NUTRITION AND DIET THERAPY Note: approximately 452 kcal/day during

NUTRI LEC the third trimester, which is an increase

of about 15% to 20% over the energy
PREGNANCY needs of nonpregnant women.

● AKA: GESTATION Note: pre-pregnancy weight, health

● lasts for a period of 266 to status, and activity level.
180 days (37-40 weeks)
● consists of 3 trimesters-
● one additional snack per day
consisting of a medium
implantation, organogenesis
banana (105 kcal), an 8-oz
and growth
serving of whole milk yogurt
(138 kcal), and 1/8 cup of
NUTRITIONAL DEMANDS OF
mixed nuts (101 kcal).
PREGNANCY
● This snack provides 344 kcal.
● mother's and the child's health ● Providing examples of exactly
depend on the pregnant what "extra energy needs"
woman eating a well-balanced means is important so that
diet with adequate essential expecting mothers do not
nutrients misunderstand the message
● General guidelines are and assume that they need to
provided in the comprehensive "eat for two."
Dietary Reference ● Increased complex
● Intakes (DRIs) issued by the carbohydrates,
National Academy of monounsaturated fats, and
Sciences. polyunsaturated fats are the
preferred sources of energy,
Factors determining nutritional needs especially during late
pregnancy and throughout
lactation.
● Age, gravida, parity
Note:
ENERGY NEEDS

Note: pre-pregnancy weight, health ● active, large, teenage, or

status, and activity level. nutritionally deficient pregnant
women may require more
1.Reasons for Increased Need energy than the DRI
guidelines
Note: 2nd Trimester: the need for adequate kilocalories to
Kilocalorie increases secure the nutrient and energy
needs of a rapidly growing
● to supply the increased fuel fetus
demanded by the metabolic ● Sufficient weight gain is vital
workload for both the mother to a successful pregnancy
and the fetus; and ● Gestational weight gain is a
● to spare protein for the predictor of infant birth
added tissue building weight and birth weight is
requirements. associated with body mass
index (BMI) later in life both
too little and too much weight
gain during gestation have
2. Amount of Energy Increase implications for the overall
health of the infant
Note: such as calcium, iron, zinc,
and fat-soluble vitamins.
● inadequate gestational weight
gain increases the risk for KEY MINERAL AND VITAMIN NEEDS
preterm deliveries, and for
low-birth-weight babies Minerals
● excessive weight gain poses
Keshan disease, goiter, cretinism, fetal
both short-term and potentially
growth restriction
long-term complications for the
mother and fetus
Keshan disease is a congestive
cardiomyopathy caused by a combination
Reasons for Increased Need (Protein)
of dietary deficiency of selenium and the
presence of a mutated strain of
NOTE: building block for the tremendous
Coxsackievirus.
growth of body tissues during pregnancy
2 major minerals
1. Development of the
placenta. CALCIUM
2. Growth of the fetus. essential for the fetal development of
3. Growth of maternal tissues. bones and teeth as well as for the
4. Increased maternal blood mother's own body needs
volume.
● Note: hemoglobin and albumin ● blood clotting
● Sources: cups of milk or milk
3. Amniotic fluid. substitute daily (e.g., calcium-
fortified soy milk), generous
Note: amounts of green vegetables,
and enriched or whole grains
Placenta - life line of the fetus. usually supplies enough
calcium.
Growth of fetus - 3.5 kgs fats in 9 months ● Calcium supplements may be
indicated for cases of poor
Normal weight of baby - 2.5 to 3. maternal intake or
pregnancies that involve more
Amount of Protein Increase than one fetus

NOTE: IRON

DRI (Dietary Reference Intake) essential for the increased hemoglobin

synthesis that is required for the greater
nonpregnant women- 46 g/day pregnant maternal blood volume as well as for the
women- 71 g/day baby's necessary prenatal storage of iron.
Sources: ● SOURCES: grains, nuts,
seeds, legumes, and
● Eggs, milk, beef, poultry, fish, vegetables
pork, cheese, soy products,
and other animal products VITAMINS
● legumes and grains
contribute additional valuable NOTE: DRIs for pregnant women are
amounts of amino acids. slightly higher for most vitamins
● Protein-rich foods also
contribute other nutrients, Folate
 ● Folate is important for both cereals contain a well-
mother and fetus throughout absorbable form of dietary folic
pregnancy. acid.
● Tetrahydrofolic acid (TH4) ● Other natural sources of folate
participates in DNA synthesis, include liver; legumes (e.g.,
cell division, and hemoglobin pinto beans, black beans,
synthesis. kidney beans); orange juice;
● It is particularly relevant during asparagus; and broccoli.
the early periconceptional
Vitamin D
period (i.e., from
approximately 2 months
before conception to week 6 of ● Recommend pregnant and
gestation) to ensure adequate lactating women consume 15
nutrient availability in the mcg/d
endometrial lining of the uterus (600 lU)
for embryonic tissue
development. SOURCES:
● The neural tube forms during
the critical period from 21 to 1. vitamin D needs can be met
28 days' gestation, and it by the mother's intake of at
grows into the mature infant's least 3 cups of fortified milk (or
spinal column and its network milk substitute) in her daily
of nerves. food plan.
● Folate helps thwart neural 2. Fortified milk contains 10 mcg
tube defects (NTDs) is (400 IU) of cholecalciferol (i.e.,
unknown vitamin D) per quart.
● Spina bifida - lower end of the Weight gain during pregnancy
neural tube fails to close
● ANENCEPHALY - upper end ● Amount and Quality
of the neural tube fails to
close. Brain fails to develop or
● 10 to 16.7 kg (22 to 36.8 lb)
is entirely absent. End in
miscarriages or death soon
after delivery.
Approximate Weight Gain Distribution
during a Normal Pregnancy

