BALANCE DIET ( UNIT VII)

BALANCE DIET ( UNIT VII)

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  BALANCED DIET SERI LOLLEN ASST.PROFESSOR (MSN)
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  DEFINITION • A balanceddiet is one which provides all essential nutrient— carbohydrates, proteins, fats, vitamins, minerals, water and dietary fibre,in adequate amounts and proper proportions to maintain health, growth, reproduction and normal body functioning. A balanced diet must: • Meet energy requirements • Maintain ideal body weight • Prevent deficiency diseases • Promote immunity
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  Principles of BalancedDiet •Adequacy •Diet should provide sufficient amounts of all essential nutrients. •Balance •Nutrients must be in correct proportion. •Example: Excess carbohydrates with low protein leads to malnutrition. •Calorie Control •Energy intake must equal energy expenditure. •Nutrient Density •Choose foods rich in nutrients rather than empty calories. •Moderation •Limit sugar, salt and saturated fat. •Variety •Include foods from all food groups daily. •Acceptability & Economy •Diet should suit cultural habits and be affordable.
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  Steps in Planninga Balanced Diet .Assess individual factors: •Age •Sex •Occupation •Physiological condition (pregnancy, lactation) •Refer to RDA (Recommended Dietary Allowances). •Select foods from all food groups. •Calculate energy and nutrient needs. •Distribute food into meals (breakfast, lunch, dinner, snacks). •Consider economic status and food availability. •Evaluate and modify if needed.
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  FOOD GUIDES –BASIC FOUR FOOD GROUPS • Food guides help in selecting foods for a balanced diet. • 1. Milk Group • Milk, curd, paneer • Nutrients: Protein, calcium, vitamin B2 • Function: Bone growth and tissue repair • 2. Meat & Protein Group • Egg, fish, meat, pulses, nuts • Nutrients: Protein, iron • Function: Body building
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  • Cereal &Grain Group • Rice, wheat, maize, millets • Nutrients: Carbohydrates • Function: Energy supply
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  RDA (Recommended DietaryAllowances) Definition : RDA is the average daily dietary intake level of a nutrient that is sufficient to meet the requirement of nearly all healthy individuals of a specific age, sex and physiological condition. Uses of RDA • Planning balanced diet • Nutritional assessment • Hospital diet planning • Public health nutrition programs • Preventing deficiency diseases
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  Limitations of RDA •Not suitable for sick individuals • Based on average values • Does not account for individual variation • May not reflect regional dietary differences
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  FOOD EXCHANGE SYSTEM Definition:- •Food exchange system is a method of grouping foods with similar nutrient value so that one food can be exchanged with another in the same group. • 🔹 Purpose • Used in diabetic diet planning • Helps in calorie and carbohydrate control • Provides flexibility in meal planning • 🔹 Example • 1 exchange of cereal = 1 slice bread = ½ cup cooked rice
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  CALCULATION OF NUTRITIVEVALUE OF FOODS • This method helps to know total calories and nutrients in a diet. 🔹 Steps • Weigh the raw food item. • Refer to standard food composition tables. • Note nutrient value per 100g. • Apply formula: • Add total values of all food items. 🔹 Example • If 100g rice = 345 kcal If 50g rice used:
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  DIETARY FIBRE Definition • Dietaryfibre is the indigestible portion of plant foods that helps in bowel movement and promotes digestive health. Types • 1. Soluble Fibre • Dissolves in water • Forms gel • Sources: Oats, fruits • Helps reduce cholesterol • 2. Insoluble Fibre • Does not dissolve • Adds bulk to stool • Sources: Whole wheat, vegetables • Prevents constipation
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  • Functions • Preventsconstipation • Reduces cholesterol level • Controls blood sugar • Prevents colon cancer • Maintains gut health
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  • Definition • MealPlanning (Menu Planning) is the process of planning meals in advance to ensure that the diet is nutritionally adequate, balanced, economical, and suitable according to the individual’s age, health status, and food habits. It helps to: • Meet nutritional requirements • Maintain health • Prevent deficiency diseases • Promote proper growth and development
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  Objectives of MealPlanning • To provide balanced nutrition. • To meet energy requirements. • To maintain ideal body weight. • To prevent malnutrition and deficiency diseases. • To satisfy hunger and provide satiety. • To suit economic condition and food availability.
