Normal hospital diet: planning and calculating a day's menu
The normal hospital diet is a balanced, RDA-based diet for patients needing no change. Plan it in order: IBW, energy, protein, menu, nutritive-value check.
Aim and principles of the diet
Aim: To plan, prepare and calculate the nutritive value of a normal hospital diet for an adult patient who needs no change in nutrients or texture. Principles: The normal (regular or house) diet is a balanced diet that meets the ICMR-NIN 2020 requirements for the patient's age, sex and activity. Activity in hospital is low, so energy is planned at the sedentary level (about 30 kcal/kg ideal body weight). Protein is kept at or a little above the RDA (0.83 g/kg), because illness and surgery increase protein breakdown and healing needs protein. Carbohydrate gives about 55-60% of energy from cereals, millets and pulses; cereal and pulse eaten together give better-quality protein. Fat gives 20-30% of energy, with about 20-25 g of visible oil. Salt stays below 5 g a day (ICMR-NIN Dietary Guidelines for Indians 2024). All food groups are included so vitamins, minerals and fibre are met, with 2-2.5 litres of fluid. Meals are familiar, mildly spiced, attractive and served at fixed times. The normal diet is the base from which every therapeutic diet is changed.
Nutrient prescription: Mr. K, 40 y, 170 cm, 66 kg, after a hernia repair
| Nutrient | Prescription | Basis and source |
|---|---|---|
| Ideal body weight | 63 kg | (170 − 100) × 0.9 (Broca's index less 10%) |
| Energy | About 1900 kcal | 30 kcal/kg IBW × 63 = 1890 (sedentary in hospital); ICMR-NIN 2020 sedentary man 2110 kcal at 65 kg |
| Protein | About 63 g | 1.0 g/kg IBW for healing; ICMR-NIN 2020 RDA 0.83 g/kg = 52 g |
| Carbohydrate | About 260-285 g (55-60% of energy) | Cereals, millets, pulses; 1900 × 0.55 ÷ 4 = 261 g and 1900 × 0.60 ÷ 4 = 285 g |
| Fat | 20-30% of energy; 20-25 g visible oil | Visible fat: ICMR-NIN 2020 gives 25 g a day for a sedentary man (20 g for a woman); use two or more oils in rotation |
| Salt | Below 5 g a day | ICMR-NIN Dietary Guidelines 2024; WHO |
| Fluid | About 2.2 L | About 35 mL/kg × 63 kg = 2205 mL |
Foods to include and avoid
| Food group | Include | Limit or avoid |
|---|---|---|
| Cereals and millets | Rice, idli, dosa, chapati, upma, pongal, ragi; some whole grain daily | Parotta, puri and fried snacks in excess |
| Pulses | All dals, sambar, sundal, sprouts | Nothing special; cook well |
| Milk and milk products | Milk, curd, buttermilk, paneer | Cream and khoa sweets every day |
| Egg, fish, meat | Egg, fish, chicken as curry or stew (non-vegetarians) | Very spicy, deep-fried or reheated meat |
| Vegetables and greens | All vegetables; greens (keerai) daily | Raw salads unless washed in safe water |
| Fruits | Banana, papaya, guava, orange, apple | Cut fruit kept open |
| Fats and sugar | Measured oil; a little sugar | Vanaspati, reused frying oil, extra sweets |
| Others | Water, rasam, buttermilk | Pickles, papad, chips (very salty) |
Sample one-day menu: normal diet (Mr. K)
| Time | Menu | Approx. amount (raw) |
|---|---|---|
| 6.00 am | Coffee | Toned milk 100 mL, sugar 5 g |
| 8.00 am | Idli (3) with sambar and tomato chutney | Rice 60 g + urad dal 15 g; tur dal 15 g, vegetables 80 g, oil 5 g |
| 11.00 am | Banana | 1 medium (100 g) |
| 1.00 pm | Rice, sambar, keerai poriyal, curd | Rice 115 g; tur dal 20 g, vegetables 50 g; greens 100 g; oil 6 g; curd 100 g |
| 4.00 pm | Tea with green gram sundal | Toned milk 100 mL, sugar 5 g; whole green gram 25 g, oil 2 g |
| 8.00 pm | Chapati (3), vegetable kurma, moong dal | Atta 75 g, oil 5 g; vegetables 100 g, oil 4 g; moong dal 20 g |
| 9.30 pm | Milk | Toned milk 150 mL, sugar 5 g |
Worked calculation: Mr. K's normal diet
Mr. K, 40 years, 170 cm, 66 kg, sedentary, is on a normal hospital diet after a hernia repair. Find his IBW, energy and protein needs, and check the sample menu against them.
