HEALTH SYSTEM: NUTRITION & DIET • spares protein from being used for - Males 5ft 112 lbs

n from being used for - Males 5ft 112 lbs ± 4lbs for every
energy (like carbohydrates) inches above (below) 5ft
NUTRITION • Dietary vehicle for vitamins A, D, E & K - Female 5ft 106 lbs ± 4lbs for every
• Science that deals with the process by which • Controls body temperature inches above (below) 5ft
components of food are made available for an • Protection against injury 𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕 − 𝑫𝑩𝑾
= 𝒙 𝟏𝟎𝟎
organism for: - RDA: 20-30% 𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕
- meeting energy requirements, building and - Energy yield: 9 kcal/g
maintaining. 3. PROTEINS INTERPRETATION
- maintaining an optimum function state. - Food source: - Obese if body weight is more than 20%
o Animal foods: fish, meat, poultry, and above the desirable weight
ESSENTIAL COMPONENTS OF NUTRITION other internal organs, seafoods - Overweight if the weight is > 10-20%
1. CARBOHYDRATES (crab, shrimps, shellfish) above the desirable weight
- prime importance in the diet o Plant foods: dried beans, mongo, - Normal if the weight is ±10% of the
- Food Sources: soybean, garbanzos, peanuts, desirable body weight
o Starches (Plain cooked rice, maize, beans, nuts, rice and bread - Underweight if the weight if >10%
bihon, puto); NUTRITIONAL STATUS below the desirable weight
o root crops (camote, cassava, gabi, ADULTS
potato); For adults aged 20 years or older, BMI fall into DETERMINATION OF TOTAL ENERGY
o fruits; sugar; one of these categories: REQUIREMENT (TER) OR TOTAL CALORIC
o vegetable (upo, beets, carrots, - Underweight ALLOWANCE (TCA)
patani, batao) - Normal • FACTORIAL METHOD
- providing the: - Overweight TCA/TER = BMR + PA + SDA
o major source of energy intake (40- - Obese
80% of total energy intake for BMI SDA = Specific Dynamic Action
Filipinos) for work and development 𝒘𝒆𝒊𝒈𝒉𝒕 (𝒍𝒃𝒔) (Thermogenic effect of blood)
because of the following reasons: = 𝒙 𝟕𝟎𝟑
𝒉𝒆𝒊𝒈𝒉𝒕𝟐 (𝒊𝒏) - The energy required for digestion,
1. Carbohydrates are readily 𝒘𝒆𝒊𝒈𝒉𝒕 (𝑲𝒈) absorption, transport, and utilization of
available being widely = food
𝒉𝒆𝒊𝒈𝒉𝒕𝟐 (𝒎)
distributed in a variety of
𝒘𝒆𝒊𝒈𝒉𝒕 (𝒌𝒈) - SDA = (BMR + PA) x 0.06 adult (≥12 y/o)
easily grown plants such as = 𝒙 𝟏𝟎, 𝟎𝟎𝟎 x 0.15 child (<12 y/o)
grains, vegetables and fruits. 𝒉𝒆𝒊𝒈𝒉𝒕𝟐 (𝒄𝒎)
PA = Physical Activity
2. The cost in the total food - Hospital patient – 10%
budget is relatively small INTERPRETATION
- Sedentary – 30%
3. Provides quick and sustained BMI WEIGHT STATUS - Light – clerks, typist (50%)
body fuel from rapid oxidation Below 15 Emaciated/Skinny - Moderate – housewives, shoemaker,
of starches and sugars 15 – 18.5 Underweight jeepney drivers, students, fishermen
yielding the needed body 18.6 – 24.9 Normal gaunt (75%)
heart and energy with CO 2 25.0 – 29.9 Overweight - Heavy – construction workers (100%)
and water as end products 30.0 – 39.9 Obese - PA = BMR x % physical activity
(TCA) 40 or more Morbidly Obese classification
- RDA (required daily allowance): 55-70% BMR = Basal Metabolic Rate
of TCA DESIRABLE BODY WEIGHT (DBW) - Minimum amount of energy needed to
- Energy yield: 4kcal/g It can be determined by: maintain the vital process of life under
2. FATS a. Height-weight tables of FNRI basal condition
- Saturated fatty acids – animal source b. Modified Tannhausers method in the - 1 kcal/kg of body weight/hour