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  Principles of MealPlanning • 1 ️ 1️⃣Nutritional Adequacy • Meal should include all essential nutrients in proper proportion. • 2️⃣Balance • Proper combination of carbohydrates, proteins, fats, vitamins, and minerals. • 3 ️ 3️⃣Variety • Include different foods, colors, textures, and flavors to avoid monotony. • 4️⃣Calorie Control • Energy intake should match energy expenditure. • 5 ️ 5️⃣Age & Physiological Condition • Diet must vary according to: • Children • Pregnant women • Elderly • Sick patients
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  • 6 ️ 6️⃣FoodHabits & Culture • Consider religious and cultural preferences. • 7️⃣Economy • Use locally available, seasonal, and affordable foods. • 8 ️ 8️⃣Palatability & Acceptability • Food should look attractive and taste good. • 9️⃣Digestibility • Avoid very oily or spicy food for sick persons. • 🔟 Time & Convenience • Consider cooking time and availability of resources.
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  Steps in MealPlanning • Assess Individual Factors 1️ 1️ ⃣ • Age • Sex • Occupation • Health condition • Activity level • Refer to RDA 2️ ⃣ • Check recommended calorie and nutrient requirements. • Decide Total Calories Required 3️ 3️ ⃣ • Example: Moderate adult woman ≈ 1900–2200 kcal/day
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  • select Foodsfrom All Food Groups 4️ 4️ ⃣ • Cereals • Pulses • Milk • Fruits • Vegetables • Fats • Distribute Meals Throughout the Day 5️ ⃣ • Breakfast • Mid-morning snack • Lunch • Evening snack • Dinner • Check Nutrient Content 6️ 6️ ⃣ • Calculate nutritive value if necessary. • Evaluate and Modify 7️ ⃣ • Ensure the diet is balanced and practical.
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  • Example ofSimple Meal Plan (Adult) • Breakfast • Milk + Boiled egg + Chapati • Lunch • Rice + Dal + Green leafy vegetable + Curd • Evening Snack • Fruit + Tea • Dinner • Chapati + Vegetable curry + Fish
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  Importance of MealPlanning for Nurses • Essential in hospital diet therapy • Helps in diabetic and hypertensive diet planning • Prevents hospital malnutrition • Promotes patient recovery
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  Definition of IYCF •Infant and Young Child Feeding (IYCF) refers to appropriate feeding practices for infants and children from birth up to 2 years of age to ensure optimal growth, development, and survival. • IYCF is recommended by World Health Organization (WHO) and UNICEF. • Objectives of IYCF • Reduce infant and child mortality • Prevent malnutrition • Promote proper growth and development • Improve immunity • Strengthen mother–child bonding
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  • BREASTFEEDING GUIDELINES •Early Initiation 1️ 1️ ⃣ • Start breastfeeding within 1 hour of birth. • First milk (colostrum) must be given. • Importance of Colostrum • Rich in antibodies (IgA) • Acts as first immunization • Prevents infection • Easy to digest
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  • Exclusive Breastfeeding(0–6 Months) 2️ 2️ ⃣ • Give only breast milk for first 6 months. • No water, honey, gripe water, or animal milk. • Benefits to Baby • Provides complete nutrition • Prevents diarrhea and respiratory infection • Improves brain development • Reduces allergy risk • Benefits to Mother • Prevents postpartum hemorrhage • Delays next pregnancy (Lactational Amenorrhea Method) • Reduces breast and ovarian cancer risk
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  Continued Breastfeeding 3️ 3️ ⃣ • Continuebreastfeeding up to 2 years or beyond. • Start complementary feeding after 6 months. Correct Position & Attachment 4️ ⃣ • Signs of Good Attachment: • Baby’s mouth wide open • Chin touching breast • More areola visible above mouth • No pain to mother
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  COMPLEMENTARY FEEDING (InfantFoods) Definition: • Complementary feeding means giving other foods along with breast milk after 6 months of age. • When to Start? • At 6 completed months Principles of Complementary Feeding • Timely introduction (at 6 months) • Adequate quantity • Proper consistency • Safe and hygienic preparation • Age-appropriate feeding frequency
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  Feeding Schedule (Asper Age) • 🔹 6–8 Months • 2–3 meals/day • Thick mashed foods • Example: Mashed rice, dal, banana • 🔹 9–11 Months • 3–4 meals/day + 1 snack • Semi-solid foods • Example: Khichdi, mashed vegetables • 🔹 12–24 Months • 3–4 meals + 2 snacks • Family foods
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  •Types of InfantFoods • Homemade Complementary Foods 1️ 1️ ⃣ • Rice porridge • Khichdi • Mashed fruits • Boiled vegetables • Advantages: • Economical • Fresh • No preservatives • Commercial Infant Foods 2️ ⃣ • Fortified cereals • Instant mixes • Should be used carefully and hygienically.
