NUTRITION & DIET

THERAPY
Sharon J. Cagas, RM, BSM
 COURSE DESCRIPTION
This course deals with the study of food in relation to
health.
• It covers nutrients and other substances and their action,
interaction and balance in relation to health and diseases
and the process by which organism ingest, digest,
absorbs, transports, utilizes and excretes food
substances.
• It will also focus in the therapeutic and food service
aspects of the delivery of nutritional services in hospitals
and other health care institutions.
 GENERAL COURSE DESCRIPTION
At the end of the course and given specific situations/ conditions, the students will be able to:

1. Define terms related to nutrition.

2. Identify essential and basic tools in nutrition.
3. Explain the role of the following basic nutrients
: carbohydrates, protein, lipids, water,
vitamins and minerals.
4. Calculate the calorie content of foods on their
carbohydrate, protein and fat content.
5. Identify how diet guidelines and menu planning
promote nutrition and health.
6.Identify appropriate measure to be employed in
meeting nutritional imbalance.
7.Identify the most common appropriate
therapeutic diets used in clinical care.
8. Prepare a sample menu based on
recommended daily allowance.
 EVALUATION / GRADING SYSTEM

Trinal Examination 50%

Quizzes 40%
Others: 10%
Assignments, Recitation,
Projects Article/Journal _____________

Total 100%
INTRODUCTION
TO
NUTRITION
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 OBJECTIVES
• At the end of 2 hours Lecture – Discussion, and 2 hours Laboratory works, the students will be
able to:
1. Define terms basic to nutrition.
2. Utilize nutrient recommendations to assess, plan and evaluate nutrient intake.
3. Apply principles in offering practical advice on how to eat for good health.
4. Identify the various nutrients, its functions and food sources that are essential to health.

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9
 “THE WAY PEOPLE EAT”
• The urge to EAT is fundamental to man and has always been an issue that preoccupies him and
advances on almost every aspect of his life.

• The urge to EAT does not comes from physiological needs to sustain life, but is also triggered by
the fact that FOOD is a source of emotional satisfaction, and a way for expressing the social need
to share.
• The urge to eat contributes to the
relationship of individuals, groups, and
societies.
 Factors
influencing
food habits
 FACTORS AFFECTING MAN’S ATTITUDE
TOWARDS FOOD AND EATING PATTERN:

1. Psychological factors

 foods popular to a “barkada”

 teens are fond of fatty foods such as fries,
hamburgers
 men consumes alcoholic beverages, “pulutan”
 a depressed individual may eat instead of talking to a
friend.
FACTORS AFFECTING MAN’S ATTITUDE TOWARDS
FOOD AND EATING PATTERN:

2. Socioeconomic factors

 Income and education

 Social pressure – prestigious food served during
festivals
 “rich men’s food” – pork, chicken, seafoods are
served during weddings, baptism, fiestas
 “poor men’s food” – fish, vegetables
 FACTORS AFFECTING MAN’S ATTITUDE
TOWARDS FOOD AND EATING PATTERN:
3. Cultural factors –

 Religion, customs, traditions

affect how man eats,
prohibiting some religious
groups from eating certain
food.
 Occasions – “suman, biko,
puto”
 During summer – “halo-halo”
 FACTORS AFFECTING MAN’S ATTITUDE
TOWARDS FOOD AND EATING PATTERN:
4. Physical or Ecological factors

 Geography, climate, season and type of soil – what,

when and how foods are produced
 Most of the protein consumed in coastal villages is
from animal sources (seafoods)
 Bicol region – is the leading consumer of starchy
roots and tubers.
FACTORS AFFECTING MAN’S ATTITUDE
TOWARDS FOOD AND EATING PATTERN:
5. Biological factor
 Vary among different groups – infants, toddlers, preschoolers, adolescents,
pregnant and lactating mothers, aged.
 Sick individual – fruits, beverages, fruit juices.
 FACTORS AFFECTING MAN’S ATTITUDE
TOWARDS FOOD AND EATING PATTERN:
6. Technological factors
 Food processing methods, food packaging, and food, and food storage
 Example – dried mangoes, mango juice
NUTRITION

Is the science of the processes by which

the body uses food for :
energy,
maintenance and
growth.
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NUTRITION

 Study of food and how the body

makes use of it .
 Maintain life by allowing one to grow
and be in a state of optimum health.

