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Other Resources: Diet Management

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Basic nutrition, clinical nutrition and nutritional requirements for different age groups and elderly …

Basic nutrition, clinical nutrition and nutritional requirements for different age groups and elderly

• A concise discussion on nutrient variation in diets during various diseases presented in a simple language

• Recent advancements in dietetics for the management of critically ill, gastrointestinal, renal and cardiovascular disorders, diabetes, surgical conditions and cancer

• Calorific values and nutritional content of different food stuffs provided for monitoring self-intake

• A large number of tables, diet charts and flowcharts added for enhanced learning

These features make this book a ready reckoner for dieticians, dietetic interns, physicians, home science and nursing students, and allied health care professionals.

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  • 1. DIET MANAGEMENT
  • 2. 6 Diet Management Fatty acid composition of some important edible oils and fats (Values are percentage of total methyl ester of fatty acid) S. Oil/fat Total sat- Total mono- Linoleic Linolenic Total no. urates unsaturates n6 n3 polyunsaturates 1. Coconut oil 89.5* 7.8 2.0 - 2.0 2. Corn oil 12.7 29.6 57.4 - 57.4 3. Cottonseed oil 25.9 22.9 50.9 - 50.9 4. Groundnut oil 20.9 49.3 29.9 - 29.9 5. Mustard or 10.7 56.0 † 18.1 14.5 32.6 rapeseed oil 6. Olive oil 14.8 74.5 10.0 - 10.0 7. Palm oil 46.3 43.7 10.0 - 10.0 8. Palmolein 47.7 41.4 10.3 0.3 10.6 9. Rice bran oil 22.1 41.0 34.3 1.4 35.7 10. Safflower oil 10.7 16.7 73.5 - 73.5 11. Gingelly 13.7 41.3 44.5 - 44.5 (sesame) oil 12. Soyabean oil 13.1 28.9 50.7 6.5 57.2 13. Sunflower oil 9.1 25.1 66.2 - 66.2 14. Butter 69.4* 28.0 2.5 - 2.5 15. Lard 46.2* 45.2 11.0 - 11.0 16. Tallow 54.9* 40.9 4.2 - 4.2 *Includes lower-chain fatty acid. † Includes 46.5% of erucic acid (22:1). Proteins A large group of related nitrogen-bearing organic compounds are termed as proteins. These complex organic molecules consist of many amino acids. Amino acids are known as the building blocks of body tissues. Proteins are widely distributed in nature and are building blocks for the tissues. They are an essential structural component of muscles and organs. Proteins are an essential component of the body to keep the immune system strong and healthy; they synthesize neurotransmitters, form hormones that trigger growth and maintain metabolism. A balanced diet supplies the proteins that we need. Meats, eggs, pulses, soy and dairy products are Chapter-01.indd 6 12/21/2010 4:52:32 PM
  • 3. Normal Nutrition 19 ‘ Others’ (Fats, oils and sweets) Eat sparingly Milk Meat group group 2-3 servings 2-3 servings Fruit Vegetable group group 2-4 servings 3-5 servings Grain group 6-11 servings Daily Food Guide An average balanced diet for a day Food groups No. of servings Approx. size of serving 1. Whole-grain cereals and cereal 9-10 or more 1 medium chapati or products: Chappati, rice, whole-wheat (This can be lower 1 large slice of bread bread, oats, idli, porridge with reduced calories.) 2. Milk and milk products—low fat 2 or more 1 glass of low-fat milk 240 mL or its equivalent 3. Pulses and legumes with husk 2 or more 1 bowl of cooked pulse 125 g or 25 g raw weight 4. Low-fat meat, poultry and fish 1 or more 30-40 g of lean chicken/fish or egg whites - 2 5. Vegetables and fruits 4-5 or more 125 g each ( Contd. ) Chapter-01.indd 19 12/21/2010 4:52:33 PM
