PRACTICAL 2

PLAN, PREPARE AND EVALUATE A DAY’S DIET FOR TYPHOID

DEFINITION
Typhoid is an infectious bacterial fever with an eruption of red spots on the chest and
abdomen and severe intestinal irritation.
ETIOLOGY
Typhoid is a bacterial infection that can spread throughout the body, affecting many organs.
Without prompt treatment it can cause serious complications and can be fatal. It is caused by
a bacterium called Salmonella typhi, which is related to bacteria that cause salmonella food
poisoning.
SMPTOMS
• Fever – that starts low & increases throughout the day, possibly reaching as high as 104°F
(40°C).
• Chills
• Headache.
• Weakness & Fatigue.
• Muscle aches.
• Stomach pain
• Diarrhoea or constipation.
• Rash.
• Loss of appetite
• Cough
• Nausea, vomiting.
• ‘Rose spots’, rash or faint pink spots, usually on Chest or stomach.
PRINCIPALS OF THE DIET
A typhoid patient is suggested a diet of
• A High calorie
• High protein
• High carbohydrates
• Low fat
• High fluid
• Low fibre
• Bland diet
FOODS TO BE INCLUDED FOODS TO BE AVOIDED
Fruit juices with glucose, coconut water, Butter, ghee, vegetable oil, no
barley water, milk, milk shakes if there is no irritating fibres foods, chillies
diarrhoea, custards, thin dal, eggs, baked and other spices, rich pastries,
fish, curds, cottage, cheese, cereals, gruels, fried foods, puddings and cream
steamed vegetable juices, milk puddings, soups.
vegetable puree.

DIETARY GUIDELINES
At first clear fluid diet is given, followed by full fluid and soft diet. On liquid diets the patient
may not meet high calorie and high protein requirements. As the patient is improving soft diet
can be given. The febrile period may upset water balance and liquid diets are helpful in
meeting water and electrolyte requirements.
SOURCE: ignou and DIETETICS – B SHRILAKSHMI
PROFILE
Name : XYZ
Gender: Male.
Age: 40 years.
Height: 172 cm. – 5.64 ft.
Weight: 80kgs. = 176.37 lb.
Lifestyle: Sedentary.
Eating habit: Non-Vegetarian
BMI:
Weight (inkg) 80 = 27.11 kg/m² BROCAS, INDEX

Height (in m²) (1.72) For women = (Height -100)×0.9.

Ideal Body weight: For men = (Height – 100) ×1

 Broca’s index
For men = (Height – 100) ×1
For XYZ =(172-100)= 72kg
 Haemwi’s method
HAEMWI’S METHOD
For men = 106lb (for 5 feet) + 6lb ( additional
For women = 100lb(for 5 ft)+ 5lb
inch)
(additional inch)
For XYZ = 106lb + 6(6)lb
For men = 106lb (for 5 feet) + 6lb
(additional inch)
= 106lb+ 36lb
=142lb/64.54kg.
TOTAL ENERGY REQUIREMENT
1. Harris benedict equation

For Male: 66.47+ (13.75×W(in kg)) + (5.0×H(in cm)) – (6.75×A(in yrs))

Where W=weight in kg (ideal weight)
H = Height in cm HARRI’S BENEDICT EQUATION

A= Age in years For Female: 655+(9.56×W (in kg))

