PPT on Nutritional requirements

1. Dr. Prashant Howal
Associate Professor
Department of Preventive & Social Medicine,
Grant Medical College, Byculla, Mumbai -400 008.

2. At the end of this lecture, 1st MBBS student
should be able to
 Describe common food sources of nutrients.
 Define Balanced Diet.
 Explain the Dietary Goals.
 Discuss dietary guidelines given by NIN,
Hyderabad.
 Comment on Carbohydrate, Proteins, Fats
and Vitamins requirement according to age,
sex, activity and physiological conditions.

3. Nutrients Foods
Energy Cereals, Pulses, Roots & Tubers, Fats & oils, Sugar & Jaggery
Protein Milk, Egg, Fish, Meat, Liver, Pulses, Nuts & oilseeds
Fat Butter, Ghee, Vegetable oils, Hydrogenated fats, Nuts & oilseeds
Carbohydrates Cereals, Pulses, Sugar & Jaggery, Roots & tubers.
Fiber
Green leafy vegetables, Fruits, Unrefined cereals, Pulses & Legumes
Calcium Milk & milk Products, Ragi, Green leafy vegetables
Iron
Liver, Green leafy vegetables, Rice flakes, Whole wheat, Flour, Ragi,
Pulses.
Vitamin A (retinal
&
-Carotene)
Fish Liver oil, Butter, Ghee, Milk, Carrots, Green leafy vegetables,
Papaya, mango.
Vitamin
B-complex
Milk, Egg & Liver, Hand pounded rice, Whole Wheat, Whole Gram,
Pulses, Green leafy vegetables, Nuts & Oil seeds
Vitamin C
Amla (Indian Gooseberry), Lime, Orange, Guava, Tomato, Lettuce,
Sprouted grams
Vitamin D Milk. Other source: Sunlight

4. Group 1: Cereals, Millets and Pulses
Group 2: Vegetables and Fruits
Group 3: Milk and Milk products, egg,
meat and fish.
Group 4: Oils and fats and nuts and oil
seeds.

8. CATEGORY SEX OCCUPATION
Sedentary
Male Teacher, Tailor, Barber, Executive,
Shoemaker, Retired Person, Peon etc.
Female Housewife, Nurse, Teacher etc.
Moderate Male
Fishermen, Basket Maker, Potter,
Goldsmith, Agriculture Labour, Carpenter,
Coolie, Driver etc.
Female Maid Servant, Beedi Maker, Weaver etc.
Heavy
Male Wood Cutter, Mine worker, Gangman,
Blacksmith, etc
Female Stone Cutter etc.

9. Protein 1 gm/kg body wt.
Fats 30% of total Calories
Carbohydrates Remaining

10. • It is the average daily dietary nutrient intake level sufficient to meet the
nutrient requirement of nearly all healthy individuals in a particular age
group and gender category.
• It covers the requirement of 97.5% of the population.
• The RDA can not used as standard to determine whether or not a given
individual’s requirement of a nutrient has been met.

11. Determining Factors of RDA
• Age
• Gender
• Physical work
• Physiological Stress
 Adequate Intake (AI), where no RDA has been established, but
the amount established is somewhat less firmly believed to be
adequate for everyone in the demographic group.
 Balanced Diet

12.  RDAs provide a standard against which the nutrients in the food eaten by
a section of the community /country can be assessed.
 Helps to find out a group with low intake of a particular nutrient. Further
nutritional investigations are then mounted to go into the details and
suitable measures can be recommended.
 RDAs are the starting point for the food and economic planning for the
agricultural, economic and food sectors.
 The national level food balance sheets are prepared keeping the
RDAs in mind.

15. Energy Requirements of Various Members of Family
Category Standard body
Wt.in Kg. app.
K cal.
Adult Male ( Sedentary )
60
2320
Adult Male ( Moderate ) 2730
Adult Male ( Heavy ) 3490
Adult Female ( Sedentary )
55
1900
Adult Female ( Moderate ) 2230
Adult Female ( Heavy ) 2850
Children ( 16 to 17 Yrs.) 55 3020
Children ( 13 to 15 Yrs.) 47 2260
Children ( 10 to 12 Yrs.) 34 2190
Children ( 7 to 9 Yrs.) 25 1690
Children ( 4 to 6 Yrs.) 18 1350
Children ( 1 to 3 Yrs.) 13 1060

16. On the basis of the heights of Indian adult, body weights of 60kg &
55kg for reference Indian man & reference Indian woman should be
used in arriving at the RDA.
Indian reference Male
 Between 20 to 39 yrs of age weight 60Kgs. Height: 1.73 m, BMI: 20.3
 Free from disease & fit for active work.
 Employed for 8 hrs. (Moderate activity)
 8 hrs. in bed
 4 to 6 hrs. sitting and moving
 2 hrs walking and active recreation.
Indian reference Female
 Between 20 to 39 yrs of age weight 55 Kgs. (NPNL). 1.61 m, BMI: 21.2
 Free from disease & fit for active work.
 Employed for 8 hrs. (Moderate activity) or household activity
 8 hrs. in bed
 4 to 6 hrs. sitting and moving
 2 hrs walking and active recreation.

