NUTRITIONAL

ASSESSMENT AND
DIETARY CALCULATIONS
ESTIMATING HEIGHT STATURE

CHILDREN
Height or Length at birth

1 year : + 24 cm.
2 years : + 12 cm.
3 years : + 8 cm.
4 to 8 years : + 6cm. every year
ESTIMATING HEIGHT STATURE
 Knee Height Measurements to
Approximate Height ( for ages
65-90)
 Equipment: Sliding Broad Blade Caliper
 Derive Height using the following
formula
 Height in cm (women)= (1.83xKH) -
(0.24x age in years) + 84.88
 Height in cm (men)= (2.02xKH) – (0.04x
age in years) + 64.19
ESTIMATING HEIGHT STATURE

 ARM SPAN
 Use for people who cannot stand
 Arms are extended straight out to the side 90
degrees angle from the body, distance from
the longest fingertip of one hand is measured
to longest fingertip of the other hand.
 Height in cm (Male)= 118.24 + (0.28 x arm
span) – (0.07 x age)
 Height in cm (Women)= 63.18 + (0.63 x arm
span) – (0.17 x age )
 ESTIMATING DESIRABLE BODY
WEIGHT

 INFANTS
 First 6 months

DBW (gms) = Birth weight (gms) +

(age in months x 600)
• If birth weight is not known, use 3000 grams

 7-12
months
DBW= Birth weight (gms) + (age in
months x 500)

 DBW (kg.) = (age in months / 2) + 3

 ESTIMATING DESIRABLE BODY
WEIGHT

 CHILDREN
 DBW (kg) = ( age in years x 2 ) + 8
 ESTIMATING DESIRABLE BODY
WEIGHT OF ADULTS

A. Tannhauser’s Method
 Measure height in centimeters. Deduct
from this factor 100and the answer is the
DBW in kg. The DBW obtained applies to
Filipino stature by taking off 10%

 example: Height 5’2’’ or 62 inches

DBW= 62 inches x 2.54= 157.48 cm. – 100
= 57.48 – 5.74 (10% of 57.48)
= 51.74 0r 52kg.
 ESTIMATING DESIRABLE BODY
WEIGHT OF ADULTS

B. Adopted Method
 For 5 feet, use 105 lbs. For every inch
above 5 feet, add 5 lbs.
 Example:
 Height: 5’2’’
5 feet = 105 lbs
2 inches = 5 x 2 = 10 lbs.
DBW = 115 lbs or 52 kg.
 ESTIMATING DESIRABLE BODY
WEIGHT OF ADULTS

C. Derived Formula Based on Body

Mass Index
 DBW (kg)= Desirable BMI x H (m)2

 Desirable BMI for men = 22

 Desirable BMI for women = 20.8 or 21
 Example:
 Male 5’3’’ 0r 1.6 meter tall

DBW (kg) = 22 x (1.6m)2

= 22 x 2.56m
= 56.32 or 56 kg.
 ESTIMATING DESIRABLE BODY
WEIGHT OF ADULTS

D. Hamwi Equation
Women : DBW(lbs)= 100lbs for first 5 feet of
height, + 5 lbs for each additional inch

Men : DBW(lbs)= 106 lbs for first 5 feet, + 6

lbs for each additional inch

* + / - 10% for frame size

 ASSESSMENT OF FRAME SIZE

 Wrist Circumference
 Frame size=Height(cm)/Wrist circumference
(cm)

Small Medium Large

Men > 10.4 10.4-9.6 < 9.6

Women >10.9 10.9-9.9 < 9.9

 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

1. Calculation of % IBW
% IBW = (Actual Weight / IBW) x 100

% IBW Interpretation
>= 200% Morbidly obese
> 130 % Obese
110-120% Overweight
91-109% Normal
80-90% Mild malnutrition
70-79% Moderate
malnutrition
< 69% Severe malnutrition
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

