The document discusses guidelines for prescribing diets based on a person's energy requirements, which are calculated based on their basal metabolic rate, physical activity level, and other factors. It provides examples of calculating energy needs for a 55kg male doing moderate work. It also discusses protein, calorie, and micronutrient requirements and food exchanges that can be used to design diets meeting those requirements. The key steps outlined are calculating needs, determining required macronutrients, selecting appropriate foods to meet those needs while maintaining palatability and cultural eating patterns.
Prof. Geeta Jaiswal from M.L.N Medical College introduces the topic.
Energy requirements are based on basal metabolic rate, physiological factors, and physical activity levels categorized as sedentary, moderate, or heavy.
Energy addition for activity: +30% BMR for sedentary, +40% for moderate, +50% for heavy work. Additional needs during pregnancy (+300 kcal) and lactation (+500 kcal).
Illustration of calculating energy needs for a 55kg male engaging in moderate work resulting in a total of approximately 2050 kcal.
Protein needs: 1g/kg for adults, 2g/kg for children, and 2.5g/kg during pregnancy/lactation. Caloric needs vary by age, gender, height, weight, health, and activity.
Dietary prescriptions should consider ideal body weight, average Indian weight, and additional caloric needs during pregnancy and lactation.
Balanced diet recommendations include a calorie distribution of 60:20:20 for carbs, proteins, and fats, incorporating specific dynamic action in total calorie needs.
Diet breakdown: 60g proteins, 35g fats, and 350g carbohydrates totaling 2000 kcal, emphasizing the importance of knowing food nutrient values.
Food exchange system allows for nutrient calculation, promoting cereal-pulse combinations for balanced amino acids despite higher cereal intake.
Requirements for a balanced, palatable diet providing necessary nutrients, emphasizing cereal-pulse balance, mineral intake, and meeting energy expenditure.
While calculating theenergy
requirements, we have to
consider the energy required
for:
1.Maintenance of basal metabolic
rate (BMR)
2.Specific dynamic action or
Thermo genic effect of food.
3.Extra energy expenditure for
physical activities.
3.
The energyrequirement would
depend on the occupation,
physical activity & life style of
the individual.
The activity levels may be
divided into 3 groups-
Sedentary,
Moderate &
Heavy.
4.
For sedentary work---- +30% of BMR
For moderate work ---- +40% of
BMR
For heavy work ------ +50% of
BMR should be added.
Requirement for energy
During pregnancy is +300 kcal/day
&
During lactation is +500 kcal/day, in
addition to the basic requirements.
5.
TYPE OF
ACTIVITY
OCCUPATION
Light
Office workers,lawyers, accountants,
doctors,
teachers, architects, shop-workers
Moderate
Students, industry workers, farm
workers, housewives without mechanic
appliances.
Very Active Agricultural workers, miners,
unskilled laborers, athletes, factor
workers.
Heavy Work Lumber jacks, blacksmiths,&
construction workers.
FOR BMR =24 × 55 Kg = 1320 Kcal
+ FOR Activity = 40% of BMR = 528 Kcal
Subtotal 1320 + 528 = 1848 Kcal
+ Need for
SDA
1848 × 10% = 184Kcal
TOTAL
1848+ 184= 2032Kcal
Approx. 2050Kcal
9.
PROTEIN REQUIREMENT:
1g perkg body weight for
adults &
2g per kg body weight
for children.
During pregnancy & lactation
protein requirement is about
2.5 g per kg body weight
As a rule,the calorie
requirement for a person is
taken as 30-35 kcal per kg of
ideal body weight.
For sedentary life style/habits,
lower values (30 kcal)
For moderate muscular
activities, higher values (35
kcal) are prescribed.
12.
WHILE PRESCRIBING THEDIET OF
A PERSON THE FOLLOWING
GENERAL RULES ARE TO BE
REMEMBERED:
THE IDEAL BODY WEIGHT:
The under weight person should be given
more nutrients & the overweight person
should reduce calories intake.
