The document provides guidelines for estimating desirable body weight and nutrient requirements for individuals. It outlines several methods for determining desirable body weight for adults and children based on factors like height, gender, and age. It also describes equations for estimating energy and protein requirements for different populations, including adults, infants, children, pregnant/lactating women, and patients under stress or with medical conditions. Formulas are provided to calculate nutrient needs based on body weight, physical activity levels, and medical factors.
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Anthropometric Measurements
The document provides guidelines for estimating desirable body weight and nutrient requirements for individuals. It outlines several methods for determining desirable body weight for adults and children based on factors like height, gender, and age. It also describes equations for estimating energy and protein requirements for different populations, including adults, infants, children, pregnant/lactating women, and patients under stress or with medical conditions. Formulas are provided to calculate nutrient needs based on body weight, physical activity levels, and medical factors.
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Anthropometric Measurements
I. Estimating Desirable Body Weight (DBW) for Adults
A. Tanhausers Method (or Broca Method) 1. Measure height in centimeters. 2. Deduct from this the factor 100. The answer is the DBW in kg. 3. The DBW obtained applis to Filipino stature by taking off 10%.
Example: Height 52 =62 DBW (kg) =62 x 2.54 = 157 cm 100 = 57.48 kg =57.48 kg 5.74 (10%) =51.74 or 52 kg
B. Hamwi Method Gender Height Calculations Male first 5 feet Allow 106 pounds + 6 pounds for each inch over 5 feet Female first 5 feet Allow 100 pounds + 5 pounds for each inch over 5 feet
C. Nutritionist-Dietitian Association of the Philippines (NDAP) formula Gender Height Calculations Male first 5 feet Allow 112 pounds + 4 pounds for each inch over 5 feet Allow 112 pounds - 4 pounds for each inch below 5 feet Female first 5 feet Allow 106 pounds + 4 pounds for each inch over 5 feet Allow 106 pounds - 4 pounds for each inch below 5 feet II. Estimating DBW for Infants and Children A. Infants 1. 0 6 months DBW (g) = Birth weight (g) + (age in months x 600) (If the birth weight is unknown, use 3000 g)
2. 7 12 months a. DBW (g) = Birth weight (g) + (age in months x 500) b. DBW (kg) = (Age in months 2) + 3
B. Children DBW (kg) = (Age in years x 2) + 8
III. Adjust Weight for Amputations Hand <5% Forearm 3.0% Arm at shoulder 6.5% Foot 2.0% Below the knee 6.0% At the knee 9.0% Above the knee 12.0% Entire leg 19.0%
Determination of Nutrient Requirements I. Estimating Energy Requirements of Adults A. Harris-Benedict Equation 1. Males BEE = 66.47 + [13.75 x weight (kg)] + [5.0 x height (cm)] [6.76 x age (years)] = ___kcal/day 2. Females BEE = 655.1 + [9.56 x weight (kg)] + [1.85 x height (cm)] [4.68 x age (years)] = ___kcal/day
*To estimate total energy requirements, the BEE (as calculated as above) must be multiplied by an activity factor (AF) and an injury factor (IF) [i.e. TER = BEE x AF x IF] Activity and Injury Factors Activity Factors Bed rest 1.0-1.1 Moderate 1.6-1.7 (AF) Very light 1.2-1.3 Heavy 1.9-2.1 Light 1.4-1.5 Strenuous 2.2-2.4 or exceptional *Use lower factor for females; higher factor for males
Injury Factors No illness/nonstress 1.0 (IF) Convalescence, mild malnutrition 1.1 Post-operative (no complication) Mild illness, noncatabolic Confined to bed 1.2 Ambulatory/out of bed 1.3 Infections and stress, catabolic Mild 1.2-1.3 Moderate 1.4-1.5 Severe, hypercatabolic 1.6-1.8 Sepsis 2.0-2.2 Burns <20% body surface 1.2-1.4 20-40% body surface 1.5-1.7 >40% body surface 1.8-2.0 Fracture, long bone 1.2-1.3 Respiratory/renal failure 1.4-1.5 COPD 1.4-1.8 Cancer with chemotherapy or radiation, cardiac cachexia 1.5-1.6 Surgery, minor/elective 1.1-1.2 Surgery, major 1.2-1.3 Trauma, skeletal/blunt 1.3-1.4 Trauma, multiple/head injury 1.5-1.6
B. Short Method for Estimating Energy Requirements 1. Activity Level kcal/kg BW Bed rest but mobile (hospital patients) 27.5 Very light or sedentary (mostly sitting down) 30.0 Light (tailor, nurse, physician, jeepney driver) 35.0 Moderate (carpenter, painter, heavy housework) 40.0 Very active (swimming, lumberman) 45.0
2. Stress condition Overweight/weight reduction 20 Nonstress, bed rest 25 Mild stress, bed rest ambulatory 35 Moderate stress, bed rest, ambulatory 40 Severe stress, polytrauma, hypermetabolic, sepsis 45 Surgery, elective/minor 32 Surgery, major, bed rest 35 ambulatory 38 Burn, major, bed rest 45 50 ambulatory 55 60
Cancer 35 45 Predialysis 40 50 Hemodialysis 35 Peritoneal dialysis 30 *Calorie allowances per kg body weiht for different activity levels and stress conditions
C. Estimating Energy Requirements of Infants and Children 1. Infants Age (months) Kcal/kg DBW 0-6 120 7-12 110 2. Children TEA/day = 1000 + (100 x age in years)
D. Estimating Energy Requirements for Pregnant and Lactating Women 1. Pregnant women (2 nd and 3 rd trimester) TEA/day = normal requirement + 430 kcal 2. Lactating women 1 st 6 months: TEA/day = normal requirement + 500 kcal next 6 month: TEA/day = normal requirement + 440 kcal
II. Estimating Protein Requirements A. Estimation of Protein Requirements of Adults Protein Requirements (g/kg DBW/day) Stress Level Normal 1.1 Mild stress 1.1-1.2 Moderate stress 1.3-1.4 Severe stress 1.5-1.7 Polytrauma, infection 1.8-2.4 Severe sepsis, major burn, head injury 2.5-3.0 Surgery, minor/elective 1.2-1.3 Surgery, major 1.4-1.5
B. Normal Protein Allowances Protein Requirement (g/kg DBW/day) Infants 2.5 3.0 Children 2.0 Adolescent 1.5 Adults 1.1
Other computations I. Recommended Distribution for Carbohydrate, Protein, and Fat Nutrients Distribution Carbohydrate 55 70% of TEA Proteins 10 15% of TEA Fat 20 30% of TEA
II. Curreri Formula Estimating the Energy and Protein Requirements for Burn Patients Adults TER (kcal) = [25 kcal x preburn body weight (kg)] + [40kcal x %TBSA burned] Protein (g) = (1.1g/kg x preburn body weight) + (3g x %TBSA burned) *TBSA total body surface
III. Temperature Conversion F = 9/5C + 32 C = 5/9 ( F 32)
Temperature: Boiling point of water 100C 212F Body temperature 37C 98.6F Freezing point of water 0C 32F