 Usual Body weight

% Usual Body Weight= (Actual weight
/ Usual Weight) x 100

% Usual Body Interpretation

Weight

85% - 90% Mild malnutrition

75% - 84% Moderate malnutrition

< 74% Severe malnutrition

 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

 Percent Weight Loss

% Weight loss= (Usual BW-Actual
BW/ Usual Body Weight) x 100

Significant Weight Severe Weight Loss

Loss
5% over 1 month > 5% over 1 month

7.5% over 3 months > 7.5 % over 3 months

10% over 6 months > 10% over 6 months

 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

Estimate of Pediatric Malnutrition

Estimate of Severity of Protein-Calorie Deficiency

Mild Moderate Severe

Malnutrition Malnutrition Malnutrition
Percent Ideal 80-90% 70-79% < than 70%
Body Weight
Percent of 90-95% 80-89% <80%
Usual Body
Weight
INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

Percent Ideal Body Weight =

Actual Weight/Ideal Body Weight
X 100

Percent Usual Body Weight =

Actual Weight/Usual Body Weight
X 100
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

GOMEZ CLASSIFICATION OF
MALNUTRITION IN CHILDREN

The child’s weight is compared to that of a normal

child (50th percentile) of the same age. It is
useful for population screening and public
health evaluations.
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS
Percent of Reference Weight for Age =
Patient’s weight/Weight of normal child of the same age X 100

Percent of Reference Interpretation

Weight for Age

90-110% normal

75-89% 1st Degree or mild

malnutrition

60-74% 2nd Degree or moderate

malnutrition

<60% 3rd Degree or severe

malnutrition
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

Wellcome Classification of
Malnutrition in Children
- It evaluates the child with edema with the
Gomez Classification System
- It does not differentiate acute from chronic
malnutrition

Wt for Age With Edema Without Edema

60-80% Kwashiorkor Undernutrition
<60% Marasmic Kwashiorkor Marasmus
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS
Waterlow Classification of Malnutrition in
Children
-Chronic malnutrition affects a child’s growth
eventually resulting in reduced stature
(stunting). Malnutrition also affects the child’s
body proportions eventually resulting in body
wastage.

Percent Weight for Height = weight of

patient/weight of normal child of the same
height X 100
INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

Percent Height for Age = Height of

patient/height of normal child of the
same age X 100

Weight for Height Height for Age

Wasting Stunting

Normal >90% >95%

Mild 80-90% 90-95%
Moderate 70-80% 85-90%
Severe <70% <85%
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS
 BODY MASS INDEX (BMI)
An indicator of nutritional status
expressed as body weight corrected for
height with the underlying assumption
that the ratios are highly correlated
with chronic energy deficiency (CED)
and adiposity.
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

o Body Mass Index

BMI (kg/m2) = weight (kg/ height(meter)2

 Interpretation:
 <18.0 Underweight
 18-24.9 Normal
 25-29.9 Overweight
 30-40 Obese
 > 40 Very Obese
 INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

 BMI
The Food and Nutrition Research
Institute of the Department of Science
and Technology (FNRI_DOST) used
the following internationally-accepted
classification for BMI.
INTERPRETATION OF BODY
WEIGHT MEASUREMENTS

CLASSIFICATION BMI VALUE

Severe CED Less than 16
Moderate CED 16 to less than 17
Mild CED 17 to less than 18.5
Normal 18.5 to less than 25
Overweight 25 to less than 30
Moderately Obese 30 to less than 40
Severely Obese 40 +
 INTERPRETATION OF BODY
MEASUREMENTS

 Waist Circumference
 An indicator of body fat distribution,
hence risk of cardiovascular disease.

 Values above 102 cm- men

 Values above 88 cm – women
 Indicates central body fat distribution, hence
an increased risk for dyslipidemia and
cardiovascular diseases.
 INTERPRETATION OF BODY
MEASUREMENTS

 Waist-Hip Ratio
 An indicator of body fat distribution
 W/H Ratio = waist circumference (in)/
hip circumference (in)
 A W/H ratio of 0.85 for women and 1.0
for men indicate central body fat
distribution hence a risk to dyslipidemia,
cardiovascular disease, NIDDM and other
diseases related to obesity.
 ESTIMATING TOTAL ENERGY
REQUIREMENT

 Infants (0-6 months)

 TER/day = 120 kcal / KDBW

 Infants (7-12 months)

 TER/day = 110 kcal /KDBW
 ESTIMATING TOTAL ENERGY
REQUIREMENT

 Children
 A. TER/day = 1000 + (100 x age in
years)
 B. Reference Range (RENI 2002)
 1-3 years old 82.3 kcal
 4-6 years old 74.2 kcal
 7-9 years old 66.6 kcal
 10-12 years old 62.9 kcal (boys)
55 kcal (girls)
 ESTIMATING TOTAL ENERGY
REQUIREMENT