  • 4. Normal Nutrition 21 Approximate food value Carbohydrates (g) 287 66% Proteins (g) 58 13% Fats (g) 41 21% Calories 1750 This diet is an example of a normal diet for a person requiring no modifications. Reduced activity on hospital admission lowers the calorie need, but other nutrient needs may be accelerated by the demands of illness and convalescence. NORMAL DIET (MENU)* BREAKFAST : Tea 1 cup with 1-2 teaspoons of sugar Whole-wheat bread—2 slices Or Whole-grain cereal (3-4 tablespoons or 50 g raw weight) Or Idli—2 medium Or Stuffed chappati—2 medium size Low fat milk (3% fat)—240 mL (1 glass) Or Curd—1 serving + buttermilk 1 glass Egg whites 2/paneer 25 g/ sprouts 1 bowl LUNCH : Salad Chappati (atta 100 g) (4 medium size) Or Rice 100 g (4 karchi) Dal 25 g (1 bowl) Curd 125 g (1 bowl) Green and other vegetables 100 g (1 bowl) Fruit (100 g) 1 medium size TEA : Tea 1 cup with 1 teaspoon of sugar Biscuits 2-3/upma/poha *All food stuffs mentioned above are in terms of raw weights and edible portions. Chapter-01.indd 21 12/21/2010 4:52:34 PM
  • 5. Normal Nutrition 25 Diet in Lactation Nutritional requirements during lactation are higher than those during pregnancy, and the diet has to be increased further. In diet during pregnancy, add: ● One glass of milk ● One serving of chappati/rice during lunch and dinner ● One serving of fruit Total fluid during the day should be 7-8 glasses. Excess use of highly flavoured, gas-producing foods like cabbage, radish, turnips, capsicums, onions, etc., should be avoided. Diet for Infants (Up to 1 Year of Age) 0-5 Months : Exclusive breast-feeding on demand : No water : No honey : No bottle milk 5-6 Months : Continue breastfeeding : Cereals (rice) = twice a day : Mashed banana, papaya, mango = once a day : Cooked/mashed potato, carrot, pumpkin = once a day : Feed = 3-4 times/day 6-9 Months : Continue breastfeeding, increase all the above-mentioned foods : Add khichri (rice + dal) or mashed chappati = twice a day Wheat to be introduced after 8 months Washed dal = twice a day *Soft boiled egg = 2-3 spoons : Mashed vegetables = twice a day : Mashed fruit = once a day : Feed = 4-5 times/day 9 Months-1 year : Continue breastfeeding, feed family food rice/chappati/khichri = 3 times/day : Washed dal = twice a day * Optional. Chapter-01.indd 25 12/21/2010 4:52:34 PM
  • 6. 38 Diet Management Many diseases or medical problems cannot be diagnosed with blood tests alone; however, they are an important tool and can help in knowing the health status. Blood tests also help in finding potential problems at an early stage, where treatments or lifestyle changes may work the best. Complete blood cell count The table below shows the normal biochemical parameters and their normal ranges pertaining to the blood cells. Some of the values differ for men and women. The physician will check on these values to advise on the management based on some other factors like age and ethnic group. Parameters Normal range Male: 5-6 million cells/ μ L Red blood cells Female: 4-5 million cells/ μ L White blood cells 4500 to 10,000 cells/ μ L Platelets 140,000 to 450,000 cells/ μ L Male: 14-17 g/dL Haemoglobin Female: 12-15 g/dL Male: 41-50% Haematocrit Female: 36-44% Blood glucose The following table has the normal blood glucose range, along with prediabetes and diabetes range. The blood samples have to be taken after 8-10 hours of fasting. Plasma glucose results (mg/dL)* Category <99 Normal 100-125 Prediabetes >126 Diabetes Chapter-03.indd 38 12/21/2010 4:53:34 PM
