Diet and Nutrition_New.ppt

Dr. Shamanthakamani NarendranM.D. (Pead), Ph.D. (Yoga Science)

Oh, God, Give us food which does not cause any disease and also gives us

strength- Yahurveda

He, who takes food in proper measure lives a long life and lives without disease,

gets strength and alertness of mind. However, his children are born healthy and without any deformity or disease.

- Mahabharata

Yoga is neither for one who over eats nor for him who observes complete

fasting.- Bhagavad Gita :VI - 16

Yoga is a science of mindHelps to control mind, desire & reaction

to stressSkilful – rather than brutal

- Maharshi Patanjali

INTRODUCTION Ensuring adequate nutrition to our expectant and

nursing mothers and to our infants and children should receive the highest priority in any public health programme.

Wide prevalence of malnutrition in mothers and children.

Faulty dietary habits, arising from ignorance and superstition.

Nutrition Advisory Committee of the Indian Council of Medical Research recognized the need.

Women in the reproductive age group and growing children continue to be the most vulnerable groups to malnutrition.

Body needs certain essential ‘nutrients’ for its well-being.

Nutrients that are derived from food.

FUNCTIONS OF FOOD1. Energy-yielding, 2. Body-building, and 3. Protective foodstuffs

according to predominant role they play in sustaining life.

FUNCTIONS OF FOOD Food provides energy to keep the body warm, the

muscles active for work and play and the various organs alert to carry out the daily activities.

Food supplies body building nutrients needed for growth, while the fetus develops in the mother’s womb, new tissues are being continuously built. This proceeds right through infancy, childhood and adolescence. During these stages of life, there is a tremendous demand for body building nutrients that are essential everyday to replace the daily ‘wear and tear.’

Protective function. Required in minute quantities. Variety of these nutrients, each responsible for

a specific task in the body. If the diet is deficient or lacking in one or more of these vital substances, it leads to derangement of the normal functioning of the different parts of the body, resulting in ill-health, stunted growth and imperfect development.

Energy-yielding foodstuffs Foodstuffs form the great bulk of the ordinary

diet. They supply energy to keep the body warm

and are hence known as ‘fuel-food.’ A few examples of energy-yielding foodstuffs

are cereals starchy vegetables, pulses, nuts, sugars, and oils.

Body-building foodstuffs

Contain a satisfactory amount of the nutrientes needs to build the body and replace the worn-out tissues.

Milk and its products, meat, fish, and eggs are the best representatives of this group of foodstuffs.

The other examples are legumes, dals, dried beans, peas and nuts.

Cereals also contain some body-building nutrients.

Protective foodstuffs Provide large number of the protective

substances needed by the body. Almost all natural foodstuffs contain one or

more of these protective nutrients. There is no single foodstuff in which all the

different protective substances are present in quantities sufficient to meet the daily needs of the body.

This is why a combination of different kinds of foodstuffs is essential in a diet.

Best examples of this group of foodstuffs are green vegetables, fresh fruits, milk, meat, fish, and eggs.

Protective foodstuffs contain sufficient amounts of one or more of the protective nutrients so that a combination of them yields enough to maintain life.

BALANCE DIET In order to obtain adequate amounts of each of the

different nutrients, our daily diet should include appropriate quantities of a variety of different foodstuffs.

An un-varied diet is not only distasteful but may have serious consequences on health and recovery from disease.

A diet in which various foodstuffs are mixed in suitable proportions to carry out adequately the three functions described above, is known as a balance diet.

Balance diet provides all nutrients in required amounts and proper proportions.

BALANCE DIET - PORTIONSFood groups g/

portionType of work

Sedentary Moderate HeavyMan Woman Man Woman Man Woman

Cereals & Millets

30 14 10 16 12 23 16

Pulses 30 2 2 3 2.5 3 3Milk 100 mL 3 3 3 3 3 3

Roots & Tubers 100 2 1 2 1 2 2Green leafy vegs 100 1 1 1 1 1 1

Other vegs 100 1 1 1 1 1 1Fruits 100 1 1 1 1 1 1Sugar 5 5 4 8 5 11 9

Fats & Oils (visible)

5 4 4 7 6 11 8

THE THREE FOOD GROUPS

Food groups serves as a general guide to chose a Balance Diet.

It also provides information as to which of the different foodstuffs can be substitute for one that may be temporarily unavailable.

STAPLE FOOD

The most commonly consumed food is called Staple food.

Varies from region to region.

In order to meet their nutrient needs, every one should eat daily at least one food item in sufficient quantity from each of the several Sub-Groups

ENERGY RICH FOODS

Major Nutritions Other Nutritions

Carbohydrates and fats

Whole grain cereals, millets

Protein, fibre, minerals, calcium, iron, B-complex, vitamins

Vegetable oils, ghee, butter Fat soluble vitamins, essential fatty acids

Nuts and oilseeds Proteins, vitamins / minerals

Sugars Nil

BODY BUILDING FOODS


Proteins

Pulses, nuts, & oilseeds B-complex, vitamins, invisible fat, fibre

Milk and milk products Calcium, vitamin A, riboflavin, vitamin B12

Meat, fish, poultry B-complex, vitamins, iron, iodine, fat

PROTECTIVE FOODS


Vitamins and minerals

Green leafy vegetables Antioxidants, fibre and other carotenoids

Other vegetables/fruits Fibre, sugar, and antioxidants

Eggs, milk and milk products and flesh foods

Protein and fat

FOOD REQUIREMENTS

Vary according to age, sex, and activity of the individual.

Special demands are made during stress periods, such as pregnancy, lactation, infancy, and childhood, since during these periods, the individual needs increased amounts of Body-Building and Protective nutrients.

ANTIOXIDANTS Protect the body from damage caused by

harmful molecules called free radicals. This damage is a factor in the development of

blood vessel disease (atherosclerosis), cancer, and other conditions.

Through by-products of normal processes. Breaks down certain medications. Through pollutants. Antioxidants include some vitamins (such as

vitamins C & E), some minerals (such as selenium), and flavonoids (in fruits, red wine, and some teas), which are found in plants.

