The document discusses guidelines for prescribing diets based on a person's energy requirements, which are calculated based on their basal metabolic rate, physical activity level, and other factors. It provides examples of calculating energy needs for a 55kg male doing moderate work. It also discusses protein, calorie, and micronutrient requirements and food exchanges that can be used to design diets meeting those requirements. The key steps outlined are calculating needs, determining required macronutrients, selecting appropriate foods to meet those needs while maintaining palatability and cultural eating patterns.

1. Prof: Geeta Jaiswal
M.L.N Medical College
Allahabad

2. While calculating the energy
requirements, we have to
consider the energy required
for:
1.Maintenance of basal metabolic
rate (BMR)
2.Specific dynamic action or
Thermo genic effect of food.
3.Extra energy expenditure for
physical activities.

3.  The energy requirement would
depend on the occupation,
physical activity & life style of
the individual.
The activity levels may be
divided into 3 groups-
Sedentary,
Moderate &
 Heavy.

4. For sedentary work ---- +30% of BMR
For moderate work ---- +40% of
BMR
For heavy work ------ +50% of
BMR should be added.
Requirement for energy
 During pregnancy is +300 kcal/day
&
During lactation is +500 kcal/day, in
addition to the basic requirements.

5. TYPE OF
ACTIVITY
OCCUPATION
Light
Office workers, lawyers, accountants,
doctors,
teachers, architects, shop-workers
Moderate
Students, industry workers, farm
workers, housewives without mechanic
appliances.
Very Active Agricultural workers, miners,
unskilled laborers, athletes, factor
workers.
Heavy Work Lumber jacks, blacksmiths,&
construction workers.

7. The energy
requirement of a
55kg male doing
moderate work, may
be calculated as

8. FOR BMR = 24 × 55 Kg = 1320 Kcal
+ FOR Activity = 40% of BMR = 528 Kcal
Subtotal 1320 + 528 = 1848 Kcal
+ Need for
SDA
1848 × 10% = 184Kcal
TOTAL
1848+ 184= 2032Kcal
Approx. 2050Kcal

9. PROTEIN REQUIREMENT:
1g per kg body weight for
adults &
 2g per kg body weight
for children.
 During pregnancy & lactation
protein requirement is about
2.5 g per kg body weight

10. CALORIE REQUIREMENT:
This depends on
 age,
sex,
height, weight,
health status &
 above all on the physical
activity & occupation.

11. As a rule, the calorie
requirement for a person is
taken as 30-35 kcal per kg of
ideal body weight.
For sedentary life style/habits,
lower values (30 kcal)
 For moderate muscular
activities, higher values (35
kcal) are prescribed.

12. WHILE PRESCRIBING THE DIET OF
A PERSON THE FOLLOWING
GENERAL RULES ARE TO BE
REMEMBERED:
THE IDEAL BODY WEIGHT:
 The under weight person should be given
more nutrients & the overweight person
should reduce calories intake.

13.  The ideal body weight for an average
adult male is taken as 48 kg for a
height of 153 cm
± 1.25 kg for every cm.
 For an average adult female the ideal
body weight is 45kg for a height of 153
cm, ± 1 kg for every cm.

14. Considering the average weight of
Indians between 55-65kg,
The average calorie requirement will
be between 1700 & 2300 kcal per
day.
An extra allowance of 300 kcal is
necessary during pregnancy & +500
kcal/day during lactation
.

15. Specific dynamic action:
An extra energy is to be
supplied to account for
SDA.
RATIO: Balanced diet
should contain calories
from Carbohydrates,
Proteins and Fats in the
ratio of 60:20:20

16. IMPORTANT
STEPS WHILE
PRESCRIBING
A DIET

17. What is the requirement
of the person with regard
to calorie & other
essential nutrients?
What is the quantity of
proximate principles
required ?

18. 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.

19. He requires 60g Proteins.
This will give him 60 × 4 = 240 kcal of
energy.
His total requirement is = 2000 kcal.
Therefore, Carbohydrates plus Fats
should produce (2000 – 240 ) = 1760 kcal.

20. As a general rule about 20% of total
calories are supplied by fat.
 Therefore, fats should supply
1760 × 20% = 350 kcal
which is provided by
(350/9) = 35 to 39 g of fats
 About 30% of total fats can be
supplied as PUFAs
The rest 1400 kcal are supplied by
350g of carbohydrates

21. Proteins 60g
Fats 35g
Carbohydrates 350g
Calories 2000kcal
Calcium 400g
Iron 25g

22. In this step we calculate
how these proximate
principles are supplied as
common foodstuffs. For
this we should know the
nutritive value of
foodstuffs.

23. Food Protein
(g)
fat
(g)
Carbs
(g)
Energy
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
(potatoes)
1 0 25 100 0 0
Green
Leafy
vegetables
2 0 4 20 20 3
Fruits
(Banana)
2 0 10 50 10 1
Nuts & Oil
seeds
20 50 20 600 50 5

24. Food Protein
(g)
fat
(g)
Carbs
(g)
Energy
kcal
Calciu
m mg
Iron
mg
Milk &
curd
3 4 5 60 200 0
Egg 13 13 0 170 50 0
Meat 20 3 0 100 150 3
Fish 20 10 0 900 0 0
Oils &
Ghee
0 100 0 900 0 0
Sugar 0 0 100 400 0 0

26. Knowing the requirements & nutritive value
of the food.
A fundamental principle of dietetics is the
“food exchange”.
It is very useful for calculation of the
proximate principles
Accordingly, foods with similar nutrients
composition are grouped together.
This is also useful to provide variety in food.

27. Food Exchange
Cereals exchange
 One chapati (20g wheat)
 One bread or
 Cooked rice 3 tablespoon
(20g raw)
 One idli
Legumes-pulses exchange
 Bengal gram (channa) 100g
 Black gram (urad) 100g
 Green gram (moong) 100g
or
 Red gram (arhar) 100g
 Horse gram (kulthi) 100g
Content
Protein 2g
Carbohydrates 15g
Energy 70Kcal
Protein 24g
Carbohydrates 60g
Energy 340Kcal
Table shows that one chapati or one idli or one large slice
bread will give equal quantities of energy & proteins.

29.  Although protein content of pulses is more
than cereals, the average Indian diet contains
more cereals,& hence proteins are mainly
supplied by cereals.
 But pulses give good quality proteins.
 A judicious combination of cereals & pulses
provide all the essential amino acids
 Pulses are deficient in methionine, while
cereals lack in lysine.
 Food should contain pulses & cereals in the
ratio 1:5 to provide good quality proteins.

31. Important points for prescribing a Diet
 It should be a balanced diet, well
planned diet containing all essential
nutrients.
 The diet should be simple, locally
available, palatable & digestible.
Adequate protein content with essential
amino acids should be supplied. This is
achieved by a cereal-pulse mixture with
additional animal proteins, if necessary.

32.  Calorie intake should be correct &
should balance energy expenditure.
Special care should be taken to see
that adequate quantity of calcium &
iron are obtained from the diet. The
absorption of these minerals is reduced
by other factors in Indian diet.
Should have variety & should not differ
very much from the habitual diet of
the person.
Should provide adequate roughage.

33. This diet will satisfy the requirements
regarding
Carbohydrate (350g)
Protein (60g),
Fats (35g),
Calories (2000kcal),
Calcium (400mg)&
iron (25mg).
o It should be seen that the cereal-pulse
ratio is maintained at 5:1.
o When calories alone are to be increased
as in the case of a person having severe
muscular exercise, tubers & roots will
serve this purpose.