  • 7. Therapeutic Nutrition or Medical Nutrition Therapy 39 Lipid profile The following tables show ranges for total cholesterol, LDL (bad cholesterol) and HDL (good cholesterol). Total cholesterol (mg/dL) Category <200 Desirable 200-239 Borderline high >240 High LDL (mg/dL) Category <100 Optimal 100-129 More than optimal 130-159 Borderline high 160-189 High >190 Very high HDL (mg/dL) Category <40 High risk 40-59 Optimal >60 Good Liver enzymes Serum glutamic oxaloacetic transaminase (SGOT): SGOT is present in the liver, heart, muscles, brain and kidney tissues. Injury to any of these organ tissues can increase the levels of SGOT in the blood. Normal range: 10-34 IU/L. Serum glutamic pyruvic transaminase (SGPT): SGPT is primarily present in the liver and is a specific test for detecting any abnormalities in the liver. Normal range: 5-35 IU/L. Alkaline phosphatase (ALP): ALP enzyme is found in the biliary duct cells of the liver. Normal range: 20-140 IU/L. Bilirubin: Normal range (direct): 0-0.3 mg/dL: normal range (total bilirubin): 0.3-1.9 mg/dL. Chapter-03.indd 39 12/21/2010 4:53:34 PM
  • 8. Diets in Gastrointestinal Diseases 59 BREAKFAST : 1 cup of tea with sugar Milk (low fat) 240 mL (1 glass) Bread or cereal 50 g (2 slices) Jam 1 tablespoon Fruit 1 (medium) 10.30 A.M. : Fruit juice 1 glass or lemon with sugar/buttermilk LUNCH : Rice or chappati 75-100 g (3-4 medium) Dal 25 g (1 bowl) Potato 100 g (1 bowl) Curd 25 g (1 bowl) Sago kheer: Milk (1 glass) Sago 25 g Sugar 15 g Fruits 2 (medium) Cooking fat 1 tsp TEA : 1 cup of tea with sugar Biscuits 2-3 DINNER : Same as lunch Recovery stage After the acute stage when enzymes begin to fall, normal diet is recommended. A diet should have normal proteins and normal fat content as tolerated. Low-Residue Diet This diet is used for patients who have undergone colostomy, ileostomy or resection of the bowel. Types of food Foods included Foods excluded Beverage Tea, coffee Extra milk 1 cup of milk Clear soup Cereals White bread, semolina, rice, chappati Whole grains, porridge, whole- prepared from refined flour wheat bread Legumes De-husked pulses Pulses with husk Meat group Tender minced chicken or fish Fried mutton and fish Eggs, cheese Egg — ( Contd. ) Chapter-05.indd 59 12/21/2010 4:53:11 PM
  • 9. 60 Diet Management Types of food Foods included Foods excluded Vegetables Pureed green vegetables, potato All other vegetables without skin Fruits Strained fruit juice, banana, cooked All fruits with seeds and skin apples, pears, peaches Fats Butter, cream, oils (as desired) Processed cheese Use soft, semisolid diet. Exclude more than 1 cup of milk. High-Residue Diet This diet is used for chronic constipation. Types of food Foods included Foods excluded Beverages All kinds including milk None Cereals Whole-wheat/bran bread White bread Whole-wheat porridge Semolina, noodles Oat meal Refined flour chappati Whole-wheat chappati Sago, arrowroot Legumes All pulses with husk De-husked pulses Soyabeans Meat group Meat/fish/chicken to be taken with green None leafy vegetables Vegetables Green leafy vegetables, beans, peas, Root vegetables cauliflower All other vegetables, other than root vegetables Fruits Guava, papaya, pomegranate, custard Fruit juice apple, other fruits with seeds and skin Fats Normal requirement as desired Refined cereals whenever taken should be taken with lots of vegetables mixed into them. Chapter-05.indd 60 12/21/2010 4:53:11 PM
