A lucid presentation on Prescription of diet to facilitate easy-learning for medical , dental , pharmacology and biotechnology students .

1. Prescription of Diet
Dr.Rohini C Sane

2. Recommended Dietary Allowance(RDA)
Dr. Rohini C Sane

3. Recommended Dietary Allowance(RDA)
Recommended Dietary Allowance (RDA): represents quantities of the
nutrients to be provided in the diet daily for maintaining good health and
physical efficiency of the body .
RDA provides extra provisions to prevent the development of deficiencies.
RDA is not minimum amount just to meet needs of body but allowance is
given for a safe margin.
Safe levels of protein intake : 0.75- 0.8 g/kg/ day
RDA has been prescribed for all the essential nutrients as per
stipulations of WHO and FAO.
Indian council of Medical Research (ICMR) has suitably modified these
for indian conditions.

4. Recommended Dietary Allowance (RDA)
RDA for an adult man weighing 70Kg
Type of nutrient RDA
Carbohydrate 400g
Fat 70g
Protein (0.8/kg Body
Weight/Day)
56g
Essential Fatty Acids 4g
Vitamin A
(Retinol Equivalents)
1000
microgram
Vitamin D
(Cholecalciferol)
5 microgram
Vitamin E 10 microgram
Vitamin K 70 microgram
Vitamin C 60mg
Type of nutrient RDA
Calcium 800mg
Phosphorous 800mg
Thiamine 1.5mg
Riboflavin 2mg
Niacin 20mg
Pyridoxine 2mg
Pantothenic Acid 10 mg
Biotin 200 microgram
Folic Acid 150microgram
Cobalamin 2 microgram
Iron 10 mg
Copper 1.5-3 mg
Iodine 150 microgram
Zinc 8-10 mg
Selenium 50-100 microgram

5. Factors affecting Recommended Dietary Allowance (RDA):1
1. Age
2. Sex
3. height
4. weight
5. Geographical location
6. Availability of Food
7. Economic Status/Occupation
8. Physical Activity

6. Factors affecting Recommended Dietary Allowance (RDA):2
Factors affecting Recommended Dietary Allowance
(RDA)/ allowances for safe margin:
1. Sex:
RDA for female< RDA for male( 20%higher)
Iron requirement for pregnant / menstruating women is
greater than non pregnant and non menstruating women.
RDA for nutrients 20-30% higher for lactating /pregnant
women compared to normal.
2. Age: protein requirement for growing age > adult
2g/ kg weight/day 1g/ kg weight/day

7. Recommended protein allowances
Group
Recommended protein allowance
(g/ kg body weight /day)
Infants 2.4
Children(up to 10yr) 1.75
Adolescent boys 1.6
Adolescent girl 1.4
Adult(men/women) 0.8
Pregnancy 2.5
Lactation 2.5

8. Balanced Diet
Dr.Rohini C Sane

9. Balanced diet
Balanced diet(Prudent diet): the diet which contains different types of foods
possessing the nutrients i.e.fats ,proteins,carbohydrates ,vitamins and minerals
in proper proportion to meet energy and nutritional requirements of the body
for maintaining health, vitality and general wellbeing . It also makes a small
provision for extra nutrients to withstand short duration of illness.
Indian council of Medical Research recommends composition of balanced
diets for Indians taking into account the commonly available food items in
India.
Vegetarian balanced diets compose of : Cereals (wheat/rice/ jawar)+ Pulses
+vegetables +roots +tubers +milk+ milk products+oils+fats+ fruits +sugar
Non vegetarian balanced diets compose of :meat /fish /eggs
Balanced dieting developed countries :daily dietary intake of <30% fat (total
fat, saturated fatty acids ,cholesterol)against the present 40-50% towards
calories and reduce the intake of total calories ,refined sugars , salt.

10. Basis of balanced diet
A balanced diet should be based on:
1. locally available foods.
2. should be within the economics means of the people.
3. should fit the local food habits.
4. diet should be easily digestible and palatable.
5. should contain enough roughage materials.