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FUNCTIONS OF NUTRITION
The recognition of the role of nutrition in
preventing disease or illness.
The concern for adapting food patterns of
individuals to their nutritional needs within the
framework of their cultural, economic and
psychological situation and style.
Awareness of the need in specified disease
states to modify nutritional factors for
therapeutic purpose.
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 IMMEDIATE EFFECTS OF GOOD NUTRITION
INCLUDES:

• Healthy appearance
• Good attitude
• Proper sleep and bowel habits
• High energy level
• Enthusiasm
• Freedom from anxiety
NUTRIENT

Is a chemical substance that is present in

food and needed by the body.

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Variables which affect nutrient
needs:
1. Age
2. Gender
3. Activity Level
4. Climate
5. Health
6. State of nutrition
CLASSIFICATION
 As to FUNCTION
- nutrients form tissues in the body and body building.
- furnish heat and energy such as fats , carbohydrates and
protein

 As to Chemical Properties
- either Organic or Inorganic

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CLASSIFICATION

As to Essentiality
- significant contribution to the body’s physiological
functioning

As to Concentration
- some nutrients are needed in large amounts than
others.
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MACRONUTRIENT

 Energy nutrients carbohydrates, protein

and fat.

MICRONUTRIENT

 INCLUDES VITAMINS, MINERALS AND

WATER.

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THE SIX ESSENTIAL NUTRIENTS AND THEIR
FUNCTIONS

Organic Nutrients Function

Carbohydrates Provide energy
Fats Provide energy
Proteins Build & repair tissues
Vitamins Regulate body processes
Inorganic Nutrients Function
Minerals Regulate body processes
Water Regulates body processes
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 CARBOHYDRATES
• Major source of human energy
• Starches or sugars
• Easily digested, grow well in most climates, keep well
without refrigeration
• Main sources: bread, cereals, pasta, crackers,
potatoes, corn peas, fruits, sugars and syrups
 FATS
• Main sources: butter,
margarine, oils, creams, fatty
meats, cheeses, and egg yolk
• Concentrated form of energy
• Help maintain body temperature
by providing insulation
• Help cushion organs and bones
• Provide flavor to meals
 • Build and repair body tissue
PROTEINS
• Provide heat and energy
• Help makes antibodies
• Make up to 22 amino acids
(9are essential)
• Main sources complete
protein: meat, fish, milk,
cheese, eggs,
• Incomplete proteins: cereal,
soybeans, dry beans, peas
and peanuts
• Organic compounds that are VITAMINS
essential to life
• Regulate body functions
• Repair body tissues
• Only a small amount required –
well balanced diet provides
required vitamins
• Excess or deficiency can cause
poor health
• Water soluble or fat soluble
MINERALS
• Inorganic (nonliving)
elements found in all body
tissues
• Regulate body functions
• Build and repair body
tissues
• They include: calcium,
phosphorus, sodium,
potassium, iron, iodine,
fluorine and others.
• Found in all body tissues
• Essential for digestion
• Makes up most of blood plasma
WATER
• Helps body tissues absorb nutrient
• Helps move waste material through body
FOOD

ANYTHING which when taken and digested
nourishes the body either solid or liquid
materials
 Vital need
 Culturally acceptable substances
 Utilized to maintain and build body tissues,
regulate body processes and supply heat
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 MEDICAL NUTRITION THERAPY
Referred in the past as DIET
THERAPY
Is the treatment of disease
through nutrition therapy by
registered dietitians

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 MEDICAL NUTRITION THERAPY
To maintain or improve nutritional status
To improve clinical or sub clinical nutritional
deficiencies
To rest certain organs of the body
To eliminate particular food constituents to which the
individual may be allergic or intolerant
To adjust the composition of the normal diet to meet
the ability of the body to absorb, metabolize, and
excrete certain nutrients and other substances
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BASIC TOOLS IN NUTRITION

Dietary Guides
- are tools devised to aid in planning, procuring, serving
and consuming meals for both normal and therapeutic
diets of individuals or groups
- assures that adequate diet is served according to an
individual’s state and need.