WHAT ARE FREE RADICAL?Free radicals are formed as Part of our natural metabolism Environmental factors – smoking, pesticides,

pollution and radiation. Free radicals are unstable molecules which react

easily with essential molecules of our body, including DNA, fat and proteins.

Free radicals are molecules with have one electron too much or to less in order to be stable.

Free radicals try to steal or give electrons to other molecules, thereby changing their chemical structure.

WHAT ARE ANTIOXIDANTS USED FOR?

People use antioxidants to help treat or prevent some medical conditions, such as coronary artery disease (CAD), some cancers, macular degeneration, Alzheimer's disease, and some arthritis-related conditions.

FUNCTIONS OF THE ANTIOXIDANTS

Vitamin A Skin, eye, bone, reproduction, growth. Vitamin C Stress (spares Vit. E), bone, cartilage. Vitamin E Stress, eye integrity, muscle integrity, reproduction, prevents oxidation of fat. Riboflavin Stress, eye function, skin integrity, muscle

strength of hind quarters. Folic Acid Prevents birth defects associated with the

nervous system. Zinc Stress, immune response, wound healing. Manganese Bone, tendon, muscle, birth weight. Copper Immune response, hair color, reproduction. Selenium Stress, muscle integrity, reproduction.

SOURCES

Vitamin C – Important sources include citrus fruits, green peppers, broccoli, green leafy vegetables, strawberries, raw cabbage and potatoes.

Vitamin E – Important sources include wheat germ, nuts, seeds, whole grains, green leafy vegetables, vegetable oil and fish-liver oil.

Beta-carotene – Carrots, squash, broccoli, sweet potatoes, tomatoes, kale, collards, cantaloupe, peaches and apricots are particularly rich sources of beta-carotene.

Selenium – Good food sources include fish, shellfish, red meat, grains, eggs, chicken and garlic. Vegetables can also be a good source if grown in selenium-rich soils.

MICRONUTRIENTS Play an essential role in the metabolic

processes of the human body, but are only required in small quantities.

Because of their essential role, when micronutrients are not sufficient from food in the diet, significant health problems can result.

NUTRITIVE VALUE OF INDIAN FOODS The food that we eat is assimilated in the body

is used for the growth and maintenance of tissues.

Plants can manufacture the food they need from simple chemicals derived from the soil, from water, and from the carbon-dioxide of the air.

Higher organisms, on the other hand, do not possess the capacity to manufacture food from simple chemicals, and hence they depend on plant life or on other animals for obtaining the food they need.

DIETARY PRINCIPLES

Foodstuffs may be broadly classified as cereals, pulses, nuts and oilseeds, vegetables, fruits, milk and milk products, and flesh foods.

These foods contain substances known as nutrients, and it is for obtaining these nutrients which perform various functions in the body that food is consumed daily by any living organism.

The nutrients include proteins, fats, carbohydrates, vitamins and mineral salts.

They are present in almost all foods in varying proportions and depending on the relative concentrations of the nutrients contained, foods are classified sometimes as protein-rich foods, carbohydrate-rich food, etc., Oils, ghee, etc., provide mostly fat, while sugar is purely a source of carbohydrate.

Proteins, fats, and carbohydrates are also sometimes called “proximate principles.”

They are oxidized (burnt) in the body to provide the energy required for the various activities of life.

Together with water, which is also a necessary dietary element, proximate principles form the main bulk of foods.

Vitamins and mineral salts do not supply energy, but they play an important role in the regulation of several essential metabolic processes in the body.

Some minerals are also important components of the body structures like bones and teeth.

PROTEINS

The chief substances in the cells of the body. They form the important constituents of

muscles and other tissues and of vital fluids like blood.

Proteins supply the building material for the body and make good the wear and tear of tissues, which is a constant feature of the process of life, and it is for tis reason that foods rich in protein are often called ‘body building foods.’

Several substances concerned with vital life processes –

eg. “enzymes,” which help in the digestion of food,

“antibodies,” which are body defences against infections – are also mainly protein in nature.

Proteins are one of the most important nutrients and the sufficiency of protein in a diet is an important measure of the adequacy and quality of the diet.

Proteins are also oxidised in the body to provide energy, but such use of protein is costly and wasteful.

It is better that most of the calorie requirement is met from carbohydrates and fats so that proteins are spared to fulfill other functions essential to life.

Most foodstuffs contain protein, but in widely varying amounts.

Animal foods such as meat, fish, eggs are rich in protein, and milk can also be considered to be rich in protein if due allowance is made for the large amount of water preset in it.

Among the vegetable foods, pulses and nuts are the richest sources of protein with amounts often exceeding those present in animal foods.

Soya bean is unique in this respect in that it contains over 40 percent protein.

The common cereals such as rich and weat are relatively poor sources of proteins.

Considering the amounts of these foods that are normally consumed daily, their contribution to the total protein intake by an individual is considerable.

Rice contains less protein than wheat does, but the protein of rice is of better quality.

The outer layers of cereals are richer in protein than the inner starchy kernel, and hence when wheat or rice is highly milled, there is some loss of protein as well as of other valuable nutrients such as vitamins and mineral salts.

Leafy and root vegetables and fruits are very poor sources of protein.

Defatted oilseed cakes which are very rich sources of protein were hitherto considered only as cattle feeds and manures.

As a result of improvement in food processing techniques in recent years, these foods are being made available for human consumption also.

BIOLOGICAL VALUE OF PROTEINS

In addition to the quantity of protein in a diet, the nutritional quality of the protein also matters in judging the protein value of a diet.

Proteins present in various foods differ in their nutritive value on account of the differences in the amnio-acid composition.

Amino-acids are the ‘bricks’ with which tissue protein is built and replaced and the more closely the amnio-acid make up of a protein resembles that of the tissues, the greater is its value.

There are about twenty amino-acids commonly found in dietary proteins.