11. Balanced diet for an adult man
Sedentary work Moderate work Heavy work
Type of Food V NV V NV V NV
Quantity g/day
Cereals 400 400 475 475 650 650
Pulses 70 55 80 65 80 65
Green leafy vegetables 100 100 125 125 125 125
other vegetables 75 75 75 75 100 100
Roots and tubers 75 75 100 100 100 100
Fruits 30 30 30 30 30 30
Milk 200 100 200 100 200 100
fats and oils 35 40 40 40 50 50
Meat and fish - 30 - 30 - 30
Eggs - 30 - 30 - 30
Sugar and Jaggery 30 30 40 40 55 55
Groundnuts - - - - 50 50
V= vegetarian, NV= Non-Vegetarian

12. Balanced diet for a non-pregnant adult woman
Sedentary work Moderate work Heavy work
Quantity g/day
Cereals 410 440 575
Pulses 40 45 50
Green leafy vegetables 100 100 100
other vegetables 40 40 50
Roots and tubers 50 50 60
Fruits 30 30 30
Milk 100 150 200
fats and oils 20 25 40
Sugar and Jaggery 20 20 40

13. Balanced diet suggested by ICMR
Children Boys Girls
Age 1-3yrs 4-6yrs 10-12yrs 10-12yrs
Quantity g/day
Cereals 175 270 420 360
Pulses 35 35 45 45
Green leafy vegetables 40 50 50 50
other vegetables 20 30 50 50
Roots and tubers 10 20 30 30
Milk 300 250 250 250
fats and oils 15 25 40 35
Sugar and Jaggery 30 40 45 45
V= vegetarian, NV= Non-Vegetarian

14. Composition of milk in different species
Human milk :70 kcal/dL , Buffalo milk: 95 kcal/dL
Milk is a good source of both fat soluble and water soluble vitamins but
deficient in vitamin C.
Constituent woman Cow Buffalo Goat
Water 87.6 87.2 83.5 87
Total solids (g/dL) 12.4 12.8 16.5 13.0
Carbohydrates (g/dL) 7.5 4.4 5.4 4.5
Lipids( g/dL) 3.8 3.8 6.5 3.5
Proteins (g/dL) 1.1 3.3 4.3 3.7
Calcium (mg/dL) 35 150 160 175
Phosphorous(mg/dL) 16 100 100 70
Magnesium(mg/dL) 2.2 13 10 8
Sodium(mg/dL) 15 60 60 50
Potassium (mg/dL) 55 140 130 85
Colostrum is the only food for the offsprings of mammals on their birth.

15. Composition of milk
component example Functions
Carbohydrate lactose
Galactose derived from
hydrolysis of lactose is source
of energy . Lactic acid
(metabolic product of lactose)
eliminates harmful bacteria.
Lipid
Triacylglycerol,
Monoacylglycerol,
Diacylglycerol
source of medium or short and
medium chain fatty acids e.g.
Palmitic acid ,Myristic acid ,
Stearic acid, Lauric acid,
Butyric acid.Oleic acid ( an
unsaturated fatty acids) is also
present.
Proteins
Casein(phosphoprotein),
lactaalbumin,lactoglobulin ,
proteases,lipase ,lysozyme ,
immunoglobulins
source of phosphorous from
Casein for calcification of bone
and teeth, white colour milk due
to calcium caseinate micelle
Minerals
Calcium, Phosphorous ,
Magnesium, Sodium,
Potassium, Chlorine
source of minerals for their
functions. Milk is poor source
of iron and copper.

16. Sequences in Prescription of diet
What is
the requirement of the person with regard to calorie and other
essential nutrients?
What is the quantity of proximate principle required ?
Which composition of food 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.

17. Rules in Prescription of Diet:1
1. Balanced , well planned diet with all essential nutrients (RDA)
2. Balanced diet : carbohydrate (60%)+ protein (20%)+ fat(20%)
3. Diet :simple ,locally available , palatable ,digestible
4. Adequate protein content with essential amino acids(cereals +pulses)
5. Calorie intake : correct and with balanced energy expenditure
6. Specific Dynamic action :extra energy to be supplied to account SDA
7. Adequate quantity of Calcium and Iron
8. Adequate roughage should be included.
9. should have variety and vary as habitual diet .

