BMI classification

Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m²). For example, an adult who weighs 70kg and whose height is 1.75m will have a BMI of 22.9.
BMI = 70 kg / (1.75 m²) = 70 / 3.06 = 22.9
Table 1: The International Classification of adult underweight, overweight and obesity according to BMI

Classisfication	BMI (kg/m2)
	Principal cut-off points	Additional cut-off points
Underweight	< 18.50	< 18.50
Severe thinness	< 16.00	< 16.00
Moderate thinness	< 16.00 - 16.99	< 16.00 - 16.99
Mild thinness	< 17.00 - 18.49	< 17.00 - 18.49
Normal Range	18.50 -24.99	18.50 - 22.99
		23.00 - 24.99
Overweight	≥ 25.00	≥ 25.00
Pre-obese	25.00 - 29.99	25.00 - 27.49
		25.50 - 29.99
Obese	≥ 30.00	≥ 30.00
Obese class I	30.00 - 34.99	30.00 - 32.49
		32.50 - 34.99
Obese class II	35.00 - 39.99	35.00 - 37.49
		37.50 - 39.99
Obese class III	≥ 40.00	≥ 40.00

Source: Adapted from WHO, 1995, WHO 2000 and WHO 2004.
BMI values are age-independent and for both the sexes. However, BMI may not correspond to the same degree of fatness in different population due, in part, to different body proportions. The health risks associated with increasing BMI are continuous and the interpretation of BMI gradings in relation to risk may differ for different populations.
In recent years, there was a growing debate on whether there are possible needs for developing different BMI cut-off points for different ethnic groups due to the increasing evidence that the association between BMI, percentage of body fat, and body fat distribution differ across populations and therefore, the health risks increase below the cut-off point of 25 kg/m² that defines overweight in the current WHO classification.

Recommended Dietry Allowances for Indians

(Macronutrients and Minerals)

Recommended Dietry Allowances for Indians

(Vitamins)

PORTION SIZES AND MENU PLAN

Portion size of Foods (raw) and Nutrients

Approximate Calorific Value of some Cooked Preparations

Before planning a sample menu is detail, one should mention the general foods which are to be avoided and preferred according to the condition. This makes food selection while planning menu, easier. For example, in liver diseases- Food avoided- fried foods, organ meat, red meat, egg yolk, whole pulses, fibre rich cereals, extra salt and baking soda, preserved foods and foods containing salts like papads, chutney and pickles. Food preferred- Cereal porridge, rice, potato, soft custards, butter cream, Fresh fruits and vegetables, non-stimulant beverages. (B. Srilakhshmi, 2011; Avantina Sharma, 2017)

Water Standards

The foods groups that are listed in comprehensive menu are converted into actual recipes and distributed in different meals like breakfast, lunch, evening, dinner. Recipes in exchange lists are converted in different meals. Example-

RDA’s should be met and nutritional requirements covered in the plan. It is extremely important to plan a menu which addresses the nutrient needs of the concerned and provide the body with the required nutrients in adequate amounts as well as leaving some extra for times of leanness. Meal plan should be feasible for the individual or family, the menu should be such that it offers the least deviation from the normal dietary pattern of the concerned, it should also address the different needs of various member of the family, and adolescent childhood requires more calories and food than a toddler who needs bland and soft diet. A pregnant lady would need food that is rich in green leafy vegetables, milk and proteins than a normal adult female. All these considerations should be kept in mind while planning diets.