It is possible for the body itself to obtain in requirements of some of these amino-acids by mutual inter-conversion among the amino-acids and from nonprotein sources.

Ten amino-acids cannot be synthesized by the body, and hence have to be supplied through the diet.

These amino-acids are called ‘essential amino-acids.’

It is the extent of the presence of these essential amino-acids that largely determines the quality of a protein.

The proteins of whole egg and human milk are considered the best amount food proteins and the pattern of essential amino-acids in these foods is usually taken as a standard against which the amounts of essential amino-acids present in other foods can be compared.

The proteins of animal foods such as milk, meat, fish, etc., generally compare well with egg protein in the distribution of essential amino acids, and hence such foods are considered to contain good quality proteins.

The proteins in foods of plant origin are not so well-balanced in their amino-acid pattern.

For instance, it will be found that in comparison with egg protein, the cereal proteins are poor in the amino-acid lysine, while pulse proteins are poor in methionine although they are rich in lysine.

Such proteins individually are incomplete proteins.

The relative insufficiency in amino-acids of particular vegetable foods can be overcome by a judicious combination of vegetable foods to provide a mixture having the desirable pattern of essential amino-acids.

The proteins of cereals and pulses have a mutual supplementary effect, and deficiency of one amino-acid in one foodstuff can be made good by an excess in another, if both foods are consumed at about the same time.

Another factor to be considered in assessing the value of the proteins of foodstuff is their digestibility.

In general proteins of uncooked vegetable foods (especially pulses) are less digestible than those of animal foods.

Cooking improves the digestibility of several foods.

B2-complex vitamins Riboflavin Nicotinic acid Vitamin B6 Pantothenic acid Folic acid Vitamin B12 Vitamin C Vitamin D

MINERAL SALTS

Calcium Phosphorus Iron Sodium and potassium Magnesium Copper Zinc Iodine Fluorine

MALNUTRITION AND ILL-HEALTH

Protein-calorie malnutrition is particularly acute in the age period 1 to 5 years.

Vitamin A deficiency – The problem of blindness arise.

Anemia – megaloblastic anemia.

PROXIMATE PRINCIPLESValues given are per 100 gms of edible portion

Name of the foodstuff

Cereal grains and productsMaize, dry Zea mays 11.1 3.6 1.5 66.2 2.0

Ragi, Eleusine caracana 7.3 1.3 2.7 72.0 6.4

Rice, parboiled, handpounded 8.5 0.6 0.9 77.4 2.8

Wheet (whole), Triticum aestivum 11.8 1.5 1.5 71.2 4.9

Prot

ein

Fat

Car

bo

hydr

ates

Iron

Min

eral

s



Pulses and legumesBegal gram (whole), Cicer arietinum 17.1 5.3 3.0 60.9 10.2

Soya bean, Glycine max Merr 43.2 19.5 4.6 20.9 11.5

Prot

ein

Fat

Car

bo

hydr

ates

Iron

Min

eral

s



Vegetables & FruitsTomato, ripe 0.9 0.2 0.5 0.8 3.6 0.4

Sapota 0.7 1.1 0.5 2.6 21.4 2.0

Pineapple 0.4 0.1 0.4 0.5 10.8 1.2

Mango, ripe 0.6 0.4 0.4 0.7 16.9 1.3

Apple 0.2 0.5 0.3 1.0 13.4 1.0

Prot

ein

Fat

Car

bo

hydr

ates

Iron

Min

eral

s

Fibr

e

Nutrition is a basic human need and a prerequisite for healthy life.

A proper diet is essential from the very early stages of life for growth, development and active life.

Food consumption, which depends on its production and distribution, determines health and nutrition of the population.

Apart from supplying nutritions, foods provide a host of other components, (non-nutrient phytochemicals) which have a positive impact on health.

CURRENT DIET AND NUTRITION SCENARIO

Among the Indian population, about 40% in the rural and 30% in the urban areas are estimated to be below the poverty line, which is defined as the expenditure needed to obtain, on the average, 2400 Kcal per capita per day in the rural areas and 2100 Kcal in the urban areas.

Long-term malnutrition leads to short adult stature, increased risk of morbidity and mortality and reduced work output.

COMMON NUTRITION PROBLEMS

Protein energy malnutrition (PEM), micronutrient deficiencies such as vitamin A deficiency (VDA), iron deficiency anemia (IDA), iodine deficiency disorders (IDD) and vitamin B-complex deficiencies are the nutrition problems frequently encountered, particularly among the poor.

Under-nutrition starts even at the time of conception.

Because of extensive maternal under-nutrition (under-weight, poor weight gain during pregnancy, and nutritional anemia, and vitamin deficiencies), about 30% of the infants are born with low birth-weights (<2500 g), as compared to less than 10% in the developed countries.

Both clinical and subclinical undernutrition are widely prevalent even during early childhood.

About 1-2% of preschool children suffer from severe and florid forms of PEM like kwashiorkor and marasmus. This is only the tip of the iceberg.

Countrywide surveys indicate that more than a half of the Indian preschool children (1-5 years) suffer from subclinical under-nutrition as indicated by low weight for age.

About 65% of them are stunted (low height for age), which indicates that under-nutrition is of long duration.

Persistent under-nutrition throughout the growing phase of childhood leads to short stature in adults.

About a half of the adults have a Body Mass Index (BMI) (Weight in kg/Height in meatres2) below 18.5, which indicates chronic energy deficiency (CED).

In the case of vitamin A deficiency, up to 3% of preschool children show Bitot’s spots and night blindness, and about 30-40 thousand children become blind every year.

Vitamin A deficiency also increases the risk of disease and death.

A large segment of the population suffers from nutritional anemia.

It is more prevalent irr pregnant women. More than 50% of preschool children also

suffer from anemia.

It is estimated that nutritional anemia contributes to about 85,000 maternal deaths every year and is one of the important causes of low birth weight.

It adversely affects work output among adults and learning ability in children.

Iron deficiency disorders (IDD) are very common in large sections of population in several parts of the country.

About 200 million are estimated to be living in such regions.