18. Rules in Prescription of Diet:2
1. Ideal body weight :
2. Calorie requirement :depends on age,sex ,height ,weight ,health status , physical activity
and occupation
Physiological normal individual :30-35 kcal / kg body weight( 1700-2300 kcal / 55-65 kg)
Extra Calorie intake for Under weight : 5kcal /kg body weight /day till ideal weight is
achieved .
Reduction in Calorie intake for Overweight : 5kcal /kg body weight /day till ideal weight is
achieved.
3. Protein requirement : depends on age ,sex ,height , weight,health status ,occupation .
Adult : 1 g/ kg body weight
Children: 2 g/ kg body weight
Pregnancy and Lactation: 2.5 g/ kg body weight
Sex Height(cm) Body weight( kg)
Male 153 48(+1.25 Kg for every cm)
Female 153 45(+1 kg for every cm)
Underweight individual:
should be given more nutrients .
Overweight individual: should
reduce calorie intake.

19. Proximate Principles
• In the diet , proximate principles are carbohydrates ,
fats and proteins.
• Moreover ,required amounts of minerals and
vitamins are also to be provided.
• Further ,additional requirements for growth ,
pregnancy ,lactation and convalescence are to be
provided in the food.

20. Steps to identify Calorie requirement:1
• Calorie requirement for 60kg sedentary man :
• First step:
(a)Energy requirement : 60x30(kcal/kg body weight) =1800 kcal
(b)extra energy requirement for Specific Dynamic action : 1800x10%=180kcal
Total energy requirement (a)+(b)= 1800+180= 2000kcal
Second step: Requirement of proximate principle:
(1) Protein Requirement(1g/kg bodyweight)=60g
(2)Energy through protein = 60g x 4=240 kcal
(3) carbohydrate +fat should produce=2000-240=1760 kcal
20% of energy through fat = 1760x20%=350 kcal
350kcal /9 = 35 g of fat daily requirement(1g of fat = 9 kcal)
About 30% of total fat may be supplied as polyunsaturated fatty acids.
Carbohydrate : Protein : Fat=60:20:20

21. First step in the prescription of diet
Energy required(1400kcal)+ SDA 2000 Kcal
Protein(1g= 4kcal) 60g
Calcium 800 mg
Iron 25 mg

22. Steps to identify Calorie requirement:2
• Daily Total requirement = 2000kcal
(1)- 240 kcal energy through Protein(daily requirement of
protein 1g/kg bodyweight=60g as 1g protein =4kcal)
(2)-350 kcal energy through fat (daily requirement of fat 35g as
1g fat= 9 kcal)
(3) -1400 kcal energy through carbohydrate (daily requirement
of carbohydrate =1400/4= 350g as 1gm carbohydrate= 4 kcal)
+400 mg Calcium
+25mg Iron

23. Second step in the prescription of diet
When calories alone are to be increased , as in the case of a person
having severe muscular exercise ,tubers and roots will serve the purpose.
Energy required(1400kcal)+ SDA 2000 Kcal
Protein(1g= 4kcal) 60g
Fat(1g=9kcal) 35g
Carbohydrate(1g=4kcal) 350 g
Calcium 800 mg
Iron 25 mg

24. Third step : General composition of Food
The nutritive value of commonly supplied foodstuffs is
calculated to apply proximate principles.

25. Fourth step: Determine the items of food
• Knowing the requirement and the nutritive value of
foodstuffs ,it is possible to write down items of food.
• Fundamental principle of dietetics is the “food exchange”
which is very useful for calculation of proximate principle.
• “food exchange”: food with similar nutrient composition
are grouped together . It is also useful to provide variety
in the food.