like meat, eggs, milk fat absence of height-weight tables - BMR = 1kcal/kg x DBW x 24 hrs
- Unsaturated fatty acids – plant source • NDAP method
like vegetable oil (olive oil, peanuts. FORMULA: - Total Caloric Allowance = DBW x 40
almonds, avocado oil) DBW(kg) = (height in cm – 100) – - To lose 1-2 lb/week, subtract 500kcal
- FUNCTIONS (10%[height in cm – 100]) daily from the calculated TCA
• source of fuel for the body to store and
burn as needed for energy NADP FORMULA:
 - Add same amount of kcal to gain 1-2 = 1200 x 0.75 A. A. Usual age 0 – 2 y/o
lb/week = 900 kcal B. Essential features
NDAP Recommendation for SDA = (BMR + PA) x 0.06 1. Edema Lower legs,
Overweight/Obese adult None sometimes face or
= 2100 x 0.06
1. Compute allowance base on DBW generalized
= 126 kcal
and subtract 500kcal/day 2. Wasting Gross loss “all Sometimes
1200kcal + 900 kcal + 126 kcal = 2226 kcal skin and hidden;
2. If only moderately overweight,
bones” sometimes fat
recommend exercise and avoidance d. NDAP method 3. Muscle wasting Obvious Sometimes hidden
of fats and sugar TCA/TER = DBW x 40 4. Growth retardation Obvious Sometimes hidden
= 50 x 40 5. Mental changes Usually irritable.
Usually
EXAMPLE COMPUTATION FOR DBW, TCA AND = 2226 Moaning, also
apathetic, quiet
DISTRIBUTION of the TCA into apathetic
CARBOHYDRATES, PROTEINS AND FATS C. Variable features
PEDIATRICS
• Filipino female, moderately active adult, 5 ft 1 1. Appetite Usually good Usually poor
1. Waterlow Classification for Wasting 2. Diarrhea Often (past or Often (past or
inch (155cm) weighing 130 lbs (59kg) classify the Computation: present) present)
nutritional status of your patient. 𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕 3. Skin changes Occasional – flaky
• Compute for the dietary intake needed to loose or = 𝒙 𝟏𝟎𝟎
𝒊𝒅𝒆𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕 𝒇𝒐𝒓 𝒂𝒄𝒕𝒖𝒂𝒍 𝒍𝒆𝒏𝒈𝒕𝒉 𝒐𝒓 𝒉𝒆𝒊𝒈𝒉𝒕 Seldom paint of enamel
gain 2 lbs/week if adjusted intake for Classification: dermatosis
carbohydrates is 60%, proteins is 10% and fats is Normal > 90% 4. Hair changes Often – sparse,
30%. Mild 80-90% straight, silky,
Seldom
Moderate 70-80% dyspigmentation;
Severe <70% gray or reddish
1. DBW
5. Moonface Seldom Often
a. Modified Tannhauser Method 2. Waterlow Classification for Stunting 6. Hepatic
DBW (kg) = (ht in cm – 100) – (10%[ht in cm – 100]) Computation: Seldom Always
enlargement
= (155 – 100) – (55 x 0.1) 𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕 𝒐𝒓 𝒍𝒆𝒏𝒈𝒕𝒉
= 𝒙 𝟏𝟎𝟎
= 50kg 𝒊𝒅𝒆𝒂𝒍 𝒉𝒆𝒊𝒈𝒉𝒕 𝒐𝒓 𝒍𝒆𝒏𝒈𝒕𝒉 𝒇𝒐𝒓 𝒂𝒈𝒆
b. NDAP method Classification:
Female 5ft 106lbs Normal > 95%
Mild 90-95%
1 inch 4 lbs
Moderate 80-90%
110 lbs (50kg) Severe <80%

𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕 − 𝑫𝑩𝑾 3. Gomez Classification

= 𝒙 𝟏𝟎𝟎
𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕 Computation:
𝒂𝒄𝒕𝒖𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕
= 𝒙 𝟏𝟎𝟎
𝟓𝟗𝒌𝒈 − 𝟓𝟎𝒌𝒈 𝒊𝒅𝒆𝒂𝒍 𝒘𝒆𝒊𝒈𝒉𝒕
= 𝒙 𝟏𝟎𝟎
𝟓𝟗𝒌𝒈 Classification:
= 15% Normal 91-100
** 59 kg is between 10-20% above the DBW of kg = 1st degree malnutrition 76-90
2nd degree malnutrition 61-75
overweight **
3rd degree malnutrition <60
PROTEIN-ENERGY MALNUTRTION
c. Factorial method MARASMUS
BMR = 1kal/kg x DBW x 24 hrs - Balanced starvation
= 1 x 50 x 24 - Very low in both protein and calories
= 1200 kcal - Caused by insufficient intake of milk
KWASHIORKOR
PA = BMR x % activity
MARASMUS KWASHIORKOR