PREGNANT WOMEN: 600 mcg/day

Product Weight
NONPREGNANT WOMEN: 400 mcg/day (lb)

● Women who are unable to

achieve such dietary
recommendations by eating Fetus 7.5
foods that are fortified with
folate may do so with a dietary
supplement
Placenta 1.5
SOURCES:

● All enriched flour and grain Amniotic Fluid 2

products as well as fortified
 Hyperemesis Gravidarum - Antiemetic
drugs
Uterus 2
Constipation

Breast tissue 2 ● Latter part of pregnancy

● There is enlargement of uterus

NSG Management
Blood Volume Increase 3
● No pharmacologic drugs
● Adequate exercises
Maternal Stores: Fat, 11 ● Bedrest with diaper
Protein, Water, and other ● Increase fluid intake
nutrients. ● High fiber diet

Note: Avoid herbal/artificial laxatives

Total 29 Hemorrhoid

● Enlargement of the veins

Note: (anus)
● Can lead to protrusion of anal
● 1-2kg - 1st trimester sphincters
● .5-1lbs - average weight gain ● Caused: Increasing weight of
of the mother weekly basis the baby and the downward
pressure that this weight
produced.
● Resolved: after delivery (it
Concerns: takes time)
Gastrointestinal Problems NSG Management

● Nausea and Vomiting ● Enough rest, especially during

(Morning Sickness) the latter stages of pregnancy.
● Caused: HCG increased - 1st
Trimester Heartburn
● Peak: 9-11 weeks of
pregnancy ● "Full" feeling, after meals.
● Resolved: 14 weeks ● Caused: pressure of the
enlarging uterus, crowding of
NSG Management the stomach.

● Small and frequent feeding NSG Management

● No spices
● Dry and gland to manage ● Avoid large amount of meals
acidity of the stomach ● Small frequent feeding
● Drink between meals ● Comfort - lose outfits
● Check the triggers: Certain
smell, person etc. Definition:
PICA:
Unusual Cravings During Pregnancy. Pica Macronutrients are nutrients that a
is the practice of craving substances with person needs in larger amounts.
little or no nutritional value. Most Macronutrients include water, protein,
pregnancy and pica-related cravings carbohydrates, and fats.
involve non-food substances such as dirt
or chalk. The word pica is Latin for magpie Classification by PREDOMINANT
which is a bird notorious for eating almost FUNCTION
anything.
PREECLAMPSIA: Nutrient
a serious blood pressure condition that - is a chemical component needed
develops during pregnancy. People with by the bodY.
preeclampsia often have high blood - chemical substances found in
pressure (hypertension) and high levels of food
protein in their urine (proteinuria). - some are manufactured in the
Preeclampsia typically develops after the body (a process called
20th week of pregnancy. “biosynthesis”)
- while some are made in the
ECLAMPSIA: laboratory ( man made nutrients
Eclampsia is when a person with useful for research or therapeutic
preeclampsia develops seizures purposes a.
(convulsions) during pregnancy. Seizures
are episodes of shaking, confusion and A. Body-building
disorientation caused by abnormal brain - They form tissues or are
activity. Eclampsia typically occurs after structural components of the
the 20th week of pregnancy. It's rare and body.
affects less than 3% of people with
preeclampsia. Water - is most abundant in the body,
accounting for about 2/3 of body weight
PIH:
Pregnancy induced hypertension (PIH) is Protein - 1/5th or 20% Minerals - 4%
hypertension that occurs after 20 weeks of
gestation in women with previously normal Carbohydrates - less than one pound
blood pressure. The broad classification of about 1/3 kilogram or 1%
pregnancy-induced hypertension during
pregnancy is gestational hypertension, Vitamins - are not considered structural
pre-eclampsia and eclampsia. nutrients since the total concentration in
the body is not even an ounce (less 28
Essential Nutrients gms b.