1. Flour should not be sieved for chapatti as it reduces bran content.
2. Minimize refined cereals like maida.
3. To improve the cereal and pulse protein quality minimum ratio of cereal protein to pulse protein should be 4:1. In terms of the grains it will be 8parts of cereals and one part of pulses.
4. Two or three servings of pulses should be taken every day.
5. Germinated pulses are more nutritious.
6. One egg weighs around 40g. this can be served along with cereal or pulses to improve the quality of protein. Instead, one serving of poultry/ fish can also be included in the diet.
7. A minimum quality of 50ml Milk per day should be included. Two glasses of milk or curd should be included in a balanced diet. Curd provides probiotic. Low fat milk should be preferred.
8. Food rich in fibre should be included in the diet.
9. Every meal should contain at least one medium sized fruit, it is better to serve the fruit raw. Taking juice out of it causes loss of vitamin C.
10. Inclusion of salads or raita not only helps in meeting the vitamin requirements but the meals should be attractive and have high satiety value due to the fibre content.
11. Green leafy vegetables can be taken more than one serving. Coloured vegetables and fruits are preferred.
12. Five servings of colourful fruits and vegetables should be included in a day’s diet to meet antioxidant requirement.
13. Energy derived from fats or oils is 15-20% of total calories and 5% from sugar and jaggery.
14. It is better to use more than one type of oil. Combinations of oils have proper balance between n-3 and n-6 fatty acids. Choose a diet low in fat, saturated fat, trans fat and, cholesterol.
15. Fried foods cannot be planned if oil allowance is less or in low calorie diets.
16. Variety of foods should be used in the menu.
17. Use salt and sugar in moderation.
18. Ideally, each meal should consist of all the 5 food groups.
19. Usually the number of meals should be four and for very young children and patients, the number of meals can be more

SAMPLE MEAL PLAN FOR ADULT MAN (SEDENTARY)

Meal Time	Food Group	Raw	Cooked Receipe	Serving Amounts
Breakfast	Milk	100 ml	Milk or	1/2 Cup
	Sugar	15 g	Tea or	2 Cup
	Cereals	70 g	Coffee	1 Cup
	Pulses	20 g	Breakfast item
Lunch	Cereals	120 g	Rice	1/2 Cup
			Pulkhas	2 Nos
	Pulses	20 g	Dhal	1/2 Cup
	Vegetables	150 g	Veg. curry	3/4 Cup
	Vegetables	50 g	Veg. salad	7-8 slices
	Milk	100 ml	Curd	1/2 Cup
Tea	Cereals	50 g	Snack	1 Cup
	Milk	50 ml	Tea
	Sugar	10 g
Dinner	Cereals	120 g	Rice	2 Cup
			Pulkhas	2 Nos
	Pulses	20 g	Dhal	1/2 Cup
	Vegetables	150 g	Veg. curry	3/4 Cup
	Milk (Curd)	50 ml
	Vegetables	50 g
	Fruit	100 g	Seasonal	1 Medium

1 Cup = 200 ml
Note: For Non-Vegetarians – Substitute one portion with one portion of egg/meat/chicken/fish
Use 35 g visible fat per day.
Breakfast Item: Idli- 4 Nos. / Dosa -3 Nos. / Upma-1-1/2 Cup / Bread – 4 Slicees / Porridge - 2 Cups / Com fakes with milk - 2 Cups.
Snack: Poha - 1 Cup / Toast - 2 Slices / Samosa - 2 / Sandwiches-2 / Biscuits-5

SAMPLE MEAL PLAN FOR ADULT WOMAN (SEDENTARY)

Meal Time	Food Group	Raw	Cooked Receipe	Serving Amounts
Breakfast	Milk	100 ml	Milk or	1/2 Cup
	Sugar	10 g	Tea or	2 Cup
	Cereals	50 g	Coffee	1 Cup
	Pulses	20 g	Breakfast item
Lunch	Cereals	100 g	Rice	1 Cup
			Pulkhas	2 Nos
	Pulses	20 g	Dhal	1/2 Cup
	Vegetables	100 g	Veg. curry	1/2 Cup
	Vegetables	50 g	Veg. salad	7-8 slices
	Milk	100 ml	Curd	1/2 Cup
Tea	Cereals	50 g	Snack	1 Cup
	Milk	50 ml	Tea
	Sugar	10 g
Dinner	Cereals	100 g	Rice	1 Cup
			Pulkhas	2 Nos
	Pulses	20 g	Dhal	1/2 Cup
	Vegetables	100 g	Veg. curry	1/2 Cup
	Milk (Curd)	50 ml
	Vegetables	50 g
	Fruit	100 g	Seasonal	1 Medium

1 Cup = 200 ml
Note: For Non-Vegetarians – Substitute one portion with one portion of egg/meat/chicken/fish
Use 25 g visible fat per day.
Breakfast Item: Idli- 3 Nos. / Dosa -2 Nos. / Upma-1 Cup / Bread – 3 Slicees / Porridge - 1-1/2 Cups / Com fakes with milk - 1-1/2 Cups.
Snack: Poha - 1 Cup / Toast - 2 Slices / Samosa - 2 / Sandwiches-2 / Biscuits-5