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  • Harmful FeedingPractices to Avoid • Pre-lacteal feeds (honey, sugar water) • Bottle feeding • Diluted animal milk before 1 year • Force feeding • 🩺 Role of Nurse in IYCF • Educate mothers about exclusive breastfeeding • Demonstrate proper positioning • Counsel about complementary feeding • Monitor child growth • Prevent malnutrition
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  DIET PLAN FORDIFFERENT AGE GROUPS 👶 Diet Plan for Children 1️ 1️ ⃣ • A) Infants (0–1 Year) 🔹 0–6 Months • Exclusive breastfeeding • No water or other foods 🔹 6–12 Months • Continue breastfeeding • Start complementary feeding • Sample Diet (8–12 months): • Morning: Breast milk • Breakfast: Mashed banana / rice porridge • Lunch: Khichdi (rice + dal) • Evening: Fruit puree • Dinner: Mashed vegetables • Nutritional Focus: • High energy • Adequate protein • Iron-rich foods B) Preschool Children (1–5 Years) • Nutritional Needs: • Energy for growth and activity • Protein for tissue building • Calcium for bone development • Iron to prevent anemia • Sample Diet Plan: • Breakfast: Milk + boiled egg / idli • Mid-morning: Fruit • Lunch: Rice + dal + vegetables + curd • Evening: Groundnuts / banana • Dinner: Chapati + vegetable curry
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  • C) School-ageChildren (6–12 Years) • Nutritional Needs: • Increased calories • More protein • Iron and calcium • Sample Diet Plan: • Breakfast: Milk + chapati / dosa • Lunch: Rice + dal + green leafy vegetables + egg • Evening: Sprouts / fruit • Dinner: Chapati + vegetable + curd
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  Diet Plan forAdolescents (13–19 Years) 2️ 2️ ⃣ • Nutritional Importance: • Rapid growth • Hormonal changes • Increased muscle mass • Increased Need for: • Protein • Iron (especially girls) • Calcium • Vitamins • Sample Diet Plan: • Breakfast: Milk + egg / sprouts + chapati • Mid-morning: Fruit • Lunch: Rice + dal + vegetable + curd + fish/egg • Evening: Nuts / boiled corn • Dinner: Chapati + vegetable + paneer / chicken • Important Points: • Avoid junk food • Encourage iron-rich foods (green leafy vegetables) • Promote adequate water intake
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  Diet Plan forElderly (Above 60 Years) 3️ ⃣ • Nutritional Considerations: • Reduced metabolism • Decreased appetite • Dental problems • Chronic diseases • Nutrient Requirements: • Moderate calories • High-quality protein • Calcium & Vitamin D • Fibre-rich foods • Sample Diet Plan: • Morning: Warm milk • Breakfast: Soft idli / porridge • Lunch: Soft rice + dal + boiled vegetables • Evening: Fruit / light snack • Dinner: Chapati (soft) + vegetable soup
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  Special Considerations: • Avoidexcess salt (hypertension) • Avoid excess sugar (diabetes) • Small frequent meals • Easy-to-digest foods
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  Introduction • Pregnancy isa physiological condition where adequate nutrition is essential for: • Growth of fetus • Maintenance of maternal health • Preparation for lactation • Prevention of complications • Poor nutrition during pregnancy can lead to: • Low birth weight • Anemia • Preterm delivery • Maternal complications
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  Nutritional Requirements DuringPregnancy Nutritional requirements increase due to fetal growth and maternal tissue expansion • Energy Requirement 1️ 1️ ⃣ • Additional ~350 kcal/day (2nd & 3rd trimester) • Supports fetal growth and maternal weight gain • Protein Requirement 2️ ⃣ • Increased by about +23 g/day • Required for: • Fetal tissue formation • Placenta development • Maternal tissue growth • Sources: • Milk • Egg • Pulses • Fish • Meat
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  • Carbohydrates 3️ 3️ ⃣ • Mainsource of energy • Should provide 55–65% of total calories • Avoid excess sugar • Fats 4️ ⃣ • Essential fatty acids help brain development • Avoid excessive fried foods • Iron 5️ 5️ ⃣ • Requirement increases (about 35 mg/day) • Prevents anemia • Needed for increased blood volume • Sources: • Green leafy vegetables • Jaggery • Liver • Egg • Iron supplementation is usually recommended. • Calcium 6️ ⃣ • Needed for fetal bone and teeth formation • Requirement: ~1200 mg/day • Sources: • Milk • Curd • Ragi • Green leafy vegetables
