WELL BALANCE

DIET
~~MENU SEIMBANG~~

by
Indraguna Pinatih
FOOD~~NUTRIENT~~NUTRITIONAL
STATUS
PRINCIPLES
 Adequacy
 Diet provides sufficient energy and other nutrient
 Balance
 Consuming enough of each type of food/nutrient
 kCalorie (Energy) control
 Intake shall be match with expenditure/requirements
 Especially designed for energy and protein
 Nutrient Density
 Eat well without overeating neither under
 Ex: cheese vs. milk or apple vs water melon
 Moderation
 Variety
PEOPLE eat for …???
 food

FOOD is any substance,

organic or inorganic,
when ingested or eaten nourishes the body
by building and repairing tissues,
supplying heat and energy
and regulating bodily process or can
be used as medicines
 NUTRIENT
CARBOHYDRATE
PROTEIN
FAT
VITAMIN
MINERAL
FOOD WATER

NON NUTRIENT
Fungsional Food
Phyto Farmaca
etc
 ENERGY
BUILDING SUBSTANCE
REGULATOR SUBSTANCE
NUTRIENT

ENERGY
BUILDING SUBSTANCE
REGULATOR
”Nutrient”
All nutrients are
physiologically essential
to the body, but some
are dietary essentials
(i.e. : these should be
suppllied in the diet or
from food because the
body does not
synthesize
these nutrients)
 FOOD

NUTRTION ST

NUTRIENT
 NUTRITION ST.

NUTRITIONAL STATUS (nutriture) is the

condition of the body resulting from the
utilization of essential nutrients
DIETARY GUIDELINES
USA INDONESIA
 DIETARY GUIDELINES
 USA
 Adequate nutrients within
energy needs
 Weight management
 Physical activity
 Food groups to encourage
 Fats
 Carbohydrates
 Sodium and Pottasium
 INDONESIA
 Food composition
 Weight management
 Carbohydrate requirements
esp. complex carb.
 Fat intake
 Use Iodine salt
 Pregnant: consider Iron
intake
 Breast fed includes 6 months
exclusive
DIETARY GUIDELINES
 USA  INDONESIA
 Alcoholic Beverages  Breakfast
 Food Safety  Enough water for drink
 Restrict alcohol
 Physical activity
 Food safety at home
 Food label and exp.
date

13 PESAN DASAR
ENERGY REQUIREMENTS
 Calculated based on
 Age BASAL METABOLIC
 Sex RATE (BMR) or
 Body weight RESTING ENERGY
 Height EXPENDITURE
 Physical activity (REE)
 Formula (Schlenker)
 Male: 1.0 kcal/kg/hr
 Female: 0.9 kcal/kg/hr
 Formula (Harris Benedict)
 Male: 66.5 + 13.7 BW + 5.0 H – 6.8 A
 Female: 665 + 9.7 BW + 1.7 H – 4.7 A
ENERGY REQUIREMENTS
 Physical Activity
 WHO table of activities
 Simplifying activities
 Heavy (40% tm for standing/sitting + 60 % heavy work)
 Moderate (25% sitting/standing + 75% light/moderate
working)
 Light/sedentary (75% sitting/standing + 25 % light work)
 Age ≥ 50 years
 Male: max 2300 kcal
 Female: max 1900 kcal
 KINDS OF ACTIVITY (LIGHT)
 Personal Care
 Dressing
 Shaving

 washing

 Sitting
 Peeling potatoes

 Playing piano, cards

 Rocking

 Sewing, Typing and Writing

 Standing or slowly standing around billiard

 LIGHT-MODERATE ACTIVITIES
 Domestic Work
 Ironing, making beds, sweeping floors, washing clothes
 Yard Work
 Light gardening, mowing (power mower)
 Light Work
 Auto repair, painting, shoe repair, store clerk, washing car
 Walking
 Walking 3-4 km/hr on a flat road and/or on the way down
 Recreation
 Archery, bicycling (9 km/hr on level surface), bowling, canoeing
4.5 km/hr
 MODERATE ACTIVITIES
 Yard Work
 Digging, Mowing lawns (not motorik), Pulling
weeds
 Walking
 Walk speed 6km/hr on surface up/ hilli
 Recreation
 Badminton, Ballet excercise, Calisthenic,
Canoeing (6 km/hour speed), Dancing, Golf
(no cart), ping-pong, tennis, volley ball
 HEAVY ACTIVITIES
 Yard work
 Chopping wood, Digging holes, Shoveling
snow
 Walking
 Walk 7.5 km/hr, up stairs, up hill, climbing
 Recreation
 Bicycling 20 km/hr, Cross country skiing,
jogging 7.5 km/hr, swimming, tennis,
waterskiing
 ENERGY REQUIREMENTS