  • 10. 78 Diet Management Harris-Benedict Formulas for Basal Energy Expenditure (BEE)/Basal Metabolic Rate (BMR) For women BMR = 655 + (9.6 × weight in kg) + (1.8 × height in cm) - (4.7 × age in years) For men BMR = 66 + (13.7 × weight in kg) + (5 × height in cm) - (6.8 × age in years) W = weight in kg H = height in cm A = age in years Equations and Factors to Estimate Actual Energy Expenditure (AEE) AEE = BEE × AF × IF × TF AF (Activity Factor) IF (Injury Factor) In bed 1.1 Uncomplicated patient 1.0 In bed, but mobile 1.2 Postoperative state 1.1 Mobile 1.3 Fractures 1.2 Sepsis 1.3 Peritonitis 1.4 TF (Thermal Factor) Multiple trauma 1.5 38°C 1.1 Multiple trauma + sepsis 1.6 39°C 1.2 Burns 30-50% 1.7 40°C 1.3 Burns 50-70% 1.8 41°C 1.4 Burns 70-90% 2.0 Equations for Predicting BMR on Adults (kcal/24 hours) Sex Age Prediction equation (years) Proposed by Proposed by ICMR expert FAO/WHO/UNU group (Indians) Male 18-30 15.3 × BW (kg) + 679 14.5 × BW (kg) + 645 30-60 11.6 × BW (kg) + 870 10.9 × BW (kg) + 833 60 13.5 × BW (kg) + 487 12.8 × BW (kg) + 463 Female 18-30 14.7 × BW (kg) + 496 14.0 × BW (kg) + 471 30-60 8.3 × BW (kg) + 827 8.3 × BW (kg) + 788 60 10.5 × BW (kg) + 596 10.0 × BW (kg) + 561 Chapter-07.indd 78 12/21/2010 11:21:32 AM
  • 11. 98 Diet Management Dietary fibre content of common Indian foods Food TDF IDF SDF Cereals, grains and products Pearl millet 11.3 9.1 2.2 Sorghum 9.7 8.0 1.7 Maize, dry 11.7 11 0.9 Finger millet 11.5 9.9 1.6 Rice 4.1 3.2 0.9 Wheat 12.5 9.6 2.9 Pulses and legumes Bengal gram, whole 28.3 25.2 3.1 Black gram, whole 20.3 15.4 4.9 Green gram, whole 16.7 6.5 1.7 Lentil, whole 15.8 13.5 2.3 Red gram, whole 22.6 19.8 2.8 Soyabean 23.0 17.9 5.1 Vegetables Carrot 4.4 3.0 1.4 Potato 1.7 1.1 0.6 Sweet potato 3.9 2.6 1.3 Yam 4.2 3.2 1.0 Bittergourd 4.3 3.2 1.1 Broad beans 8.9 6.7 2.1 Drumstick 5.8 4.8 1.0 Peas, green 8.6 7.2 1.4 Fruits Papaya 2.6 1.3 1.3 Amla 7.3 5.8 1.5 Apple 3.2 2.3 0.9 Banana 1.8 1.1 0.7 Dates, fresh 7.7 6.9 0.8 Guava 8.5 7.1 1.4 Orange 1.1 0.6 0.5 Sapota 10.9 9.1 1.8 TDF: Total dietary fibre, IDF: Insoluble dietary fibre, SDF: Soluble dietary fibre Source: Nutritive value of Indian foods, NIN, ICMR, Hyderabad Chapter-08.indd 98 12/22/2010 12:21:51 PM
  • 12. 136 Diet Management HIGH-PROTEIN DIET Recommended in chronic fevers and infections, trauma, fractures, postoperative, weight loss, anaemia, hyperthyroid, thyrotoxicosis and cancer. A high-protein diet must accompany adequate calories to spare proteins tissue, for building activity. High-protein diet Meal Menu Amount BREAKFAST : Tea (50 mL milk) 1 cup (200 mL) Milk (200 mL) 1 glass Butter 10 g Porridge 50 g/bread 2 slices Egg 1 Cheese 30 g LUNCH : Chappati or rice 100 g (4 medium sized) Vegetable A 200 g (1 bowl) Curd 125 g (1 bowl) Dal 25 g (1 bowl) Paneer 25 g Cooking fat 10 g Fruit (100 g) 1 medium TEA : Tea (50 mL milk) 1 cup Milk (200 mL) 1 glass DINNER : Chappati or rice 100 g (4 medium sized) Vegetable B 200 g (1 bowl) Curd 125 g (1 bowl) Dal/soyabeans 25 g (1 bowl) Cooking fat 10 g BEDTIME : Milk (200 mL) 1 glass N.B.: For nonvegetarians substitute dal and paneer for meat/fi sh/chicken 75 g. Milk can be substituted for cheese, paneer, curd or soyabeans. High-protein supplements can be used to achieve higher protein intake. Approximate food value Carbohydrates (g) 240 Proteins (g) 75 Fats (g) 60 Calories 1800 Chapter-09.indd 136 12/22/2010 12:19:33 PM
