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Paper No. : 16 Applied Anthropology
Module : 03 Nutrition epidemiology
Development Team
Principal Investigator Prof. Anup Kumar Kapoor
Department of Anthropology, University of Delhi
Paper Coordinator Dr. Rashmi Sinha
Faculty of Anthropology, School of Social Sciences,
IGNOU, Delhi
Content Writer Ms. Kshetrimayum Surmala Devi & Dr. Meenal Dhall
Department of Anthropology, University of Delhi
Dr. Satwanti Kapoor (Retd Professor)
Content Reviewer
Department of Anthropology, University of Delhi
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Nutrition epidemiology
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Description of Module
Subject Name Anthropology
Paper Name Applied Anthropology
Module Name/Title Nutrition epidemiology
Module Id 03
Contents:
1. Introduction
2. History of nutritional epidemiology
3. Nutritional deficiency diseases
3.1. Malnutrition
3.1.1. Protein energy malnutrition (PEM)
3.1.2. Kwashiorkor
3.1.3. Marasmus
3.2 Micro-nutrient malnutrition
3.2.1. Iron Deficiency Anaemia (IDA)
3.2.2. Vitamin A Deficiency (VAD)
3.2.2.1. Night Blindness (XN)
3.2.2.2. Conjunctival Xerosis (X1A)
3.3.2.3. Bitot’ Spot (X1B)
3.3.2.4. Corneal Xerosis (X2)
3.3.2.5. Cornea Ulceration (X3A)
3.3.2.6. Keratomalacia (X3B)
3.2.3. Iodine Deficiency Disorders (IDD)
3.2.4. Water soluble vitamin deficiency disorders
3.2.4.1. Thiamine (Vitamin B1) Deficiency Diseases
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3.2.4.2. Riboflavin (vitamin B12) Deficiency Diseases
3.3. Nutrition and Non Communicable Diseases (NCDs)
3.3.1. Obesity
3.3.2. Type 2 diabetes
3.3.3. Coronary heart disease (CHD)
Learning Objectives:
To understand:
1. Definitions and concepts of nutritional epidemiology.
2. Deficiency diseases due to suboptimal intakes of micronutrients and its dietary management.
3. Non Communicable Diseases (NCDs) due to excessive intakes of macronutrients (over
nutrition) and its dietary management.
Introduction
The word epidemiology comes from two Greek words epi, meaning on or upon, demos, meaning
people, and logos, meaning the study of. Several definitions have been proposed, but the underlying
principles and public health spirit of epidemiology following is define by the following.
“Epidemiology is the study of the distribution and determinants of health-related states or events in
specified populations, and the application of this study to the control of health problems”.
Nutritional epidemiology studies the role of food and nutrition and in relation to disease in human
populations. Nutritional epidemiological research involves the role of food and nutrition in etiology of
diseases, assess and monitor the food consumption and nutritional status of populations, measures to
prevent, control and improvement of health, develop interventions in order to maintain healthy eating
lifestyle and also to analyze the association of nutrition and physical activity in relation to diseases.
History of nutritional epidemiology
Epidemiology is the study of the distribution and frequency of diseases in human populations.
Nutritional epidemiology examines the association of diet and our health. Earliest epidemiological
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investigation dates back to more 2000 years ago, when Hippocrates conducted a clinical trial to
observe the cause of a disease and belief in notion that health depends on magical influence. Lind in
1753 observed that scurvy was caused by deficiency of vitamin C when he conducted one of the
earliest clinical trials with lemons and oranges. Milestones in classic epidemiology include John
Snow’s (1813-1858) who studied the spread of cholera due to of polluted water, and suppresses the
outbreaks of the disease 44 years even before the discovery of , the causal agent Vibrio cholera.
Casimir Funk in 1912 investigated that deficiency of substances which he called “vitamins” may cause
diseases such as sprue, beriberi, rickets, pellagra etc.
Another epidemiological investigation of 19th and 20th century include Joseph Goldberger who
observed the occurrence of pellagra among poor relying on as staple diet. He suspected the disease
could be due to nutritional deficiency. It was later identified as deficiency of niacin, a B-complex
th
vitamin (B3). With the discovery of microorganisms, at the end of the 19 century mark the era of
infectious disease epidemiology. Robert Edward Koch work on the etiology of tubercle bacillus in
1882 resulted in improved environmental conditions and interventions for preventing transmission of
certain microorganisms. Epidemiological observation thus has provided the insight into the diet-
disease relationship and the cause and prevention of diseases. Earlier epidemiologist focused on the
etiology of infectious diseases but since early decades of 20th century, they shifted to chronic disease
and remarkable contribution have made to the understanding of nutrition-related diseases as well. Band
and Dyerberg studied coronary disease in Eskimos and observed that it was uncommon despite their
high fat diet and later found that omega -3 fatty acid from fish oil is responsible for low plasma lipid
level in their diet. Hospital based case control study in 1950 showed that smoking was associated with
lung cancer. So, epidemiology play an increasingly important role and its evolution has led to the
development of specialized areas like environmental, clinical, psychiatric, genetic, occupational within
the epidemiology.
Nutrition and health related diseases
In developed countries excessive intakes of macronutrients (over nutrition) and suboptimal intakes of
micronutrients (hidden hunger), lead to obesity and related non-communicable diseases (NCDs). There
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