2. BMR study is important for
Calculation of caloric requirements of an individual for prescribing a diet of adequate calorific value and
planning nutrition for
individuals,
communities and
populations at large.

3. For total energy requirement
Specific dynamic action and physical activity levels are the important attributes of Basal Energy Expenditure.

4. Specific Dynamic Action
Also known as thermogenic effect of food.
Increased heat production following the intake of food.
Energy expenditure on digestion and absorption.
Trapped from energy stores
Actual energy from food is less than theoretical content
Activation energy needed for a chemical reaction and is to be supplied initially

5. EXAMPLE A person takes 250 grams of carbohydrates
Should produce 250 x =1000 Kcal
10% needed for activation = 100 kcal
Actual energy available = 900 Kcal
If requirement is really =1000 Kcal
Then the person should actually take an amount capable of providing 1100 Kcal i.e. 275 grams

6. SDA Values
Carbohydrates %
Protiens %
Fats %
Mixed Diet %

7. Physical Activity Level (PAL)
Energy required in kcal/hour
(over and above BMR)
1. Eating 28
2. Writing 30
3. Driving a car 63
4. Typing at high speed
100
5. Walking
140
6. Cycling
175
7. Running
490
8. Swimming
550

8. Energy Requirement and Occupation
Type of activity
Occupation
Light
Sedentary Work
Office workers, lawyers, accountants, doctors, teachers, architects, shop workers
Moderate Work
Students, industry workers, farm workers, housewives without mechanical appliances
Active heavy Work
Agricultural workers, miners, unskilled laborers, athletes, factory workers
Very Heavy Work
Lumber jacks, blacksmiths, and construction workers
BMR+30 %
BMR+40 %
BMR +50%
BMR+70 %

9. Calculation for energy requirement for a 55 kg person doing moderate work
For BMR = 24 x 55 kg = 1320 kcal
+ For activity = 40% of BMR= 528 kcal
Subtotal = = 1848 kcal
+ Need for SDA= 1848 x 10% = 185 kcal
Total = = 2033 kcal
Round to nearest multiple of 50 = 2050 kcal

10. Proximate Principles Carbohydrates Fat Proteins Minerals Vitamins
Additional requirements for growth pregnancy lactation and convalescence are to be provided in the food.

11. Respiratory Quotient
When food is oxidized, whether in an open system or closed biological system, oxygen is consumed and CO2 produced.
Volume of CO2 produced
Volume of O2 consumed
= RQ
Ratio in steady state / Unit time

12. Carbohydrates are completely oxidized and the volume of O2 used is equal to CO2 produced
C6H12O6 + 6O2  6CO2 + 6H2O
RQ =
6CO2
6O2
= 1

13. Fats
C57H104O O2  57 CO H2O
RQ = 57 = 0.71 80
Other fats have RQ  0.70

14. Using specialized technique the RQ is found to be 0.82
Proteins
RQ of proteins is a little complex to determine as it contain N & S in addition to C, H, O.
Using specialized technique the RQ is found to be

15. Alcohol
C2O5OH + 3O2  2CO2 + 3H2O
RQ = 2/3 = 0.67

16. Human Use normally mix type of food
RQ of an intact person naturally will be the sum of RQ of all the three major type of food.
Carbohydrates
Fats
Proteins

17. Ordinary mixed diet RQ = 0.85
Postabsorptive State
No food being consumed in preceding – 14 hours
RQ = 0.82

18. When diet is rich in Carbohydrates the RQ will be more close to one i
When diet is rich in Carbohydrates the RQ will be more close to one i.e. High
More fats = Lower RQ

19. Methods for determination of RQ of Man
Two method
Open Circuit
Closed Circuit

20. Open Circuit
Made to breath in a specially designed bag called Douglas Bag for few minutes
Volume of Breathed air is measured in a gasometer
Subjected to gas analyzer
Where CO2 is absorbed by KOH
Original volume of gas is reduced

21. Open Circuit Concentration of CO2 is calculated
Remaining gas is allowed to react with alkaline pyrogalate which absorb O2
O2 in the expired is found out
RQ is calculated volume of CO2
volume of O2