17. Group Particulars
Body Wt.
In Kg
Net Energy
(Kcal/day)
Man
Sedentary
60
2320
Moderate 2730
Heavy 3490
Women
Sedentary
55
1900
Moderate 2230
Heavy 2850
Pregnant 55 + 350
Lactation
0 – 6 months
55 + 600
Lactation
6 – 12 months
55 + 520
Infants
0 – 6 months 5.4 92/kg
6 – 12 months 8.4 80/kg
Children
1 – 3 yrs 12.9 1060
4 – 6 yrs 18.0 1350
7 – 9 yrs 25.1 1690
Boys
Girls 10 –12 yrs
34.3 2190
35 2010
Boys
Girls 13 – 15 yrs
47.6 2750
46.6 2330
Boys
Girls 16 – 17 yrs
55.4 3020
52.1 2440

18.  Iron: requirement are derived by using the factorial approach which
takes into account the basal loss in case of men, basal loss + menstrual
loss in case of women & basal loss + growth requirement in case of
children. Dietary iron requirements are prescribed at a level of
absorption of 3% in adult men from habitual diets based on mixed
cereals.
 Calcium & Phosphorus: because of their close relationship these
nutrients are taken together. The desirable ratio of Ca: P is 1:1.5 infants
& 1:1 for all other groups.
 Trace elements: desirable daily intakes of some trace elements
suggested for an adult are: chromium65ug, copper 2.2 mg, manganese
5.5 mg, zinc 15:5 mg & molybdenum 500ug.

19. Group Particulars
Body Wt.
In Kg
Calcium
Mg /day
Man
Sedentary
60 600
Moderate
Heavy
Women
Sedentary
55 600
Moderate
Heavy
Pregnant 55 1200
Lactation
0 – 6 months
55 1200
Lactation
6 – 12 months
55 1200
Infants
0 – 6 months 5.4
500
6 – 12 months 8.4
Children
1 – 3 yrs 12.9
600
4 – 6 yrs 18.0
7 – 9 yrs 25.1
Boys
Girls 10 –12 yrs
34.3
800
35
Boys
Girls 13 – 15 yrs
47.6
800
46.6
Boys
Girls 16 – 18 yrs
55.4
800
52.1

20. Group Particulars
Body Wt.
In Kg
Iron
Mg /day
Man
Sedentary
60 17
Moderate
Heavy
Women
Sedentary
55 21
Moderate
Heavy
Pregnant 55 35
Lactation
0 – 6 months
55 21
Lactation
6 – 12 months
55 21
Infants
0 – 6 months 5.4 46microgram/kg/d
87 microgram/kg/d
6 – 12 months 8.4
Children
1 – 3 yrs 12.9 09
4 – 6 yrs 18.0 13
7 – 9 yrs 25.1 16
Boys
Girls 10 –12 yrs
34.3 21
35 27
Boys
Girls 13 – 15 yrs
47.6 32
46.6 27
Boys
Girls 16 – 18 yrs
55.4 28
52.1 26

23.  Vitamin A: The recommended level of vitamin A (retinol)
for an adult is 600µg. In terms of B-carotene, it will be 2400
µg.
 Thiamine, riboflavin & nicotine acid: the daily allowances
for these vitamins are related to energy intake. The basic
allowances per 1000 kcal are: thiamine 0.5, riboflavin 0.6mg
& nicotinic acid 6.6 mg niacin equivalents.

24.  Folic acid: RDA of folate in pregnancy will be
300ug in addition to the normal requirement of
100µg. Therapeutic supplementation in
pregnancy is necessary.
 Vitamin B12 : Recommended intake of vitamin
B12 is 1g/day.
 Vitamin C: The recommendations for adults
are 40 mg/day. For infants, the RDA Is
25mg/Day.

25.  Vitamin D: Adequate Vitamin D can be obtained through
exposure to sunlight in India. In condition of inadequacy,
Vitamin D medicinal supplements may be given.
 Vitamin E: An intake of 0.8mg of Vitamin E per gram of
essential fatty acids is suggested.
 Vitamin B6 : Recommended intake in mg/day are adults
2.0, pregnant and lactating women 2.5, infants 0.3 in the
first six months and 0.4 in the 6 to 12 months period and
children 0.9 to 2.0 at various age levels.

34. 1. The RDA of iron for pregnant and lactating
women is respectively:
a. 30 mg and 38 mg.
b. 38 mg and 30 mg.
c. 40 mg and 38 mg.
d. 38 mg and 40 mg.