Pediatric Nutrition in Health & Disease Madhu Sharma
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1Basic Nutrition

Functions of Food1

 
BALANCED DIET
“Proper diet can become an instrument for maintaining health and cultivating increased levels of awareness”
Chinese proverb
Master Mantak Chia
All of us know and have heard so often of a ‘Balanced Diet’ and tend to believe it is a Healthy Diet. But, unfortunately they are actually confusing the two entities-rather ‘using’ it as synonyms. A ‘balanced diet’ is one which provides us with all the nutrients (present in a wide range of foods) in the right proportion and the right amount. It will also provide a regular supply of vitamins, minerals and other nutrients, ensuring optimum health and vitality. Optimum health means less illness and health complications.
A ‘healthy’ diet plan is mainly a consumption of natural, fresh and wholesome foods for each meal of the day. Such foods may be low in fats, sodium and refined sugars. The difference is, a healthy diet plan provides us with ‘some nutrients’, but the balanced diet plan provides all ‘essential nutrients’.
A combination of both healthy and balanced diet plan can help achieve the following:
  • a variety in the diet
  • provide more grain, fresh fruits and vegetables to provide energy
  • low fat intake-especially saturated fats
  • reduce sugar intake
  • lower salt intake
  • provide optimum health and vitality to remain active
  • mental well being
  • ability to withstand on going ageing process with minimum functional impairment
  • ability to combat disease, like.
    1. resisting infections, i.e. providing immunity
    2. preventing onset of degenerative diseases and cancer
    3. resisting the effect of environmental toxins and pollutants.
There is a wide variety of foods consumed by us over the whole day. Some of them may not be consumed daily or there are some which might be consumed in greater proportions compared to certain other types of food. All these foods have some role to play in our health-directly or indirectly. Based on the functions of various foods and the nutrients provided by them, these can be classified into three main types as given in Table 1.1.
Now based on these functions, foods are further classified into groups depending upon the main nutrients provided by them. Some experts have classified them into seven groups, where in fruits were grouped apart from vegetables.
TABLE 1.1   Functions of food
Food function
Nutrients provided
Energy providing
Carbohydrates, fats
Body building
Proteins
Protective
Vitamins, minerals, fiber
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Others grouped meat and other animal foods as a separate group from pulses, but grouped fruits with vegetables. But most experts have classified food into five basic groups as given in Table 1.2.1 These food groups can be used as:
  1. Tools for nutritional assessment and screening: A brief dietary history can give us an idea of the inadequacies of any nutrient from any of the groups and thus provide a hint of the possible deficiency if any.
  2. Tool for nutritional counseling: It can serve as a guide for nutrition education by any health care providers.
  3. Food labeling and surveillance: Food groups can be used for food labeling and for nutrition surveillance system.
Cereals and millets like wheat flour, rice, maize, bajra, etc. are basically the staple food item of any Indian meal. Besides providing energy which is their main function, also provides proteins and other minerals and vitamins. These are a good source of fiber too.
Pulses comprise a variety of dals, which are an important component of any Indian diet. These are a rich source of proteins, almost double those of cereals (24%). Soyabeans of course are the highest source of proteins amounting to almost 40%. These are also good substitutes for vegetarian diets with respect to protein contents. Besides these are also rich in certain other important nutrients like phytoestrogens
Pulses and cereals are generally consumed in combination in most Indian households and this is very important in order to enhance the bioavailability of proteins. The amino acid lysine is deficient in cereals but rich in pulses. On the other hand cereals are a good source of methionine but deficient in lysine. Therefore, when consumed in combination, the deficit of each food is complemented by each other, thereby improving the quality of total proteins consumed. The role of pulses is mainly body building with of course good energy content. For nonvegetarians, meat, chicken fish and eggs are an excellent source of high biological value proteins. However, unlike pulses these are poor source of fiber.
TABLE 1.2   Food groups and their nutrients
Food groups
Major nutrients
Cereal and millets
Energy, iron and B group vitamins
Pulses and Legumes Nuts and Oilseeds
Proteins, energy, B group vitamins
Milk, Egg and Flesh Foods
Proteins, calcium, vitamin A
Vegetables and Fruits
Vitamins, minerals, fiber
Fats and sugars
Energy, essential fatty acids (fats only)
Milk and milk products are a group by themselves and rich in proteins besides being a useful source of calcium for all age groups. The proteins of milk (casein) are of high biological value and considered as first class quality. Their basic role is that of body building apart from the protective role by virtue of its being rich in fat soluble vitamins like A and D.
Green leafy vegetables and fruits are mainly protective foods due to their mineral and vitamin content besides also being a good source of fiber. They are however low in calories and proteins. Vitamins like A, E and C are also considered as antioxidants, therefore a good helping of these foods in the diet can protect the body from free radical produced consequent to various metabolic actions. Fiber in the diet is a very important component of food to keep the gastrointestinal tract in action and also helps control hyperglycemia and hyperlipidemia.
Fats and oils and sugars are basically high caloric foods used as a part of the ingredients of any food preparation and termed as energy giving foods as they are calorie dense. Fats are twice as high in calories compared to sugars.
A judicious use of foods chosen from all the food groups (as per sex and age requirements) will take care of the requirements of all macronutrients, i.e. proteins, fats and carbohydrates, as also the micronutrients which include all vitamins, minerals trace elements and fiber (Fig. 1.1). Illustrates the typical food pyramid for any healthy individual. The amounts of each food group can vary depending upon the age and sex of the individual. Overall, a balanced diet should provide around 60%–70% of total calories from carbohydrates, 10%–20% from proteins and 20%–25% of total calories from fat.
The segments of the pyramid depict the ratio of the different food groups that need to be consumed in any balanced diet.
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zoom view
FIGURE 1.1: The food pyramid
Cereals and millets are shown to be consumed in the maximum ratio followed by vegetables and fruits, pulses and nuts, milk and other flesh foods and lastly the fats and sugars which need to be consumed in the least ratio.
A balanced diet may be planned and calculated using the simple exchange list for portion size and nutrient content of all food groups as given in Table 1.3.2
 
