Maintain a Healthy, and Balanced Diet

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For Who?		By Whom?^b	How Often?
Empowerment
All women	Educate on: Composition of a healthy, balanced diet (Table 1.): Vegetables and fruits (at least 2 servings of fruit and 3 servings of vegetables per day) Meat, fish, eggs, dry beans and dairy products Grain (cereal) foods, mostly wholegrain and/or varieties high in cereal fibre Choosing a variety of foods and foods rich in nutrients, including calcium, iron, zinc, iodine, and vitamins Provide adequate energy Limit intake of saturated fat, trans fat added salt, added sugars and alcohol Practical tips for food choices (Table 2.) Beneficial effects of consuming a variety of food groups, and adverse effects of unhealthy diet	Primary Healthcare Providers	Opportunistically
Women who are planning a pregnancy	Advise adequate intake of Folic acid*: 400 mcg daily	Primary Healthcare Providers	Opportunistically
Pregnant and lactating women	Provide advices on supplements to meeting the extra nutrients needs, in particularly iodine, folate supplement during 1^st trimester and increasing demand after the 1^st trimester (Table 3.) + Advise on food safety	Trained Healthcare Professionals	Opportunistically
	Advise not to take supplements containing large quantities of vitamin A
Menopause women	Advise adequate intake of Calcium for bone health	Primary Healthcare Providers	Opportunistically
Management
Women whose Body Mass Index (BMI) is <18.5 kg/m² or ≥ 23 kg/m² and have co-morbidities	Refer to individual dietetics intervention¹	Trained Healthcare Professionals	Opportunistically

1. Empowerment

a. For Who: All women

Recommended Care Components^a:

Educate on:

Composition of a healthy, balanced diet (Table 1.):
- Vegetables and fruits (at least 2 servings of fruit and 3 servings of vegetables per day)
- Meat, fish, eggs, dry beans and dairy products
- Grain (cereal) foods, mostly wholegrain and/or varieties high in cereal fibre
- Choosing a variety of foods and foods rich in nutrients, including calcium, iron, zinc, iodine, and vitamins
- Provide adequate energy
- Limit intake of saturated fat, trans
Practical tips for food choices (Table 2.)
Beneficial effects of consuming a variety of food groups, and adverse effects of unhealthy diet

By Whom^b: Primary Healthcare Providers

How Often: Opportunistically

b. For Who: Women who are planning a pregnancy

Recommended Care Components^a:

Advise adequate intake of Folic acid*: 400 mcg daily

By Whom^b: Primary Healthcare Providers

How Often: Opportunistically

c. For Who: Pregnant and lactating women

Recommended Care Components^a:

Provide advices on supplements to meeting the extra nutrients needs, in particularly iodine, folate supplement during 1^st trimester and increasing demand after the 1^st trimester (Table 3.)

+ Advise on food safety

Advise not to take supplements containing large quantities of vitamin A

By Whom^b: Trained Healthcare Professionals

How Often: Opportunistically

d. For Who: Menopause women

Recommended Care Components^a:

Advise adequate intake of Calcium for bone health

By Whom^b: Primary Healthcare Providers

How Often: Opportunistically

2. Management

a. For Who: Women whose Body Mass Index (BMI) is <18.5 kg/m² or ≥ 23 kg/m² and have co-morbidities

Recommended Care Components^a:

Refer to individual dietetics intervention¹

By Whom^b: Trained Healthcare Professionals

How Often: Opportunistically

* in form of supplement
BMI = Body Mass Index

^a	Grade of recommendation according to colour code: Recommended (Strong) Conditionally recommended Practice points Generally not recommended Not recommended (Strong)

Primary Healthcare Providers – All providers of health services in primary healthcare settings
Primary Healthcare Professionals – Includes doctors, dentists, chinese medicine practitioners, nurses, pharmacists, physiotherapist, occupational therapist, dietitians
“Trained” Healthcare Professionals – Additional post-qualification training required to deliver the respective care component(s)