The World Health Organization (WHO) B. Regulatory

notes that essential nutrients are crucial in - they maintain normal
supporting a person’s reproduction, good - physiologic processes.
health, and growth. The WHO divides - include all the six groups of
these essential nutrients into two nutrients.
categories: micronutrients and - They maintain homeostasis of
macronutrients. body fluids and expedite
metabolic processes.
Micronutrients are nutrients that a
person needs in small doses. C. Furnish energy
Micronutrients consist of vitamins and - are carbohydrates, fat and
minerals. Although the body only needs protein.
small amounts of them, a deficiency can - sometimes referred to as the
cause ill health. “fuel nutrients”
 There are 16 essential minerals:
According to CHEMICAL NATURE/ ● Calcium
STRUCTURE ● Phosphorus
- nutrients are either organic or ● Potassium
inorganic. ● Sulfur
● Sodium
A. Organic nutrients are those that ● Chloride
come from anything food-based ● Magnesium
that contains carbon in its genetic ● Iron
makeup. This includes ● Zinc
carbohydrates, lipids, vitamins, ● Copper
and protein. ● Manganese
B. Inorganic Nutrients Inorganic ● Iodine
nutrients are different from ● Selenium
organic nutrients in one key way: ● Molybdenum
they do not contain carbon. - ● Chromium
There are only two groups of ● Fluoride
inorganic foods that you need to
be concerned about: minerals 6. Water:
and water. As a beverage and a component
of many foods, especially
According to ESSENTIALITY vegetables and fruits.
- The six major nutrients are a
group of individual nutrients each According to CONCENTRATION
of which has an important - Some nutrients are needed in
physiological role in the body. larger amounts than others.
- All nutrients are physiologically - nutrients may be termed
essential to the body, but some macronutrients or micronutrients.
are dietary essentials (these
should be supplied from food Macronutrients
because the body does not - Water, protein, fat and
synthesize them). carbohydrates (present
There are six major nutrients: in the body in large
Carbohydrates (CHO), Lipids (fats), amounts)
Proteins, Vitamins, Minerals, Water
Micronutrients
1. Proteins: - all vitamins and the
meat, dairy, legumes, nuts, trace minerals, which
seafood and eggs are measured in
milligrams or fractions.
2. Carbohydrates:
Glucose dietary fiber According to DIGESTIBILITY

3. Lipids (most commonly called Carbohydrates are simply grouped into:

fats): - Digestible
linoleic acid linolenic acid. sugars, starches, dextrin and
glycogen
4. Vitamins:
water soluble B group vitamins - Partially digestible
and vitamin C, galactogens, mannosans, inulin
fat soluble vitamins A, D, E and K and pentosans

5. Minerals - Indigestible carbohydrates

cellulose and Hemicellulose
 - Only the digestible A. Monosaccharide
carbohydrates Monosaccharides are
sugars and starches, supply simple sugars (glucose,
energy, upon complete fructose, and galactose)
hydrolysis- 1 gram yields 4 kcal. that do not need to be
further digested to be
Indigestible carbohydrates – like the absorbed.
dietary fibers (cellulose, hemicellulose) not
broken down by the human beings in the B. Disaccharides
intestine into glucose units due to lack of Are sugars formed from
specific enzymes so they do not yield two monosaccharides. -
energy. Ordinary cane sugar
(sucrose) is a
CARBOHYDRATES disaccharide composed
- Originally called saccharides, a of glucose and fructose
Greek word, meaning “sugars” monosaccharide units.
- Organic compounds abundant in
plants and widespread in nature. C. Polysaccharides
- About 50-60 percent of energy Starch, glycogen,
needs come from carbohydrates. cellulose and most
- It contains or is made up of types of fiber are
molecules carbon(C), polysaccharides.
hydrogen(H), and oxygen(O).
Carbohydrates are the most D. Oligosaccharides
widespread organic substances contain less than ten
and play a vital role in all life. monomer units to make
- The ratio of hydrogen to oxygen up the molecule. They
is 2:1 as in water molecule, are present in a number
hence the word carbo-hydrate of plant foods including
referring to “a hydrated carbon” leeks, garlic, onions,
Jerusalem artichokes,
FUNCTIONS lentils and beans.
● Energy
● Special Functions RECOMMENDED DIETARY INTAKE
● Glycogen-carbohydrate Storage
● Protein-Sparing Action While there is no (RDA) for
● Antiketogenic Effect carbohydrate, a level of 50 to 60% of total
● Heart Action caloric requirement should be provided by
● Central Nervous System carbohydrates.

TYPES/CLASSIFICATION ACCORDING DEFICIENCY

TO COMPLEXITY
In severe deficiencies, in case of famine
1. COMPLEX CARBOHYDRATES and prolonged starvation, the ill effects of
contain many more nutrients than a limited total food intake result in multiple
simple carbohydrates nutrient deficiencies, particularly protein
energy malnutrition (PEM).
2. SIMPLE CARBOHYDRATES
are usually refined foods such as The first clinical signs are decreased
white sugar, white bread or cola. blood sugar level, loss of weight, and
These foods contain little else retarded growth for infants and children.
besides energy (ie. empty
calories). EXCESS
 4. Glycine
Obesity or adiposity becomes the
problem TYPES OF PROTEIN

SOURCES OF FIBER Complete proteins: These foods contain

● Beans all the essential amino acids. They mostly
● Broccoli occur in animal foods, such as meat,
● Berries dairy, and eggs.
● Avocados
● Popcorn Incomplete proteins: These foods
● Whole Grains contain at least one essential amino acid,
● Apple so there is a lack of balance in the
● Dried Fruits proteins. Plant foods, such as peas,
● Potatoes beans, and grains mostly contain
● Nuts incomplete protein.