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  • Folic Acid 7️ 7️ ⃣ •Prevents neural tube defects • Required especially in first trimester • Supplementation advised • Vitamins 8️ ⃣ • Vitamin A – fetal growth • Vitamin C – immunity • Vitamin D – calcium absorption • B-complex – metabolism • Water 9️ 9️ ⃣ • 2–3 litres/day • Prevents constipation and dehydration
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  •Principles of Dietin Pregnancy • Balanced and nutritious • Small frequent meals • Easily digestible • Avoid very spicy and oily foods • Avoid alcohol and smoking • Maintain proper weight gain (10–12 kg total)
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  Sample Balanced DietPlan for Pregnant Woman • Early Morning • Glass of milk • Breakfast • Chapati / Idli + boiled egg • Fruit • 🥗 Mid-morning • Fruit juice / Coconut water • 🍛 Lunch • Rice / Chapati • Dal • Green leafy vegetable • Curd • Fish/Chicken/Egg • ☕ Evening Snack • Sprouts / Nuts • 🌙 Dinner • Chapati • Vegetable curry • Milk before bed
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  • Foods toAvoid • Unpasteurized milk • Undercooked meat • Excess caffeine • Junk food • 🩺 Role of Nurse • Educate mother about balanced diet • Monitor weight gain • Prevent anemia • Counsel on iron and folic acid supplementation • Promote antenatal care visits
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  Definition • Anemia inpregnancy is defined as hemoglobin level less than 11 g/dL, as per the World Health Organization. • It is one of the most common nutritional deficiency disorders in pregnant women, especially in India. Causes of Anemia in Pregnancy • A. Nutritional Causes • Iron deficiency (most common) • Folic acid deficiency • Vitamin B12 deficiency • Protein deficiency • B. Non-Nutritional Causes • Blood loss • Hookworm infestation • Malaria • Repeated pregnancies with short birth spacing • Poor socioeconomic status
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  Classification (Based onHb Level – WHO) Type • Hemoglobin Level • Mild10–10.9 g/dL • Moderate7–9.9 g/dL • Severe<7 g/dL
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  Signs and Symptoms •Pallor (conjunctiva, nail beds) • Fatigue and weakness • Breathlessness • Dizziness • Headache • Palpitations • Swelling (in severe cases)
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  Complications • Maternal • Pretermlabour • Postpartum hemorrhage • Infections • Cardiac failure (in severe anemia) • Fetal • Low birth weight • IUGR • Preterm baby • Increased perinatal mortality
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  Nutritional Management ofAnemia in Pregnancy • A. Iron Requirement in Pregnancy • Normal woman: 21 mg/day • Pregnant woman: 35 mg/day (Due to increased blood volume and fetal needs) • B. Iron-Rich Foods** • 1. Heme Iron (High Absorption – 15–35%) • Liver • Red meat • Egg yolk • Fish
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  2. Non-Heme Iron(Low Absorption – 2–10%) • Spinach • Amaranth leaves • Lentils • Chickpeas • Beans • Jaggery • Dates • Groundnuts • Sesame seeds • C. Vitamin C Rich Foods (Increase Absorption) • Lemon • Orange • Guava • Amla • Tomato
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  Iron and FolicAcid (IFA) Supplementation • As per Ministry of Health and Family Welfare guidelines: • Prophylactic Dose (Non-anemic Pregnant Woman) • 100 mg elemental iron • 500 mcg folic acid • Once daily • From 14 weeks of pregnancy • Continue for 180 days in pregnancy + 180 days postpartum • Therapeutic Dose (Anemic Woman) • 100 mg iron + 500 mcg folic acid • Twice daily for 3 months