LIGHT MODERATE HEAVY

MALE 1.55 1.78 2.10

FEMALE 1.56 1.64 1.82

Source: Energy & Protein

requirements, WHO, 1985
 ENERGY REQUIREMENTS

SEDENTARY LIGHT MODERATE HEAVY

20 % RMR 30 40 50

Shall be added to RMR

Source: Schlenker, 2003

PROTEIN REQUIREMENTS

 Calculated based on nitrogen balance

 Simple formula
All ages : 0.8 – 1 gr./kg. body weight
> 50 : 1 - 1.2 gram/ kg. body weight
FAT INTAKE

 Intake maximum: 30% of total energy

requirements
 Saturated intake < 10% total energy
 PUFA < 10 % total energy
 Balancing Ω6 : Ω3 (reducing the First and
increasing the later)
 Cholesterol < 300 mg/ day
 Preferable Plant sterol or stanol esters
 VITAMINS MINERAL
 EAR : Estimated Average Requierement
 RDA: Recommended Daily Allowance.
 ADI: Average Daily Intake
 AI : Adequate Intake
 UL : Tolerable Upper Intake Level
 Dietary intakes of micronutrientd can be
assessed by direct dietary analysis and by
taking dietary histories.
 To estimate positive or negative balances:
Direct measurement of total dietary intake
over several days + measurement of output
in urine, feces and other routes
RDA
 BALANCE

FOOD

REQUIREMENT
NUTRIENT DEFICIENCY
TISSUE
DEPLESION NHNI
BIOCHEMISTRY
CHANGES NHNI
FUNCTIONAL
DISORDERS NHNI
ANATOMIC
CHANGES ILL
 NUTRIENT DEFICIENCY

EPM VAD
TISSUE THIN Vit.A tissue
DEPLESION deplet
BIOCHEMIST Vit.A tissue
MOD. deplet
FUNCTIONAL
DISTURBANCE Night Blindness

ANATOMIC MARAS
CHANGES XEROPHTHALMIA
KWAS
 OVER NUTRITION
KARBOHIDRAT OVERWEIGHT
PROTEIN (OBESITY)
LEMAK

VITAMIN ~~~

MINERAL ~~~
 BALANCE DIET

HOW ……. ?????

 BALANCE

FOOD

REQUIREMENT
 BALANCE DIET

MENU NEEDS
AVAILABLE NUTRIENT

STAPLE AGE
SIDE DISH SEX
PHYSICAL CON
VEGETABLE
ACTIVITY
FRUIT Etc.
BALANCE DIET INDONESIAN MODEL
 STAPLE/MAIN
PROTEIN ANIMAL+NON
VEGETABLE + FRUITS
miscellaneus
 MENU DIET “BALANCE”
(in measurement/ size of PORSION)

RICE ¾ GLASS
“MEAT” 1 SLIZE
TEMPE 2 SLIZES

VEGETABLE 1 GLASS
1 BANANA
FRUITS
MILK
SUGAR 1 SP
OIL ½ SP
 AGE 18 year

NUTRIENT NEED BALANCE

(base on RDA) DAILY
MENU
ENERGY : 2600 Calori
Protein : 65 gram
Vit. A : 600 RE BREAKFAST
Vit D : 5 mcg SNACK
Dst.
LUNCH
Ca : 1000 mg. SNACK
P : 1000 mg. DINNER
Mg. : 270 mg.
Fe : 15 mg. SUPPER?
etc.
 AGE 18 Year

NUTRIENT NEED BALANCE

(base on RDA)
DAILY MENU
ENERGY : 2600 Kalori
Protein : 65 gram RICE (4 ½ p)
Vit. A : 600 RE
Vit D : 5 mcg ANIMAL SIDE DISH (3p)
Dst. VG SIDE DISH (3p)
VEGETABLES (3p)
Ca : 1000 mg.
P : 1000 mg. FRUITS (3p)
Mg. : 270 mg. SUGAR (2p)
Fe : 15 mg. OIL (6p)
Etc.