Author:- Snehalatha SN Dornala Associate Professor, PG Dept of Kaumarabhritya VYDS Ayurved Mahavidyalaya, Khurja, Bulandshar Dist., UP, India.

1. Nutritional errors and disorders in children –
Challenges and scope of Ayurvedic RUTFs & RUSFs
Snehalatha SN Dornala
Associate Professor, PG Dept of Kaumarabhritya
VYDS Ayurved Mahavidyalaya, Khurja, Bulandshar Dist., UP, India.

2. Copyright & Disclaimer
All material in this presentation particularly ACRONYMS
and other unique thought contents may be copied,
reproduced, distributed, republished, displayed, posted or
transmitted in any form or by any means with proper
citation.

3. Introduction
 Article 47 of the Indian Constitution clearly states that a key
responsibility of the state is to ensure the “raising of the level of
nutrition and the standard of living of its people and the improvement
of public health”.
• Right to adequate nutrition - UNCRC
 India Health Report: Nutrition 2015’ states that “child under nutrition
rates in India are among the highest in the world with nearly one half of
all children under three years of age being either underweight or
stunted.

4. Dual epidemic – Hypo/Hyper nutrition
India - 20% of the poor of the world, is facing obesity crisis.

5. Ages and stages of development of children
Age Stage
0 – 1 year Infants
1 – 3 yrs Toddlers
3 – 5 yrs Pre - schoolers
6 – 11 yrs Middle childhood
12 – 14 yrs Young Teens
15 – 17 yrs Teenagers
https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/preschoolers.html

6. Nutritional errors
 The word ‘error’ in relation to Nutrition refers to
improper selection of foods, unhealthy eating habits,
incorrect combination of foods, untimely food
consumption etc.,
 Ayurveda has given due importance to Nutritional
errors in the causation of nutritional disorders under
the heading of “Nindita Ashana”.

7. Nindita Ashana
• Anashana – Taking no food or fasting
• Pramitashana – Habitual intake of food in extremely small quantities.
• Atyashana or Mahashana – Excessive food intake or having frequent meals without
any need or voracious eater or eating much either in quantity and/or frequency
• Ajirnashana – Consuming food when the previously taken food is not digested.
• Viruddhashana - Consuming incompatible foods like fish and milk together
• Vishamashana- Consuming less or more quantity at improper time (akale bahucha
alpam va bhuktam tu vishamashana)
• Adhyashana - Consuming large quantity of food even before the previous meal is digested
constitutes Adhyasana
• Samashana - Consuming suitable and unsuitable foods mixed together constitutes
Samashana

8. Anashana – Taking no food or fasting
 “Between the ages of two and five, the average child
grows about 2½ inches taller each year, and also gains 2
to 2.5kgs each year.
 Non- availability leads to Kwashiorkar, marasmus,
wasting, stunting, underweight etc
“Anashanam aayusho hraswakaraanaam”
 Food jags

9. Pramitashana – Habitual intake of food in
extremely small quantities.
 8 to10 times a small quantity
 Digestive system needs rest – for effective gut microbiome. (The telegraph By Helen
Foster 2015)
 Micronutrient malnutrition like vitamin & mineral deficiencies,
malabsorption syndrome
 High frequent meals associated with low body
weight.(Eating Frequency and Overweight and Obesity in Children and
Adolescents: A Meta-analysis)
“Pramitashanam karshaniyanaam”

10. Atyashana or Mahashana
 Metabolic disorders such as diabetes & diet-related non-communicable
diseases (such as heart disease, stroke, diabetes and some cancers) and
Fatty liver
 Chocaholic
 Billy bunter
 Overweight & obesity
“Atimatraashanam aamapradhoshahetunaam”

11. Ajirnashana – Consuming food when previously
taken food is not digested
 Children with habit of pica have difficulty in digestion
“Ajirnaashanam grahanidoshananaam”