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  Side Effects ofIron Tablets • Nausea • Vomiting • Constipation • Black stools (normal) • Gastric irritation • Reassure mother that black stool is normal. Counselling Points for Pregnant Woman • Importance of hemoglobin for mother and baby • Take IFA tablets regularly • Do not skip doses • Take tablets after meals (if gastric irritation occurs) • Eat iron-rich diet daily • Add vitamin C with meals • Regular ANC visits • Deworming after 2nd trimester if prescribed • Maintain spacing between pregnancies
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  • Role ofNurse • Screening and Hb testing • Nutritional assessment • Health education • Ensuring compliance • Monitoring side effects • Referral in severe anemia
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  Introduction • Lactation isthe period after childbirth during which the mother produces milk to feed her baby. Proper nutrition during lactation is essential for: • Adequate breast milk production • Maintaining maternal health • Preventing nutritional deficiencies
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  Nutritional Requirements DuringLactation • According to the Indian Council of Medical Research (ICMR): • A. Energy Requirement • Additional +550 kcal/day (first 6 months) • Additional +400 kcal/day (6–12 months) • B. Protein Requirement • Extra +25 g/day • Total requirement ≈ 75–85 g/day • Sources: • Milk and milk products • Eggs • Fish • Pulses • Soybean
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  C. Fat • 20–30%of total calories • Include healthy fats (groundnut oil, mustard oil, nuts) D. Calcium • Requirement: 1200 mg/day • Sources: • Milk, curd • Ragi • Sesame seeds • Green leafy vegetables E. Iron • 21 mg/day • Continue IFA supplementation for 180 days postpartum
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  • F. VitaminA • Increased requirement for better immunity of baby • Sources: • Carrot • Mango • Papaya • Green leafy vegetables • G. Fluids • 3–3.5 liters/day • Water, soups, milk, buttermilk
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  • F. VitaminA • Increased requirement for better immunity of baby • Sources: • Carrot • Mango • Papaya • Green leafy vegetables • G. Fluids • 3–3.5 liters/day • Water, soups, milk, buttermilk
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  Sample Diet Plan •Early Morning: Milk + soaked almonds • Breakfast: Vegetable upma / chapati + egg / dal • Mid-Morning: Fruit (banana/orange/guava) • Lunch: Rice/chapati Dal Green leafy vegetable Curd Salad • Evening: Sprouts / groundnuts / milk • Dinner: Chapati Vegetable curry Fish/egg/paneer
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  • Complementary Feeding •Complementary feeding means giving solid or semi-solid foods along with breast milk after 6 months of age. • Recommended by the World Health Organization. • Why Complementary Feeding is Needed? • Breast milk alone is insufficient after 6 months • Baby needs more energy, protein, iron
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  • Principles ofComplementary Feeding • Start at 6 months completed • Continue breastfeeding up to 2 years • Start with semi-solid foods • Increase quantity and frequency gradually • Maintain hygiene • Use locally available foods • Types of Complementary Foods • Rice porridge • Dal water • Mashed banana • Mashed potato • Khichdi • Egg yolk • Suji porridge
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  • Weaning • Weaningis the gradual process of introducing complementary foods and reducing breastfeeding. • Signs Baby is Ready for Weaning • Sits with support • Loss of tongue-thrust reflex • Shows interest in food • Doubled birth weight
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  • Rules forWeaning • Introduce one new food at a time • Start with soft consistency • Avoid sugar and salt • Avoid honey (risk of botulism) • Avoid bottle feeding (infection risk) • 6. Problems During Weaning • Diarrhea (poor hygiene) • Malnutrition • Food allergy • Refusal of food
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  • Role ofNurse • Educate mother on balanced diet • Demonstrate preparation of complementary foods • Monitor child growth • Counsel on exclusive breastfeeding for 6 months • Prevent malnutrition