BASIC TOOLS IN NUTRITION those from which the bran and germ portion

of the grain has been removed through

The Food Guide Pyramid
milling. The ideal intake is 3 to 4 ounces per
 Teaches the principle of eating a day.
variety of foods every day at the right
6.) Oils - The oil group includes healthy fats
amounts.
and foods that are naturally high in healthy
 The guide teaches moderation in
oils, such as nuts, olives, avocados and some
some while emphasizing the
fish. / daily oil allowance falls between 5 and
importance of other foods.
7 teaspoons
 The Food Guide Pyramid is but one of
the many nutritional and dietary tools 10 NGF (Nutritional Guidelines for Filipinos)
and guidelines developed by the FNRI
- a set of dietary guidelines based on the
to help the Filipino achieve good
eating pattern, lifestyle, and health status of
health and nutrition.
Filipinos. Contains all the nutrition messages
What Are the Categories of Food in the Food to healthy living for all age groups from
Guide Pyramid? infants to adults, pregnant and lactating
women, and the elderly.
Six major food groups: fruits, vegetables,
protein, dairy, grains and oils The 10 Kumainments – aims to improve the
eating habits and behaviors of Filipinos to
1.) Fruits - includes any whole fruit or 100
prevent malnutrition and diet-related non-
percent /general recommendations range
communicable diseases such as cancer,
from 1.5 to 2 cups
diabetes, and cardiovascular disease.
2.) Vegetables - includes any whole
Recommended Energy and Nutrition Intake
vegetables or 100 percent vegetable juice.
(RENI)
- may be raw, cooked, fresh, canned, frozen or
dehydrated/ General vegetable  Formerly termed RDA
recommendations range from 2 to 3 cups  Amount of energy and essential
nutrients needed to meet the
3.) Protein - at least 8 ounces of seafood per
minimum requirement to:
week -- to meet your nutritional needs/
o Maintain health
Recommended intake ranges from 5 to 6.5
o Provide reserves
ounces
o Added amount for incomplete
- Meat, poultry, seafood, eggs, nuts, seeds,
digestion
soy foods, beans, peas and any items made
 Factors that influence RDA:
from these foods belong to the protein group
o Age
4.) Dairy - All fluid milk and products made o Sex
from milk, such as cheese, yogurt, ice cream o Physiologic stresses
and pudding, belong to the dairy group. All
adults should consume 3 cups of low-fat or RECOMMENDED ENERGY AND NUTRIENT
fat-free dairy products each day. INTAKES (RENI)  recommended nutrient
intakes (RNIs) for infants, from birth to <6
5.) Grains - Foods such as wheat, rice, oats,
barley or cornmeal belong in the grains food mo are "adequate intakes" (AI) derived from
group. Foods in this group are further the intakes of fully breastfed infants, based on
categorized into whole grains and refined an average daily milk consumption of 750 mL
grains. Whole grains are those that contain for the first six months multiplied by the
the entire grain kernel, and refined grains are nutrient concentration in breast milk.
Desirable Contribution of Carbohydrates, be explained as a substitution, choice, or
Fats, & Protein to Total Dietary Energy (TDE): serving.

CHO 55- 70% Food and nutrition labeling requirements

FATS & Fatty Acids30-40% for Infants impact food formulation and marketing of
20-30% for all foods.
others
CHON 10-15% Food labels are designed to provide
MINIMUM DAILY REQUIREMENTS FOR consumers with information to help make
WATER informed food choices.

Population Group MDR General Requirements

Infants There are five pieces of information that are
Birth to <6 mos. 800 ml
required on all food labels with few
6 to <12mos. 1000 ml
exceptions:
Children (1-18 y.o.)
Wt. (kg)  a statement of identity
10-20 1000 ml + 50 ml/ kg  a net weight or contents
in excess of 10 statement
>20 1500 ml + 20 ml/ kg
 the Nutrition Facts panel
Adults (>18 yrs.) in excess of 20
 an ingredients statement
Older persons (>65 2500 ml
 a statement that gives the name
y.o.) 1500 ml
Pregnant women Additional 300 ml and place of business of the
Lactating women Additional 750-1000 product’s manufacturer, packer,
(1st 6 mos.) ml or distributor.