- IBW (Broca's index less 10%) = (170 − 100) × 0.9 = 70 × 0.9 = 63 kg. His actual weight, 66 kg (BMI 22.8), is close to this, so plan on 63 kg.
- Energy = 63 kg × 30 kcal/kg (sedentary, in hospital) = 1890, rounded to 1900 kcal. (ICMR-NIN 2020 gives 2110 kcal for a sedentary 65 kg man, about 32 kcal/kg.)
- Protein = 63 kg × 1.0 g/kg = 63 g (the ICMR-NIN 2020 RDA is 0.83 g/kg, i.e. 52 g; a little extra helps healing after surgery).
- Approximate values used (kcal and g protein per 100 g raw unless stated; rounded from Indian food composition tables, mainly IFCT 2017 and the older Nutritive Value of Indian Foods; a few, such as toned milk, are estimates): toned milk 60 and 3 per 100 mL; sugar 400; rice 355 and 8; urad dal 325 and 23; tur dal 330 and 22; mixed vegetables 30 and 1.5; oil/ghee 900; banana 100 and 1.2; greens 35 and 3; curd 60 and 3; whole green gram 325 and 23; atta 320 and 10.5; moong dal 325 and 24.
- Cereals (rice 175 g, atta 75 g): 861.3 kcal, 21.9 g protein.
- Pulses (urad dal 15 g, tur dal 35 g, whole green gram 25 g, moong dal 20 g): 310.5 kcal, 21.7 g protein.
- Milk and milk products (toned milk 350 mL, curd 100 g): 270.0 kcal, 13.5 g protein.
- Vegetables (mixed vegetables 230 g, greens 100 g): 104.0 kcal, 6.5 g protein.
- Fruits (banana 100 g): 100.0 kcal, 1.2 g protein.
- Oil and ghee (oil/ghee 22 g): 198.0 kcal.
- Sugar (sugar 15 g): 60.0 kcal.
- Energy = 861.3 + 310.5 + 270.0 + 104.0 + 100.0 + 198.0 + 60.0 = 1903.8 kcal.
- Protein = 21.9 + 21.7 + 13.5 + 6.5 + 1.2 = 64.8 g.
- Compare with the prescription: energy 1903.8 ÷ 1900 × 100 = 100%; protein 64.8 ÷ 63 × 100 = 103%.
- Each group is rounded to one decimal and the totals are the sums of those rounded figures; all values are approximate.
IBW 63 kg; prescription about 1900 kcal and 63 g protein. The sample menu gives about 1904 kcal (100%) and 65 g protein (103%), so it meets the prescription.
Preparation and serving tips, and result
- Cook to normal texture, season mildly, and serve hot food hot and cold food cold.
- Measure oil with a teaspoon (1 level tsp ≈ 5 g ≈ 45 kcal) so the day's total stays near 20-25 g.
- Add salt only while cooking, not at the table, to keep the day below 5 g.
- Serve on a clean covered tray labelled with the patient's name, bed number and diet; send meals at fixed times.
- One colourful vegetable and one fruit on each tray make the meal attractive for a patient with poor appetite.
- Result: A normal hospital diet was planned for Mr. K (IBW 63 kg). It gives about 1904 kcal and 65 g protein against a prescription of 1900 kcal and 63 g protein.
In the hospital diet kitchen, the normal diet is the base menu cooked in bulk. Most therapeutic diets are made by changing it: less salt for a cardiac patient, mashed for a semi-solid diet, no sugar for a diabetic. If you can plan and calculate the normal diet, you can plan every other diet.
Short answer: “What is a normal hospital diet?” A balanced diet meeting the ICMR-NIN 2020 requirements for a patient who needs no change in nutrients or texture. It is the base from which therapeutic diets are made.
Short answer: “How is ideal body weight calculated?” Broca's index: height in cm − 100. Many Indian manuals take 10% less, (height − 100) × 0.9. For 170 cm: 70 × 0.9 = 63 kg. Some dietitians use a BMI-based weight instead: about 22 × height in m², e.g. 22 × 1.7 × 1.7 ≈ 64 kg.
Structured question: “Explain the principles of planning a normal hospital diet.” Meets ICMR-NIN 2020 needs at the sedentary level (about 30 kcal/kg IBW); protein 0.83-1 g/kg; carbohydrate 55-60% and fat 20-30% of energy; all food groups for vitamins, minerals and fibre; salt below 5 g; 2-2.5 L fluid; familiar, mildly spiced, attractive and hygienic food at fixed times; base for therapeutic diets. Check the menu total against the prescription.
I-E-P-M-C: IBW → Energy → Protein → Menu → Check. The same five steps open every diet in this paper.