PROTEIN AND AMINO ACIDS Complementary proteins: These refer to

two or more foods containing incomplete
Protein came from the Greek proteins that people can combine to
word “protos' '/proteios meaning"primary supply complete protein. Examples
" " or "holding first place”/ “is of prime include rice and beans or bread with
importance” since it is the first substance peanut butter.
recognized as a vital part of a living tissue.
It contains nitrogen in addition to the basic RECOMMENDED INTAKE
carbon, hydrogen and oxygen.
They are organic substances that ADULT – 0.9 gm/kgBW
on digestion yield their constituent unit
building blocks amino acids. CHILDREN – growth needs vary
according to age and growth patterns
a. There are 22 amino acids
b. All amino acids exist in nature as PREGNANCY – rapid growth requires an
alpha-amino carboxylic acids increase of 30 gms over that of the
c. Glycine is the simplest amino nonpregnant woman
acid identified in 1820.
d. Threonine was the last to be LACTATION - requires an increase of 20
identified in 1935 gms

MULDER: a Dutch chemist proposed the DEFICIENCY AND EXCESS OF

name in 1840. PROTEIN INTAKE

FUNCTIONS OF PROTEINS AND Protein deficiency is when people

AMINO ACIDS do not get adequate amounts of protein
from their diet. Kwashiorkor, its most
1. Body building or Structural Role severe form, is most commonly seen in
2. Source of energy children in developing countries.
3. Regulator of bodily Processes
1. Edema
2. Fatty Liver
3. Skin hair problem
SOURCE OF ESSENTIAL AMINO ACIDS 4. Loss of muscle mass
5. Greater Risk of Bone Fractures
1. Methionin 6. Stunted Growth in Children
2. Phenylalanine 7. Increased Severity of Infections
3. Tryptophan
 8. Greater Appetite and Calorie - Visible fats and oils such as
Intake butter, margarine, lard, cooking
oils, fish-liver oils, pork fat,
TOXICITY OR TOO MUCH PROTEIN chicken fat.
INTAKE - Very good sources found in
nuts, such as oil seeds and some
1. Weight gain legumes.
2. Bad breath
3. Constipation RECOMMENDED DAILY ALLOWANCES
4. Diarrhea
5. Dehydration In the Philippines, it is suggested
6. Kidney damage that at least 20% of total caloric allowance
7. Increased cancer risk be supplied by dietary fat.
8. Heart disease
9. Calcium loss DEFICIENCY AND EXCESS

SOURCES Deficiency of fats reduce caloric

supply in the body and cause protein
1. grass-fed lean meats, catabolism.
2. pasture-raised poultry, and
organic dairy Signs of inadequate fat intake include:
3. wild fish 1. Dry and scaly skin
4. eggs from pastured hens 2. Dry eyes
5. legumes, nuts, and whole grains 3. Feeling constantly cold
4. Dry hair and/or hair loss
FATS/LIPIDS 5. Hormonal problems, including
loss of menstrual cycle
Fat is one of the three main 6. Inability to feel full/always feeling
macronutrients, along with the other two: hungry
carbohydrate and protein. Fats molecules 7. Issues concentrating and/or
consist primarily of carbon and hydrogen mental fatigue
atoms, thus they are all hydrocarbon 8. Deficiencies in fat-soluble
molecules. Examples include cholesterol, vitamins - Constant fatigue
phospholipids and triglycerides. 9. Excessive intake above the
normal levels resulting in extra
FIVE FUNCTIONS OF FAT IN OUR caloric supply leads to obesity.
BODIES
CHOLESTEROL is a waxy, fat-like
1. Promotes Absorption of Fat- substance that's found in all the cells in
Soluble Vitamins your body. Your body needs some
2. Supports Optimal Health cholesterol to make hormones, vitamin D,
3. Boosts Brain Function and substances that help you digest
4. Provides Energy foods.
5. Insulates the Body
Causes:
TYPES OF FAT 1. Low-density lipoprotein (LDL).
LDL, or "bad" cholesterol,
1. Unsaturated Fats transports cholesterol particles
2. Saturated Fats throughout your body. LDL
3. Trans Fat cholesterol builds up in the walls
of your arteries, making them
FOOD SOURCES hard and narrow.
2. High-density lipoprotein (HDL).
HDL, or "good" cholesterol,
 picks up excess cholesterol and
takes it back to your liver MINERALS

Risk Factors: These are groups of minerals

1. Poor diet which are needed by the body in minute
2. Obesity amounts to perform certain vital
3. Lack of Exercise functions. They are sometimes called
4. Smoking trace minerals. Ordinarily these minerals
5. Age can be supplied by an average mixed diet
6. Diabetes since the amounts needed are very small.