Iodine deficiency causes goitre (enlargement of thyroid gland in the neck), neonatal hypothyroidism among newborns, mental retardation, delayed motor development, stunting, deaf-mutism and neuromuscular disorders.

The most important consequence of iodine deficiency in mothers is cretinism in which the children suffer from mental and growth retardation since birth.

About 90,000 stillbirths and neonatal deaths occur every year due to maternal iodine deficiency.

Around 40 million persons are estimated to have goitre, 2.2 million have cretinism and 6.6 million suffer from mild psychomotor handicaps.

With increasing urbanization, energy-rich diets containing higher amounts of fat and sugar, which also provide less dietary fibre and complex carbohydrates, are being consumed, particularly in high-income groups.

The urban population is tending to be more sedentary with little physical activity.

Consumption of alcohol, providing empty calories, and of tobacco is also common.

Prevalence of disorders like obesity, heart disease, hypertension, and diabetes, is on the increase.

DIETARY GOALS Maintain a state of positive health and optimal

performance in populations at large. Ensure adequate nutritional status for pregnant

women and lactating mothers. Improve birth weights and promote growth of

infants, children, and adolescents to achieve their full genetic potential.

Achieve adequacy in all nutrients and prevent deficiency diseases.

Prevent chronic diet-related disorders. Maintain the health of the elderly and increase the

life expectancy.

DIETARY GUIDELINES

A nutritionally adequate diet should be consumed through a wise choice from a variety of foods.

Additional food and extra care are required during pregnancy and lactation.

Exclusive breast-feeding should be practised for 4-6 months. Breast-feeding can be continued up to 2 years.

Food supplements should be introduced to infants by 4-6 months.

Adequate and appropriate diet should be taken by children and adolescents, both in health and disease.

Green leafy vegetables, other vegetables and fruits should be used in plenty.

Cooking oils and animal foods should be used in moderation, and vanaspati/ghee/butter should be used only sparingly.

Over-eating should be avoided to prevent over-weight and obesity. Proper physical activity is essential to maintain desirable body weight.

Salt should be used in moderation.

Foods consumed should be safe and clean. Healthy and positive food concepts and

cooking practices should be adopted. Water should be taken in adequate amounts

and beverages should be consumed in moderation.

Processed and ready-to-eat foods should be used judiciously. Sugar should be used sparingly.

The elderly should eat a nutrient-rich diet to keep fit and active.

NUTRITIONALLY ADEQUATE DIET SHOULD BE CONSUMED THROUGH A WISE

CHOICE FROM A VARIETY OF FOODS

Nutrition is a basic prerequisite to sustain life. Variety in food is not only the spice of life but

also the essence of nutrition and health. A diet consisting of several food groups

provides all the required nutrients in proper amounts.

Cereals, millets and pulses are major sources of most nutrients.

Milk which provides good quality proteins and calcium must be an essential item of the diet, particularly for infants, children, and women

Oils and nuts are calorie-rich foods, and are useful for increasing the energy density.

Inclusion of eggs, flesh foods and fish enhances the quality of diet. However, vegetarians can derive almost all the nutrients on cereal/pulse/milk-based diets.

Vegetables and fruits provide protective substances such as vitamins/minerals.

WHY DO WE NEED NUTRITIONALLY ADEQUATE FOOD?

Carbohydrates, fats, and proteins are macronutrients, which are needed in large amounts.

Vitamins and minerals constitute the micronutrients and are required in small amounts.

These nutrients are necessary for physiological and biochemical processes by which the human body acquires, assimilates and utilizes food to maintain health and activity.

CARBOHYDRATES

Are either simple or complex, and are major sources of energy in all human diets.

They provide energy of 4 Kcal/g. The simple carbohydrates, glucose, and

fructose, are found in fruits, vegetables, and honey, sucrose in sugar and lactose in milk, while the complex polysaccharides are starches in cereals, millets, pulses, and root vegetables and glycogen in animal foods.

The other complex carbohydrates which are resistant to digestion in the human digestive tract are cellulose in vegetables and whole grains, and gums and pectins in vegetables, fruits and cereals, which constitute the dietary fibre component.

In India, 70-80% of total dietary calories are derived from carbohydrates present in plant foods such as cereals, millets, and pulses.

Dietary fibers delay and retard absorption of carbohydrates and fats and increase satiety value.

Diets rich in fiber reduce glucose and lipids in blood and increase the bulk of the stools.

Diets rich in complex carbohydrates are healthier than low-fiber diets based on refined and processed foods.

PROTEINS

Are primary structural and functional components of every living cell.

Almost half the protein in our body is in the form of muscles and the rest of it is in bone, cartilage and skin.

Proteins are complex molecules composed of different amino acids.

Certain amino acids which are termed ‘essential’ since they are not synthesized in the human body and have to be obtained from proteins in the diet.

Other non-essential amino acids can be synthesized in the body to build proteins.

Proteins perform a wide range of functions and also provide energy (4 Kcal/g)

Protein requirements vary with age, physiological status and stress.

More proteins are required by growing infants and children, pregnant women and individuals during infections and illness or stress.

Animal foods like milk, meat, fish, eggs and plant foods such as legumes are rich sources of proteins.

Animal proteins are of high quality as they provide all the essential amino acids in right proportions, while plant or vegetable proteins are now of the same quality because of their low content of some of the essential amino acids.

A combination of cereals, millets, and pulses provides most of the amino acids, which complement each other to provide better quality proteins.

legumes

FATS Oils and fats such as butter and ghee constitute

dietary facts. Fats are a concentrated source of energy

providing 9 Kcal/g, and are made up of fatty acids in different proportions.

Dietary fats are derived from two sources viz. the invisible fat present in plant and animal foods, and the visible or added fats and oils (cooking oil).

Fats serve as a vehicle for fat-soluble vitamins like vitamins A and E and carotenes and promote their absorption.

They are also sources of essential polyunsaturated fatty acids.