+(1.84×H(in cm)) – ( 4.67×A(in yrs))
For XYZ : 66.47+ (13.75×W) + (5.0×H) –
(6.75×A) For Male: 66.47+ (13.75×W (in kg)) +
(5.0×H(in cm)) – (6.75×A(in yrs))
= 66.47+ (13.75×64.54)+(5×172) - (6.75×40)
= 66.47+ 887.42+ 860 - 270
= 1813.89 – 270
= 1543.89
Total energy expenditure (TEE) = Total energy requirement ×1.4
= 1543.89 ×1.4
= 2161.44
Thermic effect of food = 10%(TEE)
= 10% (2161.44)
= 216.14
ENERGY = TEE + TEF
= 2161.44+ 216.144
= 2377.59 KCAL
2. Thumb’s rule
= IBW ×25 KCAL
= 64.54 × 25
=1613.5 = 1614 KCAL.
CALORIE DISTRIBUTION
• Carbohydrates: 60% of (Total calories)
= 60% (2377.59)
=1426.55 Kcal.
Carbohydrates =1426.55 ÷ 4
= 356.63gms = 357 gms
• Protein: 15% (Total Calories)
=15% (2377.59)
= 356.63 Kcal
Protein = 356.63 ÷ 4
= 89.15 gms = 89 gms
• Fat 25% (Total Calories)
=25% (2377.59)
= 594.39 Kcal
Fat: 594.39 ÷ 9
= 66.04 = 66 gms
MEAL CALORIE DISTRIBUTION
RATIO TIMINGS ENERGY PROTEIN FAT (in CARBOHYDRATE
(kcal) (in gm) gm) (in gm)
1/4th Early
morning+ 432.73 16.4 20.85 43.54
Breakfast
1/3rd Mid-
morning + 601.6 30.72 17.14 94.63
lunch
1/12th Evening
snack 37.28 0.70 0.13 7.92
rd
1/3 Dinner +
bedtime 274.47 12.59 12.11 43.93

EXCHANGE LIST
Food Quantity Number of Energy Carbohydrate Protein Fat (gm )
groups exchanges (Kcal) (gm) (gm)
Cereals and 30 3.6 360 72 10.8 2.88
millets
Pulses 30 1.6 160 24 9.6 1.12
Egg 50 2 170 - 14 14
Meat , 50 - - - - -
chicken or
fish
Milk and 100 2 140 10 60 6
milk
products
Roots and 100 1.3 104 24.7 1.69 -
 tubers
Green leafy 100 1 45 - 3.6 0.4
vegetables
Other 100 1.1 33 - 1.87 0.22
vegetables
Fruits 100 2.5 100 25 - -
Sugar 5 1 20 5 - -
Fats and 5 4 180 - - 20
oils
Total 20.1 1312 160.7 101.56 44.62

SPLIT EXCHANGE LIST

Early Breakfast Mid Lunch Evening Dinner Bedtime
morning morning snack
Cereals - 1 - 0.8 - 1 -
and
millets
Pulses - - 1 - - 0.6 -
Egg - - - 2 - - -
Meat , - - - - - - -
chicken or
fish
Milk and - 0.5 - - - - 1.5
milk
products
Roots and - 0.4 - 0.7 - 0.2 -
tubers
Green - 1 - - - - -
leafy
vegetables
Other - 0.4 - 1.5 - 0.2 -
vegetables
Fruits - - - 1.5 1 - -
Sugar - - - - - - 1
Fats and - 2 - 1 - 1 -
oils
Total 5.3 1 7.5 1 3 2.5

SAMPLE MENU PLAN

Time Menu plan Quantity
Early morning Tender coconut water 1 Glass
 Breakfast 1. Poha 1 Bowl
2. Spinach paneer Half Bowl