MINIMUM DAILY REQUIREMENTS FOR
FL is a primary means of communication
ELECTROLYTES
between the manufacturer & the consumer.
Populati Wt. Sodiu Chlori Potassiu 2 Components of FL:
on (kg) m de m (mg)
Group (mg) (mg) 1.) Nutrient Declaration - a standardized
Months statement or listing of the nutrient content of
Birth – 5 4.5 120 180 500 food
6-11 8.9 200 300 700
Years 2.) Nutrition Claim - representation which
1 11.0 225 350 1000 implies that a food has some nutritional
2-5 16.0 300 500 1400 proponents
6-9 25.0 400 600 1600
10-18 50.0 500 750 2000 Brown eggs do contain a slightly larger
>18 70.0 500 750 2000 concentration of Omega-3.
FEL (Food Exchange List)
Egg Nutrition
- a classification or groupings of common
Yolk White
foods in terms of equivalent amounts of CHO,
Fat 4.5 g Fat 0g
CHON, Fat & Calories Sat. Fat 1.6 g Sat. Fat 0g
-the word exchange refers to the fact that Cholesterol 184 mg Cholesterol 0 mg
each item on a particular list in the portion Carbohydrates 0.5 g Carbohydrates 0g
listed may be interchanged with any other Protein 2.5 g Protein 4g
food item on the same list. An exchange can
ENERGY FROM FOOD 1g of carbohydrates contains 4 kcal
1g of protein contains 4kcal
ENERGY -the force that enables the body to
1g of fat contains 9kcal
do its work/ chemical energy locked in
foodstuffs brought about by metabolism
Empty Calories - Cal that provide energy but
METABOLISM -the chemical process of very little nutritional value. Contain virtually
transforming food into complex tissue no dietary fiber, amino acids, antioxidants,
elements & of transforming complex body dietary minerals, or vitamins.
substances into simple ones, along with the Solid fats: Although these exist naturally in
production of heat & energy many foods, they are often added during
industrial food processing, as well as during
FOUR BASIC FORMS OF ENERGY the preparation of certain foods. Example:
 Chemical - for synthesis of new Butter
compound Added sugars: These are sweeteners that are
 Mechanical - for muscle contraction added to foods and beverages during
 Electrical - for brain and nerve activity industrial processing. They are filled with
 Thermal - for regulation of body calories. The most common types of added
temperature sugars are Sucrose and High-Fructose Corn
Syrup .
What are CALORIES?

 The chemical energy stored in foods; Alcohol can also contribute empty calories to
energy used by the cells of the body the diet. 1 serving of beer can add 153 kcal to
to allow it to function; energy used a person's intake for the day.
releases heat The following foods and drinks provide the
 It is the unit of measurement for the largest amounts of empty calories:
energy that the body gets from food
and energy used in physical activity. Solid fats and added sugars
 ice cream
Kilogram calorie (kcal) – is the unit of energy  donuts
commonly used in human nutrition  pastries
 cookies
_CALORIES ARE NOT EATEN. THEY ARE BY-
 cakes
PRODUCTS OF CHO, CHON, & FATS THAT ARE
Solid fats
OXIDIZED IN THE BODY.
 ribs
Two types of calorie:  bacon
 hot dogs
a) Small calorie or gram calorie (cal) is
 sausages
the amount of energy required to
 cheese
raise the temperature of 1 gram (g) of
 pizza
water by 1° Celsius (° C)
b) Large calorie, food calorie, or Added sugars
kilocalorie (Cal or kcal) is the amount
of heat energy required to raise 1  fruit drinks
kilogram (kg) of water 1° C  sports drinks
1 Kcal or Calorie = 1000 small cal.  energy drinks
Calorific values (Fuel factor) of 3 main  soda
components of food:
CALORIE health risk)
Healthy weight 18.5-24.9 Average
 the heat energy required to increase Overweight(pre- 25-29.9 Increased
one kilogram of water by one degree obesity)
C. Obesity, class I 30-34.9 Moderate
 derived from the latin word – Calor; Obesity, class II 35-39.9 Severe
meaning HEAT Obesity, class III >40 Very severe
 first defined in 1824 by French
chemist professor Nicolas Clement DESIRABLE BODY WEIGHT -a weight that is
 an absolute measure of how much believed to be maximally healthful for a
heat energy a foodstuff, or anything person, based chiefly on height but modified
else for that matter, contains. by factors such as gender, age, build, and
degree of muscular development.