  • 13. 156 Diet Management Alcohol Alcohol is not a recommendation. However, studies have shown that there is a correlation between moderate alcohol and coronary artery disease (CAD). Moderate could be 1-5 drinks/week and not more than two at a time for men and one for women. One drink is 30 mL of hard drink (whisky, gin and vodka) or 120 mL of wine or 360 mL of beer. Red wine being rich in flavanoids is more beneficial, 1 g of alcohol also means 7 calories. Please check table for the calorie content of alcohol. Caloric value of hard and soft drinks Beverages Quantity Carbohydrate(s) (g) Alcohol (g) Calories Beer 250 mL (1 glass) 13 10 122 Brandy 30 mL (1 peg) - 14 98 Gin 30 mL (1 peg) - 12 84 Rum 30 mL (1 peg) - 14 98 Whisky 30 mL (1 peg) - 13 91 Champagne (dry) 30 mL (1 peg) 2 10 78 Red wine 100 mL 3 10 82 White wine 100 mL 3 9 75 Sherry 100 mL 2 5 43 Port 30 mL 4 5 51 Cola 30 mL 21 - 84 Orange drink 300 mL—1 bottle 21 - 84 Lemon drink 300 mL—1 bottle 21 - 84 Plain soda 300 mL—1 bottle 0 0 0 Traditional foods Fenugreek. A commonly used condiment (methi), it is a rich source of dietary fibre. There are studies to show the hypocholesterolemic effect of fenugreek in patients who received fenugreek for a period of over 10 days. Fenugreek being bitter has to be incorporated into the diet, up to the level of 25 g/day. Garlic. Garlic (Allium sativum) is a commonly used food world- wide. Ayurvedic recommendations for garlic as a remedy for heart ailments are ancient, but recently scientific studies have also Chapter-10.indd 156 12/21/2010 4:51:58 PM
  • 14. Diets Modified in Fats 163 4. Avoid all aerated drinks and alcohol except plain soda. 5. Avoid whole milk and use skimmed milk for tea, coffee, curd and paneer. 6. Avoid the use of processed cheese and use cottage cheese or low fat cheese. 7. Avoid pure ghee, butter, cream, ice cream and other rich cream-based desserts.
    • Replace cooking fat with almonds and walnuts.
    • Use whole grain cereals, whole grams and pulses, whole wheat porridge and whole wheat bread and oats.
    • Do not sieve flour to remove bran.
    • Supplement wheat with whole Bengal gram and do not sieve flour to remove fibre (wheat and Bengal gram 4:1 ratio).
    • Mix rice with whole grams or pulses in a ratio of 1:1 to incorporate fibre.
    13. Use white meat, i.e. fish and chicken. Avoid the use of pork, mutton and other glandular meats. 14. Use omega 3 rich foods like fish and flax seeds. 15. Use plenty of fresh green vegetables and sprouts. A Day’s Menu for Low-Cholesterol, High-HDL Diet BREAKFAST : Tea 1 cup with small amount of sugar Milk (low fat) 1 glass (200 mL) Whole-wheat bread slices 2 or whole-wheat porridge or oats 50 g Egg white 1 or paneer 25 g or sprouts LUNCH : Salad, chappati (wheat and Bengal gram 4:1) 80 g (4 medium-size) Curd (low-fat milk) 125 g (1 bowl) Whole pulse with husk 25 g (1 bowl) Green vegetables 125 g (1 bowl) Cooking oil 10 g (2 teaspoons) Fruit 200 g (2 medium) TEA : 1 cup of tea with little sugar Sprouts/soya upma 50 g (1 serving) Chapter-10.indd 163 12/21/2010 4:51:58 PM