13.
The idealbody weight for an average
adult male is taken as 48 kg for a
height of 153 cm
± 1.25 kg for every cm.
For an average adult female the ideal
body weight is 45kg for a height of 153
cm, ± 1 kg for every cm.
14.
Considering the averageweight of
Indians between 55-65kg,
The average calorie requirement will
be between 1700 & 2300 kcal per
day.
An extra allowance of 300 kcal is
necessary during pregnancy & +500
kcal/day during lactation
.
15.
Specific dynamic action:
Anextra energy is to be
supplied to account for
SDA.
RATIO: Balanced diet
should contain calories
from Carbohydrates,
Proteins and Fats in the
ratio of 60:20:20
What is therequirement
of the person with regard
to calorie & other
essential nutrients?
What is the quantity of
proximate principles
required ?
18.
Which composition offood
will give the above
requirement ?
How can a palatable diet
that contains these food
items be prescribed ?
The total quantity may be
divided into 3 or 4 meals at
convenient intervals of time.
19.
He requires 60gProteins.
This will give him 60 × 4 = 240 kcal of
energy.
His total requirement is = 2000 kcal.
Therefore, Carbohydrates plus Fats
should produce (2000 – 240 ) = 1760 kcal.
20.
As a generalrule about 20% of total
calories are supplied by fat.
Therefore, fats should supply
1760 × 20% = 350 kcal
which is provided by
(350/9) = 35 to 39 g of fats
About 30% of total fats can be
supplied as PUFAs
The rest 1400 kcal are supplied by
350g of carbohydrates
Knowing the requirements& nutritive value
of the food.
A fundamental principle of dietetics is the
“food exchange”.
It is very useful for calculation of the
proximate principles
Accordingly, foods with similar nutrients
composition are grouped together.
This is also useful to provide variety in food.
27.
Food Exchange
Cereals exchange
One chapati (20g wheat)
One bread or
Cooked rice 3 tablespoon
(20g raw)
One idli
Legumes-pulses exchange
Bengal gram (channa) 100g
Black gram (urad) 100g
Green gram (moong) 100g
or
Red gram (arhar) 100g
Horse gram (kulthi) 100g
Content
Protein 2g
Carbohydrates 15g
Energy 70Kcal
Protein 24g
Carbohydrates 60g
Energy 340Kcal
Table shows that one chapati or one idli or one large slice
bread will give equal quantities of energy & proteins.
29.
Although proteincontent of pulses is more
than cereals, the average Indian diet contains
more cereals,& hence proteins are mainly
supplied by cereals.
But pulses give good quality proteins.
A judicious combination of cereals & pulses
provide all the essential amino acids
Pulses are deficient in methionine, while
cereals lack in lysine.
Food should contain pulses & cereals in the
ratio 1:5 to provide good quality proteins.
31.
Important points forprescribing a Diet
It should be a balanced diet, well
planned diet containing all essential
nutrients.
The diet should be simple, locally
available, palatable & digestible.
Adequate protein content with essential
amino acids should be supplied. This is
achieved by a cereal-pulse mixture with
additional animal proteins, if necessary.
32.
Calorie intakeshould be correct &
should balance energy expenditure.
Special care should be taken to see
that adequate quantity of calcium &
iron are obtained from the diet. The
absorption of these minerals is reduced
by other factors in Indian diet.
Should have variety & should not differ
very much from the habitual diet of
the person.
Should provide adequate roughage.
33.
This diet willsatisfy the requirements
regarding
Carbohydrate (350g)
Protein (60g),
Fats (35g),
Calories (2000kcal),
Calcium (400mg)&
iron (25mg).
o It should be seen that the cereal-pulse
ratio is maintained at 5:1.
o When calories alone are to be increased
as in the case of a person having severe
muscular exercise, tubers & roots will
serve this purpose.