_The Total Energy (total calorie content) Desirable Weight - A general term for a
available from food can be measured by a person's optimal weight for a particular height
device called a Bomb Calorimeter Computation of DBW
1. Ador Dionisio’s Method
Bomb calorimeter is a type of constant-
volume calorimeter used in measuring the Height - Male (for every 5 ft., allow 110 lbs
heat of combustion of a particular reaction. then multiply the additional inches by 2)
Bomb calorimeters have to withstand the Female (for every 5 ft., allow 100 lbs then
large pressure within the calorimeter as the multiply the additional by 2)
reaction is being measured. Age – Multiply any age between 25 & 50 by 2
then divide by 5
THE JOULE Example:
Male, 45 years old, 5’4” tall
 It is the measure of energy in the
metric system
Ht. = 5 ft = 110 lbs
 It is equal to the energy transferred to
4 inches x 2 = 8 lbs
an object when a force of one newton
118 lbs
acts on that object in the direction of
the force's motion through a distance
Age = (45 yrs) = 18 lbs
of one metre
5
 1 calorie (kilocalorie) = 4.184 joule
DBW = 118 lbs + 18 lbs = 136 lbs
(kilojoules)
2. Tannhauser’s Method
- Measure height in cm & deduct 100. From
Example: 1 cup of milk = 170 kcal 170
the difference, take off its 10%
kcal x 4.184 kjoules = 711.28 kjoules
Example:
DIETARY COMPUTATIONS
Male, 45 yrs. Old, 5’4” tall
BMI (Body mass index) is a value derived
from the mass and height of a person/ ratio of
Ht. = 5’4” = 164.59 cm
weight to height.
164.5 –100 = 64.59 cm
Classification:
10% of 64.59 cm = 6.256
64.59- 6.459 = DBW (kg)
Classification BMI (kg/m2) Risk of co- DBW (kg) = 58.13 kg or 128 lbs
morbidities Basal metabolism/ ree
Underweight <18.5 Low (other
  The measure of energy needed by the - athletes with great muscular dev’t.
body at rest for all its internal show about 5% inc. in BM over non-
chemical activities which is approx. 1 athletic individuals
cal/kg of body wt./H for an adult
 It is the minimum amt. of energy  State of Nutrition
needed by the body at rest in the - a dec. in the mass of active tissue
fasting state (respiration, cellular causes a lowered metabolism (as
metabolism, circulation, glandular much as 50% below normal)
activity, & the maintenance of temp.)  Sleep
- during sleep, the MR falls approx. 10%
Basal metabolic rate (BMR) is the rate of -15% below that of waking levels (d/t
basal metabolism in a given person at a given muscular relaxation & dec. activity
time & situation. It constitutes ½ of the calorie SNS)
requirements of an individual.  Endocrine Glands
- the EG are the principal regulators of
Conditions Necessary for BMR Test
the MR (the male sex hormones inc.
To ensure accuracy:
the BMR about 10%-15% ) (fem.- a
1. The subject must be in fasting or
little less)
postabsorptive state (at least 12H post meal)
 Fever
(usually taken in the morning)
- it increases the BMR about 7% for
2. The subj. must be awake, lying quietly, &
each degree rise in the body temp.
free from physical fatigue, nervousness, or
above 98.6 F or 37 C
tension as this causes an increase in heat
Calculation of BMR
production
1. Rule of thumb (1 kcal per kg per hour for
3. The envi. temp. should be between 20 C –
adult male & 0.9 kcal per kg per hour for
25 C so that the subject can maintain his/her
adult female)
temp.
-this may not be applicable for obese or lean
Factors that affect the BMR
indiv.