  • 15. Diets Modified in Calories 185 Approximate Daily Allowances of Each Food Group for an Adult on Reducing Diet/Day Food groups No. of servings Approximate size of serving Cereals and cereal products chap- 5-6 or more 1 medium chappati or pati, rice, bread, idli, porridge 1 large slice of bread Milk and milk products (low fat) 2 or more 1 glass of low-fat milk (240 mL or its equivalent) Pulses and legumes with husk 2 or more 1 bowl of cooked pulse or 25 g raw weight Meat and meat products 1 or more 100-200 g of lean chicken/fish or egg whites 2 Vegetables and fruits 4-5 or more 125 g each Fats and oils (cooking medium) 2-3 1 tsp of oil Optional group Not required - Simple sugars, alcohol Not required - A Day’s Menu BED TEA : One cup of tea or coffee without sugar BREAKFAST : Whole-wheat bread 2 slices Or Idli 2 medium Or Porridge 1 bowl Or Oats 1 bowl Or Stuffed chappati 1 medium-size Low-fat milk 240 mL (1 glass) Or Curd 1 bowl Or Buttermilk 2 glasses Egg whites 2/sprouts Chapter-12.indd 185 12/21/2010 12:20:38 PM
  • 16. 186 Diet Management LUNCH : Salad, Clear soup (without starch and fats) Chappati two medium (channa:wheat 1:4) Pulses with husk one serving Green vegetable one serving Curd from low-fat milk one serving Fresh fruit 1 medium (125 g) TEA : One cup of tea or coffee Biscuits two or three or sprouts DINNER : Salad Soup (without starch and fats) Chappati two medium or rice Curd one serving Dal with husk one serving Cooking oil (sunfl ower/mustard) 15 g (2-3 tsp/day) Soya nuggets/paneer from low-fat milk 1 serving Or Grilled fi sh/chicken (lean) Some low-calorie alternative food items No. Items Alternatives 1. Parantha (200 cal) Plain chappati (80 cal) 2. Pulao/fried rice (170 cal/75 g) Plain boiled rice (80 cal/75 g) 3. Fried vegetables (140 cal/100 g) Baked vegetables (50 cal/100 g) 4. Fried or curried chicken or fish preparation Grilled (tandoori) chicken/fish (250 cal/135 g) (160 cal/135 g) 5. Fried eggs: omellete (120 cal) Poached/half boiled egg (60 cal) 6. Salad oil (1 tbs/14 g) or mayonnaise Lemon dressing (0 cal) dressing (100 cal/1 tbs/14 g) 7. Sour cream (210 cal/100 g) Yogurt (60 cal/100 g) 8. Regular sugar (20 cal/1 tsp) Caramelized sugar (5 cal/1 tsp) 9. Regular pudding or dessert (average 150 Fresh fruit as a dessert (40 cal/piece) cal/1 serving) 10. Aerated soft drink (60-80 cal) Plain soda with fresh lime (0 cal) 11. Whole milk (170 cal/1 glass) Skimmed milk (80 cal/1 glass) 12. Sharbat (80 cal/1 glass) Buttermilk (40 cal/1 glass) Chapter-12.indd 186 12/21/2010 12:20:38 PM
  • 17. 216 Diet Management Foods to Be Included 1. Whole-grain cereals that are rich in fibre, vitamins and minerals like pearl millet (bajra), wheat, finger millet (ragi), maize, millets. 2. Green leafy vegetables and other vegetables. 3. Whole pulses and soyabeans. 4. Low-fat milk, curd and other milk products. 5. Sugar and oils for palatability. Dietary Tips for Elderly 1. Take simple but nutritious diet. 2. Improve the quality of diet by adding liberal amounts of green leafy vegetables, fruits and whole cereals. 3. Take small frequent meals. 4. Take semisolid food and plenty of fluids. 5. Avoid fried foods. 6. Reduce total fats and refined carbohydrates. 7. Reduce salt intake. 8. Avoid fasting. 9. Maintain good social and psychological environment for normal health. 10. Do regular physical exercise like brisk walking. 11. Avoid inactivity, loneliness and social isolation. A Day’s Menu for an Elderly Person BED TEA : 1-2 cups of tea or coffee with sugar BREAKFAST : 1 glass of low-fat milk (200 mL); 2 slices of whole-wheat bread or porridge or chappati made from whole-wheat flour, paneer 25 g/egg white 1 10:30 A.M. : Buttermilk 1 glass/tea LUNCH : Salad, soup, chappati 2 medium (whole wheat) 20 g each, rice 1 karchi, dal with husk 1 bowl, curd 1 bowl, green vegetables 1 bowl, soya/mustard cooking oil 1 tsp, fresh fruit (100 g) 1 medium 3:30 P.M. : 1 cup of tea or coffee Chapter-15.indd 216 12/21/2010 12:29:05 PM
