal:
The surest way of preventing lathyrism is to STOP;
EATING KESARI DAL. REFUSE TO ACCEPT KESARI
[dal for WAGES.
* atoeping method. Boil a large amount of water. Soak the dal in this hot
water for2'hours.Drain the water and wash the dal with cold water. Dry it
in the sun.
° Parboiling. Soak kesari dal in water for 1 2 hours. Then steam the dal
for half an hour. After this soak it in cold water for one hour.
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