 Surface Area
- Formula : 1 kcal x kg x 24H (SHORT
- the greater the body surface area the
METHOD)
greater the amt. of heat loss (muscle
Example: Male, 75 kg
tissue requires more 0xygen than
= 1kcal x 75 x 24
adipose tissue)
= 1,800 kcal
 Sex
Female, 65 kg
- women, in general, have a
= 0.9 kcal x 65 x 24
metabolism of about 5% to 10% less
= 1,404 kcal
than that of men
2. Harris-Benedict Formula (uses info. on wt.,
 Age
ht., age, & sex)
- the MR is highest during the periods
Harris-Benedict equation
of rapid growth, chiefly during the
 Men= 66 + (13.7 x weight kg) + (5 x
first & second years, & reaches a
height Cm) - (6.8 x age in years)
lesser peak through the ages of
 Women=655.1 +(9. X weight kg) + (1.8
puberty & adolescence in both sexes
x ht cm) - (4.7 x age in years)
 Body Composition
Short method
- a large proportion of inactive adipose
 Men: 1kcal/kg/hour x 24 hours
tissue lowers the BMR
 Women: 0.9 kcal/kg/hour x 24 hours
Harris-Benedict Equation
  Men's BMR = 66+ (13.7 x weight kg) + to the root cause (or etiology) of the nutrition
(5 x ht cm) - (6.8 x age in years) problem and aimed at alleviating the signs
 BMR = 66+ (13.7 x 54 kg) + (5 x 162 and symptoms of the diagnosis.
cm) – (6.8 x 36 yo) Nutrition Monitoring/Evaluation: The final
 BMR = 66+740+810-244.8 BMR 1371 step of the process is monitoring and
kcal = 1400 kcal evaluation, which the RDN uses to determine
Short Method if the client has achieved, or is making
 Men: 1 kcal/kg/hour x 24 hours progress toward, the planned goals.
 BMR = 54 x 24 = 1296 kcal = 1300 kcal NUTRITIONAL HISTORY
3. Method developed by WHO • Dietary data collection and capture are
Formula: 1.6 x wt. (kg) + 879 = REE 1.6 X 50 kg designed to provide a representation of
+ 879 = 1,487 kcal intakes from food and dietary supplements
THREE BODY TYPES that will allow for accurate and reliable
1. ECTOMORPH nutrient intake estimation. Intake of foods is
 Narrow hips and clavicles also used to craft dietary guidance and
 Small joints (wrist/ankles) evaluate the risks associated with food-borne
 Thin build hazards.
 Stringy muscle bellines Methods of Assessing Dietary Intake
 Long Limbs  24-hour dietary recall (24HR) is a
2. MESOMORPH structured interview intended to
 Wide clavicles capture detailed information about all
 Narrow waist foods and beverages (and possibly,
 Thinner joints dietary supplements) consumed by
 Long and round muscle bellies the respondent in the past 24 hours,
3. ENDOMORPH most commonly, from midnight to
 Blocky midnight the previous day. A key
 Thick rib cage feature of the 24HR is that, when
 Wide/Thicker joints appropriate, the respondent is asked
 Hips as wide for wider) than for more detailed information than
clavicles first reported. For example, a
 Shorter limbs respondent reporting chicken for
Nutrition Care Process (NCP) - is a systematic dinner or a sandwich for lunch would
approach to providing high quality nutrition be asked about the preparation
care. The NCP consists of four distinct, method and type of bread. This
interrelated steps: openended response structure is
Nutrition Assessment: The Registered designed to prompt respondents to
Dietitian Nutritionists (RDN) collects and provide a comprehensive and detailed
documents information such as food or report of all foods and beverages
nutrition-related history; biochemical data, consumed. A 24HR usually requires 20
medical tests and procedures; anthropometric to 60 minutes to complete.
measurements, nutrition-focused physical Utility of Data
findings and client history.  24HR data can be used to assess
Nutrition Diagnosis: Data collected during the total dietary intake and/or
nutrition assessment guides the RDN in particular aspects of the diet: The
selection of the appropriate nutrition 24HR yields detailed information
diagnosis (i.e., naming the specific problem). on foods and beverages
Nutrition Intervention: The RDN then selects consumed on a given day. The
the nutrition intervention that will be directed total amount of each specific food
 and beverage consumed is anthropometry are height,
captured. Similar types of food weight, body mass index (BMI),
and beverage items reported, body circumferences (waist, hip,
such as soups or sugar-sweetened and limbs), and skinfold thickness.
beverages, can be grouped. Totals Some common anthropometric
for each group can then be measurements include:
summed. • Height or length.
