Dr K N Prasad
Community Medicine

 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.

 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

1.
Region
2.
Economic status
3.
Religion
4.
Customs
5.
Culture
6.
Taboos
7.
Taste
8.
Habits of the people

 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 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.

1.
Age
2.
Sex
3.
Body composition
4.
Physical activity
5.
Working conditions
6.
Physiological state

 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

 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

 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

 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 )

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

 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

 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.

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

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