 Adolescents
 A. Reference Range ( RENI 2002)
 13-15 years old 56 kcal (boys)
45.9 kcal (girls)
 16-18 years old 50 kcal (boys)
40 kcal (girls)
 ESTIMATING TOTAL ENERGY
REQUIREMENT OF ADULTS

 A. Method I ( Cooper et. Al)

TER/day = Basal metabolic Needs
=1 cal KDBW/hr
+ Physical Activity = % above basal

Bed Rest 10
Sedentary 30
Light 50
Moderate 75
Heavy 100
 ESTIMATING TOTAL ENERGY
REQUIREMENT OF ADULTS

 B. Method II (Krause)
TER/day = Cals/KDBW/Day

Activity
Bed Rest 27.5
Sedentary 30
Light 35
Moderate 40
Heavy 45
 ESTIMATING TOTAL ENERGY
REQUIREMENT OF ADULTS

 C. NDAP FORMULA
Activity Level Male Female
In bed but mobile 35 30
Light 40 35
Moderate 45 40
Heavy 50 -

Example of activities:
Sedentary – secretary, clerk, cashier, teller
Light- teacher, nurse, students
Moderate- housewife w/o maid, vendor, jeepney driver
Heavy- farmer, laborer, fisherman
 ESTIMATING TOTAL ENERGY
REQUIREMENT OF ADULTS

 D. Harris Benedict Formula

HBEE (males)
= 66.47 + 13.75(W) + 5(H) – 6.78(A)
HBEE (females)
= 655.1 + 9.56 (W) +1.85(H) – 4.68(A)

Where:
W = weight in kg.
H= Height in cm.
A= Age in years
 ESTIMATING TOTAL ENERGY
REQUIREMENT OF ADULTS

 FOR WEIGHT GAIN (1 lb. per

week)
Add 500 kcal to TER

 FOR WEIGHT LOSS (1 lb per

week)
Deduct 500 kcal from TER
 ESTIMATING TOTAL ENERGY
REQUIREMENT OF ADULTS

 PREGNANT WOMEN (2nd and 3rd

Trimester)

TER/day = Normal Requirement + 300

kcal

 LACTATING WOMEN
TER/day= Normal Requirement = 500
kcal
Distribution of TER Into Carbohydrates,
Protein and Fats

 Method I- by percentage
distribution
% of TER
1. Carbohydrates 50-70%
2. Proteins
Infants 10%
Adults 10-12%
3. Fats
Normal Adults 20-25%
Children, adolescents 30-35%
Distribution of TER Into Carbohydrates,
Protein and Fats

 Method II- NPC Method

Determine the protein calories first
according to the normal allowances in
gms/KBW and divide the non-protein
calories (NPC) into:

CHO: 55-80% or an average of 70%

Fats: 20-45 % or an average of 30%
Distribution of TER Into Carbohydrates,
Protein and Fats

 Normal protein allowances per day

gm/KDBW
Infants 1.6
Children 1.5-2.0
Adolescents 1.2
Adults 1.1
SEATWORK # 1

 Mrs. Annie Reyes is a 25 years old

teller who is 5’2’’ tall and present
weight is 59 kg. She is 5months
pregnant. Her pre-pregnancy weight
was 115 lbs.She has good appetite.
Guide Questions:

 What is her nutritional status prior

to pregnancy?
 How much weight did she gain? Is
her weight gain normal?
 What is your diet prescription for
her?
 Make a 1 day sample menu
Take Home Exercise # 1
 Aaron Cruz is a 6 years old kid who weighs
15kg. He was 52 cm. long at birth. His
present height is unknown.
 What is his nutritional status?
 What should be his height now based on
his birth length?
 What should be his dietary prescription?
 What are the nutrients that should be
increase in his diet?
 Make a one day sample menu.
Take Home Exercise #2
 Mr. Pedro Perez is 70 years old man who is
5’7’’ tall and with present weight of 53 kg.
He has poor appetite and difficulty in
chewing because of his poor dentures.
 What is his nutritional status?
 What is your diet prescription?
 What are the modifications needed in his
diet to increase his food intake?
 Give practical tips on how to improve his
appetite.
 Make a one day sample menu.