22. Remember that when rate of utilization of
fat increases in relation to carbohydrates, RQ falls.
Commonly seen in Diabetes mellitus
Utilization of carbohydrates increases RQ

23. Energy requirement of a normal person
While calculating we should consider the energy required for
Maintenance of BMR
Thermogenic effect of food (SDA)
Extra energy expenditure for PA

24. Remember that when rate of utilization of
fat increases in relation to carbohydrates, RQ falls.
Commonly seen in Diabetes mellitus
Utilization of carbohydrates increases RQ

25. BALANCED DIET

26. BALANCED DIET
Diet which provides all the five basic nutrients in a quantity which ensures healthy life is known as Balanced diet.
These are :
Carbohydrates
Fats
Proteins
Vitamins and
Minerals

27. The Food Pyramid

28. The Food Pyramid

29. Nutrient Pool

30. Water
Water of course is another important essential nutrient required for normal metabolism of all the essential five.

31. NUTRITIONAL IMPORTANCE OF CARBOHYDRATES

32. Polysaccharides and Disaccharides
Cannot be utilized until digested to the monosaccharide stage.
When introduced directly into blood stream, they act as foreign bodies and are excreted by the kidneys.

33. Role of carbohydrates in diet
Glucose, fructose, galactose and to a minor degree, manose / Precursors are available to the body as energy source.
Pentoses in foods seem to be of limited nutritional value and form a very small fraction of the total carbohydrate intake of diet.
Ribose, deoxyribose are required for nucleic acid synthesis and are obtained from HMP-Shunt.

34. Requirement of carbohydrates in diet
55 to 65% of the total food calories should come from carbohydrates.
A moderately active man requiring 3000 C per day, should take about 450 gm carbohydrates daily.
But poorer sections of the population derive more than 85% of the food calories from carbohydrates.

35. Role of carbohydrates in diet
Undue restriction of dietary CHO influences both fat and protein metabolism adversely, even if the calorie intake is adequate.
Fat mobilization from the depots and utilization is increased
Ketogenesis is increased and ketosis may develop.

36. Role of carbohydrates in diet
The effect on protein metabolism is of a specific nature, not shared by other substances, e.g. fats, alcohol and not related to its calorigenic action.
This is referred to as "protein sparing action of carbohydrates".

37. Protein sparing action of CHO
Adequate amount of CHO in the diet may reduce the protein requirement due to :
Metabolic products of CHO, e.g. oxaloacetate, pyruvates and glutarates provide the C-skeletons for the formation of NEAA through transamination,

38. Protein sparing action of CHO
CHO reduce the need for gluconeogenesis from AA
CHO and fats are catabolized for energy and thus spare the proteins from being used for this purpose.
Dietary fats may also depress the SDA of proteins.

39. Action of CHO on Plasma Lipids
Replacement of a low or moderate CHO diet by a high CHO diet may produce temporary rise in plasma TG and VLDL and temporary reduction in blood cholesterol.
Substitution of starch by fructose or sucrose in the diet may also increase plasma TG by increasing lipogenesis from fructose.

40. B-vitamins Requirements
With diets rich in CHO, the requirements for vitamins, particularly thiamine (vit B1) increases because of the essential role of these in carbohydrate metabolism.

41. Role of Cellulose Celluloses are polysaccharides found in plants.
They are indigestible by human beings as there is no enzyme in our GI tract which can split  l -4 linkage.

42. Role of Cellulose
Celluloses in diet contribute bulk to the intestinal contents, and therefore, in normal amounts promote intestinal motility, i.e. increases peristalsis and removes constipation.
When present in excess, they may be irritating to intestinal mucous membrane, producing diarrhea or a spastic type of constipation.

43. Health Benefits of Fiber
Adds bulk to stool / improves peristalsis
Decreased transit time = decreased exposure to toxins
Weight control
Helps prevent
Colon cancer
Hernia
Ulcerative colitis
Hemorrhoids

44. Health Benefits of Fiber
Helps control blood sugar
Helps lower cholesterol
Helps prevent diverticulitis
How Much?
25–35 g per day from food
No more than 50 g

45. Excessive intake of carbohydrates in diet:
Ingestion of excessive amounts, specially in infants, may occasionally produce intestinal disturbances due to irritation induced by products of bacterial fermentation.
There is some evidence in experimental animal (rats) that continued ingestion of super tolerance amounts of galactose, may result in the formation of cataracts.
A similar phenomenon has been suggested as possibly occurring in man.