It is necessary to have adequate and good quality fat in the diet with sufficient polyunsaturated fatty acids in proper proportions for meeting the requirements of essential fatty acids.

The type and quantity of fat in the daily diet influence the level of cholesterol and triglycerides in the blood.

Diets should include adequate amounts of fat particularly in the case of infants and children, to provide concentrated energy since their energy needs per kg body weight are nearly twice those of adults per kg body weight.

Adults need to be cautioned to restrict intake of saturated fat (butter, ghee, hydrogenated fats) and cholesterol (eggs, organ meat).

Excess of these substances could lead to obesity, diabetes, cardiovascular disease and cancer.

VITAMINS AND MINERALS

Vitamins are chemical compounds required by the body in small amounts.

They must be present in the diet as they cannot by synthesized in the body.

Vitamins are essential for numerous body processes and for maintenance of the structure of skin, bone, nerves, eye, brain, blood and mucous membrane.

They are either water-soluble or fat-soluble.

Vitamins A, D, E, and K are fat-soluble, while vitamin C and the B-complex vitamins such as thiamin (B1), riboflavin (B2), niacin, pyridoxine (B6), folic acid and cyanocobalamin (B12) are water soluble.

Provitamins like beta-carotene are converted to vitamins in the body into vitamin A.

Fat-soluble vitamins can be stored in the body while water-soluble vitamins are not and get easily excreted in urine.

Vitamins B-complex and C are labile vitamins are easily destroyed by heat, air or during drying, cooking and food processing.

Minerals are inorganic elements found in body fluids and tissues.

The important macrominerals are sodium, potassium, calcium, phosphorus, magnesium, and sulphur, while zinc, copper, selenium, molybdenum, fluorine, cobalt, chromium, and iodine are microminerals.

They are required for maintenance and integrity of skin, hair, nails, blood and soft tissues.

They also govern nerve cell transmission, acid/base and fluid balance, enzyme and hormone activity as well as blood-clotting processes.

WHAT IS A BALANCE DIET? A balance diet is one which provides all the

nutrients in required amounts and proper proportions.

It can easily be achieved through a blend of four basic food groups.

The quantities of foods needed to meet the nutrient requirements vary with age, gender, physical activity and physiological status.

A balanced diet should provide around 60-70% of total calories from carbohydrates, preferably starch, about 10-12% from proteins and 20-25% from fat.

In addition, a balanced diet should provide other non-nutrients such as dietary fiber, antioxidants and phytochemicals which bestow positive health benefits.

Antioxidants such as vitamins C and E, beta-carotene, riboflavin and selenium protect the human body from free radical damage.

Other phytochemicals such as polyphenols, flavones, etc., also afford protection against oxidant damage.

Species like turmeric, ginger, garlic, cumin and cloves are rich in antioxidants.

WHAT ARE FOOD GROUPS?

Foods are conventionally grouped as: Cereals, millets and pulses Vegetables and fruits Milk and milk products, egg, meat, and fish Oils and fats and nuts and oilseeds.

Foods may also classified according to their functions.

ENERGY RICH FOODS

MAJOR NUTRIENTS OTHER NUTRIENTS

Carbohydrates & fats

Whole grain cereals, milletsProtein, fibre, minerals,

calcium, iron and B-complex vitamins

Vegetable oils, ghee, butter Fat soluble vitamins, essential fatty acids

Nuts and oilseeds Proteins, vitamins/minerals

Sugars Nil

BODY BUILDING FOODS


Proteins

Pulses, nuts, oilseeds B-complex vitamins, invisible fat, fibre

Milk and milk products Calcium, vitamin A, riboflavin, vitamin B12

Meat, fish, poultry B-complex vitamins, iron, iodine, fat

PROTECTIVE FOODS


Vitamins & Minerals

Green leafy vegetables Antioxidants, fibre and other carotenoids

Other vegetables/fruits Fibre, sugar and antioxidants

Eggs, milk, and milk products and flesh foods Protein and fat

Choose a variety of foods in amounts appropriate for age, gender, physiological status and physical activity.

Use a combination of grains, grams, and greens. Include jaggery or sugar and cooking oils to bridge the calorie or energy gap.

Prefer fresh vegetables and fruits in plenty. Include in the diets, foods of animal origin such as

milk, eggs and meat, particularly for pregnant and lactating women and children.

Adults should choose low-fat, protein-rich foods such as lean meat, fish, pulses and low-fat milk.

Develop healthy eating habits and exercise regularly.

IMPORTANCE OF DIET DURING DIFFERENT STAGES OF LIFE

For growth and appropriate milestones.

Breast-milk, energy rich foods (fats, sugar)

For growth, development and to fight infections.

Energy, body building and protective food (milk, vegetables, and fruits.

For growth spurt, maturation and bone development

Body building and protective foods.

For maintaining health productivity and prevention of diet-related disease and to support pregnancy/lactation.

Nutritionally adequate diet with extra food for child bearing/rearing.

For being physically active and healthy.

Nutrient dense low fat foods.

BALANCED DIET FOR ADULT MAN (SEDENTARY)

* Portion Size **No. of portionsElderly man: Reduce 3 portions of cereals and millets and add an extra serving of fruit.

CEREALS AND MILLETS*30 g x 14**

FRUITS *100 g x 1**

PULSES *30 g x 2**

FATS/OILS SUGAR*5 g x 4** *5 g x 5**

MILK & MILK PRODUCTS*100 g x 3**

VEGETABLES*100 g x 4**

BALANCED DIET FOR ADULT WOMAN (SEDENTARY)

* Portion Size **No. of portionsElderly man: Reduce 3 portions of cereals and millets and add an extra serving of fruit.