Prevention: 1. Iron
1. Eat a low-salt diet that 2. Zinc
emphasizes fruits, vegetables 3. Selenium
and whole grains 4. Copper
2. Limit the amount of animal fats 5. Iodine
and use good fats in moderation
3. Lose extra pounds and maintain WATER
a healthy weight
4. Quit smoking Water is defined as an essential
5. Exercise on most days of the nutrient because it is required in amounts
week for at least 30 minutes that exceed the body's ability to produce it.
6. Drink alcohol in moderation, if at
all Distribution of water in the body
7. Manage stress
It constitutes about 60-70% of the
VITAMINS AND MINERALS total body weight so that a body deprived
of water by as much as 10% will already
Vitamins were formerly called result in illness and a 20% loss of body
“accessory food factors” because their water may cause death. It is next to
presence in minute quantities is easily oxygen in importance for the maintenance
overlooked. of life.
The word “vitamin” was
originated by Casimir Funk in 1912 when FUNCTIONS
he was searching for a constituent in rice
bran which could cure beriberi. - flushing out waste from your
body
FAT-SOLUBLE VITAMINS - regulating body temperature
1. Vitamin A - helping your brain function
2. Vitamin D - it helps create saliva
3. Vitamin E - it regulates your body
4. Vitamin K temperature
- It protects your tissues, spinal
WATER SOLUBLE VITAMINS cord, and joints
1. Vitamin C (Ascorbic acids) - It helps excrete waste through
2. Vitamin B perspiration, urination, and
a. thiamine (B1) defecation
b. riboflavin (B2) - It helps maximize physical
c. niacin (B3) performance
d. pantothenic acid (B5) - It helps prevent constipation
e. pyridoxine (B6) - It aids in digestion
f. biotin (B7) - it helps with nutrient absorption
g. folate (B9) - It helps you lose weight
h. cobalamin (B12)
 - It improves blood oxygen
circulation
- It helps fight off illness
- It helps boost energy
- It aids in cognitive function
- It helps improve mood
- It helps keep skin bright
- It prevents overall dehydration

RECOMMENDED INTAKE

- about 15.5 cups of water (125

ounces) each day for men
- about 11.5 cups (91 ounces)
daily for women

DEFICIENCY

Dehydration may be serious if the

loss is about 10% of the total body body
water and fatal if the loss is from 20-22%.

TOXICITY

If the cells and tissues become

water-logged due to the entrance of the
accumulated water, symptoms which may
include anorexia, vomiting,
convulsions, coma and even death
result. Excess fluid also becomes
apparent as edema. Edema is defined as
the accumulation of water in the interstitial
fluids.
 Note: at least +2 kg every year

3. ADULTS

Hamwi Method:

Women: 100 for 5ft add 5lbs for additional

in.

Men: 106 for 5ft add 6lbs for additional in.

NUTRITION AND DIET THERAPY NDAP:

NUTRI LAB
Male: 112 lbs for 5ft, +- 4
Unit 4: Dietary Computation Female: 106 for 5ft. +- 4

CALCULATION OF IDEAL BODY 4. TANHAUSSER’S METHOD OR

WEIGHT (IBW) BROCCA INDEX
- This is used for under 5 children
in monitoring their weight to be DBW = Height cm - 100
compared with the standards
(*for filipino, deduct 10%)
Remember:
1 month = 30 day 5. ADOPT METHOD
1 year = 12 months
5ft for 105 lbs, +- 5
IBW = DOW - 2008 - 12 - 06
DOB - 2006 - 03 - 02 6. BMI = Weight kg/Height = m2
2 09 04
= 2 X 12 = 24 + 9 B. DIETARY CALCULATIONS
= 33 mos
BMR - 1kcal x weight x 24 hrs
A. Determining Ideal/Desirable Body
Weight (IBW/DBW) Infants: TEA (Total Energy Allowance)

1. INFANTS 0-6 mos: TER DBWkg x 120 kcal

7-12 mos: DBWkg x kcal/DBW/day
a. 1st 6 months
DBWgm = Birthweightgm + (Age mos x Children: TEA (Total Energy Allowance)
600)
M1 = TER = 1000 (age yr x 100 kcal)
b. 7-12 months M2 = TER = DBWkg x 110 kcal)
DBWgm = Birthweightgm + (Age mos x
500)
Age kcal/BDW/day
● Infant’s weight doubles at 5-6
months 1-3 105
● Triples at 12 months
● Quadruples at 24 months 4-6 90

2. CHILDREN 7-9 75

DBW kg = (Age in years x 2) +8 10-12 65 (b) 55 (g)

 heavy manual
activities, other
heavy manual
work

Cooper et al. Method

TEA = ___kcal (basal needs) ___ (%PA) =

___ kcal
Adolescents: TEA (Total Energy
Allowance)

TER = DBW x kcal/DBW/day % Total Calories

Consumed

Carbohydrate 40 - 65
Age kcal/DBW/day
Protein 10 - 35
13 - 15 55 (b) 45 (g)
Fat 20 - 35
16 - 19 45 (b) 40 (g)
Linoleic Acid (n-6) 5 - 10
KRAUSE METHOD
Alpha-linolenic 0.6 - 1.2
TER = DBW (kg) x Physical Activity Factor acid (n-3)

= round off to the nearest 50

Activity kcal/kg BDW day
Distribute TEA among CHO, CHON, &
Bedrest ( mobile ) 27.5 FAT

Sedentary/ Very 30 CHO = 50 – 70 %

Light – mostly CHON = 10 – 15 %
sitting down FAT = 20 – 30 %

Light – student, 35 Cooper et. Al Method: TER = BMR + PA

nurse, teacher, + SDA
engineer,
housewife w/ BMR = 1 kcal/kg DBW/ hour
maid, restaurant
trades, childcare, Note: 1 day = 24 hours PA = % above
table tennis, golf basal or BMR -

Bedrest = 10%
Moderate – wife 40
Sedentary = 30%
w/o maid, vendors
Light = 50%
running on the
Moderate= 75% Heavy = 100%
streets, jeepney
drivers, dancing

Heavy – walking 45
activities w/ load,
 ● Dieting - the deliberate
selection of food to control
body weight or nutrient intake.
● Diet food - foods that aid in
dieting.
● Cuisine - the diet of a
particular culture.
● Fad Diet - a diet popular for a
time that often promises
unreasonably fast weight loss
NUTDTH1 or health improvements.
INTRODUCTION TO NUTRITION
4. BALANCED DIET: - A diet in which
foods are chosen to provide kCalories,
As HIPPOCRATES believed, ‘the body
essential nutrients, and fiber in the right
must be treated as a whole and not just a
proportions.
series of parts'; He also quoted, 'let thy
food be thy medicine and the medicine be
thy food.' Today Hippocrates is known as 5. ENZYMES - Are generally named by
the "Father of Medicine." adding the ending "-ase" to the name of
the substance on which the enzyme acts
(for example, protcase is an enzyme that
Antoine Laurent de Lavoisier is the
acts on proteins). Most enzymes are
father of nutrition and chemistry; he
recognized by the ending asc, like -
discovered metabolism in 1770. He
maltase, lipase and transaminase.
demonstrated that energy from food is
derived due to oxidation of it.
6. KILOCALORIES/CALORIES - The
term used to represent the amount of
COMMON TERMS USED IN THE STUDY
energy required to raise the temperature
OF NUTRITION
of a liter of water one degree centigrade at
sea level.
1. NUTRITION - The study of how your
body uses the food that you eat; It is A bomb calorimeter is used to
the science of food in relation to health determine the energy values of foods by
of an individual, community, or society placing a sample of food in a chamber,
and the process through which food is surrounding it with water, and then
used to sustain life & growth. burning it.

2. MALNUTRITION - "Poor nutritional A calorie is the amount of heat

status"; A state in which a prolonged needed to raise the temperature of 1
lack of one or more nutrients retards kilogram of water 1 degree Celsius.
physical development or causes the
appearance of specific clinical
conditions (anemia, goiter, rickets, etc.)

3. DIET - All-inclusive term referring to

food regularly eaten and liquids
regularly consumed; the sum of the
food consumed by an organism or
group.
 6. Offers variety and planned
within socio-economic context.

10.GOOD NUTRITION - Means eating the

right quantity, quality and diversity of foods
and getting the care we need to keep our
bodies strong and healthy and prevent us
from getting sick.

1. When a person is
undernourished, there are
usually numerous reasons.
2. Often, these reasons are
connected. If a child is
malnourished, the father may
blame the mother for not
feeding the child enough.
3. Yet the father may not be
7. GOOD NUTRITIONAL STATUS - giving the mother the right
Implies appropriate intake of the variety of foods to cook.
macronutrients-carbohydrates, proteins,
and fats and the various vitamins and 4. Maybe he cannot afford it, or
minerals often referred to as he does not have enough land.
"Micronutrients" because they are needed
in small quantities.
5. It is important to do a proper
analysis and not blame one
person.
8. MEDICAL NUTRITION THERAPY.
"DIET THERAPY" - Is the treatment of 6. In many cases, the solution to
disease through nutritional therapy by one person's malnutrition will
registered dietitians (RDs) involve the whole community.

9. FOOD-MATERIAL - Usually of plant or 11. NUTRIENTS - Consist of various

animal origin, that contains or consists of chemical substances in the food that
essential body nutrients, such as makes up each person's diet; (A nutrient is
carbohydrates, fats, proteins, vitamins, or a chemical substance in food that helps
minerals, and is ingested and assimilated maintain the body.) Some provide energy.
by an organism to produce energy,
stimulate growth, and maintain life. ● All help build cells and tissues,
regulate bodily processes such
QUALITIES OF A GOOD FOOD as breathing.
● No single food supplies all the
1. Nourishing or nutritious. nutrients the body needs to
2. It has satiety value. function.
3. Prepared under sanitary
conditions, aesthetically and
● Deficiency Disease: failure to
meet your nutrient needs.
scientifically.
4. Free from toxic agents. Nutrients are the components of
5. Palatability satisfies the food which have a function in...
consumers.
● Providing energy,
 ● Providing material for growth,
● Repair
● reproduction,
● starting and controlling various
processes immune system;
iron and red blood cells
12. NUTRIENT DENSITY - A measure of
the nutrients provided in a food per
kilocalorie of that food.
13. ESSENTIAL NUTRIENTS - Nutrients
that either cannot be made in the body or
cannot be made in the quantities needed
by the body; therefore, we must obtain
them from food.

14. HEALTH - Is a slate of complete

physical, mental and social well-being and
not merely the absence of disease or
infirmity.

15.HORMONES - A hormone is a
chemical produced in one part of the body
and released into the blood to trigger or
regulate particular functions of the body.

● For example, insulin is a

hormone made in the
pancreas that tells other cells
when to use glucose for
energy.
● Chemicals produced by cells
of the body stimulate or relard
certain life processes such as
growth and reproduction.