 Food Frequency Questionnaires • Weight.
(FFQ) are a type of dietary • Mid-upper arm circumference (MUAC)
assessment instrument that • Demi-span or arm span.
attempts to capture an • Knee height.
individual's usual food • Sitting height.
consumption by querying the • Skin fold thickness.
frequency at which the • Head circumference.
respondent consumed food items  MALNUTRITION UNIVERSAL
based on a predefined food list. SCREENING TOOL (MUST) is a
 Dietary History is a retrospective five-step screening tool to identify
structured interview method adults, who are malnourished, at
consisting of questions about risk of malnutrition
habitual intake of foods from the (undernutrition), or obese. It also
core food groups (e.g. meat and includes management guidelines
alternatives, cereals, fruit and which can be used to develop a
vegetables, dairy and 'extras') and care plan. It is for use in hospitals,
dietary behaviours (e.g. skipping community and other care
breakfast, dieting). settings and can be used by all
 Food Record (also called a food care workers.
diary) is a self-reported account of  Subjective Global Assessment
all foods and beverages (SGA) is the gold standard for
consumed by a respondent over diagnosing malnutrition. SGA is a
one or more days simple bedside method used to
 OBSERVATION OF FOOD INTAKE diagnose malnutrition and
Direct observation of dietary identify those who would benefit
intake is often undertaken as a from nutrition care. The
means of validating a dietary assessment includes taking a
assessment method by providing history of recent intake, weight
an objective measure of dietary change, gastrointestinal
intake. Eating behaviours symptoms and a clinical
including items and amounts of evaluation. SGA has been
foods consumed, received or validated in a variety of patient
given away, or spilled can all be populations.
noted  Mini Nutritional Assessment
PHYSICAL ASSESSMENT (MNA) has recently been
 ANTHROPOMETRIC designed and validated to provide
MEASUREMENTS are a series of a single, rapid assessment of
quantitative measurements of the nutritional status in elderly
muscle, bone, and adipose tissue patients in outpatient clinics,
used to assess the composition of hospitals, and nursing homes. It
the body. The core elements of has been translated into several
 languages and validated in many  Milk
clinics around the world. The  Yogurt
MNA test is composed of simple  Cream Cheese
measurements and brief
questions that can be completed
in about 10 min.
 GERIATRIC NUTRITIONAL RISK
INDEX (GNRI) The Geriatric
Nutritional Risk Index (GNRI) is a
nutritional screening method
primarily developed for elderly
people; it is also reported to be
useful for predicting mortality in
patients on maintenance dialysis.
"BEST BY" OR "BEST IF USED BY DATE
- This date tells you when the food will
have the best flavor. It is still safe to
eat past this date.
"USE BY" OR "EXPIRATION" DATE
- This is the last date that the product
will be at its peak quality. It is still safe
to eat past this date (except for baby
formula).
"PACKING/MANUFACTURING" DATE
- This is the date used by
manufacturers for tracking. It is not
an expiration date-it is not related to
food quality or safety.
"SELL BY" DATE
- This tells the store how long to display
the product for sale. It is still safe to
eat past this date.
GOOD FOR UP TO ONE YEAR AFTER THE
DATE:
 Packaged food like cereal, pasta, dried
beans, and baking mixes
 Frozen foods
 Canned goods including soup,
condiments, meat, fruit, and
vegetables

GOOD FOR UP TO 30 DAYS AFTER THE
DATE:
 Butter
 Cheese
 Eggs
GOOD FOR UP TO SEVEN DAYS AFTER
THE DATE: