Nutrition and Diet

UST Faculty of Pharmacy

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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.
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I. 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)
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I. CARBOHYDRATES

providing the:
- major source of energy intake (40-80%
of total energy intake for Filipinos) for
work and development because of the
following reasons:
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Reasons
1. Carbohydrates are readily available being
widely distributed in a variety of easily
grown plants such as grains, vegetables
and fruits
2. The cost in the total food budget is
relatively small
3. Provides quick and sustained body fuel
from rapid oxidation of starches and sugars
yielding the needed body heat and energy
with CO
2
and water as end products (TCA)

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I. Carbohydrates
RDA (reqd. daily allowance): 55-70% of TCA
Energy yield: 4kcal/g
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II. FATS
Food Source:
Saturated fatty acids
animal source like meat,
eggs, milk fat
Unsaturated fatty acids
plant source like
vegetable oil (olive oil,
peanuts, almonds,
avocado oil)
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II. FATS
A. Functions
source of fuel for the body to store and
burn as needed for 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
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II. FATS
RDA: 20-30%
Energy yield: 9 kcal/g
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III. PROTEINS
D. Food source:
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

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ADULTS
Body Mass Index (BMI)
shows body weight adjusted for height.

calculated with simple math using inches and
pounds, or meters and kilograms.
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Adults
For adults aged 20 years or older, BMI
fall into one of these categories:
Underweight
Normal
Overweight
obese

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BMI


wt (lbs)
h
2
(in)
x 703
=
________
BMI =
BMI
BMI =
wt (Kg)
wt (Kg)
________
________
h
2
(m)
h
2
(cm)
x 10,000
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Interpretation
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
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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 REQUIRMENT (TER) OR TOTAL
CALORIC ALLOWANCE (TCA)
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DESIRABLE BODY WEIGHT
(DBW)
It can be determined by:
a. Height-weight tables of FNRI

b. Modified Tannhausers method in the
absence of height-weight tables

DBW(kg) = (height in cm - 100) - (10%[ht in cm 100])
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DBW
c. NADP Formula
Males 5ft 112 lbs 4 lbs for every
inches above (below) 5ft
Female 5ft 106 lbs 4 lbs for every
inches above (below) 5ft

_Actual weight - DBW _ x 100
Actual weight
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Interpretation
Obese if body weight is more than 20%
above the desirable weight
Overweight if the weight is >10%-20%
above the desirable weight
Normal if the weight is 10% of the
desirable body weight
Underweight if the weight is >10%
below the desirable weight
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DETERMINATION OF TOTAL ENERGY
REQUIREMENT (TER) OR TOTAL CALORIC
ALLOWANCE (TCA)
Factorial Method

TCA/TER = BMR + PA + SDA
Specific Dynamic Action or SDA
Basal Metabolic Rate (BMR)
Physical Activity (PA)

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Basal Metabolic Rate (BMR)

Minimum amount of energy needed to
maintain the vital process of life under
basal condition
1 kcal/kg of body weight/hour

BMR = 1 kcal/kg x DBW x 24 hrs
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Physical Activity (PA)
Hospital patient - 10%
Sedentary - 30%
Light - clerks, typist (50%)
Moderate - housewives,shoemaker,jeepney
drivers,students, fishermen (75%)
Heavy construction workers (100%)
PA = BMR x % physical activity classification
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Thermogenic effect of blood
(Specific Dynamic Action or SDA)
The energy required for digestion,
absorption, transport, and utilization of
food
SDA = (BMR + PA) x 0.06 adult (12 y/o)
0.15 child (<12 y/o)
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NDAP method

TCA = DBW x 40

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TOTAL CALORIC ALLOWANCE
To lose 1-2 lb/week, subtract 500 kcal
daily from the calculated TCA
add same amount of kcal to gain 1-2
lb/week
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NDAP Recommendation
NDAP Recommendation for
overweight/obese adult
1. Compute allowance base on DBW and
subtract 500kcal/day
2. If only moderately overweight,
recommend exercise and avoidance of
fats and sugar
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Example
EXAMPLE COMPUTATION FOR DBW, TCA AND
DISTRIBUTION of the TCA into
CARBOHYDRATES, PROTEINS AND FATS
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%.
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1. DBW
a. Modified Tannhauser Method

DBW (kg) = (height in cm -100) (10%[height in cm-100])
= (155-100) (55 x 0.1)
= 50 kg
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NDAP Method
b. NDAP method
Female 5 ft 106 lbs
1 inch 4 lbs
110 lbs (50 kg)

Actual weight DBW x 100
Actual weight
59kg 50kg x 100 = 15%
59 kg

***59 kg is between 10-20% above the DBW of kg =
overweight

____________________
_________________
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TCA/TER

a. Factorial method

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
_____________
2226 kcal
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NDAP
b. NDAP method

TCA/TER= DBW x 40= 50 x 40= 2226
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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

256 gm
_________
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PEDIATRICS
1. Waterlow Classification for Wasting
Computation:
Actual weight
Ideal weight for actual length or height x 100 =___%
Classification:
Normal >90%
Mild 80-90%
Moderate 70-80%
Severe <70%
________________
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PEDIATRICS
2. Waterlow Classification for Stunting
Computation:
Actual height or length
Ideal height or length for age x 100 =___%

Classification:
Normal >95%
Mild 90-95%
Moderate 80-90
Severe <80%
_______________________________________
_
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PEDIATRICS
Gomez Classification
Computation:
Actual weight
Ideal weight x 100 = __%
Classification:
Normal 91-100
First degree malnutrition 76-90
Second degree malnutrition 61-75
Third degree malnutrition <60

______________________
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PROTEIN-ENERGY MALNUTRITION
MARASMUS
*Balanced starvation
*Very low in both protein
and calories
*Caused by insufficient
intake of milk
KWASHIORKOR
*Very low in protein, but
one in which contains
calories in the form of
carbohydrates
A. Usual age 0-2 y/o 1-3 y/o
B. Essential features
1. Edema None Lower legs, sometimes
face or generalized
2. Wasting Gross loss
all skin and bones
Sometimes hidden;
sometimes fat
3. Muscle wasting Obvious Sometimes hidden
4. Growth retardation Obvious Sometimes hidden
5. Mental changes Usually apathetic, quiet Usually irritable,
moaning, also apathetic
C. Variable features
1. Appetite Usually good Usually poor
2. Diarrhea Often (past or present) Often (past or present)
3. Skin changes Seldom Occasional flaky paint
or enamel dermatosis
4. Hair changes Seldom Often sparse, straight,
silky, dyspigmentation;
gray or reddish
5. Moonface Seldom Often
6. Hepatic enlargement Seldom Always
PROTEIN-ENERGY MALNUTRITION

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