FN 16- NUTRITION FOR THE AT-RISK GROUPS

Date Performed: August 18, 2015

Group No. and Section: Group 5 WCDE-A

Date Submitted: September 1, 2015

Group Members:
Dagdagan, Aaron Paul
Macalia, Carol Marie
Magsino, Cecilio Gabriel
Nisce, Natalie Roxanne

Methodology, Results, Discussion

Introduction, Methodology, Results, Discussion

Costing, Conclusion
Results, Discussion

Exercise No. 1
Planning Diets of Pregnant and Lactating Women

I. Introduction
David Barker stated in his theory that intrauterine growth retardation, low birth weight
and premature birth have a causal relationship to the origins of hypertension, coronary heart
disease and non-insulin-dependent dependent diabetes in middle age (Barker, 1990). This
means that, aside from genetic heredity, poor neonatal nutrition of both the mother and the fetus
also causes a greater effect of the child which could happen in his or her near future. A woman,
expectant of bearing a child, must always consider obtaining well-balanced intakes of nutrients
satisfying the requirements through proper diets as well as intake of certain supplements
necessary for pregnancy. During the period of pregnancy, effects of not only physiological
changes (such as hormonal, cardiovascular, renal and respiratory functions) but also social,
psychological, and medical changes put the mother and fetus at risk (Boo, 2006).
The life of the fetus almost solely depends on the mother to survive by acquiring different
nutrients for his or her physiological developments. Hence, whatever the mother consumes and
eat affects her child whether positively or negatively. Lack or excess intakes of certain nutrients
could cause malformations in the fetal development while also affecting the maternal health at
the same time. In this thought that indeed among all the period of human life cycle, pregnancy is
the most critical and unique. It is unique since this is the stage when another life depends on
another for survival; while it is critical in the sense that almost all the factors- physiological,
psychological, mental, social and medical- greatly influence the survival of the dependent life
(Claudio, 2010). Although, the said dependence of fetus for his or her life does not abruptly
stops when delivery is finished but still continues as the baby feeds on the breast milk of the
1

mother. This reason still places the considerations made for pregnant woman almost the same
for lactating woman.
This paper focuses on planning, serving, evaluating, and costing a healthy diet of a
regular adult woman and adjusting it to satisfy the needs of pregnant and lactating women.
Planning the said regular diet which is safe to eat and avoiding any maternal and fetal harm,
aesthetically pleasing so the mother will consume served food items in order to get all the
required nutrients for her and her baby, nutritionally adequate meals which means less
requirement for a supplement is needed to also lessen the expenses, and economical meals
considering that really not all pregnant and lactating women can personally afford costly meals
and supplements securing a healthy and normal baby. Considerations on bioavailability and
nutrient to nutrient interactions are also stated in this paper, as well as the timing and intake of
the said food items for the nutrient absorption.

II. Methodology
The group was first assigned to plan a one-day diet for a 24-year old woman, whose
height is 52 and whose physical activity is sedentary or mostly sitting. Two methods were used
in the computing for the Total Energy Allowance (TEA). The first method used was the
Tannhauser method; this method was used in order to determine the subjects Desired Body
Weight (DBW).In order to determine the subjects TEA, the Krause method was used on the
subjects known physical activity factor and DBW. One method used in determining the caloric
distribution of the three macronutrients (carbohydrates, proteins, and fats) is the percentage
distribution method which distributes and converts the subjects TEA into grams for each of the 3
macronutrients. In computing for the DBW of the subject, the factor 100 is subtracted from the
height, which is expressed in centimeters, and then adjusting this value to Filipino stature by
deducting 10% from the desired body weight, which is expressed in kilograms. The Krause
method uses different factors depending on the amount of physical activity that the subject may
be exerting. For the subject who has a physical activity which is sedentary, the factor given is
30. The values computed are rounded up to the nearest 50 for energy expressed in kcal, and to
the nearest 5 for each of the 3 macronutrients (carbohydrates, proteins, and fats) expressed in
grams.

On the other hand, another method may be used in determining the caloric distribution of
an individual. This method is the Non-Protein Calories (NPC) method which uses a factor of 1.1
gram of protein per kilogram of the DBW in obtaining the grams of protein needed by an adult.
The grams protein is then converted to calories and then subtracted from the total calories
computed using the Krause method. The new value for total calories is distributed to the
carbohydrates and fats by allotting 70% and 30%, respectively. The equation flow in Appendix
1 shows the computation from DBW, TER, and caloric distribution.
The obtained values for each method were then summarized into two diet prescription.
For the Percentage Method, it was Diet Rx: Energy 1550 kcal; CHO 250 g; CHON 60 g; Fat 35
g; while it was Diet Rx: Energy 1550 kcal; CHO 235 g; CHON 55 g; Fat 45 g for the NPC
method. There were comparisons made between the two methods due to some considerations
for the pregnant and lactating women.
The group ultimately chose to use the NPC method as the way of distributing the energy
allowance for the entire physiologic group, prioritizing the higher fat and lower carbohydrate
allotment of the NPC method over the slightly higher protein allotment of the Percentage
method. Fat is of vital importance during both pregnancy and lactating. During pregnancy, Fat
specifically alpha linoleic acid (ALA), Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid
(DHA) are responsible in forming the structural components of the central nervous system
(Claudio 2010). Low consumption by the mother of the said fatty acid has been associated with
low IQ and sometimes mental retardation among their children. In Lactation, the amount of fat
consumed influence the fatty acid composition of breast milk as a lack of it results in shortchained fatty acids. Fat is also the preferred fuel by the mother, who has a greater energy need
than the fetus whose preferred fuel is glucose. Even though carbohydrate prescription is lower
in the NPC method, it is still more than enough to support the glucose needs of the fetus.
In determining the number of exchanges for each food variety, the group used the
recommended intakes for pregnant and lactating women by Claudio as its guideline. The
allotted amount of fat in the percentage distribution was simply too low. If the said method was
used the only fat source left for the subject would be from fat from cooking oil. Cooking oil has
relatively low amounts of the essential fatty acid discussed. In using the NPC method there is an
additional 10 grams of fat available, extra fat exchanges could be allocated to medium fat meat
and milk which are good sources of the essential fatty acid. As a side result of having more

meat and milk exchanges, there is also a greater flexibility in the kind of meals that can be
incorporated into the diet which in turn increases the palatability of the meal plan.
The NPC method offers a higher allocation for protein as it is a method that is suited for
healthy individuals and it prioritizes the distribution of the TEA into protein. Protein is also very
important as it is the building block for all the new cells and tissues formed by the mother and
the fetus. However, the difference between the allotments in both methods is relatively low at 5
grams. The protein allotment for the NPC method (55) also came within ten percent of the total
protein requirement in the RENI (58).
The next step was to convert the diet prescriptions into number of exchanges
equally distributed into eight food groups namely, vegetables A & B, fruit, milk, rice, meat fat and
sugar to satisfy the firstly computed amounts of energy, carbohydrates, proteins and fats. The
group then translated the distributed number of exchanges into one-day meal plans each for
normal, pregnant, and lactating women. The considerations such as the priority nutrients,
bioavailability, nutrient to nutrient interactions, and the cost of the meals (One hundred Pesos
were allotted for the three meals for each stage) were taken into account. The meals included in
the plan were breakfast, morning snack, lunch, afternoon snack, dinner, and bedtime snack.
The nutrient contents of all the planned dishes were computed using The 1997 Philippine Food
Composition Table (FCT) and were based on the standards of the 2002 Required Energy and
Nutrient Intakes (RENI). Both the theoretical (estimation of the weight for each ingredients) and
the actual nutrient calculations were done by the dietitian of the group and were being
compared for discrepancies. Except for the three snacks, the three major meals were prepared
and cooked in the laboratory after requesting the ingredients, equipment, and utensils during the
class hours. After all the groups in the class have prepared all their meals, sensory evaluations
were conducted by each of the groups to other respective groups. The presentation of all the
computations from total energy allowance, caloric distributions, diet prescriptions, number of
exchanges, meal planning, and explanations of several considerations followed after all the said
activities.
III. Results
Table 1. Computations for Total Energy Allowance and Diet Prescription
Aspects

Normal

Pregnant

Lactating

Given

5'2'', Sedentary, Female

5th Month

6th Month

TEA

1550

1850

2050

CHO

235

280

305

CHON

55

65

80

Fat

45

55

60

Diet Rx

1550 KCal, 235g CHO,

1850 KCal, 280g CHO, 65g 2050 KCal, 305g CHO, 80g

55g CHON, 45g Fat

CHON, 55g Fat

*NPC method

*NPC method

CHON, 60g Fat

*NPC method

As explained before, the method used in determining the caloric distribution for the diet
prescription was the NPC method, in which the desired body weight was determined by
Tannhauser method and the total energy allowance (TEA) was by the Krause method. For the
determination of the diet prescription for the pregnant woman, the TEA was increased by 300
kcal to address the the increase in metabolic rate to support the work required growth of fetus
and the accessory items, as well as the mothers normal physical activity (Claudio, 2010). The
adjustment is also due to increasing maternal and fetal masses which each comprises one-third
of the additional calories while the last 33% is for the increased heart work and respiration.
Although the addition of 300 kilocalories is a rough estimation and may vary among women
because of their physiological need, stage of pregnancy and physical activity. The weight gain
may be used in the estimation of energy status since it is assumed that proper weight gain is the
result of adequate energy intake (Brown, 2011). As for the lactating mother, additional 500 kcal
is recommended by RENI because the production of 100 mL of breastmilk requires about 85
kcal. The more often the baby is breastfed, the rate of milk production is higher. However, for
those mothers who have higher fat stores need lower than 500 kcal during lactation. The
distribution of the calories for carbohydrates, proteins, and fats for both the pregnant and
lactating also followed the NPC method. New protein requirements for both pregnant and
lactating women were based on the needs of the normal woman. For the diet prescription of the
pregnant woman, an additional 10g of protein was added bringing the total up to 65 grams. 65
grams of protein was then converted to calories. Total calories was subtracted by calories from
protein and the difference was multiplied by 70% and 30% to attain the allotted calories from
carbohydrate and fat respectively. The product was then divided by 4 for carbohydrate and 9 for
fat to finally attain gram carbohydrate and fat. There is an increased need for protein in pregnant
women as it is the primary structural basis for all new cells and tissues in the mother and fetus
(Claudio, 2010) Lactating mothers are given an extra 23 grams of protein per day since protein

is usually stored in the breast milk. 23 grams is added to the normal protein allowance of 55
grams giving a total of 77 grams, rounded up to 80g in the diet prescription. Likewise, the
calories from protein is subtracted to the total calorie allowance with the difference multiplied by
70 and 30 percent to get the total grams carbohydrate and fat.
Table 2. Distribution of the normal subjects food exchanges into a meal plan.
Determination of Number of Exchanges

Distribution of Exchanges

# of
Food

Exchang

Group

es

kCal

CHO CHON Fat Breakfast

AM

Lunc

Snack

PM

BT

Snack Dinner Snack

Veg. A

16

Veg. B

60

12

Fruit

160

40

170

12

10

Sugar

100

25

Rice

600

138

12

Fat)

164

32

Fat

270

1540

230

Normal Milk (Whole

Milk)

1
1
2

30

57

44

Meat (Low

Total

Table 3. Distribution of the pregnant subjects food exchanges into a meal plan.
Determination of Number of Exchanges

Distribution of Exchanges

# of

Pregnan
t

Food

Exchang

Group

es

AM
kCal CHO CHON Fat Breakfast

PM

Snack

BT

Lunch Snack Dinner Snack

Veg. A

32

0.5

0.5

Veg. B

64

12

Fruit

240

60

(Whole)

170

12

10

Sugar

120

30

Rice

700

161

14

(Low Fat)

164

32

Meat (MF)

86

Fat

315

35

40 1891

281

68

55

Milk
1
2
2

Meat

Total

Table 4. Distribution of the lactating subjects food exchanges into a meal plan.
Determination of Number of Exchanges

Distribution of Exchanges

# of

BT

Food

Exchang

Group

es

Break
kCal CHO CHON Fat

AM

PM

fast Snack

Veg. A

32

Veg. B

80

15

Fruit

240

60

e Milk)

170

12

10

Sugar

120

30

Rice

800

184

16

164

32

Fat)

172

16

12

Fat

315

35

43 2093

307

79

61

Lunch

Snac

Snack

Dinner

k
2

2
2

2
1

Milk(Whol
Lactating

4
2

Meat
(Low Fat)
Meat
(Medium

Total

2
2

The tables above show the groups translation of the diet prescription to number of
exchanges which is distributed to the six meals for one day. The distribution considered the
physical activity of the subject and emphasized nutrients in different stages. For the normal
woman, there was no special consideration done as it was assumed that the subject had no
food aversion or any condition that may alter the diet. Recommended exchanges of Vegetables
A and B, Fruit,Sugar found in the Food exchange list for a normal person was followed. Rice
exchange was then determined by subtracting the prescribed carbohydrate by the carbohydrate
already assigned and then divided by 23. The quotient was then rounded off to the closest
whole number. The procedure was done similarly to protein, wherein prescribed protein value
was subtracted by the gram protein already distributed and then divided by 8. Likewise the
quotient was rounded off to the closest whole number. Prescribed fat subtracted by the total

gram from fat exchange determined the extra fat available. The extra fat exchange was placed
on whole milk. A similar process was done with pregnant women, with additional exchanges put
on Vegetable A and fruit to address increased vitamin needs. There was an increase in
exchanges for both Rice and Sugar to make up for the increased caloric need. An exchange of
medium fat milk was added to add variety in both protein and fat sources. For lactating mothers,
there is an increase yet again in Rice exchanges as the allotment for calories also increased.
Medium fat Meat exchanges is also up as it is essential to get a lot of variation in dietary fat from
to improve fatty acid composition.
The majority of the food exchanges is allocated on the three main meals: Breakfast,
Lunch, Dinner. These are the meals that a common filipino would less likely to skip, as such it is
crucial to make it as full with the exchanges and the required nutrients as possible to help attain
the recommended intakes for each of the nutrients.
Table 5. Sample menu for the normal subject
N
O
R
M
A
L

Meal
Pattern

Food/ Drink

Approx. Size/ Serving

Food Group

# of
Exchanges

Breakfast

Rice Gruel (Lugaw)

-Rice, cooked
-Chicken Bouillon
-Fish Sauce
-Garlic
-Soy Sauce

-160g
- 1/2 cube (6g)
-1 mL
-2 cloves (4g)
-1 mL

-Rice
-Free food
-Free food
-Free food
-Free food

-2

Minatamis na
Saging na Saba
-Saging na Saba
-Sugar Syrup

-140g
-5g

-Fruit
-Sugar

-2
-1

Kalabasa-Petsay
Guisado
-Pechay
-Squash
-Pork tenderloin
-Oil, corn

-1 cup (raw), 25g

-1 cup (raw), 80g* (113g)
-60 g
-15 ml

-Veg. A
-Veg. B
-Meat (LF)
-Fat

-1
-2
-2
-3

-Rice, cooked

160g

-Rice

-2

Ripe Papaya
Smoothie
-papaya
-honey

-85 g* (133g)
-10 ml

-Fruit
-Sugar

-1
-2

AM
Snack

Lunch

PM
Snack

-milk, whole
Dinner

Chopsuey
-Cabbage
-Carrot
-Baby corn
-Chicken Liver
-Chicken breast,
Shredded
-Oil
-Rice, cooked

BT Snack

Strawberries with
condensed milk
-Strawberries
-Condensed milk

-250g

-Milk

-1

-1 cup (raw), 25g

- cup (raw), 40g
-2 (8 cm long x 5 cm
circ. each), 15g
- cup, 35g
- breast, 35g

-Veg A
-Veg B
-Veg B

-1
-2

-Low Fat
-Low Fat

-1
-1

-3tsp,15g
-160g

-Fat
-Rice

-3
-2

-1 cup, 165g
-4 tsp., 20 g

-Fruit
-Sugar

-1
-2

Table 6. Sample menu for the pregnant subject

P
R
E
G
N
A
N
T

Meal
Pattern

Food/ Drink

Approx. Size/ Serving

Food Group

# of
Exchanges

Breakfast

Whole Wheat
Oatmeal Pancakes
-Whole wheat flour
-Quick cook oats
-Whole milk
-Plain Yogurt
-Chicken Egg

-33g
-25g
-125g
-32g
-60g

-1
-1
-
-
-1

-Brown Sugar
-Banana lacatan
-Butter
-Syrup

-10g
-102g
-5g
-10mL

-Rice
-Rice
-Milk
-Milk
-Medium fat
meat
-Sugar
-Fruit
-Fat
-Sugar

Grilled Vegetables
with Pineapple
-Oil, corn
-Eggplant
-Tomato
-Carrots
-Pineapple

-5g
-22.5g
-22.5g
-45g
-258g

-Fat
-Veg. A
-Veg. A
-Veg. B
-Fruit

-1
-
-
-1
-2

Sinigang na
Bangus
-Malunggay
-Sitaw
-Bangus belly

- cup (raw), 12.5g

- cup (raw), 20g (22g)
-70g* (108g)

-Veg. A
-Veg.B
- Meat (LF)

-0.5
-1
-2

AM
Snack

Lunch

-2
-2
-1
-2

10

-Mango, green

-1-2 slices, 80g* (90g)

-Fruit

-1

-Rice, cooked

-160g

-Rice

-2

-25g
- cup (raw), 7.5g
- cup (raw),7.5g
- cup (raw), 20g
-10ml
-5 ml

-Rice
-Veg.A
-Veg.A
-Veg.B
-Fat
-Fat

-1
-0.25
-0.25
-1
-2
-1

Chopsuey
-Cabbage
-Chayote fruit
-Carrot
-Chicken Breast
-Chicken Liver
-Oil
-Rice, cooked
-Baby Corn

-1 cup (raw), 25g

-1 cup (raw), 25g
- cup (raw), 40g
- breast, 30g
-35g cup
-2 tsp, 10g
- cup, 80g
-1 cup, 90g

-Veg A
-Veg A
-Veg B
-Low Fat
-Low Fat
-Fat
-Rice
-Rice

-1
-1
-1
-1
-1
-2
-1
-1

-Banana, Saba
-Honey

-1pc, 40g
-2 tsp,10g

-Fruit
-Sugar

-1
-2

PM Snack Lumpia with

Malunggay-Wrap
-Cornstarch
-Malunggay (ground)
-Celery
-Togue
-Mayonnaise
-Oil, corn
Dinner

BT Snack

Table 7. Sample menu for the lactating subject

L
A
C
T
A
T
I
N
G

Meal
Pattern

Food/ Drink

Approx. Size/ Serving

Food Group

# of
Exchanges

Breakfast

Green Smoothie
-Whole milk
-Bananas
-Peanut butter
-Quick cooking Oats
-Malunggay
-Carrots
-Brown Sugar

-250g
-153g (3 pcs)
-20g
-90g
-25 g
-25 g
-10g

-Milk
-Fruit
-Fat
-Rice
-Veg. A
-Veg. B
-Sugar

-1
-3
-2
-3
-1
-1
-2

Cheese Omelette
-Chicken Egg

-60g

-Medium fat
meat

-1

-Cheddar Cheese

-35g

-Oil, corn

-5 mL

AM Snack

-1
-Medium fat
meat

-1

-Fat
Lunch

Tinolang Halaan

11

PM Snack

-Halaan
-Ampalaya leaves
-Green Papaya

-60g* (194g)
- cup (raw), 12.5g* (28g)
- cup (raw), 12.5g* (20g)

