NUTRITION AND DIET

Nutrition
Science that deals with the process by which
components of food are made available for an
organism for :
Meeting energy requirements, building
and maintaining.
Maintaining an optimum function state.
Essential Components
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)
Providing the :
Major source of energy intake (40-80% of total
energy intake for Filipinos) for work and
development because of the following reason:
Carbohydrates are readily available being
widely distributed in a variety of easily grown
plant 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 CO
2
and
H
2
O as end products TCA (Total Caloric Effect).

*RDA (Required Daily Allowance) 55-70% of
*TCA Energy yield:
4kcal
/g
FATS
Food Sources:
- Saturated fatty acids (animal source like, meat,
eggs ,milk fat )
- Unsaturated fatty acids (plant source like,
vegetable oilolive oil, peanuts, almonds,
avocado oil.)
Functions:
Source of fuel for the body to store and
burn as needed for the energy.
Spares protein from being used for energy
(like carbohydrates).
Dietary vehicle for vitamins A, D, E and K.
Controls body temperature.
Protection against injury.

*RDA: 20-30%
*Energy yield:
9kcal
/g
PROTEINS
Food Sources:
- 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.

NUTRITIONAL STATUS
Based on the height and weight of the
individual.
Body Mass Index (BMI)
Shows body weight adjusted for height
calculated with simple math using inches and
pounds.
For adult aged 20 years or older, BMI fall into of
these categories:

*Underweight
*Normal
*Overweight
*Obese
BMI =

BMI =

BMI =

BMI Weight Status
Below 15 Emaciated/Skinny
15-18.5 Underweight
18.6-24.9 Normal gaunt
25.0-29.9 Overweight
30.0-39.9 Obese
40 or more Morbidly Obese
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
*Total Energy Requirement (TER) or Total Caloric
Allowance (TCA)
It can be determined by:
Height-Weight tables of FNRI
Modified Tannhausers method in absence of
Height-Weight Tables.
DBW = (height in cm- 100) (10% [ht in cm-100])
NADP Method (National Association
Development Pediatric)
Male: 5ft 112lbs 4lbs for every inch above
(below) 5 ft.
Female: 5ft 106 lbs 4lbs for every inch above
(below) 5 ft.

INTERPRETATION:
Obese if body weight is more than 20% above
the desirable body weight.
Overweight if body weight is greater than 10-
20% above the desirable body weight.
Normal if the body weight is 10% of the
desirable body weight.
Underweight if body weight is greater than 10%
below the desirable body weight.
DETERMINATOR OF TER OR TCA
FACTORIAL METHOD
TCA/ TER = BMR + PA + SDA
Specific Dynamic Action or SDA
Basal Metabolic Rate or BMR
Physical Activity or PA
BASAL METABOLIC RATE (BMR)
Minimum amount of energy needed to
maintain the vital process of life under basal
condition.

1kcal
/kg of
bodyweight
/hour
BMR=
1kcal
/kg x DBW x 24 hours
PHYSICAL ACTIVITY (PA)
Hospital patient 10%
Sedentary 30%
Light (clerk, typist) 50%
Moderate (housewives, shoemaker, jeepney,
drivers, students, fisherman) 75%
Heavy(construction workers) 100%
PA = BMR x %PA classification
THERMOGENIC EFFECT OF BLOOD (SPECIFIC
DYNAMIC ACTION)
The energy required for digestion,
absorption, transport and utilization of
food.
SDA = (BMR+PA) x 0.06 adult (12 y/o)
SDA = (BMR+PA) x 0.15 child (<12 y/o)
NADP METHOD
TCA/ TER = DBW x 40
To lose 1-2 lbs/ week , subtract 500 kcal
daily from the calculated TCA add same
amount of kcal to gain 1-2 lbs/ week.
NADP RECOMMENDATION
NADP Recommendation for overweight/ obese adult.
1. Compute allowance base on DBW and subtract
500 kcal/ day. If only moderately overweight,
Recommendation: Exercise and avoidance of
fats and sugar.

PROBLEM SOLVING
EXAMPLE COMPUTATION FOR DBW, TCA AND
DISTRIBUTION of the TCA into CARBOHYDRATES,
PROTEINS AND FATS
1. 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%.

1. Desirable Body Weight
a. Modified Tannhauser Method
DBW (kg) = (height in cm -100) (10%[height in cm-
100])
= (155-100) (55 x 0.1)
= 50 kg
b. NADP method
Female :
5 ft 106 lbs
1 inch 4 lbs
110 lbs 4 lbs

59 kg is between 10-20% above the DBW of kg =
overweight
2. Total Caloric Allowance/ Total Energy Required
Factorial method
TCA/ TER = BMR + PA + SDA
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
1200 kcal + 900 kcal + 126 kcal = 2226 kcal
a. NADP method
TCA/TER= DBW x 40
= 50 x 40= 2226
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/4g = 31 gm
Fats = TCA x 0.30= 1226 x 0.30= 368 kcal/9g = 41 gm
184 gm + 31 gm + 41 = 256 gm

PEDIATRICS
1. Waterlow Classification for Wasting
Computation:



CLASSIFICATION
Normal >90%
Mild 80-90%
Moderate 70-80%
Severe <70%

2. Waterlow Classification for Stunting
Computation:



CLASSIFICATION
Normal >95%
Mild 90-95%
Moderate 80-90%
Severe <80%

Gomez Classification
Computation:



CLASSIFICATION
Normal 91-100
First Degree Malnutrition 76-90
Second Degree Malnutrition 61-75
Third Degree Malnutrition <60





FORMULAS:
BMI =

BMI =

BMI =

1. DESIRABLE BODY WEIGHT
a. Modified Tannhausers method
DBW = (height in cm- 100) (10% [ht in cm-100])
b. NADP Method (National Association Development
Pediatric)
Male: 5ft 112lbs 4lbs for every inch above (below) 5
ft.
Female: 5ft 106 lbs 4lbs for every inch above (below)
5 ft.
2. TOTAL CALORIC ALLOWANCE/ TOTAL ENERGY
REQUIRED
a. Factorial method
TCA/ TER = BMR + PA + SDA
BMR = 1 kcal/kg x DBW x 24 hrs
PA = BMR x % activity
SDA = (BMR+PA) x 0.06 adult (12 y/o)
SDA = (BMR+PA) x 0.15 child (<12 y/o)
b. NADP method
TCA/TER= DBW x 40

PEDIATRICS
1. Waterlow Classification for Wasting
Computation:



CLASSIFICATION
Normal >90%
Mild 80-90%
Moderate 70-80%
Severe <70%

2. Waterlow Classification for Stunting
Computation:



CLASSIFICATION
Normal >95%
Mild 90-95%
Moderate 80-90%
Severe <80%

Gomez Classification
Computation:



CLASSIFICATION
Normal 91-100
First Degree Malnutrition 76-90
Second Degree Malnutrition 61-75
Third Degree Malnutrition <60


BMI Weight Status
Below 15 Emaciated/Skinny
15-18.5 Underweight
18.6-24.9 Normal gaunt
25.0-29.9 Overweight
30.0-39.9 Obese
40 or more Morbidly Obese