Tutorial: How to prepare a diet plan for a pregnant woman

Recently some students requested that I help them answer a question on preparing a diet plan for a 30 year old pregnant woman.

In this tutorial I will provide general guidance on how to prepare a diet plan, using the example of a pregnant woman.

Disclaimer: The principles and Recommended Dietary Allowances (RDAs) mentioned are appropriate for the Indian setting only.

Tutorial

There are four elements in a diet prescription

  1. Principles of Balanced Diet
  2. Calculation of weight/volume
  3. Food chart
  4. Meal plan/ menu (optional in a theory examination)

The first step in any diet prescription is the computation of requirements for total calories and total proteins.

In order to do this, refer to the Summary of Recommended Dietary Allowances (RDA) for energy, protein, fat and minerals for Indians 2010 (Table 29 on page 636 of Park, 23rd edition).

If the subject is a pregnant woman, one must determine the activity level, as the calorie requirements vary by activity level.

A housewife is considered to be a moderate worker.

Assuming the pregnant woman is a housewife, and weighs 55kg, the total calorie requirement would be:

Calorie requirement for woman engaged in moderate work:           2230 calories plus

Calorie requirement for a pregnant woman:                                        350   calories

Total calorie requirement:                                                                       2580 calories per day

 

Similarly, from the table, the total protein requirement for a pregnant woman is 78 grams per day

 

All subsequent calculations will be based on the above two values (total calorie and total protein requirement).

A. Principles of a balanced diet

  1. Cereals: 60-70% of total calories should come from cereals

100 g cereals yield 350 Kcals energy and 10 g of Cereal Protein

  1. Pulses: The ratio of cereal protein to pulse protein should be 5:1

100 g pulses yield 350 Kcals energy and 20 g of Pulse Protein

  1. Fats: Should not be >10% of total calories

1 g of fat yields 9 Kcals energy and no protein

  1. Refined sugar: Should not exceed 5% of total calories

1 g of refined sugar yields 4 Kcals energy and no protein

  1. Milk:

100 ml milk yields 65 Kcals energy and 3.2 g Milk Protein

  1. Boiled egg:

1 boiled egg yields 80 Kcals energy and 6 g of protein

  1. Green Leafy Vegetables (GLV):

100 g of GLV yields 25 Kilocalories

B. Calculation

  1. Cereals:

The total calorie requirement is 2580 Kilo calories, so calories from cereals should be 70% of 2580à 1806 Kcals.

100 g of cereals yield 350 Kcals, so the amount of cereals required to provide 1806 Kcals is (1806/350)*100 = 516 g.

516 g cereals will provide 51.6 g cereal protein

 

  1. Pulses:

As the total proteins obtained from cereals is 51.6 g, pulse proteins should be: 51.6/5 = 10.32 g (or 10 g).

Since 100 g of pulses yield 20 g of pulse protein, the amount of pulses required to provide 10 g protein would be: (100/20)*10= 50 g.

50 g pulses will yield (350/2)= 175 Kilocalories energy

 

  1. Fat:

The total calories required are 2850, so the total calories from fat should not exceed 285. The total grams of fat permissible would therefore be 285/9 = 31.6 g (32 g).

 

  1. Refined sugar:

The total calories required are 2850, so the total calories from refined sugar should not exceed 142.5 calories. As one gram of carbohydrate yields 4 kilocalories, the total grams of refined sugar permissible would be 142.5/4= 35.6 grams.

Note: The WHO recommends a maximum of 25 grams of free sugars per day for adults.

  1. Milk:

On average, a person may consume 2 cups (400 ml) of milk in a day.

This volume would yield 4*65= 260 kilocalories energy and 12.8 g of milk protein

  1. Boiled egg:

The consumption of one boiled egg would yield 80 kilocalories energy and 6 grams protein

  1. Green Leafy Vegetables:

As the subject is a pregnant woman, she would need to consume at least 100 grams of GLV to meet the dietary iron requirements.

This would yield 25 kilocalories and no proteins

C. Food Chart

S. No. Food item Amount (vol/wt) Energy (Kcal) Protein (g)
1. Cereals 516 g 1806 51.6
2. Pulses 50 g 175 10
3. Fat 32 g 285
4. Refined sugar 35.6 g 142.5
5. GLV 100 g 25
6. Milk 400 ml 260 12.8
7. Boiled egg 60 g (1 egg) 80 6
  Total   2773.5 80.4

From the table, it is seen that although the protein requirements are satisfied, the calorie requirements are deficient by 76.5 kilo calories.

To overcome this deficit, one could increase the amount of GLV to 200 g. This will increase the calorie intake by an additional 25 kilo calories without increasing the protein value.

Alternatively, one more boiled egg could be included- this will provide an additional 80 kilo calories and 6 grams of protein.

S. No. Food item Amount (vol/wt) Energy (Kcal) Protein (g)
1. Cereals 516 g 1806 51.6
2. Pulses 50 g 175 10
3. Fat 32 g 285
4. Refined sugar 35.6 g 142.5
5. GLV 100 g 25
6. Milk 400 ml 260 12.8
7. Boiled egg 120 g (2 eggs) 160 12
  Total   2853.5 86.4

The addition of one more boiled egg provides the required calories and proteins.

 

Note: The preparation of a menu (meal plan) is optional.

The same approach could be used to prepare a diet plan for other subjects.

Note: The most important part is the computation of total calorie and protein requirement. If this is wrong, all elements except the ‘principles of a balanced diet’ will be wrong as well.

Further reading:

Essentials of Community Medicine Practicals by DK Mahabalaraju

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s