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Peshawar Medical College, NWFP Pakistan BALANCED DIET Peshawar Medical College, NWFP Pakistan Healthy nutrition means having a balanced diet, in order to maintain the balance that God has established in all matters, Allah says in Quran: "And He enforced the balance. That you exceed not the bounds; but observe the balance strictly,. and fall not short thereof". (55:7-9) Peshawar Medical College, NWFP Pakistan Example: Calculation of BMR Age Weight Height O2 Cons Corrected = = = = = 35 years 70 kg 170 cm 1.2 liters/6min 1.2 x 10 = 12 liters/hour Energy output / Heat produce = 12 x 4.825 = 58 C/hour Surface area = 1.8 Sq meter BMR = 58C = 32 C/hour 1.8 Normal for this person = 38.5 C/hour/Sq meter Peshawar Medical College, NWFP Pakistan BMR Variation with Age Age BMR kcal Upto 6 years 57.5 12 50.4 20 40 30 38 40 38.5 70 35.5 Peshawar Medical College, NWFP Pakistan BALANCED DIET Diet which provides all the five basic nutrients in a quantity which ensures healthy life is known as Balanced diet. These are : Carbohydrates Fats Proteins Vitamins and Minerals Peshawar Medical College, NWFP Pakistan Peshawar Medical College, NWFP Pakistan The Food Pyramid Peshawar Medical College, NWFP Pakistan The Food Pyramid Peshawar Medical College, NWFP Pakistan Nutrient Pool Peshawar Medical College, NWFP Pakistan Water Water of course is another important essential nutrient required for normal metabolism of all the essential five. Peshawar Medical College, NWFP Pakistan Water Solvent in which the chemistry of life occurs Cell chemistry occurs in an aqueous medium Water carries essential nutrients to cells Water carries metabolic wastes away from cells Hydrolysis & dehydration reaction Stabilizes body temperature. Peshawar Medical College, NWFP Pakistan How to Plan a Balanced Diet? 1. Age, sex and calorie requirements: While planning diet for any individual, his/her age and sex, physical activity involved and special nutritional needs, viz. a growing child or a pregnant / lactating lady, if any, must be taken into account in determining the total calorie requirements and total daily requirement of nutrients. Peshawar Medical College, NWFP Pakistan 2. Selection of Nutrients from ‘Basic Food Groups The required quantities of food items are to be selected from the four basic food groups in such a way that their total nutritive values satisfy the estimated requirements. The selection should be based on varieties of foods and if the requirements for calories and proteins are met, the vitamins and mineral requirements are automatically fulfilled. Peshawar Medical College, NWFP Pakistan 3. Economic status of the individual In formulating balanced diet , it is imperative and necessary that the economic status of the individual is taken into account so that the diet is within the purchasing capacity of the individual. Peshawar Medical College, NWFP Pakistan 4. High-cost and low-cost diet For a rich person planning of a balanced diet does not pose any problem, because he can afford to purchase the foods recommended. In case of a person, belonging to low income group, it poses the problem. Cheaper items have to be selected and at the same time care should be taken that nutritional and calorie requirements are fulfilled. A balanced diet formulated loses relevance if it does not conform to his or her purchasing capacity. Peshawar Medical College, NWFP Pakistan Formation of any balanced diet must be followed by an approximate costing of the diet based on the local market values of the different commodities. Peshawar Medical College, NWFP Pakistan Need for “low cost” balanced diet: Need for formulating ‘ low-cost’ balanced diets is necessary to bring a compromise between the nutritive values and the cost . But now even the cheapest sources of nutrients like pulses, nuts, etc. have become costlier and to make the a balanced one, the cost cannot be Kept low. Hence, the term ‘low-cost’ diet should br eplaced by ‘minimum cost’ diet. Peshawar Medical College, NWFP Pakistan Costlier items like meat/fish/milk and eggs should be replaced by comparatively cheaper foods of vegetable origins. So that The cost is less and nutritionally considered adequate. Limitation: Such a diet based exclusively on vegetarian foods there will be a possibility of developing deficiency of vit. B12 in future. It should be kept in mind Peshawar Medical College, NWFP Pakistan Peshawar Medical College, NWFP Pakistan NUTRITIONAL IMPORTANCE OF CARBOHYDRATES Peshawar Medical College, NWFP Pakistan Role of carbohydrates in diet Glucose, fructose, galactose and to a minor degree, manose / Precursors are used by the body as energy source. Pentoses in foods seem to be of limited nutritional value and form a very small fraction of the total carbohydrate intake of diet. Ribose and Deoxyribose are required for nucleic acid synthesis and are obtained from HMPShunt. Peshawar Medical College, NWFP Pakistan Requirement of carbohydrates in diet 55 to 65% of the total food calories should come from carbohydrates. A moderately active man requiring 3000 C per day, should take about 450 grams carbohydrates daily. But poorer sections of the population derive more than 85% of the food calories from carbohydrates. Peshawar Medical College, NWFP Pakistan Protein sparing action of CHO Adequate amount of CHO in the diet may reduce the protein requirement due to : Metabolic products of CHO, e.g. oxaloacetate, pyruvates and glutarates provide the C-skeletons for the formation of NEAA through transamination. Peshawar Medical College, NWFP Pakistan Role of carbohydrates in diet The effect on protein metabolism is of a specific nature, not shared by other substances, e.g. fats, alcohol and not related to its calorigenic action. This is referred to as "protein sparing action of carbohydrates". Peshawar Medical College, NWFP Pakistan B-vitamins Requirements With diets rich in CHO, the requirements for vitamins, particularly Vitamin B-1 increases because of the essential role of these in carbohydrate metabolism. Peshawar Medical College, NWFP Pakistan Role of Cellulose Celluloses are polysaccharides found in plants. They are indigestible by human beings as there is no enzyme in our GI tract which can split l - 4 linkage. Peshawar Medical College, NWFP Pakistan Role of Cellulose Cellulose in diet contribute bulk to the intestinal contents, and therefore, in normal amounts promote intestinal motility, i.e. increases peristalsis and removes constipation. When present in excess, they may be irritating to intestinal mucous membrane, producing diarrhea or a spastic type of constipation. Peshawar Medical College, NWFP Pakistan Health Benefits of Fiber Adds bulk to stool / improves peristalsis Decreased transit time = decreased exposure to toxins Weight control Helps prevent Colon cancer Hernia Ulcerative colitis Hemorrhoids Peshawar Medical College, NWFP Pakistan Health Benefits of Fiber Helps control blood sugar Helps lower cholesterol Helps prevent diverticulitis How Much? 25–35 g per day from food No more than 50 g Peshawar Medical College, NWFP Pakistan In general, diet rich in fiber improves: Bowel motility prevents constipation decreases reabsorption of bile acids Thus lowering cholesterol level and improves glucose tolerance Peshawar Medical College, NWFP Pakistan