  • 18. Test Meal 17 300 g Carbohydrate Diet To be given for 3 days prior to glucose tolerance test (GTT) as the normal diet for an adult (Page 20). Add another 4 spoons of sugar or 2 tablespoons of jam or 1 glass of fruit juice. 350 Calorie Breakfast for Diabetics Used for determination of postprandial blood sugar after the fasting blood sugar sample. Breakfast I : 1 cup of tea without sugar 1 glass of milk (200 mg) 2 slices of bread/50 g of porridge 1 egg 1 teaspoon of butter (5 g) Breakfast II : 1 cup of tea without sugar 2 small chappatis (50 g atta) 1 bowl of curd (125 g) 1 bowl of green vegetables Paneer 25 g/soya nuggets 25 g/1 egg Breakfast III : 1 cup of coffee without sugar Idli 2 medium size Sambhar 1 bowl Curd 1 bowl or buttermilk 1 glass Chapter-17.indd 221 12/21/2010 4:52:42 PM
  • 19. Appendix CALORIE EXCHANGE (Food stuffs equivalent to 1 chappati—80 calories) Name of the snack Amount (g) Generic measure Dal vada 15 One small Dhokla 65 Three medium-size pieces Mathri 20 One small Namakpara 15 3-4 pieces Pakora 40 Two medium Potato chips 15 Approx. 7 pieces Potato kachori 20 Half medium Samosa 30 One small Biscuits (salted) 15 Approx. 5 pieces Biscuits (sweet) 15 Approx. 5 pieces Cream cracker 15 Approx. 2 pieces Arrowroot biscuits 15 Approx. 3 pieces Cheese titbits 14 Approx. 40 pieces Fruit cake 20 One slice Plain cake 20 One slice Badam halwa 15 One tablespoon Balushahi 17 Half medium Burfi 20 One small Fruit jelly 110 One small bowl Gujia 15 Half small Gulab jamun 20 One small Imarti 15 Half medium Jalebi 20 One small Nan khatai 15 One small Petha 50 One small Pinni 15 Half small Appendix.indd 223 12/21/2010 12:54:31 PM
  • 20. 224 Diet Management Name of the snack Amount (g) Generic measure Rasgulla 25 One regular Shakarpara 15 Two small Sohan halwa 20 One-fourth regular size Suji halwa 50 Half katori Ice cream 40 Half cup Puri 20 One small Popcorn 20 One bowl Parantha 15 Half medium Condensed milk 35 Five teaspoons Cheese (Amul) 20 Half cube Baked custard 70 Half cup Kheer 45 Half small katori Milk cake 25 One small piece Chakali 15 One small Chewra (fried) 20 One tablespoon FOOD VALUE OF PORTIONS COMMONLY USED Food stuffs Unit (raw Carbo- Pro- Fats Calo- Na K weight) hydrates teins (g) ries (mg) (mg) (g) (g) (g) Milk and milk products Milk (cow) 240 mL 11 8 10 166 40 350 Milk (buffalo) 240 mL 12 10 16 232 45 255 Curd (cow) 125 g 6 4 3 67 40 160 Paneer or channa 25 g - 4 3 39 58 18 Milk (skimmed dry) 25 g 13 9 - 88 40 350 Milk (skimmed fresh) 240 mL 11 6 - 70 40 350 Buttermilk (lassi) 240 mL 1 2 3 37 40 160 Khoa (whole milk) 25 g 5 4 8 108 - - Cheese (processed) 25 g 1 6 6 82 175 21 Cereals and pulses Atta, wheat (chappati) 25 g 17 3 - 80 5 79 Porridge (oatmeal) 25 g 16 4 3 107 - 885 Suji 25 g 18 3 - 84 5 21 Appendix.indd 224 12/21/2010 12:54:31 PM