-Meat
-Veg.A
-Veg.A

-2
-0.5
-0.5

-Rice, cooked
-Banana cue

-160g*
-40g

-Rice
-Fruit

-2
-2

Binatog
-Sweet Corn
-Coconut, grated
-Coconut cream
-Sugar

-40g
-10g
-22.5 ml
-10g

-Veg. B
-Fat
-Fat
-Sugar

-2
-0.5
-1.5
-2

-80ml

-Sugar

-2

-1 cup (raw), 25g

-1 cup (raw), 25g
- cup (raw), 40g
- cup (raw),40g
-30g
-35g
-2 tsp, 10g
-1 cup, 160g
-1 cup, 90g
- cup, 85g

-Veg A
-Veg A
-Veg B
-Veg B
-Low Fat
-Low Fat
-Fat
-Rice
-Rice
-Fruit

-1
-1
-1
-1
-1
-1
-2
-2
-1
-1

-Taho with syrup and

sago
Dinner

Chopsuey
-Cabbage
-Chayote fruit
-Carrot
-Mung Bean sprouts
-Chicken Breast
-Chicken Liver
-Oil
-Rice, cooked
-Baby Corn
-Papaya

BT Snack
*The highlighted meals were not prepared in the laboratory but included in the nutrient calculations.

Table 8. Costing calculations for the meal plan of the normal subject.
Normal

Food Item

E.P. Weight

AP Cost

Total Cost ()

Rice

560 g

61 / 1.5 kg

22.77

Garlic

4g

19 / 200 g

00.38

Soy Sauce

1 mL

20.95 / 540 ml

00.04

Pechay

25 g

15 / 350 g

01.07

Squash

80 g

30.78 / 592 g

04.16

Pork Tenderloin

60 g

56.05 / 76 g

45.04

Corn Oil

30 mL

74.25 / 500 mL

04.46

Cabbage

25 g

36 / 450 g

02.00

12

Carrot

40 g

44 / 520 g

03.38

Baby Corn

15 g

60 / 369 g

02.44

Chicken Liver

35 g

15.75 / 105 g

05.25

Chicken Breasts

35 g

120.75 / 805 g

05.25

Total

96.25

Table 9. Costing calculations for the meal plan of the pregnant subject.
Pregnant

Food Item

E.P. Weight

AP Cost

Total Cost ()

Whole Wheat
Flour

66 g

23.6 / 200 g

07.79

Quick Cook Oats

25 g

25.45 / 200 g

03.18

Low Fat Milk

125 mL

127.9 / 2 L

08.00

Plain Yogurt

32 g

40 / 125 g

10.24

Chicken Egg

60 g

82 / 720 g

06.83

Brown Sugar

10 g

12 / 250 g

00.48

Lacatan, Banana

102 g

55 / 1 kg

05.61

Malunggay

5g

35 / 100 g

04.38

Sitaw

20 g

18 / 400 g

00.90

Bangus Belly

70 g

75 /108 g

48.61

Green Mango

80 g

25 /90 g

22.22

Rice

380 g

61 /1.5 kg

13.02

Cabbage

25 g

36 /450 g

02.00

Chayote Fruit

25 g

18 /300 g

01.50

Carrot

40 g

44 /520 g

03.38

Chicken Breast

35 g

120.75 /805 g

05.25

Chicken Liver

35 g

15.75 /105 g

05.25

10 mL

74.25 /100 g

07.43

90 g

60 / 369 g

14.63

Corn Oil
Baby Corn

13

Fresh Cows Milk

250 g

133 / 2 L

Total

16.63
187.33

Table 10. Costing calculations for the meal plan of the lactating subject.
Lactating

Food Item

E.P. Weight

AP Cost

Total Cost ()

