Balanced Diet

• Defined as – Diet which contains different types

of foods possessing the macronutrients &
micronutrients ( carbohydrate, protein, fat and
vitamins, minerals) in proportion to meet the
requirements of the body
• Balanced diet supplies a little more than
absolute needs
• Balanced Diet can be achieved using locally
available foods. It will vary as per
• climatic conditions, economic capacity, religion,
customs ,tastes and habits,
• Should contain enough roughage
 Balanced diet
• Balanced diet should contain all essential
nutrients including vitamins and trace elements
• These are distributed in diff. quantities in foods
• Basic four Groups:-
• Milk Group:- Dairy products
• Meat group :- meat, fish, eggs,/ pulses, beans,
nuts
• Green leafy vegetables and Fruit Group
• Cereal Group :- Rice, Wheat , Bajra, Bread
 To plan a balanced diet :-
• Factors to consider:-
• Age, Sex and Caloric Requirement
• Proper selection of nutrients from ‘Basic food
groups’
• Economic status of an individual
• Selection of food items from high and low cost
foods
 Balanced diet suggested by ICMR
Food item Sedentary Moderate Heavy Sedentary Moderate Heavy
work work work work work work

Man Man Man Woman Woman Woman

Quantity In Gms per day
cereals 460 520 670 410 440 515
pulses 40 50 60 40 45 50
Leafy 40 40 40 100 100 100
Vegetable
vegetable 60 70 80 40 40 50
Roots 50 60 80 50 50 60
tubers
milk 150 200 250 100 150 200
Oil &fat 40 45 65 20 20 40
Sugar 30 35 55 20 20 40
jaggary
 Nutritional Disorders
Malnutrition is defined as pathological state resulting
from relative/absolute deficiency or excess of one
or more essential nutrients
Clinical malnutrition:-
Over nutrition : excess nutrients, overfed, effect of
affluence
Under nutrition:
≥ 13 million children suffer. Undernutrition
Exhibit :- Growth retardation
Chronic illness in late life . ↓Immunity, Learning
failure, Anemia
 Nutritional Disorders

Protein Calorie Malnutrition (PCM) or (PEM)

Caused by Protein and Energy deficiency
Classification :- 1) Kwashiorkor (edema)
2) Marasmus (no edema)

Other Nutritional Disorders include :-

Vitamin deficiency disorders :xerophthlmia
,Beriberi, Rickets, Pelagra, scurvy
Pernicious anemia, goiter
 Protein Calorie Malnutrition
Kwashiorkor:- (weaning Disease)
Term introduced by Jamaican pediatrician -
Cicely Williams for a nutritional disease affecting
people of Ghana (Lancet 1933)
Occurence :- Children 1-5 yrs of age
Economically backward class, Weaning children on
High carbohydrate and low protein diet
Biochemical Manifestations:-
↓Plasma Albumin< 2 gms/dl
↓K⁺‘ levels (due to diarrhea) ↓ RBP .
Osmotic imbalance edema
Disturbance in Carbohydrate, fat, protein metabolism
 Protein Calorie Malnutrition
Kwashiorkor:- Symptoms Treatment
Pitting Oedema proteins 3-6 gms /Kg
Distended abdomen body wt. in diet
Stunned Growth
Diarrhea
De pigmented hair, skin
Anemia
Apathy, Irritability
Moon phase
Enlarged Liver,
Kwashiorkor
 Protein Calorie Malnutrition
Marasmus:- Wasting away
• Severe form of malnutrition
• In children < 1year age
• Consists of Chronic wasting away of fat,
protein carbohydrate,
• Poverty, Inadequate food intake
• Deficiency of Calories
 Protein Calorie Malnutrition

• Marasmus Symptoms:- arrested growth,

• Chronic Diarrhea,
• Loss of subcutaneous fat
• Rapid weight loss
• Extreme muscle wasting
• Weakness, dizziness ,fatigue
• Anemia
• No edema
• Diet deficient in calories, proteins. diet may
consist of only watery gruel
Marasmic child
 Kwashiorkor and Marasmus
marasmus
Starvation in young children
Diet may be adequate
qualitatively but insufficient
CALORIES :limiting factor
Age: less than 1 year
Retarded growth, emaciated,
underweight, depleted
subcutaneous fat and muscles
Skin :thin,wrinkled bones
prominent .hair lusterless
‘little monkey ‘ appearance
Kwashiorkor
Diet very low in proteins
PROTEIN : limiting factor
calories may be sufficient
2nd or 3rd year of life
Oedema , apathy ,
anorexia
Pitting oedema , skin
lesions ,hair dry ,thin,
redish, depigmented
 Kwashiorkor and Marasmus
Marasmus Kwashiorkor
Serum proteins ↓ Serum proteins ↓↓↓
A/G ratio maintained Albumin ↓↓
βglobulins↓
A/G ratio reversed
Fatty liver not common Fatty liver may be seen
No Edema Pitting edema present on
legs ,appears first soft,
painless
Prognosis ok. Prognosis not so good.
Mortality high 10-20%