  • 21. Appendix 227 CALORIFIC VALUE OF HARD AND SOFT DRINKS Quantity CHO* (g) Alcohol (g) Calories Beer 250 mL (1 glass) 13 10 122 Brandy 30 mL (1 peg) - 14 98 Rum 30 mL (1 peg) - 14 98 Whisky 30 mL (1 peg) - 13 91 Gin 30 mL (1 peg) - 12 84 Champagne (dry) 100 mL 2 10 78 Red wine 100 mL 3 10 82 White wine 100 mL 3 9 75 Sherry 30 mL 2 5 43 Port 30 mL 4 5 51 Cola 1 bottle 21 - 84 Orange drink 1 bottle 21 - 84 Lemon drink 1 bottle 21 - 84 Plain soda 1 bottle 0 0 0 * CHO—carbohydrate. HOUSEHOLD MEASURES 1 glass (240 mL) Height 4.11/2” Diameter on top 3” Diameter at bottom 2” 1 glass (200 mL) Height 4.11/2” Diameter on top 2.1/2” Diameter at bottom 2” 1 bowl - 125 g Height 2” (cooked weight) Diameter 3” 1 tablespoon 15 g 1 teaspoon 5 g 1 karchi (cooked weight) 100 g 1 cup (120 mL) Tea cup height 2” Diameter 2” Appendix.indd 227 12/21/2010 12:54:32 PM
  • 22. 228 Diet Management STANDARD HEIGHTS AND WEIGHTS CHART Height Standard weight Men Women cm ft kg lb kg lb 152.3 5’-0” - - 50.8-54.4 112-120 154.8 5’-1” - - 51.7-55.3 114-122 157.3 5’-2” 56.3-60.3 124-133 53.1-56.7 117-125 159.9 5’-3” 57.6-61.7 127-136 54.4-58.1 120-128 162.4 5’-4” 58.9-63.5 130-140 56.3-59.9 124-132 165.0 5’-5” 60.8-65.3 134-144 57.6-61.2 127-135 167.5 5’-6” 62.2-66.7 137-147 58.9-63.5 130-140 170.0 5’-7” 64.0-68.5 141-151 60.8-65.3 135-144 172.6 5’-8” 65.8-70.8 145-156 62.2-66.7 137-147 175.1 5’-9” 67.6-72.6 149-160 64.0-68.5 141-151 177.7 5’-10” 69.4-74.4 153-164 65.8-70.3 145-155 180.2 5’-11” 71.2-76.2 157-168 67.1-71.7 148-158 182.7 6’-0” 73.0-78.5 161-173 68.5-73.9 161-163 185.3 6’-1” 75.3-80.7 166-178 - - 187.8 6’-2” 77.6-83.5 171-184 - - 190.4 6’-3” 79.8-85.7 176-189 - - Source: Life Insurance Corporation of India Appendix.indd 228 12/21/2010 12:54:32 PM
  • 23. RECOMMENDED DIETARY ALLOWANCES FOR INDIANS—2010 Group Particulars Body Net Protein Visible Cal- Iron Vit. A μ g/d Thia- Ribo- Niacin Pyridox- Ascorbic Dietary Vit. B 12 Magne- Zinc wt energy g/d fat cium mg/d Reti- β - caro- mine flavin eqivalent ine acid folate μ g/d sium mg/d kg kcal/d g/d mg/d nol tene mg/d mg/d mg/d mg/d mg/d μ g/d mg/d Sedentary work 2320 25 1.2 1.4 16 Man Moderate work 60 2730 60.0 30 600 17 600 4800 1.4 1.6 18 2.0 40 200 1.0 340 12 Heavy work 3490 40 1.7 2.1 21 Sedentary work 1900 20 1.0 1.1 12 Moderate work 2230 55.0 25 600 21 600 4800 1.1 1.3 14 2.0 40 200 1.0 10 Heavy work 2850 30 1.4 1.7 16 Woman 55 310 Pregnant woman +350 82.2 30 1200 35 800 6400 +0.2 +0.3 +2 2.5 60 500 1.2 Lactation 0-6 m +600 77.9 30 +0.3 +0.4 +4 2.5 12 1200 25 950 7600 80 300 1.5 6-12 m +520 70.2 30 +0.2 +0.3 +3 2.5 92 kcal/ 1.16 g/ 46 μ g/ 0-6 months 5.4 - 0.2 0.3 710 μ g/kg 0.1 30 - kg/d kg/d kg/d Infants 500 350 2800 25 25 0.2 80 kcal/ 1.69 g/ 6-12 months 8.6 19 05 0.3 0.4 650 μ g/kg 0.4 45 - kg/d kg/d 1-3 years 12.9 1060 16.7 27 09 0.5 0.6 8 0.9 80 50 5 400 3200 Children 4-6 years 18.0 1350 20.1 25 600 13 0.7 0.8 11 0.9 40 100 0.2-1.0 70 7 7-9 years 25.1 1690 29.5 30 16 600 4800 0.8 1.0 13 1.6 120 100 8 Boys 10-12 years 34.3 2190 39.9 35 21 1.1 1.3 15 1.6 120 9 40 140 0.2-1.0 Girls 10-12 years 35.0 2010 40.4 35 27 1.0 1.2 13 1.6 160 9 Boys 13-15 years 47.6 2750 54.3 45 32 1.4 1.6 16 2.0 165 11 800 600 4800 40 150 0.2-1.0 Girls 13-15 years 46.6 2330 51.9 40 27 1.2 1.4 14 2.0 210 11 Boys 16-17 years 55.4 3020 61.5 50 28 1.5 1.8 17 2.0 195 12 40 200 0.2-1.0 Girls 16-17 years 52.1 2440 55.5 35 26 1.0 1.2 14 2.0 235 12 Source: Nutrient Requirements and Recommended Dietary Allowances for Indians. ICMR/National Institute of Nutrition, Hyderabad, India, 2009.