500 mL

127.9 / 2 L

31.98

Lacatan, Banana

153 g

55 / 1 kg

08.42

Peanut Butter

20 g

43.45 / 141 g

06.16

Quick Cook Oats

90 g

25.45 / 200 g

11.45

Spinach

25 g

40 / 100 g

10.00

Carrots

65 g

44 / 520 g

02.12

Brown Sugar

5g

12 / 250 g

00.24

Halaan

60 g

135 / 1 kg

08.10

Ampalaya
Leaves

12.5 g

20 / 100 g

02.50

Green Papaya

12 .5 g

10 / 350 g

00.36

Rice

320 g

61 / 1.5 kg

13.02

Banana Cue

40 g

15 / 100 g

06.00

Cabbage

25 g

36 / 450 g

02.00

Chayote Fruit

25 g

36 /450 g

01.50

Toge

15 g

18 /300 g

00.58

Chicken Liver

35 g

120.75 /805 g

05.25

Chicken Breast

35 g

15.75 /105 g

05.25

10 mL

74.25 /100 g

07.43

Low Fat Milk

Corn Oil
Baby Corn

90 g

60 / 369 g

14.63

Papaya

85 g

45.18 / 1.412 kg

02.72

250 mL

41.25 / 1 L

10.31

Whole Milk
Total

150.02

14

The tables above (Table. 8 - 10) show the cost of all three meals (breakfast, lunch, and
dinner) for each stage of the subject assigned. It can be seen in Table 8 that for the diet of the
normal stage, the cost was kept under the cost restriction given which was 100. This is due to
the fact that the the normal stage required fewer calories than the other stages as well as fewer
need for priority nutrients that can only be acquired through food items that may be more costly.
The cost of the three meals for the normal stage only cost 96.25 with the greatest contributors
being the rice, due to the amount used and not the price of rice itself, and the pork tenderloin.
For the diet of the pregnant stage, the meals cost about twice the price of that of the
normal stages at 187.33. The main contributors to this were the bangus belly, green mango,
fresh cows milk, and baby corn which were all bought from the supermarket. Some of these
items could have been purchased from wet markets at lower prices, with the exception of the
fresh cows milk, which could have helped the group cut costs and meet the cost restriction.
Another way to cut the cost for this stage could have been the substitution of cheaper food
items such as, galunggong instead of bangus and mung bean sprouts instead of baby corn. The
only disadvantage these cheaper alternatives bring is the lower nutrient density they contain, for
example is the lower amounts of omega-3 fatty acids (DHA) found in galunggong in comparison
to bangus as DHA is a priority nutrient for pregnant individuals. In the case of substituting mung
bean sprouts instead of baby corn, this would be economical as mung bean sprouts can be
purchased cheaper and contain vitamins C, vitamin K, manganese, and is a better source of
iron which is one of the priority nutrients for the pregnant stage. Even though, the cost
surpassed the 100 restriction, it is still justifiable that nutrient content and density is still a
higher priority over cost. The higher need for calories also played a role in the increase in costs.
The diet for the lactating stage cost less than that of the pregnant stages at 150.02
but is still over the 100 restriction per day. The main contributors for the high cost were the low
fat milk, whole milk, quick cook oats, baby corn, spinach, and rice. Low fat milk was the highest
contributor as low fat milk can only be found in groceries as it is a processed food product. It is
hard to find alternatives to milk exchanges as all low fat milk products can only be found in
groceries and supermarkets. Spinach, which is a relatively more expensive food item than other
food items of the same food group, contains folate which is a priority nutrient for lactating
individuals therefore making it worth the extra cost. Another kind of rice exchange could have
been substituted for quick cook oats as quick cook oats are processed and more expensive.
Flour and cornstarch are some alternatives to quick cook oats as cheaper sources of rice
exchanges that are also ingredients for making a hotcake dish. Again, mung bean sprouts could
have been used instead of baby corn to cut costs without sacrificing a loss in nutrient density of
the meals. There is a 500 kcal and 23 g of protein increase in the caloric intake of a lactating
individual, this increase in energy required from the normal stage can be the cause of the
increase in cost as more food items are needed in order to reach the required amount of energy
as well as to acquire priority nutrients. Again, nutrient intake is prioritized over the cost as
reaching the required values of nutrients and energy is more vital for an individual as
deficiencies and clinical diseases are more costly.
Overall, only the normal stage meals met the 100 restriction. The main cause of the
overshoot of the pregnant and the lactating stages meals were due to the unit cost of food
items that contained priority nutrients which were typically found in groceries and supermarkets
as they were not common food items normally found in wet markets where the price of food
items are at their cheapest.

15

For the breakfast meals and AM snacks of the three stages, the priority nutrients
considered were carbohydrates, protein, vitamin A, B vitamins, vitamin C, vitamin D, and
calcium. Each meal contained carbohydrates to serve as fuel for the rest of the day. Sources of
carbohydrates from the meals are rice, bananas, oats, wheat flour, and vegetables. Protein can
also be found in each meal to provide satiety. Protein contribution was high from the chicken
broth, chicken egg, peanut butter and cheddar cheese.
The breakfast and AM snack meals focused on the absorption of calcium with the help of
vitamins B and D. For the normal stage, chicken broth is high in calcium and the bananas are
high in vitamin B6. For the pregnant stage, milk is high in calcium. The milk used was fortified
with vitamin D, which helps absorb calcium. Egg, oats, whole wheat flour and eggplant are high
in B vitamins, specifically vitamin B6, which also helps absorb and transport calcium. For the
lactating stage, milk is high in calcium. The cheese from the omelette contains vitamin B and
calcium. Calcium was focused on for the breakfast and AM snacks due to the prioritization of
iron for meals later in the day. Iron and calcium should not be consumed together as they have
the same charge and will compete in receptors and transporters.
The major contributors to vitamin A were the carrots, malunggay cheddar cheese and
chicken broth. The main sources of vitamin C were the malunggay, bananas and oats. The
added doses of vitamins A and C are needed to supply the needs of the fetus during pregnancy.
Vitamin C is especially important during lactation as breast milk is known to have low amounts
of vitamin C.
For the lunch meals of the three stages, some of the micronutrients highlighted were
calcium, vitamin A, ascorbic acid, B-vitamins, and zinc. Although the group planned to have high
amounts of iron in the food items, the values are seen to be low to meet the requirements. The
lunch prepared for the normal woman contained high amounts of calcium, vitamin C, and
vitamin A which are both mainly from the pechay and the squash. Iron sources were still the
pechay and squash in addition to the pork and rice. The increased amount of ascorbic acid
could also increase the absorption of iron in the diet. As for the energy sources, corn oil, pork,
and rice provided the highest amounts.
The priority nutrients for the dinner meals of the three stages were carbohydrates,
protein, vitamin A, B vitamins, vitamin C, vitamin D, calcium, and iron. The same dish was used
for the three stages as chop suey, is a versatile dish wherein different types of vegetables and
meats may be used depending on the nutrients required. Due to the two stages (namely
pregnant and lactating) similar need for certain priority nutrients, the group has decided to use
the same types of vegetables and meats for the three meals as it will have no adverse effect on
the normal stage as long as the required nutrients are met. The major sources of carbohydrates
were mainly from rice and baby corn. Chicken liver and chicken breast provided for the dishes
protein. Cabbage is rich in vitamin C as well as small amounts of calcium, iron, vitamin B6 and
magnesium. Baby corn, chicken liver and chayote are sources of iron. Chicken liver, carrots,
and baby corn all provide vitamin A. There might be a problem with the iron and calcium

16

interaction as the dish contains both nutrients, but the amounts of each nutrient might be small
enough to be negligible.
For the pregnant women, vitamin C was still highlighted in the dish provided by the
green mango and malunggay in order to increase the amounts of iron absorbed from the diet.
The group limited the amount of vegetable A (dark, green, leafy vegetable group) to one-half
exchanges as well so at not to interfere with the iron absorption. Interference may due to
phytates present which are anti-iron absorption by intercalating to the said nutrient, preventing
to be absorbed. Calcium and vitamin A were still highlighted by the food items used as well as
B-vitamins. Calcium, together with phosphorous, helps in mineralization of fetal skeleton and
deciduous teeth during pregnancy. Calcium is also stored in maternal skeleton for its later use in
lactation (Claudio, 2010). Folate and vitamin B12 were also prioritized since they contribute to
methyl donations in metabolic reactions for the DNA synthesis. Folate supplements are 85%
bioavailable if consumed with food items and nearly 100% if taken in on an empty stomach. The
naturally occurring folates are greater than 50% bioavailable on average (Brown, 2011).
The amount of calcium is still in high amounts for the lactating since milk production is
emphasized in this stage. For zinc, there is an added 1.9 mg to the recommended nutrient
intake due to the dramatic drop of zinc content of the human milk (Claudio, 2010). Zinc in
human milk is bound to protein and is highly available (Brown, 2011). The group also used
halaan or clam shells for lunch due to its high zinc amounts. Although references have stated
that consuming shellfishes during lactation period is not advisable due to development of
allergens, the American College of Obstetricians and Gynecologists explained that considerable
amounts of shellfishes can be consumed given that these are cooked thoroughly (the shells are
fully open already and no foul smell is released when cooking). Shellfishes also provide omega3 fatty acid which improves visual and cognitive development (The Dietary Guideline for
Americans, 2010).

