Carbohydrates have 4 calories per gram. So, calories present in 90g carbohydrates = 4*90 = 360 calories
Proteins also have 4 calories per gram. So, calories present in 10g proteins = 4*10 = 40 calories
Fats have 9 calories per gram. So, the calories present in 10g fats = 9*10 = 90 calories
So, total calories in the patient’s diet = 360 + 40 + 90 = 490 calories.