26. Nutritive value of food items (per 100 g of edible portion)
Food
Protein
(g)
Fat
(g)
Carbohydrate
(g)
Energ
y
(kcal)
Calciu
m (mg)
Iron
(mg)
cereals
(Wheat,rice)
10 1 65 300 20 5
Pulses
(Bengal gram)
20 5 55 300 50 10
Tubers (potato) 1 0 25 100 0 0
Green leafy
vegetables
2 0 4 20 20 3
Fruits ( banana) 2 0 10 50 10 1
Nut and oil seeds 20 50 20 600 50 5
Milk and curd 3 4 5 60 200 0
Meat 20 3 0 100 150 3
Fish 20 10 0 170 20 1
oils and ghee 0 100 0 900 0 0
Sugar 0 0 100 400 0 0

27. General composition of food
Depending upon nutritive value and requirement Items of
food Principle of Dietetics “ Food Exchange”
Food with similar nutritive composition group together.
One large slice bread =one idli=one chapati= 3 table
spoons of cooked rice = equal quantities of energy and
protein
2g protein + 5g carbohydrate=750Kcal

28. Food exchange system
Food exchange content:one chapati or one idli or one large slice of bread will give equal
quantities of energy and proteins.They are nutritionally equivalent.
Cereals exchange
One chapati (20 g wheat) Protein 2g
or One large slice of bread Carbohydrate 15 g
or Cooked rice 3 table spoon(20g raw) Energy 70kcal
or one idli
Legumes -pulses exchange
Bengal gram(channa )100g Protein 24g
or Black gram (urad)100g Carbohydrate 60 g
or Green gram (moong)100g Energy 340kcal
or Red gram (arhar) 100g
or Horse gram (kabul) 100g
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29. Legume -Pulses Exchange system
Protein content of Pulses > Protein content of Cereals.
contents of Indian diet cereals > pulses
Therefore protein is supplied as cereals (Indians).
Combination of pulses + Cereals = in ratio 1:5
Combination of pulses plus cereals (chapattis +dal) will cancel each other’s
deficiency .
Cereals protein= animal protein (higher cost)
30 g meat exchange (mutton /chicken / fish/pork)=7g protein +5g fat =70 kcal
Deficient in Methionine ,
rich in Lysine
Deficient in Lysine,
rich in Methionine
supply of good
quantity protein

30. Diet for vegetarian and non-vegetarian adult man(60kg)
with sedentary activity
Item Quantity vegetarian(g) Quantity non-vegetarian(g)
Sugar 25 25
Cereals 350 350
Pulses 75 60
vegetarian oil 40ml 25ml
Milk 250ml 150 ml
Leafy vegetables 200 200
Fish/meat 60

31. Fifth step : Three meals per day
The total quantities of proximate principles are
calculated are divided in three meals per day into:
1.Breakfast
2. Lunch
3. Supper

32. Objectives of nutrition in the elderly
• Nutritional needs and energy requirement in the
elderly aim towards:
1. to increase life expectancy over 3 or 4 folds in the
number old people (chronological age > 65yrs).
2. to reduce risk of diseases like cancer, dementia,
osteoporosis, cardiovascular and cerebrovascular
incidents.Regenerative capacity in elderly is limited.
3. to reduce vulnerability of elderly to malnutrition, BMR,
and Lean body mass (which decreases with increase
in age).

33. Nutritional requirements in the elderly per day
NPHCE: National Programme for health Care of Elderly ( NPHCE)
Lower Specific nutritional needs for elderly( WHO) and energy requirements :
1. Vulnerability to malnutrition
2. BMR decrease with age
3. Lean body mass decrease with age
Nutritional requirement in the elderly /
day (recommended by NPHCE)
Item Male Female
Energy(60-69yrs) 2300 kcal 1900kcal
Energy(>70yrs) 2100kcal 1800kcal
Calcium 700mg 700mg
Phosphorous 550 mg 500mg
Protein 53g 48g
Iron 15mg 15mg
Vitamin A 600 mcg 600mcg
Vitamin D 1500 IU 1500IU
Folic acid 200 mcg 200mcg
Vitamin B12 1.5mcg 1.5mcg
WHO : set stage for
“keep fit for life ,
meeting the nutritional Needs”

34. Estimation of Caloric requirement using Harris Benedict’s equation
Daily calorie requirement can be estimated with help of
Harris -Benedict’s equation.
The basal energy expenditure (BEE) is as follows:
BEE (women)= 655+ (9.5xW) +(1.8XH)-(4.7XA)kcal/day
BEE (men)= 66+ (13.7xW) +(5XH)-(6.8XA)kcal/day
where W =weight in kg, H= height in cm, A = age in years.

35. Thank You