IV. Discussion
Pregnancy and lactation are highly important yet risky stages of life. A mother with
optimum nutrition during these times helps ensure a normal and healthy birth and growth of the
child but a malnourished mother will have increased risks for abnormality and even mortality.

Cardiovascular changes during pregnancy include plasma volume increases

approaching the second trimester. As the plasma volume increases, nutrients and composition
should also increase. Mothers with hypertension, renal disease, low maternal weight gain,
17

diuretic treatment, pre-eclampsia and those who are smokers and alcohol drinkers experience
limited plasma volume increase and are at risk of having the baby still born or having low
birthweight. Aside from plasma volume, the mothers blood flow also increases to maintain the
supply of oxygen and nutrients to the fetus. This causes the mothers blood pressure to
decrease.
The mothers respiratory system also increases workload as maternal oxygen
requirements rise due to higher basal metabolic rate. As capillaries fill up, edema and excess
blood build up in the nose, pharynx, trachea, and bronchi which causes nasal and sinus
congestion. Other effects are nosebleeds, voice changes, ear swelling, ear aches, impaired
hearing, and inflammatory responses to mild respiratory infections.
Instead of being reabsorbed, a pregnant mothers renal system filters out glucose, amino
acids, and water soluble vitamins at a faster rate through urine to facilitate clearance of waste
products, both her own and the fetus. This means that intake of the said nutrients in the diet
should be increased to avoid deficiency.
The gastrointestinal system is also affected by pregnancy, mostly by the hormones
released during this time. Hormonal changes lead to loss of appetite, nausea, altered taste, and
vomiting. Increase in the amount of the hormone progesterone may cause a decrease in the
muscle tone and motility of the GI system, reverse peristalsis and esophageal regurgitation. The
growing uterus pressing upon the diaphragm and intestines causes acid reflux, constipation and
heartburn. Altered taste may also be a sign of deficiency for the nutrients zinc and Vitamin B12.
It can be said that most changes during pregnancy are because of hormones. Insulin is
less effective during the later months of pregnancy because of the need for glucose by the
fetus. It takes more insulin to clear the usual amounts of glucose. This is an important factor in
planning diets for pregnant women because of the increased risk for diabetes. The hormone
estrogen induces water retention which can lead to edema and pre-eclampsia.
Another factor to consider when planning diets for pregnant mothers would be the
trimester of pregnancy. The first trimester is considered to be the most critical period because
this is the time wherein the growing number of cells and tissues are vulnerable to abnormalities.
If the desired number of cells and tissues is not achieved, irreversible effects will be apparent in

18

the latter stages of development and cannot be reversed in any way. An example of a dietary
concern which changes based on the trimester of pregnancy would be protein intake. Protein
provides structural basis for all new cells and tissues for both mother and fetus. During the first
month of pregnancy, only an additional 0.6 grams is needed but by the thirtieth week of
pregnancy, the need for protein increases to an additional 6.1 grams per day due to increased
need for synthesis.
Despite the high demand for additional nutrients, the pregnant mother faces several
challenges in being able to consume the right types and amounts of food. For example, a
pregnant mother should consume an additional 300 kcal per day. However, the hormone leptin,
responsible for the feeling of satiety, rises in number and may cause the mother to skip meals
due to the absence of the feeling of hunger. In addition to this, other hormonal changes can
cause nausea, vomiting, and change in sense of taste, which may all be factors that can lead to
loss of appetite and eventually malnutrition.
Maternal weight gain is another factor taken into consideration in planning diets for
pregnant women. All pregnant women need to gain weight to be able to promote growth and
overall health for the fetus and to maintain their own health as well. Weight gain during
pregnancy is related to the birth weight of the infant. Low infant birthweight can lead to health
problems and delayed development in the future.
All these factors need to be taken into consideration when planning exchanges and
nutrient content of meals. The general guidelines and recommended nutrient intakes are
properly tabulated in references such as the Recommended Energy and Nutrient Intake for
pregnant women. One must refer to these standards to ensure proper nutritional value of meals
for pregnant women.
Energy intake must facilitate weight gain of 0.4 kg per week during the last 30 weeks
pregnancy. It is recommended that pregnant mothers add 300 kcal to their daily diets. This
amount can easily be fulfilled by the consumption of snacks within the day. The following are
some examples of snacks amounting to around 300 kcal. Banana and peanut butter
combination serves as a simple and quick to prepare snack. A medium banana is around 110
kcal eaten with two tablespoons of peanut butter amounting to 190 kcal. Peanut Butter contains
protein and fat. The fat in peanut butter is healthy fat, poly and monounsaturated fat. It is best

19

for pregnant mothers to avoid trans and saturated fat because aside from adding to risks of
hypertension and rapid weight gain, it also alters the fat composition of breast milk, which is not
good for the baby.
Another simple snack to prepare would be cereals and milk. It is best to choose whole
wheat cereal fortified with vitamins. A one cup serving of most cereals is around 200 kcal. Low
fat or nonfat milk is the best milk choice at around 90-100 calories for a one cup serving. Cows
milk used should be low fat or non-fat options because whole milk is high in saturated fat. Milk
contains calcium, which is good for fetal bones, healthy heart, nerves, and muscles, and vitamin
D, having low vitamin D is associated with neonatal rickets and low birth weight. Sufficient
vitamin D during infancy lowers the risk of osteoarthritis later in the childs life. One should
choose milk fortified with vitamin D as vitamin D helps the absorption of calcium. Milk is also
high in protein which helps build the uterus, blood supply and tissues of the baby. Insufficient
protein intake can lead to low birth weight in babies. Milk also contains riboflavin. Decreased
riboflavin is associated with low weight, length and head circumference of babies.
Fruit and yogurt combo is a refreshingly healthy and nutrient dense snack for around
300 kcal as well. A cup of yogurt is around 110 kcal and the remaining calories can be
consumed by eating various amounts of fruits. A sample of a 200 kcal fruit combo would be an
orange, 100 grams of grapes and an apple. Just like milk, yogurt is also high in calcium. Yogurt
contains probiotics, needed during pregnancy because digestion slows down to make more
nutrients available for the baby, which leads to constipation. The pressure on the digestive tract
by the growing baby also affects digestion. Yogurt is rich in B vitamins (Riboflavin and
Pantothenic Acid), Potassium and Magnesium.
Other special requirements for pregnant mothers include protein intake, sodium intake,
and mineral intake. Pregnant mothers must consume an additional 10 g of protein a day from
food sources. Sodium intake must be at least 2000 mg a day. Iron and folic acid are
recommended to be taken in supplement form as it is difficult to consume the required amounts
from usual food intake alone.
Alcohol consumption and smoking are strictly prohibited due to the damaging lasting
effects on the fetus. Caffeine intake should be limited to around two cups of coffee per day or