CEREALS AND MILLETS*30 g x 10**

FRUITS *100 g x 1**

PULSES *30 g x 2**

FATS/OILS SUGAR*5 g x 4** *5 g x 4**

MILK & MILK PRODUCTS*100 g x 3**

VEGETABLES*100 g x 3**

Approximate nutritive value of some ready-to-serve preparations (per serving)

Qty. Quantity Wt gm Weight in grams Cal gm Calories in grams

Food Preparations Qty. Wt. gm

Cal gm

Protgm

Fat gm

CBH gm

Cereal preparations

Corn flakes 1 cup 25 94 2.0 0.1 21.2

Beaten rice 1 cup 30 114 1.8 0.2 26.3

Puffed rice 1 cup 14 54 0.8 0.1 12.3Oat meal 1 cup 25 101 3.6 1.8 17.6Wheat flakes 1 cup 35 133 3.8 0.6 28.1

Prot gm Protein in grams CBH gm carbohydrates in grams



Cal gm

Protgm

Fat gm

CBH gm

Baked products

Bread, toasted 2 slic 46 120 4.0 1.0 23.6

Bun 1 no. 31 100 2.3 2.3 17.5

Biscuits 2 nos 19 64 1.6 2.0 9.9Cake, plain 1 no. 55 180 3.4 4.5 31.4

Prot gm Protein in grams CBH gm carbohydrates in grams Slic Slices



Cal gm

Protgm

Fat gm

CBH gm

Pulse preparations

Bengal gram, puffed

--- 1 oz. 106 6.4 1.5 16.7

Peas, puffed --- 1 oz. 102 6.5 0.4 18.0

Prot gm Protein in grams CBH gm carbohydrates in grams 1 oz. (ounces) 28.35 gm.



Cal gm

Protgm

Fat gm

CBH gm

Nuts

Almonds 12-15 nos. 1 oz 186 5.9 16.7 3.0

Cashewnuts roasted 15 no 1 oz 169 6.0 13.3 6.3

Coconut, fresh 1 oz 127 1.4 11.8 3.7Groundnut roasted 1 oz 155 7.6 11.3 5.8Walnuts 1 oz 195 4.4 18.3 3.1




Cal gm

Protgm

Fat gm

CBH gm

Fruits

Apple (medium) 1 66 42 0.2 0.3 9.9

Banana (big) 1 100 99 1.2 0.2 23

Dates, dried --- 28.5 80 0.9 0.1 19.1Grapes (bunch) 1 140 44 0.8 --- 10.2Guava (medium) 1 100 66 1.5 0.2 14.5Mango (medium) 1 100 39 0.6 0.1 8.8Tomato, ripe 1 150 30 1.5 0.4 6.0




Cal gm

Protgm

Fat gm

CBH gm

Fruit products

Jam (tablespoon) 1 20 58 0.1 0.1 14.2

Jelly (tablespoon) 1 20 52 0.1 0.1 13.0

Marmalade (tbsp) 1 20 60 0.1 0.1 14.7Orange squash (glass) 1 6 oz 69 0.1 --- 17.1Lemon squash (glass) 1 6 oz 69 0.1 --- 17.2Pineapple (glass) 1 6 oz 69 0.1 --- 17.2Mango (glass) 1 6 oz 72 0.1 --- 17.8




Cal gm

Protgm

Fat gm

CBH gm

Preparations containing milk

Coffee 1 cup 6 oz 78 1.9 1.7 13.8

Tea 1 cup 6 oz 64 0.7 0.8 13.5

Cocoa 1 cup 6 oz 174 7.5 7.0 20.2Suji payasam 1 cup 154 178 3.4 4.3 31.5




Cal gm

Protgm

Fat gm

CBH gm

Snacks – Savory

Potato bonda 1 no 28 61 1.1 2.04 9.6

Pakoda 4 nos 47 176 8.0 8.0 18.0

Masala vadai 2 nos 45 150 6.4 6.2 17.0Dahi vadai 2 nos 99 177 6.5 102 14.8

Prot gm Protein in grams CBH gm carbohydrates in grams no/nos number/numbers.



Cal gm

Protgm

Fat gm

CBH gm

Dairy products

Butter (1 tbsp) ½ oz 103 0.1 11.3 0.1

Cheese (1 cube) 1 oz 112 7.1 9.1 0.6

Cream (1 tbsp) ½ oz 50 0.3 5.2 0.5Ghee (1 tbsp) ½ oz 127 --- 14.2 ---




Cal gm

Protgm

Fat gm

CBH gm

Carbohydrate foods

Honey (1 tbsp) 21 67 0.1 --- 16.7

Jaggery (1 tbsp) 1 oz 108 0.1 --- 27.0

Sugar (1 tbsp) 1 oz 114 --- --- 28.4




Cal gm

Protgm

Fat gm

CBH gm

Cereal and millet preparations

Rice plain (3 plates) 504 595 11.9 0.9 14.8

Sambhar bath (1/2 plate) 485 405 13.5 5.1 76.2

Curd bath (1 plate) 253 221 6.0 7.0 33.3Sweet rice (1 plate) 177 432 3.6 12.0 77.4Pulao with peas (1 plate) 252 400 8.0 14.4 59.5Pulao with potatoes 263 405 5.5 14.7 62.7Pulao with cauliflower 252 369 6.5 14.7 52.7




Cal gm

Protgm

Fat gm

CBH gm

Cereal and millet preparations

Idli (2 nos) 136 130 4.6 0.2 27.6

Rice uppuma (1 plate) 260 397 7.0 16.8 54.4

Plain dosai (2 nos) 100 216 4.1 9.7 28.2Onion dosai (1 no) 132 337 7.3 13.0 47.8Masala dosai (1 no) 1.1 212 4.6 8.4 29.4Khicheri (1 plate) 266 445 11.5 15.3 65.4Jaggery dosai (2 nos) 114 441 4.4 18.4 64.5




Cal gm

Protgm

Fat gm

CBH gm

Maize and Jowar

Maize roti (2 nos) 142 314 9.6 5.5 56.4

Mixed floor roti (1 no) 49 215 10 2.7 37.7

Maize vegetable paratha (1 no)

