Nutrition and Diet

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NUTRITION

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Science that deals with the process by

which components of food are made
available for an organism for meeting
energy requirements, building and
maintaining and in more general terms,
for maintaining the organism in an
optimum function state.

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I. CARBOHYDRATES

prime importance in the

diet

Food sources:
Starches (Plain cooked rice,
maize, bihon, puto); root
crops (camote, cassava,
gabi, potato);fruits; sugar;
vegetable (upo, beets,
carrots, patani, batao)
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I. CARBOHYDRATES

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providing the major source of energy

intake (40-80% of total energy intake
in different country and total energy
intake for Filipinos) for work and
development because of the following
reasons

Reasons
1.

2.
3.

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Carbohydrates are readily available being

widely distributed in a variety of easily
grown plants such as grains, vegetables
and fruits
The cost in the total food budget is
relatively small
Provides quick and sustained body fuel
from rapid oxidation of starches and sugars
yielding the needed body heat and energy
with CO2 and water as end products
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Carbohydrates
RDA: 55-70% of TCA
Energy yield: 4kcal/g

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II. FATS
Food Source:
Saturated fatty acids
animal source like meat,
eggs, milk fat
Unsaturated fatty acids
plant source like
vegetable oil (olive oil,
peanuts, almonds,
avocado oil)
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II. FATS
A. Functions
Containing source of fuel for the body to
store and burn as needed for energy
Like carbohydrates, fat spares protein
from being used for energy
Dietary vehicle for vitamins A, D, E and K
Controls body temperature
Protections against injury
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II. FATS

RDA: 20-30%
Energy yield: 9 kcal/g

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III. PROTEINS
D. Food source:
Animal foods: fish, meat, poultry, and other internal
organs, seafoods (crabs, shrimps, shellfish)
Plant foods: dried beans, mongo, soybean,
garbanzos, peanuts, beans, nuts, rice and bread

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ADULTS
Body Mass Index (BMI)
It is the number that shows body weight
adjusted for height.
BMI can be calculated with simple math
using inches and pounds, or meters and
kilograms.
For adults aged 20 years or older, BMI fall
into one of these categories: underweight,
normal, overweight, or obese
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Adults
For adults aged 20 years or older, BMI
fall into one of these categories:
Underweight
Normal
Overweight
obese

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BMI
BMI

BMI

BMI

wt (lbs)
________
x 703
2
h (in)

wt
(Kg)
________
h2 (m)
wt (Kg)
________

10,000

h2 (cm)

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Interpretation
BMI
Below 15
15-18.5
18.5-24.9
25.0-29.9
30.0-39.9
40 or more
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Weight status
Emaciated
Underweight
Normal
Overweight
Obese
Morbidly Obese
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DESIRABLE BODY WEIGHT

(DBW)
DETERMINATION
The DBW, and not the actual weight of
the individual is used as the basis in
the calculation of TER or TCA.

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DBW
It can be determined by:
a. Height-weight tables of FNRI
b. Modified Tannhausers method in the
absence of height-weight tables
DBW(kg) = (height in cm - 100) - (10%[ht in cm 100])

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DBW
c. NADP Formula
Males 5ft 112 lbs 4 lbs for every
inches above (below) 5ft

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Female 5ft 106 lbs 4 lbs for every

inches above (below) 5ft

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Interpretation
Obese if body weight is more than 20%
above the desirable weight
Overweight if the weight is >10%-20%
above the desirable weight
Normal if the weight is 10% of the
desirable body weight
Underweight if the weight is >-10%
below the desirable weight

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DETERMINATION OF TOTAL ENERGY

REQUIRMENT (TER) OR TOTAL CALORIC
ALLOWANCE (TCA)

Factorial Method
TCA/TER = BMR + PA + SDA

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Basal Metabolic Rate (BMR)

Minimum amount of energy needed to

maintain the vital process of life under
basal condition
1 kcal/kg of body weight/hour

BMR = 1 kcal/kg x DBW x 24 hrs

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Physical Activity (PA)

Hospital patient - 10%

Sedentary - 30%
Light - clerks, typist (50%)
Moderate - housewives,shoemaker,jeepney
drivers,students, fishermen (75%)
Heavy construction workers (100%)

PA = BMR x % physical activity classification

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Aleth Therese L. Dacanay

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Thermogenic effect of blood

(Specific Dynamic Action or SDA)