12. Viruddhashana -Consuming incompatible foods like fish
and milk together
The most common food allergies in children are milk, eggs, peanuts, tree nuts,
soy and wheat.
 Food Allergy – Attacks immune system Ex Milk allergy.
 Food intolerance- Ex Lactose intolerence
 “Viruddhaviryashanam ninditavyadhikaranaam”
 “Pathya sevanamaarogyam”
 Vaghbhat – Gara visha

13. Giving soft drinks to kids is child abuse

14. Vishamashana - Consuming less or more
quantity at improper time
 Not offering as per demand of child.
 Offer food forcefully when they are sleeping
 Just before giving bath/ late night
 convienient time of working mother
 “Vishamashanam agnivaishamyakaranaam”
 “Kaala bhojanam aarogyakaranaam”

15. Adhyashana - Consuming large quantity of food even
before the previous meal is digested
 Binge eating disorder
 Birthday parties

16. Samashana - Consuming suitable and unsuitable foods
 Sweetened bevarages like coke, sprite, cookies along with
staple food.
 Endocrine disruptor chemicals such as bisphenol A – BPA
(present in children’s toys, plastic bottles and food
containers, food can linings.

17. Ashana trayam
 Vishamashana
 Adhyasana
 Samashana
All the above three conditions either cause death or dreaded
diseases. (AH Su.8/33 – 34)
 Ashana due to pragnyaparadha:

18. Children are Faddy eaters
 Picky eaters – remove fibre, tomoto peels, jeera etc from plate.
 Child size portions
 say no
 hold food in their mouth and refuse to swallow it
 keep their mouth shut
 spit food out repeatedly or vomit
 turn their head away
 cry, shout or scream
 push away a spoon, bowl
 gag or retch

19. Diversified diets
 Shadrasa yukta ahar is ideal
 Preserve the treasure of gut microbial diversity

20. Wholesome Vs Unwholesome food
 Food jags
 Eating only aloo or dal
 “Ekarasabhyaso daurbhalyakaranaam”

21. Vulnerable group
 Rural & Urban poor children
 Children whose care is under paid maid
 Children staying at Day care centre
 Poor SES with Big family size
 Differently abled children
 Celiac disease, cystic fibrosis etc

22. Outcome of Nutritional errors leading to
Common nutritional problems
 Irreversible stunting
 Failure to thrive
 Marasmus
 Underweight
 Refusal of foods
 Allergies and intolerances
 Iron deficiency anemia
 Vitamin deficiencies
 Electrolyte Imbalance
 Risk of chronic diseases
 Poor cognitive development
 Childhood obesity
 Inflammatory BD
 Irritable BS
 Constipation
 Tooth decay

23. Malnutrition & Micronutrient Malnutrition
 Medium – Wasting & Stunting; High – Underweight
 Iron deficiency anemia, Vit A, Zn, Se
 May be delay in Balance & co ordination of motor
movements.
 Insignificant growth in communication skills & language
development -A bad start for education

24. Worms affecting Nutrition
 Highest Intensity of infection in pre school children-
inadequate sanitation, access to safe water n food.
 By feeding on the contents of the host's gut, tissues,
maldigestion, malabsorption, inflammatory disorders
 Deworming is safe easy and cheap
 Worms aggravate malnutrition, anaemia and stunting
levels and retard both physical and cognitive
development.
 Body constitution

25. Nutrition - Disability
 Nutrition and disability are intimately related: both are
global development priorities;
 CP- feeding difficulties; ASD- complex reaction to
particular food, texture & colour
 Down syndrome – prefer smooth foods
 Collabaration between health & disability
 Educating & training
 Community based approach &Twin track approach

26. Role of Ayurvedic pediatric dietician is to advise pathyapathya
ahara and to provide therapeutic foods
 Preventing the nutritional disorders
 Managing food allergies
 Treating diagnosed nutrient deficiencies
 Managing faddy eating
 Managing obesity and weight related issues
 Managing faltering growth
 Appropriate prescribing.

