Dr K N Prasad Community Medicine Balanced diet Dr K N Prasad Community Medicine

Definition Balanced diet is the one which contains a variety of foods in such quantities and proportions that the need for energy, proteins, vitamins, minerals and fats is adequately met for maintaining health, vitality and general well being and also makes a small provision for extra nutrients to withstand short duration of leanness. Objective is to safeguard the population from nutritional deficiencies.

Principles of balanced diet/ Dietary goals it should meet the energy intake from Protein – 10-15% of energy intake Fats- 15-30% of energy intake Carbohydrate – remaining Pattern of balanced diet vary in different parts of the world Each country have their own standards

Determining factors Region Economic status Religion Customs Culture Taboos Taste Habits of the people

Energy energy requirement is defined as that level of energy intake in relation to expenditure which is least likely to result in obesity, heart disease or prolong active life. It is Individualised because Basal metabolism- 1cal per kg body weight per hour Daily activities – walking, dressing, sitting, etc. Occupational work- Light, moderate or heavy

Reference standards Reference man: Aged 20-30 years weighs 60kg, free from diseases and physically fit for active work, 8 hours work, 8 hours sleep, 4-6 hours sitting or other routine works and 2 hours in walking , recreation or in household activities. Reference woman: Aged 20-30 years weighs 50kg, free from diseases and physically fit for active work, 8 hours work, 8 hours sleep, 4-6 hours sitting or other routine works and 2 hours in walking , recreation or in household activities.

Factors affecting energy requirement Age Sex Body composition Physical activity Working conditions Physiological state

Energy requirement- adults Reference Man: 45 cal / kg weight/per day Reference Woman: 40 cal / kg weight/per day Reference Man- per day Light work – 2425 cal Moderate work – 2875 cal Heavy work – 3800 cal Reference Woman- per day Light work – 1875 cal Moderate work – 2225 cal Heavy work – 2925 cal

Energy- vulnerable group Pregnant woman - daily reqt + 300 cal per day Lactating mother(0-6 months) - daily reqt + 550 cal per day Lactating mother(7-12months) - daily reqt + 400 cal per day Children – rapid growth period needs 100-120 cal per day and later on 80-90 cal per day Puberty – requriement is same as adults Adults – generally 2% decline of resting metabolism for each decade for adults After 40 years – reduce by 5% each decade till 60 years After 60 years – reduce 10% each decade

Proteins Infections , worm infestations, emotional disturbances, stress situations Protein quality ( Protein energy ratio) =Energy from protein X 100 Total energy intake Ratio of protein calorie to the total energy calories Reference Man- 8.3 % Reference Woman- 9.1% Pregnant woman- 10% Lactating mother-11% If PE is less than 4 % unable to satisfy the protein requirement Recommended- 15-20% of total calorie intake

Protein intake Intake is expressed in terms of Grams per Kg body weight ICMR recommends 1 gram per Kg body weight for adults Infants – 2 Gms per kg body weight ( first 6months) 1.5 - 1.8 Gms per kg body weight till 10 years Adolescents- 1.2 to 1.4 gms per kg body weight During pregnancy- additional 14 gms per day During lactation – 25 gms per day ( 0-6 months )

Protein no extra recommendations for elderly higher intake of protein does not confers great benefit Surplus quantity intake in more harmful than beneficial

Amino acids Requirement of amino acids decreases sharply and age advances EAA requirement expressed in Mgms per kg body weight Infants – 742 mg Pre children- 352 mg School children – 260 mg Adults – 84 mg

Fats During infancy – fats constitutes 50% of total energy intake Adults – fat constitutes 20% of total energy intake 50% should be EFA from Vegetable oils Requirement of EFA ranges from 3-6% of energy intake in young children Recommended as equal proportion of Visible and invisible fats in the diet for all age groups.

Percentage of total energy Percentage of EFA per day Fat intake Group Intake per day in Grams Percentage of total energy Percentage of EFA per day Reference man & woman 20 9 3 Pregnant woman 30 12.5 4.5 Lactating mother 45 17.5 5.7 Children 22- 25 15

Carbohydrate Intake should be 50-70% of total energy intake In India, 90% of energy intake is mainly from Carbohydrates.

what you do not want others to do to you, do not do to others. Thought for the day what you do not want others to do to you, do not do to others. - Confucius

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