20

about 200 mg caffeine per day. Lastly, overall well being should be maintained through light
exercise and enough sleep.
Nutritional requirements for lactating mothers vary slightly from that of the diet of a
pregnant mother. Certain nutrient intakes must be increased such as energy, protein, zinc,
vitamin A, vitamin C, and B vitamins riboflavin, thiamin, niacin and pyridoxine. Energy intake is
increased to 500 kcal from 300 kcal during pregnancy. An additional 23 g protein per day is
added to the diet of a mother during the first 6 months of lactation and decreased to 18 g for the
next 6 months. Zinc intake should be increased to 11.5 mg from 9.6 mg per day. Vitamin C
intake should be increased because breast milk lacks this vitamin. Intake is increased to 100105 mg from 80 mg during pregnancy. B vitamins riboflavin, thiamin, niacin and pyridoxine
intakes are increased to an additional 0.6 mcg, 1.5 mg, 3 mg, and 2 mg respectively.
Pregnancy is the foundation for life. It is a complex period where many changes occur.
The normal birth of every healthy infant is truly a miracle because many things can go wrong for
both the mother and the fetus. The following are some of the complications that occur during
pregnancy and their treatments through diet intervention.
Anemia occurs during pregnancy due to the deficiencies in iron and folic acid. When a
mother is anemic, the infant may become anemic as well. The mother may experience feeling
tired, weak and may appear pale and have shortness of breath. Anemia can be avoided by
taking iron and folic acid supplements as well as eating food rich in iron and vitamin B.
Gestational Diabetes Mellitus occurs when a pregnant mother has very high blood sugar
levels. This may occur due to stress during pregnancy and disappears after the infant is born.
Symptoms include extreme thirst, hunger and fatigue. This particular condition can be controlled
by following a healthy meal plan which includes lower caloric intake, limited carbohydrate intake
spread out into different meals throughout the day and by eating smaller meals. A pregnant
mother with Gestational Diabetes must see a doctor regularly to ensure the condition is
controlled. If not consequences include death of the infant, premature birth and complications
during delivery.
Pregnancy induced hypertension is diagnosed when a pregnant mother has high blood
pressure. Signs are rapid weight gain, edema, excretion of albumin in urine, and convulsions.

21

This condition must often be examined by doctors to ensure that it is not pre-eclampsia. Preeclampsia signs include hypertension and proteinuria wherein the mother has swollen hands
and face, stomach pains, dizziness, blurred vision and headaches. Deficiencies in calcium and
magnesium are said to be causes of preeclampsia. To prevent this condition, high protein food
and sources of iron, calcium, sodium, potassium and magnesium must be added into the diet.
An even more advanced condition is eclampsia, where the effects include convulsion and coma.
For this experiment, Diet prescription was used as the guideline In preparing the meals
for each group of women. The amount of calories allotted in the diet prescription attained by the
group was lower than the RENI amount for the same person. This means that the food items
included by the group into the meal plans must be nutrient dense in order to make up for the lost
calorie allowance. As a result, foods that are empty calories must be eliminated. Furthermore,
allocation for vegetables and fruits are increased due to the fact that they are low in calorie but
very nutrient dense.The combination of these considerations, however, may result in a decrease
in the acceptability of the meals. To avoid this, the group tried to mask the undesirable taste of
the vegetables by limiting their portion sizes but increasing the frequency of meals with
vegetables in it.
The diet prescription also left the group limited in terms of the flexibility of the meals
prepared as there is a set amount of carbohydrates, protein and especially fat. Many meals that
was considered was ultimately dropped since it could not fit within the set exchanges. The
group as a response manipulated the ingredients, some increased some decreased, for it to fit.
Table 1.11-1.13. Total Nutrient Content of the One-Day Meal Plan and Its Percentage RENI
Kcal

Protein

Totals

1766

48.9

795

RENI Values

1860

58

Percent RENI

95

84

Kcal
Totals

1721

CHON
58.4

Ca

Vit A

Vit B1

Vit B2

13.6

3110

1.09

2.1

330

750

27

500

1.1

1.1

70

106

50

622

99

191

471

Fe

Vit A

Vit B1

Vit B2

14.2

4228

0.65

1.76

Ca
682

Fe

Vit C

Vit C
178

22

RENI
Percent RENI

2160

66

800

34

800

1.4

1.7

80

80

88

85

42

529

46

104

226

Kcal

CHON

Ca

Fe

Vit A

Vit B1

Vit B2

Vit C

Totals

2059

74.3

1380

22.1

4158

0.67

2.58

237

RENI

2360

81

750

27

900

1.5

1.7

105

87

92

184

82

462

45

152

226

Percent RENI

Tables 1.11 to 1.13 shows the actual total nutrient content of the one-day meal plan
prepared by the group for normal, pregnant and lactating women respectively. For the normal
diet, requirement for calories, calcium, thiamine were all adequately addressed. Vitamins A, C,
Thiamine however well exceeded the recommended intake. Vitamin A, in particularly exceeded
the recommendation by more than six times. Although the Vitamin A value of 3110 was still well
below the reported value with which adverse effects have been reported at 25,000 (Claudio,
2015), it would be better to reduce the amount. To do this, either the carrot or the chicken liver
of chopsuey should be removed from the ingredients. Either one of the two could sufficiently
address the daily requirement of the body since their vitamin A content is really high.
Strawberries in the strawberry milkshake accounted for 160mg out of the actual total Vitamin C
content which is 330 grams. A better alternative would be a coconut milkshake as it has lower
vitamin C content as well as having high Iron, a nutrient that the meal plain failed to adequately
provide. Protein and Iron amount failed to reach within ten percent of the recommended
amount. Actual protein amount of 48.9 is actually close to the diet prescription of 55 grams but
the RENI recommendation stands 58. Iron was distinctly low, only achieving 50 percent of the
recommendation. An appropriate adjustment would be to swap chicken liver in the chopsuey
with pork liver. Pork liver has high significantly higher Iron content while having similar vitamin A
amounts.
For the pregnant meal plan, both calories and protein was unable to reach the RENI
recommendation but was close with the diet prescription.RENI recommendation for riboflavin
was adequately addressed . Vitamins A and C again exceeded the recommendation, excess
Vitamin A can be addressed by using the same strategy done in the normal meal plan. Vitamin
C content could be lower by replacing the unripe mango serve during lunch with a ripe one.