The energy required for digestion,

absorption, transport, and utilization of
food

SDA = (BMR + PA) x 0.06 adult (12 y/o)

0.15 child (<12 y/o)

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NADP method

TCA = DBW x 40

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To lose in 1-2/week, subtract 500 kcal

daily from the calculated TCA
respectively and conversely add same
amount of kcal to gain 1-2 lb/week

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NADP Recommendation
NDAP Recommendation for
overweight/obese adult
1. Compute allowance base on DBW and
subtract 500kcal/day
2. If only moderately overweight,
recommend exercise and avoidance of
fats and sugar

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Example
EXAMPLE COMPUTATION FOR DBW, TCA AND
DISTRIBUTION of the TCA into
CARBOHYDRATES, PROTEINS AND FATS
Filipino female, moderately active adult, 5 ft
1 inch (155cm) weighing 130 lbs (59kg)
classify the nutritional status of your patient.
Compute for the dietary intake needed to
loose or gain 2 lbs/week if adjusted intake
for carbohydrates is 60%, proteins is 10%
and fats is 30%.
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a.

1. DBW
Modified Tannhauser Method

DBW (kg) = (height in cm -100) (10%[height in cm-100])

= (155-100) (55 x 0.1)
= 50 kg

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NADP Method
b. NDAP method
Female 5 ft
1 inch
110 lbs

106 lbs
4 lbs
(50 kg)

Actual weight DBW x 100

____________________
Actual weight
59kg 50kg x 100 = 15%
_________________
59 kg

***59 kg is between 10-20% above the DBW of kg =

overweight
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TCA/TER
a.

Factorial method

BMR = 1 kcal/kg x DBW x 24 hrs = 1 x 50 x 24 = 1200 kcal

PA = BMR x % activity = 1200 x 0.75 = 900 kcal
SDA = (BMR + PA) x 0.06 = 2100x 0.06 =126 kcal

_____________

2226 kcal

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NADP
b. NDAP method
TCA/TER= DBW x 40= 50 x 40= 2226

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Special Considerations

To lose 2 lbs, deduct 1000 kcal from TCA = 2226 1000 =

1226 kcal

Carbohydrates = TCA x 0.60 = 736 kcal/4kcal/g = 184 gm

Proteins = TCA x 0.10 = 1226x0.10= 123 kcal/4.1g = 30

gm

Fats = TCA x 0.30= 1226 x 0.30= 368 kcal/9g

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_________
= 41 gm
255 gm

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PEDIATRICS
1. Waterlow Classification for Wasting
Computation:
Actual weight
________________
Ideal weight for actual length or height x 100 =___%

Classification:
Normal
Mild
Moderate
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Severe

>90%
80-90%
70-80%
<70%

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PEDITRICS
2. Waterlow Classification for Stunting
Computation:
Actual height or length
_______________________________________
Ideal
height or length for age x 100 =___%
_

Classification:
Normal
Mild
Moderate
Severe
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>95%
90-95%
80-90
<80%
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PEDIATRICS
Gomez Classification
Computation:
Actual weight
______________________
Ideal weight x 100
= __%
Classification:
Normal
First degree malnutrition
Second degree malnutrition
Third degree malnutrition

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91-100
76-90
61-75
<60

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PROTEIN-ENERGY MALNUTRITION

PROTEIN-ENERGY MALNUTRITION

A. Usual age
B. Essential features
1. Edema

MARASMUS
*Balanced starvation
*Very low in both protein
and calories
*Caused by insufficient
intake of milk
0-2 y/o

KWASHIORKOR
*Very low in protein, but
one in which contains
calories in the form of
carbohydrates

None

Lower legs, sometimes face

or generalized
Sometimes hidden; sometimes
fat
Sometimes hidden
Sometimes hidden
Usually irritable, moaning,
also apathetic

1-3 y/o

3. Muscle wasting
4. Growth retardation
5. Mental changes

Gross loss
all skin and bones
Obvious
Obvious
Usually apathetic, quiet

C. Variable features
1. Appetite
2. Diarrhea

Usually good
Often (past or present)

Usually poor
Often (past or present)

3. Skin changes

Seldom

Occasional flaky paint or

enamel dermatosis

4. Hair changes

Seldom

Often sparse, straight,

silky, dyspigmentation;
gray or reddish

5. Moonface
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Hepatic enlargement

Seldom
Seldom

Often
Always

2. Wasting

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