71 155 5.5 1.6 29.6

Jowar roti (2 nos) 150 252 7.5 1.3 52.5




Cal gm

Protgm

Fat gm

CBH gm

Wheat

Wheat Uppuma (1 plate) 128 163 3.8 5.4 24.7

Chapaties (2 nos) 57 193 5.0 5.5 30.8

Puris (2 nos) 32 136 2.2 8.4 13.0Plain Parathas (1 no) 56 304 4.5 19.6 27.3Parathas stuffed with peas 97 322 6.5 18.0 33.4Parathas stuff with potato 80 307 5.12 17.0 33.6Ravai Iddli (2 nos) 144 212 5.0 8.5 28.7




Cal gm

Protgm

Fat gm

CBH gm

Pulse preparations

Bengal gram dal 1 cup 151 284 9.0 16.4 25.2

Green gram dal 1 cup 142 171 7.0 7.7 18.4

Red gram dal 1 cup 192 220 12.8 4.0 32.8Dal rasam 1 cup 130 19 1.0 0.6 2.5Green gram dal and spinach

¾ cup

120 137 7.9 3.5 18.6




Cal gm

Protgm

Fat gm

CBH gm

Pulse preparations

Dal + vegetables – ¾ cup 119 127 5.6 4.3 16.5

Brinjal Samber – ¾ cup 196 103 4.1 3.6 13.4

Besan curry – 1 ½ cup 56 271 9.1 15.5 23.8Dal potato kachori – 2 nos 34 196 5.2 11.2 18.6




Cal gm

Protgm

Fat gm

CBH gm

Vegetable preparations

Potato + Methi 1 pl 142 175 3.2 7.5 23.8

Potato + tomato curry

1¼ pl 142 195 2.3 10.7 22.5

Vegetable cutlets 1 no 57 126 1.2 8.6 11.0Potato curry ½ pl 84 160 1.8 8.6 19.0Mixed vegetable ½ pl 127 134 4.3 6.0 15.6

Prot gm Protein in grams CBH gm carbohydrates in grams Pl Plate



Cal gm

Protgm

Fat gm

CBH gm

Vegetable preparations

Cabbage + carrot curry

½ pl 56 81 1.5 5.6 6.1

Drumstick leaves curry

1 pl 112 126 6.2 5.0 14.0

Tomato rasam 1½ cup

185 35 1.5 0.6 5.8

Prot gm Protein in grams CBH gm carbohydrates in grams Pl Plate

Food Preparations Quantity CaloriesSweetsBarfi 1 pc 100Halwa 1 pc 570Gulab Jamun 1 pc 100Jalebi 1 pc 200Mysore Pak 1 pc 357Rasogolla 1 pc 150Ladoo 40 gms 250Petha 40 gms 250

Food Preparations Quantity CaloriesSweetsBaln shah 40 gms 250Imarti 40 gms 250Patisa 40 gms 250Mesu 40 gms 250Rasmalai 40 gms 250Sohan Halwa 40 gms 250Malpuri 40 gms 250

Food Preparations Quantity Calories

Alcoholic Drinks Beer 1 glass 100Brandy 1 peg 70Dry Wines 1 wine glass 75Champagne 1 glass 115Whisky 1 peg 75Rum 1 peg 75Gin 1 peg 105

Calories Need According To Lifestyle

The number of calories you need to attain or maintain a desired weight would depend on your level of physical activities.

Gauging from your typical lifestyle, as described, you can decide the number of calories you should be consuming based on your long term weight goals.

If you are gaining weight over time this means that you should be exercising more and/or eating less.

Basal or Resting Metabolic Rate measures the calories the body needs to keep it in being. 1654 calories per day is the number of calories to keep the circulatory system and other vital bodily functions in operation.

Sedentary Lifestyle means you are very inactive physically; you only walk when absolutely necessary. This approximates most closely to your basal metabolic rate. If you are happy with your weight and general health then consuming approximately 2067 calories per day will maintain your current weight.

Light Activity means you are engaged in activities such as light house keeping. To maintain your current weight you could consume approx 2150 calories per day.

Moderate Activity means you walk a couple miles per week on a regular basis. To maintain your current weight you could consume approx 2480 calories per day.

Heavy Activity means you run at least 10 miles a week. To maintain your current weight you could consume approx 2811 calories per day.

Very Heavy Activity means you are training for marathons running at least 30 miles a week. To maintain your current weight you could consume approx 3307 calories per day.

One pound of fat is approximately equal to 3500 calories. To loose one pound in a week would mean cutting calorie intake by 500 calories a day (3500/7). To loose a pound in two weeks would mean cutting consumption by only 250 calories a day.

This could represent a food reduction of no more than 2 ounces of carbohydrates and fat, and half an ounce of protein.

Remember, maintaining an optimal weight can have beneficial effects on your outlook on life and on your over-all general health prospects in terms of avoiding heart attacks and strokes.

Sources of Water The best source of water is plain, pure drinking

water. Sodas have a lot of sugar in them and aren't a

good source. Herbal teas that aren't diuretic are fine. Sports drinks contain electrolytes and may be

beneficial.

BMIBody Mass

Index

Weight in Kilogram

Height in meters2==

OBESITY

Defined as excess accumulation of body fat. Has several adverse health effects and can

even lead to premature death. It increases the risk of high blood pressure,

high blood cholesterol and triglycerides, heart disease, diabetes, gallstones and certain cancers.

Obesity is not a simple consequence of overeating.

Its psychosocial consequences are significant.

Adult man may not normally regulate his daily energy intake to balance his daily energy expenditure.

If he maintains constant body weight, it indicates that he is in energy balance.

Overweight and obesity are due to positive energy balance.

Overeating and reduced physical activity together lead to obesity.

Genetic predisposition cannot be ruled out as a contributing factor.

Prevention and control of obesity are directly related to dietary management and physical activity.

Obesity is based on the degree of excess fat. Normal (ideal) BMI ranges between 18.5 and

25. An average BMI of a population should be 21

or 22. Less than 18.5 denotes chronic under-nutrition. Between 25-30 considered as overweight. Above 30 indicate obesity.

More than a general accumulation, the distribution of fat around the abdomen (male type obesity) is now considered to be more harmful than fat around the hips (female type obesity).