Mid morning Bengal gram sundal 1 Bowl

Lunch 1. Scrambled egg 2 Eggs
2. Banana 1 Banana
3. Potato pea roll 1 Roll

Evening snack Orange 1 whole

Dinner 1. Red lentil dal 1 Cup
2. Rice 1 Cup

Bedtime Turmeric milk 1 Glass

NUTRIENT CALCULATIONS
Early Ingredie Quanti Energ Carbohydr Prote Fat Dieta Vitam Vitam
morning nt ty (g) y ate (g) in (g) (g) ry in A in C
Tender (kcal) Fiber (ug) (mg)
coconut (g)
water Tender 200ml 30.58 6.32 0.52 0.32 - - 1.28
coconut
water
Breakfa Poha 30 106.1 23.02 2.23 0.34 1.03 - -
st 1
Poha Onion 20 9.60 1.91 0.3 0.04 0.49 0.21 1.33
Tomato 20 3.77 0.64 0.15 0.05 0.31 302.6 5.05
Oil 5 45 - - 5 - - -
Peanut 5 26 0.86 1.18 1.98 0.51 1.13 -
Spinach Paneer 50 128.9 6.20 9.43 7.39 - 2.19 -
paneer 4
Oil 5 45 - - 5 - - -
Onion 20 9.60 1.91 0.3 0.04 0.49 0.21 1.33
Tomato 20 3.77 0.64 0.15 0.05 0.31 302.6 5.05
Spinach 100 24.36 2.04 2.14 0.64 4.76 2605 30.28
Sub 432.7 43.54 16.4 20.8 7.9 3213. 44.32
Total 3 5 94
Mid- Bengal 30 86.11 11.86 5.63 1.53 7.56 51.6 -
morning gram
Bengal whole
gram
sundal
Lunch Eggs 100 67.5 - 13.28 9.15 - 198 -
Scrambl Banana 150 157.7 35.44 1.84 0.49 2.91 85.17 7.14
ed eggs 4
Banana Onion 20 9.60 1.91 0.3 0.04 0.49 0.21 1.33
Aloo Oil 5 45 - - 5 - - -
 pea roll Potato 50 34.89 7.4 0.77 0.11 0.85 - 11.57
Pea 50 40.63 5.94 3.62 0.06 3.16 60.5 19.2
Whole 50 160.1 32.08 5.28 0.76 5.68 1.33 -
wheat 3
flour
Sub 601.6 94.63 30.72 17.1 20.65 396.8 39.24
Total 4 1
Evening Orange 100 37.28 7.92 0.70 0.13 1.29 31.94 42.72
snack
Orange
Sub 37.28 7.92 0.70 0.13 1.29 31.94 42.72
Total
Dinner Red 20 64.48 10.50 4.87 0.15 2.08 1.26 9.99
Red lentil
lentil dal
dal Onion 20 9.60 1.91 0.3 0.04 0.49 0.21 1.33
Tomato 20 3.77 0.64 0.15 0.05 0.31 302.6 5.05
Oil 5 45 - - 5 - - -
Rice Rice 30 106.9 23.47 2.38 0.15 0.84 - -
0
Bedtime Milk 150 109.2 7.41 4.89 6.72 - 20.50 3.01
Turmeri
c milk
Sub 274.4 43.93 12.59 12.1 3.72 324.5 19.38
Total 7 1 7
Grand 1462. 208.2 gm 66.56 52.0 41.12 4018. 146.9
Total 77 gm 3 gm 78 ug 4 mg
Kcal gm

COMPARISON TABLE
S.No. Nutrients Modified RDA Obtained RDA Difference
1. Energy 1549 KCAL. 1463 KCAL -86
2. Carbohydrates 357 gms 208 gms -149
3. Protein 89 gms 67 gms -22
4. Fat 66 gms 52 gms +14

EVALUATION/ INTERPRETATION
This recipe is planned for a patient suffering from typhoid disease. Therefore, High calorie,
High protein, High carbohydrates, Low fat, High fluid, Low fibre, Bland diet is given.
Paneer is considered for a good source of protein and calcium, especially for vegetarians,
Helps build muscle, Good for bones and teeth, good for brain health. Eggs are bioavailable
sources of protein and are good source of Vitamin A. Tomatoes are a powerful antioxidant,
super rich in Vitamin C, good for heart. Oranges are a rich source of Vitamin C. Bengal gram
consumption improves insulin response, keeps heart heathy and a high source of fibre. Green
leafy vegetable like spinach has all the nutrients required for a human body. Coconut water is
the Best alternatives for sugary juices, help in good digestion and helps to detox the body.
The given recipe is meeting all micronutrients required according to RDA/ EAR.