Principles of Planning a Balanced Diet
While planning a balanced diet there are certain important criteria to keep in mind. These apply to the family as a whole, but in the case of a child special points need to be considered:
  1. Meeting the nutritional requirements: A menu providing adequate nutrients from all the food groups, which includes macro and micro nutrients.
  2. Meal pattern should fulfill family needs: The menu should be such that members of different age groups and sex need to be accounted for. The requirements of a 5-year-old girl would be different from those of her adolescent sib, which again would differ for another sib who is an adult in the family and perhaps a sports person.
  3. Meal planning should be time sparing: Any meal planning should be such that the housewife is not left to spend long hours cooking or the recipes are such that they involve a great deal of effort time and energy.
  4. Economic considerations: The meal planned is based on the economic factors to a large extent. Low cost nutritious recipes can be counseled to families with limited resources, like utilizing the seasonal foods available judiciously can be healthier then spending more on foods not easily available or difficult to procure.
  5. Prevention of maximum nutrient losses: Meal planning should involve recipes and techniques which do not involve excessive nutrient losses, e.g. too much of frying or boiling involved in recipes, though may be delicious, but may result in maximum losses especially of the water soluble vitamins or fat soluble vitamins in case of frying for long duration.
    TABLE 1.3   Nutrient exchange list for portion size of various food groups
    Food groups
    G/portion
    Energy (kcals)
    Protein (g)
    Carbohydrate (g)
    Fat (g)
    Cereals/Millets
    30
    100
    3.0
    20
    0.8
    Pulses
    30
    100
    6.0
    15
    0.7
    Egg
    50
    85
    7.0
    -
    7.0
    Meat/Chicken/Fish
    50
    100
    9.0
    -
    7.0
    Milk (toned)
    100
    70
    3.0
    5.0
    3.0
    Roots/Tubers
    100
    80
    1.3
    18.0
    -
    Green Leafy Veg.
    100
    45
    3.6
    -
    0.4
    Other Vegetables
    100
    30
    1.7
    -
    0.2
    Fruits
    100
    40
    -
    10.0
    -
    Sugar
    5
    20
    -
    5.0
    -
    Fats/Oils
    5
    45
    -
    -
    5.0
    Source: NIN2
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    Cooking methods involving pressure cooking, baking or micro-wave cooking can save time, nutrient losses and also retain maximum flavor of the food itself. Sprouting, malting or fermenting processes can enhance certain nutrients in the meals.
  6. Likes and dislikes: Although meal planning should consider nutrient quality and balance of all nutrients, etc. it is equally important to consider the individual likes and dislikes of the child. he recipes can be modified to appeal to their taste or some other substitutes may be offered instead.
  7. Variety: Variety is not only the spice of life as is said, but also helps break monotony in the meals from day to day. Recipes may be modified or substituted for equally balanced alternatives so that the interest of the child is maintained. This can specially be of help for ‘fussy eaters’.
  8. Meals should give satiety: If a meal is prepared taking into account all the food groups, comprising cereals, pulses, fats, etc. it can provide more satiety than just cereal alone or some vegetables. Spaced out meals are better than one time heavy meals.
  9. Availability of foods: Meals should include locally available foods rather than planning off season foods, which are not only expensive but, may also not be fresh, or need more cumbersome procedure for cooking or processing it.
REFERENCES
  1. BVS Thimayamma and Swaran Pasricha. Balanced Diet In Textbook of Human Nutrition, eds by MS Bamji, N Prahlad Rao, Vinodini Reddy, 1996.
  1. Nutrient Requirements and Recommended Dietary Allowances for Indians. A report of the expert group of the Indian Council of Medical Research. New Delhi, Indian Council of Medical Research,  2010.