Ratio of waist to hip circumference is an important predictor of risk of chronic degenerative diseases.

Ratio of more than 0.9 in males are more than 0.85 in females is associated with increased risk of several chronic diseases.

WHY SHOULD WE AVOID OBESITY? There are several health consequences of

obesity. Excessive body weight increases the risk of

heart diseases, hypertension, diabetes, gallstones, cancer and arthritis.

Obesity invariably predisposes to reduced levels of high density lipoproteins (good cholesterol) and to increased levels of low density lipoproteins (bad cholesterol), and triglycerides, besides an abnormal increase in glucose and insulin in blood following an oral glucose load (insulin resistance).

Considering the increasing prevalence of coronary artery disease, hypertension, and diabetes in urban India, it is important to maintain desirable body weight for height and avoid obesity.

34.1 45.5 56.8 102.3 113.6 12579.5 90.968.2Lbs Kgs

WEIGHT

HOW TO REDUCE BODY WEIGHT? Weight reduction diets should contain at least

800 Kcal/day and provide all nutrient requirement, except energy.

Loss of half a kilogram per week is generally considered safe.

Extreme approaches should be avoided and use of drugs may be dangerous.

In children, obesity should be controlled by increasing physical activity rather than restricting food intake.

Modifications in dietary habits have to be incorporated into one’s lifestyle along with adequate exercise to keep the body weight within the normal limits.

As fat contains more than twice the calories per gram of either protein or carbohydrate, weight reduction diets should limit the fat intake.

Refined sugars and alcohol provide empty calories and should be avoided.

Plant foods that provide complex carbohydrates and fibre may need preferred as they reduce blood glucose, cholesterol, and triglycerides.

Weight-reducing diets must be rich in proteins and low in carbohydrates and fats.

Consumption of plenty of fruits and vegetables would not only result in satiety but could also help to maintain adequate micronutrient intake.

Frequent fasting/semi-fasting followed by adequate or excess food consumption will also aggravate the problem of weight gain.

All reducing regimens should be monitored by a doctor and a dietitian.

Slow and steady reduction in body weight is advised.

Severe fasting may lead to health hazards. Enjoy a variety of foods in amounts needed to

balance your physical activity. Eat small meals regularly at frequent intervals. Cut down on sugar, fatty foods, and alcohol. Use low fat milk.

SALT SHOULD BE USED IN MODERATION Sodium is the major electrolyte in the extracellular

fluid. Sodium plays an important role in nerve conduction

and fluid balance in the body. Maintenance of sodium balance depends on kidney

function. High intake of salt is associated with high blood

pressure and stomach cancer. All foods contain sodium. The sodium requirements

can be met with moderate salt intake. Sodium intake needs to be balanced by

potassium intake.

Salt is an essential ingredient of diets and enhances its taste and flavor.

From time immemorial, it has been used as a preservative.

All food substances contain sodium, but added salt is the major source of sodium in our diet.

Sodium is primarily involved in the maintenance of water balance and equilibrium.

It also plays an important role in electro-physiological functions of the cell.

Humans have powerful inbuilt mechanisms for maintaining blood pressure even on mineral sodium intake.

Sodium is rapidly absorbed from the gastrointestinal tract and a positive balance is achieved on intakes just above minimal requirements.

Sodium requirements depend on its losses through urine, faces, and sweat.

The sweat loss varies according to climatic conditions.

High ambient temperatures and vigorous physical exercise increase sodium loss through sweat.

Even after 6 hours of hard physical labor, which may generate 3 liters of sweat, the requirement of sodium chloride may not be more than 8 g/day.

SOURCES OF SODIUM

Sodium content in natural diets, in general, will be about 300-400 mg a day.

Cereals, pulses, vegetables, milk, animal, and sea foods are the major sources of sodium.

Indian data indicate that daily salt consumption rages from less than 5g to 30g in different States with almost 40% of families consuming about 10g.

Since the taste for salt is an acquired habit, salt consumption should be restricted from an early age.

Preserved foods such as pickles, sun dried foods, and cannot foods contribute to higher intakes of salt.

PROBLEMS ASSOCIATED WITH EXCESSIVE SALT/SODIUM INTAKE?

There is strong association between salt intake and blood pressure.

Prevalence of hypertension is low in populations consuming less than 3g salt per day.

The usual increase in bp with age is also not seen with such intakes.

The amount of salt consumed is reflected in urinary sodium.

Drastic restriction of dietary salt decreases the risk of hypertension.

This effect is not uniform as only 20-30% of population are salt sensitive.

Potassium-rich foods such as fresh vegetables and fruits decrease blood pressure.

In fact, it is the ratio of sodium to potassium in the diet which is important.

Salt intakes higher than 10g have been identified as a risk factor for hypertension.

Besides increasing blood pressure, excessive salt may also affect stomach mucosa and result in atrophic gastritis and gastric cancer.

Higher sodium intake leads to greater calcium excretion which may result in reduction in bone density.

Existing evidence reveals a deleterious impact of high salt intake on blood vessels, blood pressure, bones, and gastrointestinal tract.

Salt intake in our population generally exceeds the requirement.

It should not be more than 8g per day. In India, salt has been identified as a vehicle

for food fortification since it is the only commodity which is universally consumed.

Restrict the intake of added salt from an early age.

Develop a taste for food/diets low in salt. Restrict intake of preserved and processed

foods like papads, pickles, sauces, ketchup, salted biscuits, chips, cheese and fish.

Eat plenty of vegetables and fruits to provide adequate potassium.

Use always iodized salt.

EAT ENOUGH IODINE-CONTAINING FOODS/USE ONLY IODIZED SALT

Iodine is required for formation of thyroid hormones.

Thyroid hormones are necessary for growth and development.

Iodine deficiency leads to goiter. Lack of iodine in water and diet is the main cause

of iodine deficiency disorders. Iodine deficiency during pregnancy results in still

births, abortions, and cretinism. Use of iodized salt ensures adequate iodine intake.