17. NUTRITURE - The state of the

nutrition of the body. Nutritional status,
especially with regard to a specific
nutrient.
 A.1 DIET HISTORY
- through interview
- food preferences & intolerances
- taste, appetite, recent wt.
Changes
- desired wt. & usual wt.
- estimation of typical kilocalorie &
nutrient intake

TOOLS:

A.2. 24-HOUR food RECALL

- quick & easy of evaluating intake
- person must be able to recount
all the types & amounts of foods
& beverages consumed during a
24-hour period
UNIT 5: NUTRITION-FOCUSED
NURSING CARE PLAN A.3 FOOD FREQUENCY CHECKLISTS
- Applying the nutrition care - a checklist of particular foods that
process will vary to a degree helps determine what’s
depending on the health care consumed & how often
setting - may list the foods in one column,
& the person marks off how often
A. NUTRITIONAL ASSESSMENT they are eaten 266
- Data gathering with use of some - periods of time
- how often the food is consumed
TOOLS like: (per day/ per week, or per m0nth)
- Interview medical charts, - if the food is eaten frequently,
- Simple assessment seldom, never
- Laboratory Values - typically does not include the
- Physical signs of nutritional serving size, & it may only
status include specific foods or nutrients
- Develop rapport & trust suspected of being deficient or
excessive in the diet.
1. HISTORY A.4. CALORIE COUNT
- Dietary history - The ENERGY (CALORIE) value
- no one approach can provide of food is the amount of energy
complete information because produced in the body as a result
food habits change for most of food metabolism. Calorie
persons - the most common term to
- used in conjunction w/ physical express energy a unit measure of
parameters of health heat
- current & past health history
A.5. FOOD DIARY
a. DIET EVALUATION
2. PHYSICAL EXAMINATION/FINDINGS 2. A fat distribution pattern that is
- CLINICAL associated w/ a low risk of illness
- provide a clue to the presence of & premature death.
malnutrition 3. A medical history that reflects an
- indicators of malnutrition absence of risk factors
- appearance of hair, skin, oral associated w/ obesity, such as
cavity, fingernails elevated blood cholesterol, blood
- presence of edema glucose, or blood pressure.

A. ANTHROPOMETRY
Anthropometry is the study of the
measurement of the human
Wt. Gain Loss
body. Anthropometric
measurements include metrics 1 lb/ wk (1/2 kg) = - less 500 cal
such as height, weight, or head add 500 kcal./ day
circumference. Height is
assessed using a stadiometer. 2 lbs/ wk ( 1 kg ) = - less 1000 cal
Length refers to the add 1000 kcal./
measurement of infants and day
children who are 2 years or
younger or those 24–36 months ● Bec. 35000 kcal equates to
who are not able to stand without approximately 1 lb of body fat.
assistance, or who measure less ● Safe & permanent wt. loss ---
than 30 inches while 267 lying should lose a maximum of 1 – 2
down.27 Growth charts used for lb/ wk.
children age 0–36 months use ● Rapid wt. loss --- compel the body to
recumbent length, whereas use protein (muscle) instead of fat →
stature is used for those age 2– ↓muscle mass --- body fat
20 years. percentage increases

Common Anthropometric BODY MASS INDEX

Measurements - uses a pt’s wt. & ht. to help
classify a person as underwt.,
A.1 WEIGHT normal, or obese
- measures weight in relation to
Types of Weighing Scale height
1. Bar scale - measure of adiposity or overfat,
2. Scalter Scale not simply overweight
3. Platform Scale - should not be applied to children,
adolescents, adults over 65 y/o,
HEALTHY WEIGHT - defined by 3 pregnant & lactating women, &
criteria: highly muscular individuals.
- determined by dividing weight
1. A weight that is within the (kg) by the square of height
suggested range for height (meter – 1m = 39.37in)

FORMULA:
BMI = weight (kg)/Height(m²) 2.Try to include only those foods
which are liked by the patient,
18.5 – underwt. otherwise food may not be eaten
18.5 – 24.9 – normal at all.
25.0 – 29.9 – overwt. 3. Serve the meal in an attractive
30.0 – 34.0 – obese – class 1 way to make them feel like
35 – 39.9 – class 2 eating.
40 or greater – morbid obesity TYPES OF MODIFICATION OF A
NORMAL DIET

The types of modifications that may have

to be made are as follows:

1. In diet consistency
2. In nutrient content
3. In interval and frequency of
feeding

1. Modifications in diet
consistency
UNIT VII: DIET THERAPY
- In some diseases the thickness
LESSON 1 GENERAL DIETS of the food has to be changed.
- The food can then be served in
- The application of nutritional two consistencies:
science to promote human health
and treat disease 1. Liquid
- involves the modification of food 2. Semi solid
intake
- A means of management for 2. Modifications in nutrient content
such metabolic diseases or it
supports the overall therapeutic - Depending on the nature of the
program diseases, modifications may
need to be made in one or more
Some points to remember nutrients in the diet.
- The modifications can be in
While modifying the diet of a patient, keep terms of an increase or decrease
the following points in mind: in the amount of the nutrient.
1. Do not plan a completely different
diet because:
- Diets based on a person's daily 3. Modifications in interval and
diet have better acceptance. 417 frequency of feeding
- Such diet do not make a patient
feel that he/she is eating - Normally you eat 3-4 meals a
something completely different day, that is, breakfast, lunch, tea
from the family members. and dinner.
- It is difficult to prepare.
 - In sickness, you find it difficult to - Bed patients not requiring
eat the amount you usually eat at therapeutic diets
one time.
- However, your body must get all 2. Vegetarian Diet
the nutrients in correct amounts. - Vegetarian diets are used by
- Small amounts of food at individuals who abstain from
intervals of 2-3 hours and as eating all or specific foods of
many as 8-10 small meals in a animal origin.
day instead of 3-4 meals
facilitates speedy recovery. TYPES