27. Ready to Use Therapeutic Foods (RUTFs)
• RUTF, the remedy recommended by UNICEF for the community-
based treatment of SAM, is an energy-dense paste consisting of
milk powder, vegetable oil, sugar, peanut butter and powdered
vitamins and minerals used in therapeutic feeding.
• Govt of India in a major change in its nutrition policy has decided
in November 2017 that states are free to take a call on providing
ready-to-use therapeutic food to children suffering from severe
acute malnutrition.
• Nuflower – Unicef accredidated - Collaborated with India

28. Scope of Ayurvedic RUTF
 It can be planned for MAM & SAM.
 Limited Nurtitional rehabilitation center’s- limited geographic reach & cost
intensive.
 RUTF along with RUSF.
 Promotion of use of nutritious, safe and locally available herbs.
 Ladoos, dry soups, hot infusions-tea bags,
lozenges, jellies, snack foods etc

29. Ayurvedic RUTFs & RUSF
 Mridu, madhura surabhi sheeta sharkara
 Balapanchamrit – Hingu, Sunti, Kana, Pathya, Mishi (RRS) - to
enhance the bioavailability of foods
Advantages:
 Improves food standard, quality
 Helps in optimum growth & development
 Acts as antioxidants and prevent recurrent infections
 Preventing & managing diet related to non communicable diseases

30. Plant milk
 Plant milk has been consumed for centuries in various cultures,
both as a regular drink and as a substitute for dairy milk.
 Rice milk, soy milk, coconut milk, almond milk
 Shadrasa yukta ahara

31. Hot infusions- just like Tea bags
 Small pottali filled with herbs like Yastimadhu, satavari coarse
powder and dipped in a cup of milk..
 Antioxidant tea bags– Tulasi, Guduchi
 Dipan pachan tea bags– Panchakola, Ela, Ginger, teja patra

32. Srikhand

33. Roti
 Clinical condition specific roti’s can be made for example whole wheat -pippali roti,
Whole wheat - ashwagandha roti etc)

34. Chywanprash Lollypops
 Yastimadhu stick with chyawanprash

35. Lozenges
 They can be prepared to enhance immunity and to supplement
vitamins and minerals.
 Zandu - Immu

36. Worm infestation
 Modaka – prepared with vidanga, tila and jaggery

37. Malnutrition laddoo
 Crushed dry dates with nuts and coconut powder mixed with
chousasth pippali and made into laddoo

38. To enhance cognitive development
 Mini dose packing of Different Avalehya with
add on flavours.

39. Buttermilk- Appetizer
 Buttermilk mixed with lavana bhaskar churna

40. Probiotic yogurt or curd

41. Nourishing cookies – Ashwaganda cookies

42. Yusha (Soups)
 Mudga yusha
 Dadima yusha
 Moolaka yusha
 Ready to use soup packets

43. Recipes with shigrudala (Moringa oleifera)

44. Oral Rehydration Solution
 Shadanga paniya with saindha lavana and mishri

45. Tofee (Desirable Vs Undesirable)

46. Chyawanprash cookies
 Kesar badam chyawanprash
 Chyawanprash with gold
 Mukta yukt chyawanprash
 Chyawanprash with rajata bhasm, loha bhasm,
swarnamakshika, yasada added with dry fruits – made
into toffee

47. Prevention
 Improving maternal nutrition
 Promoting optimal IYCF.
 Providing Home made foods
 Eating all together
 Stop eating junk foods - whole family
 Regular nutritional status health check up

49. Conclusion
 Food and Nutrition Security at National, Community and Household
Levels through Ayurvedic RUTFs & RUSFs.
 Appropriate complementary feeding with Ayurvedic RUTF & RUSF to
achieve the mission of India i.e., “kuposhan mukt bharat”
 Introducing Ayurvedic therapeutic & supplementary foods in
community nutritional programmes.
 Promoting effective nutritional education

50. Dr. Snehalatha SN dornala
9310475039/ dornala.snehalatha@gmail.com