Table 1. Functions and Daily Requirement of Essential Nutrients for Healthy Adult Women^2-4

Nutrient	Functions	Daily Requirement
Energy (Calorie)*	Provides the body with fuel for various functions such as metabolism, physical activity, and organ function	2100 kcal/day for healthy women aged 18-49
Protein	Essential for building and repairing tissues, supporting immune function, and serving as enzymes and hormones	Contributes 10%-15% of daily energy intake
Carbohydrate	Main source of energy for the body, particularly important for brain function and physical activity	Contributes 55%-75% of daily energy intake
Dietary fibre	Aids in digestion, helps maintain bowel health, and may reduce the risk of chronic diseases like heart disease	Not less than 25g per day
Total fat	Provides energy, supports cell growth, helps with vitamin absorption, and serves as a protective layer for organs	Contributes 15%-30% of daily energy intake for adults
Saturated fat	Consuming too much can raise cholesterol levels and increase the risk of heart disease	Contributes not more than 10% of daily energy intake
Trans fat	Raises bad cholesterol levels (LDL) and lowers good cholesterol levels (HDL), increasing the risk of heart disease	Contributes not more than 1% of daily energy intake
Sodium	Excessive sodium (salt) intake will increase the risk of developing hypertension, stroke and coronary heart disease	No more than 5 g of salt (slightly less than 1 tea spoon) a day
Sugar	Excess intake of sugars can lead to weight gain and other health issues including tooth decay	No more than 50 g (about 10 teaspoons) of free sugars a day for a diet of 2000 kcal per day
Folic acid (folate)	Adequate intake prevents the foetus from being affected by neural tube defect (malformations of the brain and spinal cord), as well as prevents women from developing anaemia	400 mcg a day for women aged 18-64
Vitamin D	Helps calcium absorption, essential for bone health and development	10 mcg (400 IU) for women aged 18-64
Calcium	Building block for bones and teeth	1000 mg for women aged 18-64
Iron	Adequate intake ensures normal foetal growth and brain development, and prevents women from anaemia during pregnancy and after delivery	18 mg for women aged 18-49 10 mg for women after menopause
Iodine	Necessary for the normal functions of the thyroid gland Essential for foetal growth and brain development. Iodine deficiency may cause serious health consequences for the baby	150 mcg for women aged 18-64

Nutrient: Energy (Calorie)*

Functions:

Provides the body with fuel for various functions such as metabolism, physical activity, and organ function

Daily Requirement:

2100 kcal/day for healthy women aged 18-49

Nutrient: Protein

Functions:

Essential for building and repairing tissues, supporting immune function, and serving as enzymes and hormones

Daily Requirement:

Contributes 10%-15% of daily energy intake

Nutrient: Carbohydrate

Functions:

Main source of energy for the body, particularly important for brain function and physical activity

Daily Requirement:

Contributes 55%-75% of daily energy intake

Nutrient: Dietary fibre

Functions:

Aids in digestion, helps maintain bowel health, and may reduce the risk of chronic diseases like heart disease

Daily Requirement:

Not less than 25g per day.

Nutrient: Total fat

Functions:

Provides energy, supports cell growth, helps with vitamin absorption, and serves as a protective layer for organs

Daily Requirement:

Contributes 15%-30% of daily energy intake for adults

Nutrient: Saturated fat

Functions:

Consuming too much can raise cholesterol levels and increase the risk of heart disease

Daily Requirement:

Contributes not more than 10% of daily energy intake

Nutrient: Trans fat

Functions:

Raises bad cholesterol levels (LDL) and lowers good cholesterol levels (HDL), increasing the risk of heart disease

Daily Requirement:

Contributes not more than 1% of daily energy intake

Nutrient: Sodium

Functions:

Excessive sodium (salt) intake will increase the risk of developing hypertension, stroke and coronary heart disease

Daily Requirement:

No more than 5 g of salt (slightly less than 1 tea spoon) a day

Nutrient: Sugar

Functions:

Excess intake of sugars can lead to weight gain and other health issues including tooth decay

Daily Requirement:

No more than 50 g (about 10 teaspoons) of free sugars a day for a diet of 2000 kcal per day

Nutrient: Folic acid (folate)

Functions:

Adequate intake prevents the foetus from being affected by neural tube defect (malformations of the brain and spinal cord), as well as prevents women from developing anaemia

Daily Requirement:

400 mcg a day for women aged 18-64

Nutrient: Vitamin D

Functions:

Helps calcium absorption, essential for bone health and development

Daily Requirement:

10 mcg (400 IU) for women aged 18-64

Nutrient: Calcium

Functions:

Building block for bones and teeth

Daily Requirement:

18 mg for women aged 18-49
10 mg for women after menopause

Nutrient: Iodine

Functions:

Necessary for the normal functions of the thyroid gland
Essential for foetal growth and brain development. Iodine deficiency may cause serious health consequences for the baby

Daily Requirement:

150 mcg for women aged 18-64

LDL = Low-density Lipoprotein; HDL = High-density Lipoprotein
*Assuming 55kg for women with a moderate activity level

Table 2. Practical Tips in Choosing Foods in the Food Groups⁵

Food Group	DOs	DON’Ts
Eat the most Grains	Select more foods made from grains like bread, cereal, rice, and pasta Choose whole grain foods like whole wheat bread and oatmeal Prefer whole grains over refined grain foods	Avoid high-fat foods like fried rice, fried noodles, or instant noodles
Eat more Fruit and vegetables	Include plenty of fruits and vegetables in your diet for fibre, antioxidants, vitamins, and minerals Choose colourful options Opt for whole fruits over fruit juices	Avoid overcooking vegetables
Eat moderately Meat, fish, eggs, dry beans, dairy products and alternatives	Select low-fat meat, such as lean cut pork, loin, poultry without skin, fish, etc. Include protein-rich foods like dry beans and tofu Low-fat milk and skimmed milk are lower in saturated fat	Limit intake of deep-fried tofu, and tofu sticks Limit intake in processed meat, e.g. sausages, ham
Eat the least Fat, oil, sugar and salt	Use fresh foods over canned or preserved options. Minimize added sugar and salt Utilize natural seasonings for flavouring and use less oil in cooking methods	Avoid foods high in fat and sodium Reduce sugar intake

Food Group: Eat the most Grains

DOs:

Select more foods made from grains like bread, cereal, rice, and pasta
Choose whole grain foods like whole wheat bread and oatmeal
Prefer whole grains over refined grain foods

DON'Ts:

Avoid high-fat foods like fried rice, fried noodles, or instant noodles

Food Group: Eat more Fruit and vegetables

DOs:

Include plenty of fruits and vegetables in your diet for fibre, antioxidants, vitamins, and minerals
Choose colourful options
Opt for whole fruits over fruit juices

DON'Ts:

Avoid overcooking vegetables

Food Group: Eat moderately Meat, fish, eggs, dry beans, dairy products and alternatives

DOs:

Select low-fat meat, such as lean cut pork, loin, poultry without skin, fish, etc.
Include protein-rich foods like dry beans and tofu
Low-fat milk and skimmed milk are lower in saturated fat

DON'Ts:

Limit intake of deep-fried tofu, and tofu sticks
Limit intake in processed meat, e.g. sausages, ham

Food Group: Eat the least Fat, oil, sugar and salt

DOs:

Use fresh foods over canned or preserved options. Minimize added sugar and salt
Utilize natural seasonings for flavouring and use less oil in cooking methods

DON'Ts:

Avoid foods high in fat and sodium
Reduce sugar intake

Table 3. Key Differences in Energy and Nutrient Requirements across Life Stages Key Points about Changes in Nutritional Needs during Pregnancy

Further Readings Community Resources Reference Materials for Healthcare Professionals Education and Self-Help Materials for the General Public References