Balanced dietDr.S.Sethupathy M.D, Ph.D.,Professor of Biochemistry,

RMMC, AU

The diet that contain a variety of foods Fulfills the need for energy , amino acids ,

vitamins , minerals and other nutrients For maintaining health Provides extra nutrients to withstand short

duration of illness.

Balanced diet

Balanced diet is planned according to:1.Kinds of food produced in the region2.Economic capacity3.Religion4.Customs, tastes and habit of the people

1.Cereals food group : Rice and wheat are the major cereals. Millets include jowar, Bajra and maize. Provides carbohydrates, protein, B- complex vitamins such as niacin, thiamine and dietary fiber.2.Milk groupsIt includes milk, butter milk, butter and cheese .Provides high class protein, calcium, phosphorus, riboflavin and vitamin D.

Food groups

3.Meat – Pulses and legume group Meat, poultry, fish and eggs. Provides protein, B12. Pulses - red gram, Bengal gram, black gram, green

gram, cow peas, kidney beans and chick pea. 4.Vegetable group Green leafy vegetables, roots and tubers. Spinach ,amaranth, fenugreek, drum stick,

coriander leaves. Provides calcium, iron, vitamin A, vitamin C,

riboflavin and dietary fiber. Roots and tubers are potato, sweet potato,

carrots ,tapioca. Rich in calcium, vitamin C , beta carotene.

5.Fruit groupMango, papaya are rich in carotene.Banana is rich in carbohydrate and potassium. Alma and guava are rich sources of vitamin C.Iron is rich in dry fruits like dates and raisins. Fruits provide water soluble vitamins, minerals and fiber.6.Fats, oils and sweet groupProvide essential fatty acids and fat soluble vitamin. Excess consumption of sucrose is associated with increased coronary heart disease.

The ideal body weight For an average adult male ,weight is as taken as

48 kg for a height of 153 cm. Plus or minus 1.25 kg for every cm and for female it is 45 kg for a height of 153 cm plus or minus 1 kg for every cm.

Protein requirements For adults, 1 gm / kg body weight is required . 2 gm/kg for children, and 2.5 gm/kg body weight

during pregnancy and lactation are needed.

Prescription of a balanced diet

For sedentary work +30% of BMR , for moderate work + 40% of BMR and for heavy work, +40% of BMR, is to be added. Extra energy is to be supplied for SDA also.

I step. For a sedentary man with 60 kg weight For BMR 60 x 24 = 1440 kcal For activity + 30 % BMR = 432 kcal Total = 1872 kcal +For SDA = 187.2 Total = 2059.2 Rounded to = 2060 kcal

Energy requirements

Macronutrients intake The protein requirement is 60 gm protein (60x 1 gm /kg body

weight = 60 gm) The total requirement is 2060 kcal From protein the energy obtained is 60 x 4=280 kg/kcal The fat should give 20% of kcal from total calories intake ie 412 One gram of fat provides kcal So far 412 kcal, the intake of fats is 46 gm The remaining is from carbohydrates 2060 – (240 + 412) = 1408

kcal/ 1gm of carbohydrates = 4 kcal So the carbohydrate intake is 1408 /4=352 gm.

II step

To calculate how these proximate principles

are supplied as common food stuffs, the nutritive value of common foods stuffs are analyzed.

Table (vasudevan page 36.18) The food items and determined.

III step

Food exchange systems is very useful for calculation of the proximate principles.

For example 1 chapati (20 gm) = one large slice of bread

Cooked rice 3 table spoon (20 gm ) or one idly . Protein 2 gm Carbohydrate 15 gm Energy 70 kcal

IV step

Legumes – pulses exchange Bengal gram or black gram or green gram or

red gram or horse gram 100 gm – protein 24 gm, carbohydrate 60 gm, 340 calories

The pulses and cereals combination in the ratio of 1:5 provides good quality proteins

Legumes

It should contain all essential nutrients. Adequate protein with all essential amino acids is to be

taken Calorie intake should balance energy expenditure Adequate quantity of calcium, iron and other minerals is to

be taken Diet should have variety, simple ,locally available ,

palatable and digestible. The total quantity of proximate principles calculated are

divided into breakfast, lunch and supper.

Prescribing diet

Diet for patients with diabetes mellitus Diet having low glycemic index is given. Small quantity of food is taken at frequent

intervals

It is assessed by the glycemic response after the test diet and comparing with a reference meal, ie 50 gm glucose

Glycemic index = area under glucose tolerance after 50 gm test meal/ Area under reference meal (50 gm glucose)

Simple carbohydrates such as sugar have high glycemic index Complex carbohydrates have low glycemic index Carbohydrates when combined with proteins, fat , fiber

decrease the glycemic index. Ice cream has low glycemic index but it is calorie rich due to

it’s high fat content.

Glycemic index

General principles of prescribing a diet Sugar, sweet and refined simple

carbohydrates are to be avoided Leafy vegetables should be consumed more

and tubers are to be restricted Frequent small meals are taken.

Thank you