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Principles of Diet formulation

Understand the principles of formulating
diets for normal persons and ones with
metabolic diseases.

Dr.Sanath Mahawithanage
Dept. of Biochemistry
Part II
 Scope 2
1. Factors that influence nutritional requirements and principles of formulating
diets.
2. Principles of complementary feeding
3. Key principles in formulating diets for
1. Children
2. Adults
3. Pregnancy and lactating
4. Elderly
5. Individuals with metabolic diseases
(Diabetes mellitus, atherosclerosis, chronic kidney diseases
and obesity)
6. Introduction to functional foods
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Infancy (0-12 months)
• Highest growth rate during the first 6 months.
Birthweight doubled in 4-6 months and triple by the end
of the first year.
• Length increases by 50% at the end of the first year and
doubled by the 4th year.
• Capacity of the stomach increases from 10-20 ml at birth
to 200 ml by the first year.
• Requirements are higher per unit body weight
• Breast milk provides adequate nutrition 4-6 months
• Introduction of complementary food at the completion of
6th month.
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Early childhood (1-5 years)
• Principle dietary needs are for
– Rapid liner growth
– Rapid brain growth and development
– Rapid development of immunity
– Rapid recovery from infections
– Physical activity
• Dietary requirements
– High quality diet (sufficient energy, high
quality proteins essential nutrients such as
calcium ect)
Standard Children 1-5 years
 School children 5-10 years and adolescents (10-19 years) 6
• Still there is a higher demand for nutrition
• Change of habits- meal skipping (breakfast), out of home consumption and
susceptible to advertising
• Encourage healthy snacks
Healthy snacks

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Standard Adolescents
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Pregnancy and lactation
• Protein and energy requirements increase
– Fetal growth and associated tissue growth
• A healthy mother expected to gain 12.5 kg during the pregnancy
• Factors to be considered in formulating diets
– Extra energy need
– Extra protein need
– Key micronutrients – folate, iron, calcium, Vitamin C, Iodine
– Fiber rich food items
Standard Pregnancy
 Elderly
• Factors to be considered in formulating diets
– Reduction in lean body mass hence decreased metabolic rate
– Reduction in appetite hence reduced food intake
– Reduction of sense of taste and smell
– Difficulties in digestion and malabsorption
– Increased nutrient loss in disease status

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 Elderly
• Dietary recommendations
– Though the energy requirement decline needs for
• Protein high quality
• vitamins -thiamin, riboflavin, B12, folic acid- neurological and
behavioral effects,
• vitamin D and C
• Minerals- calcium and iron
• Supplements – depends on the need
– Softer more digestible food (cooking and processing)
– Fiber rich food – whole grain cereals, fruits, vegetables
– Variety and nutrient dense food
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 Scope 13
1. Factors that influence nutritional requirements and principles of formulating
diets.
2. Principles of complementary feeding
3. Key principles in formulating diets for
1. Children
2. Adults
3. Pregnancy and lactating
4. Elderly
5. Individuals with metabolic diseases
(Diabetes mellitus, atherosclerosis, chronic kidney diseases
and obesity)
6. Introduction to functional foods
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The Goals of the diabetic diet
1. Achieve normal blood glucose either on dietary management alone or with oral
medication and/or insulin administration.
2. to prevent cardiovascular disease such as high blood pressure, high cholesterol
3. Proper weight management
4. To prevent or delay other complications
Standard dietary requirements for a patient
with diabetes mellitus- Carbohydrates
• Carbohydrates should provide 55–60% of total daily
calories (realistic goal is 50%).
– No meal skipping (3 meals plus 2 snacks)
– Include Carbohydrates in every meal and spread it evenly
throughout the day as even distribution helps to prevent high
and low fluctuations of blood glucose.
– Encourage eating at regular intervals which helps control
hunger and prevents overeating at the next meal.
• Select foods with complex carbohydrates & low glycemic
index (GI) 15
Standard dietary requirements for a patient
with diabetes mellitus- Proteins
• Proteins should provide 15–20% of daily calories.
Requirement same as normal (0.7-1g/kg/day).
• Consider a mixture of plant and animal food
• Fish is important as it provides omega 3 FAs
• Consider lean meat and limit red meat to once a week.
• Two to three eggs a week.

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Standard dietary requirements for a patient
with diabetes mellitus- Fat
• Fats should provide 20–25% daily calorie intake,
• Mono unsaturated and poly unsaturated fatty acids
specially omega 3 are preferred.
• Limit saturated fats to less than 7%.

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 Standard dietary requirements for
Dyslipidemia (hyperlipidemia)
• Hyperlipidemia refers to elevated levels of lipids and
cholesterol in the blood, and is also identified as
dyslipidemia.
• Three major dietary factors that contribute to high levels
of serum cholesterol including LDL cholesterol are,
– 1. high intake of saturated fat and transfat
– 2. high intake of dietary cholesterol
– 3. an imbalance of calorie intake and activity levels leading to
obesity
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Standard dietary requirements

• Total fat <30 % of total calories
Saturated Fat – less than 7% of total calories (eg-fatty or processed meat
such as bacon)
Transfat – less than 1 % (industrially processed food such as baked
goods and fat spreads)
Polyunsaturated Fat – up to 10% of total calories (fish oil (omega 3),
sunflower oil (omega 6))
Monounsaturated Fat – up to 20% of total calories (Olive oil, canola oil ect)
• Dietary Cholesterol – less than 200 milligrams a day
• Carbohydrates – 50% - 60% of total calories
• Protein – Approximately 20% of total calories
• Fibre – 20-30 grams per day (eg. Whole grain cereals, fruits and vegetables).
• Limit salt intake less than 5 g a day (one tea spoon)
 Chronic kidney diseases
• Progressive disease

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 Chronic Kidney Disease (CKD)
1. Key nutrients/components
– Energy
– Protein
– Sodium
– Potassium
– Phosphate
– Fluid
– Supplements
2. Depends on the stage of the progression
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 Standard dietary requirements of CKD patients
• Energy requirement of approximately 35 – 40 kcal per kg of ideal body
weight is needed. But this is based on the nutritional status of the patient
• A low to moderate protein diet. Based on the level of kidney disease, age
and weight of the patient etc. Should be good quality proteins. Milk to be
limited
– Generally accepted levels of protein restriction for patients of CKD stage I to III is – 0.75
g/kg bw per day stage IV to V is – 0.6 g/kg bw.
• Low potassium diet but not at the beginning. Based on the potassium level
in blood.
– Avoid/limit high potassium food items such as banana, dried fruits, papaya, pomegranate
– Reduce potassium content in the diet- Vegetable (and yams) should be peeled and cut
into small pieces and placed in a large pot of water. (around 10 times of vegetables) After
soaking preferably more than 2 hours, rinse vegetable with clean water. Patients on low
potassium diet are advised to boil vegetables for 5–10 minutes using large amount of
water and to discard water after cooking to further decrease the vegetable potassium
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content.
 Standard dietary requirements of CKD patients
• A daily intake of Sodium should be less than 1 -3 g/ day (for end stage).
Limit food items with added salt
• Restricted dietary phosphates
– Avoid high phosphate food such as milk
– incorporate phosphate binders such as calcium carbonate or aluminium hydroxide into
the diet .
• A daily allowance of fluid should be equal to 500ml of fluid plus the
equivalent to the previous day’s urine output (only in late stages).
• Supplements particular, calcium and vitamin D supplementation.

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Thank you

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