23

Portion sizes of malunggay could also be reduced to further lower vitamin C content. Calcium,
Iron and Thiamine failed to reach the target amount. Since calcium amount is close to the
recommendation, a swap of Chayote into Broccoli would suffice. Thiamine deficiency could be
solved by reducing the exchanges of rice in favor of the more thiamine dense wheat bread. Iron
is very important during pregnancy and should be of vital consideration in Pregnant meal
planning, however the group failed to properly prioritize iron and as a result Iron only had 42
percent of the recommended amount. Since bioavailability of Iron is really low, it is advisable for
the pregnant woman to take in Iron supplements during this period.The group also successful
had a high amount of Vitamin C- critical for increased absorption of Iron. Nevertheless, to
increase the Iron in the meal plan the following tweaks should be done. Chicken breast in the
chopsuey could be exchanged with a richer iron alternative of Tofu. Snacks containing raisin
bread that is fortified should have also been considered.
Calorie and Protein requirements were reached in the Lactating meal plan. Calcium,
Vitamin A and C exceeded the recommended amounts. Vitamins A could be solved by dropping
the carrots from the chopsuey while Vitamin C excess could be lessened by dropping the
papaya served in favor of apple during dinner and reducing the malunggay amount in the Green
Smoothie. Thiamine and Iron yet again fails to reach a hundred percent of its recommendation.
Thiamine could be solved by swapping rice exchanges into wheat bread. Iron content in the
lactating meal plan improved thanks to the inclusion of halaan but can be further be improved
by likewise swapping chicken breast with tofu in the chopsuey.
As an additional task in this exercise, fifteen pregnant or lactating women were
interviewed about their knowledge and traditional beliefs on pregnancy and lactation and from
whom they learned these from. The mothers basic information and profiles can be viewed in the
attached interview forms. Their responses were segregated into four categories namely, beliefs
which are good for nutrition, beliefs which are bad for nutrition, beliefs unrelated to nutrition and
beliefs which have uncertain relationship with nutrition. The said information is tabulated below.

Beliefs which are

good for nutrition

Beliefs which are

bad for nutrition

Beliefs unrelated to
nutrition

Laging kumain ng

Laging uminom ng

Bawal umupo o

Beliefs which have

uncertain
relationship with
nutrition

24

gulay at sabaw

milo

huminto sa pintuan,
paatras at paabante
pagnanganak

Laging kumain ng
kanin

Bawal kumain ng
talong kasi magiging
asul o itim ang anak
o kaya magkakaroon
ng balat sa likod

Iwasan ang
madudulas na bagay

Kumain ng prutas
(orange, mango,
mangosteen,
strawberry)

Huwag kumain ng
kambal na saging,
magkakaroon ng
kambal na anak

Huwag manood ng
cartoons

Kumain ng isda

Huwag ipainom ang

unang gatas
(colostrum)

Bawal mahamogan,
magkakasipon o sakit

Huwag kumain ng
masyadong maalat,
magkaka UTI

Huwag kumain ng
mais

Bawal masyadong
malapit sa apoy,
magkakaspot na
white sa mukha

Huwag masyado
mapagod habang
nagpapadede

Huwag humakbang
sa alambre dahil
mahihirapan
manganak, masakit

Kumain ng maraming
malunggay

Bawal magbuhat ng
mabigat

Uminom ng
maraming gatas

Exercise sa umaga

Bawal uminom ng
softdrinks

Maglagay ng walis sa
tabi ng bata para
hindi lapitan ng
aswang

Bawal uminom ng
kape

Usog

Kumain ng pulang
sabaw (tomato soup)

Bawal magpagawa
ng bahay

Bawal mag yosi at

alak
Huwag kumain ng
masyadong matamis

25

Huwag kumain ng
maasim
The responses were classified under beliefs good for nutrition when it was related to
food and suggested consuming healthy and nutritious food. The responses were classified
under beliefs bad for nutrition when it was related to food and suggested eating an unhealthy
food item or disallowed the consumption of a food item due to false claims. The responses were
classified under beliefs unrelated to nutrition when it was unrelated to food. No responses
were classified under beliefs which have uncertain relationship with nutrition. The interviewees
learned their beliefs from the health center, doctors, aunts, friends, parents, neighbors,
grandmothers, other mothers, mothers-in-law and some just knew them as part of personal
knowledge.
Most of the good beliefs related to nutrition have really scientific basis such as
avoidance of alcohol and cigarette and moderation, or even avoidance, in taking in coffee and
carbonated drinks. During pregnancy, alcohol also crosses the placenta and have detrimental
effects on fetal developments especially dysfunctions on central nervous system. There is no
safe intake of alcohol during pregnancy as it affects the cell differentiation and blastogenesis of
the fetus (Little R., Anderson, K., et.al., 1990). On the other hand, research have shown that
alcohol has less effect on baby during lactation as long as the mother will let the alcohol exit her
body first few hours after consuming before breastfeeding the infant (Alvik, et.al. 2007).
Although, there must still be control and moderation in the intake of alcohol because of its
possible harmful effects to the baby.
Consumption of fish, fruits and vegetables during pregnancy is strongly advised since
these food items contain important nutrients such as B-vitamins, vitamin C, calcium, iron, and
folate which are needed for the growth and development of the fetus. Meanwhile, several beliefs
such as not eating eggplant and not consuming chocolate drinks because of the effect of having
a dark-colored baby had no scientific proofs.

V. Conclusion

26

VI. References
Alvik, A.; Haldorsen, T.; Lindemann, R.; Alcohol consumption, smoking and breastfeeding in the
first six months after delivery. Acta Paediatrica: Nurturing the Child 95-6: 686-696, 2007.

Barker, D. (1990). The developmental origins of chronic adult disease.Acta Paediatrica,

26-33.
Boo, H., & Harding, J. (2006). The developmental origins of adult disease (Barker)
hypothesis. Australian and New Zealand Journal of Obstetrics and Gynaecology, 46, 414.
Claudio, V.; and Ruiz, A. Basic Nutrition for Filipino. 6th ed. Manila: Merriam School & Office
Supplies, 2010.
Dover G.J., The Barker Hypothesis: How Pediatricians Will Diagnose and Prevent Common
Adult-Onset Diseases. American Clinical and Climatological Association 120: 199207,
2009.
Little, R. E.; Anderson, K. W.; Ervin, C. H.; Worthington-Roberts, B.; and Clarren, S. K. Maternal
alcohol use during breastfeeding and infant mental and motor development at one year.
New England Journal of Medicine 321: 425 430, 1990.
VII. Reflection
VIII. Appendix
Appendix 1. The equation flow in the computation for the Desired Body WEight, Total Energy
Allowance, Caloric Distribution (Percentage Distribution Method and Non-Protein calorie
Method)

27

28