TYPES OF DIETS Dietary restrictions based on patients own

- Diets used in the treatment of restrictive practices.
disease are termed by specific 1. Lacto-ovo vegetarian - Diet
names that show a special includes milk products & eggs will
composition and often indicate meet the recommendations.
the purpose for which the diet is 2. Lactovegetarian diets – include
intended. milk products
3. Pure vegetarians/ Vegans- eat
General Diets only plants
1. Regular/ Normal/ Full Diet
2. High Fiber PURE VEGAN DIETS: benefits
3. Low Fiber
4. Vegetarian - Low in fat
5. Therapeutic - High in fiber
- Cholesterol-free ↓
- Decreased risk of:
- Coronary heart disease
1. Regular Diet – “Normal diet”/ “full - obesity
diet”/ house/ dat (diet as - Type II diabetes
tolerated) - Constipation
- Certain cancers – breast & colon
- composed of all types of foods
and is well balanced 3. THERAPEUTIC DIETS
- capable of maintaining a state of
good nutrition - are modifications of the regular
- It is intended for convalescing diet and are designed to meet
patients who do not require a specific patient needs.
therapeutic diet.
These include modifications in:
INDICATIONS
- When no dietary modification is - method of preparation (e.g.,
needed and solid foods can be baking, boiling, or broiling),
tolerated. - consistency (e.g., ground or
- No dietary restrictions Includes chopped),
the basic food groupS. - total calories (e.g., high or low
- For ambulatory patients calorie),
 - nutrients (e.g., altering - Intended for a very short
carbohydrate, protein, fat, durations (3 days or less) due to
vitamins, and minerals) allowing nutritional inadequacies.
only specific foods (e.g., diabetic
diet). 2. FULL LIQUID DIET
LESSON 2: DIETS MODIFIED IN
CONSISTENCY - Consists of foods that are in a
liquid state at body temperature.
1. CLEAR LIQUID - A full liquid diet includes all the
liquids served on a clear liquid
A short-term, highly restrictive diet
diet composed only of clear fluids or foods - with the addition of strained
that are fluid at body temperature cream soups, milk and milk
drinks, ice cream, puddings, and
It requires minimal digestion and leaves a custard.
minimum residue. - The full liquid diet is inadequate
- Non-stimulatinG in iron, folic acid, niacin, fiber and
- Non-gas forming possibly Vitamin A and thiamin.
- No-irritating diet - Can be supplemented to
- 400 - 500 kcal approximate the nutritional value
of a regular or highcalorie, high-
FOODS ALLOWED protein diet
- Allows visually clear and
minimum residue liquids. FOODS ALLOWED
- Water, - includes regular foods blended
- Bouillon and strained in liquid form
- Fat-free broth - all foods allowed on clear and full
- Carbonated beverages liquid diets.
- Tea, Coffee, regular & decaf - All the foods in clear liquid diet
- Gelatin (plain) - includes regular foods blended
- Popsicles and strained in liquid form
- Sugar, honey, hard candy - all foods allowed on clear and full
- Fruit juices, strained & clear liquid diets.
- All the foods in clear liquid diet
INDICATIONS
- Initial feeding after surgery or INDICATIONS
parenteral nutrition - As a transitional diet between a
- In preparation for surgery (pre- clear liquid diet and a soft diet
op) and various diagnostic tests - some postoperative cases
of the bowel - acute illnesses
- for acute episodes of nausea and - inflammatory conditions of the
vomiting to promote bowel rest. gastrointestinal (GI) tract
- Clients who have difficulty
CONTRAINDICATIONS chewing or swallowing
- Long-term use - Important - feedings consist of 6
to 8 ounces or more be given
 every 2 to 3 hours while the - vegetables (including baked,
patient is awake. mashed, and scalloped
potatoes).
CONTRAINDICATIONS
- Severe lactose intolerance PERMITTED DESSERTS ARE:
- custards
3. SOFT DIET - gelatin
- puddings
- Normal diet modified in - soft fruits
consistency to have limited fiber - simple cakes and cookies.
- often called a low fiber diet (free - Foods prohibited in a soft diet
from most of the fibers of a include fried foods, raw
normal diet) vegetables, and nuts.
- soft in texture (easily digestible)
- and consists of liquids and semi- MODIFICATIONS
solid foods. - Low residue
- It contains only materials and - No fiber or tough connective
foods that are soft in consistency tissue
and easily chewable. - Traditional bland – no chemical,
thermal, physical stimulants
INDICATION - Cold soft – tonsillectomy
- serves as an intermediate diet
between liquid and normal diet.
- helpful when you have
gastrointestinal problems
- contain nutrition that is adequate
and sufficient for most people.
- It is indicated in certain
postoperative cases
- for convalescents who cannot
tolerate a regular diet
- in acute illnesses
- in some gastrointestinal disorders
- To decrease peristalsis and limit
stimulation of the GI tract,
typically used with PUD and
GERD.

FOODS ALLOWED
- Little or no spices are used in its
preparation.
- includes all liquids other than
alcohol
- foods that may be incorporated
into a soft poultry