46. Excessive intake of carbohydrates in diet:
In children, in the presence of hepatic functional impairment, in which the conversion of galactose to glucose (or glycogen) may be impaired, with consequent elevation of blood galactose level.
The incidence of cataract is relatively high also in uncontrolled diabetes mellitus, a phenomenon presumably related to persistently elevated blood glucose concentration and altered metabolism.

47. Recommendation for Simple Sugar Intake
Low nutrient density
No more than 10% of total kcal / day
Average U.S. intake: 16% of total kcal/day
Added to food and beverages during processing

48. High-Sugar Diets
Calories adding to excess
Obesity
Dental caries

49. Lactose Intolerance Enzyme (lactase) is needed to break down lactose.
Reduction in this enzyme, leads to diarrhea, bloating, flatulence when dairy products are consumed

50. What to Do If , Lactose Intolerant
Determine amount one can tolerate
Eat dairy with fat
Cheese is usually tolerated well
Yogurt is usually tolerated well
Use Lact-Aide
Use soya or rice-based dairy substitute products

51. Dietary Sources Of Carbohydrates
Major dietary polysaccharide is starch, which is digested by amylase to maltose and then hydrolyzed to glucose.
Starch is the major source of fuel for most organs and tissues.
Excess is converted to fat and stored.
Cooking makes starch more soluble and accessible to digestive enzymes.

52. DIETARY SOURCES Cereals, pulses and tubers
Rice is also a rich source of carbohydrates along with vitamin B1

53. Carbohydrate Content of Common Food
Cane sugar 100%
Rice 80%
Honey 80%
Wheat – 80%
Cakes – 65%
Bread – 60%
Potatoes %

54. Sucrose Cane sugar is mainly used as a sweetening agent.
In young children high intake of sucrose and sucrose-rich food items predispose to the development of dental caries.
Sucrose is easily fermented by the bacteria present in dental plaque, which would damage the enamel and lead to caries (tooth decay).

55. In adults
Consumption of large quantities of refined sugars is not advisable since they tend to lead to a sudden rise in blood glucose level.
This will also lead to excessive caloric intake.
Sucrose consumption also results in increased levels of plasma lipids.

56. While prescribing diets for diabetic patients and for weight reduction, sucrose should be strictly avoided.
Jiggery (Brown sugar from dates) an alternative source of sucrose is beneficial, since it is a good source of iron as well.

57. Dietary Fiber
The unavailable or indigestible carbohydrate in the diet is called dietary fiber.
The comparatively high incidence of colon cancers in developed countries, and the low incidence of the same in vegetarian population, pointed to the importance of dietary fiber .
Dietary fiber is also necessary to maintain the normal motility of gastro-intestinal tract.

58. The beneficial effect is more with soluble fiber present in vegetables and only a diet having plenty of vegetables and green leaves will have the desired effect.
Dietary fiber requirement is about 30 g/day.

59. In general, diet rich in fiber improves:
Bowel motility
prevents constipation
decreases reabsorption of bile acids
Thus lowering cholesterol level and improves glucose tolerance

60. Role in weight reduction
Fiber rich food is helpful in weight reduction, since it provides a feeling of fullness without consumption of excess calories.

61. Excessive intake of carbohydrates in diet
The incidence of cataract is relatively high also in uncontrolled diabetes mellitus, a phenomenon presumably related to persistently elevated blood glucose concentration and altered metabolism.

62. Recommendation for Simple Sugar Intake
Low nutrient density
No more than 10% of total kcal / day
Average U.S. intake: 16% of total kcal/day
Added to food and beverages during processing

63. While prescribing diets for diabetic patients and for weight reduction, sucrose should be strictly avoided.
Jiggery (Brown sugar from dates) an alternative source of sucrose is beneficial, since it is a good source of iron as well.

64. THANKS