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Dietary Reference
Intakes
DIETARY REFERENCE INTAKES
 Comprise of a set of four nutrient – based
reference values being developed by Food
and Nutrition Board (FNB) of the National
Academy of Sciences.
 These values, intended to replace and
expand on the familiar RDA.
 Can be used for planning and assessing
diets.
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DIETARY REFERENCE INTAKES
1. Recommended Dietary Allowance
2. Estimated Average Requirement
3. Adequate Intake
4. Tolerable Upper Intake Level

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 1. RECOMMENDED DIETARY
ALLOWANCE (RDA)
 RDA of a nutrient is the
average daily intake
needed to meet the
requirements of virtually
all healthy people in a
given life stage or
gender group.
 Prevents nutritional
deficiency rather than
promote optimal health
 2. ESTIMATED AVERAGE
REQUIREMENT (EAR)
 Is the average dietary intake needed to meet
the requirements of half of all healthy people in
a given life stage or gender group.
 Determination of this value isn’t based solely on
preventing nutritional deficiency

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ESTIMATED AVERAGE
REQUIREMENT (EAR)
• For risk reduction and bioavailability of a
given nutrient
 3. ADEQUATE INTAKE (AI)
 Assigned to a nutrient if the FNB lacks
sufficient information to establish an RDA and
an EAR.
 Recommended daily intake level based on
estimates of nutrient intake by a group of
healthy people.

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ADEQUATE INTAKE (AI)
4. TOLERABLE UPPER INTAKE LEVEL
( UL )
 Is the highest level of nutrient intake that
doesn’t cause adverse health effects in
most individuals in the general population.

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 DIETARY GUIDES
a. Three Food Groups or Your Guide to Good Nutrition
( YGGN )
b. Plate Model
c. Food Pyramid
d. Recommended Energy and nutrient Intakes
(RENI)
e. Nutritional Guidelines for Filipinos
f. Food Composition Tables (FCT)
g. Food Exchange List (FEL) 49
 A. THREE FOOD GROUPS

Energy Giving
Foods
Body Building
Foods
Body – Regulating
Foods

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 B. PLATE MODEL
Illustrates the types of food needed for a healthy diet
and the proportions that should be eaten everyday.
For healthy eating which is simple designed so that
appropriate food selection without having to weigh or
measure foods
Eat more fruits and vegetables,
Less fat and cholesterol
Control amount of carbohydrates
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PLATE MODEL
 C. FOOD PYRAMID
 Hierarchy of food groups in a person’s diet that help
to put Dietary Guidelines into action.
 Formulated by the Food and Nutrition Research
Institute (FNRI).
 Provides guidance on types and amounts of food to
eat that meet current scientific standards for
healthful eating to help individuals assess and
improve their diet.

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54
MY PYRAMID
 Uses wedges of different width and colors to
represent the recommended amount of food
a person should choose from a food group.

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ANATOMY OF MYPYRAMID
• Activity = importance of daily physical
activity
• Moderation = narrowing of each food
group
• Proportionality = suggest how much
food a person should choose from
each food group
• Variety = symbolizes by six bands of
food groups including oil
• Gradual Improvement = suggest that
individual can benefit taking small
steps to improve diet and lifestyle
• Personalization = recommendations
of kind and amount of food to eat

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 FILIPINO FOOD PYRAMID
 Drink a lot - water, clear broth
 Eat most – rice, root crops, corn, noodles, bread
and cereals
 Eat more – vegetables, green salads,
fruits or juices
 Eat some – fish, poultry, dry beans, nuts,
eggs, lean meats, low fat dairy
 Eat a little – fats, oils, sugar, salt
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d. Recommended Energy and Nutrient
Intakes (RENI)
Is the revised Recommended Daily Allowance
(RDA)
Defined as levels of intakes of energy and
nutrients which , on the basis of current scientific
knowledge are considered adequate for the
maintenance of health and well being of nearly all
healthy persons in the population.

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 RECOMMENDED ENERGY AND NUTRIENT
INTAKES (RENI) 

To emphasize that the standards are in terms of

nutrients, and not foods or diets.

RENIs are defined as levels of intakes of energy and

nutrients which, on the basis of current scientific
knowledge, are considered adequate for the
maintenance of health and well being of nearly all
healthy persons in the population.

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RECOMMENDED ENERGY AND NUTRIENT
INTAKES (RENI)

RENI = AR + 2SD or AR +2CV

o AR = Average physiologic requirement

o SD = Standard Deviations
o CV = Coefficient of variation

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REFERENCE WEIGHTS
The reference weights for adults are the average
weights derived from the 1998 National Nutrition
Survey (NNS). These weights are higher by 3 kg
in the male and 2 kg in the female than the
reference weights used in the 1989 Philippine
RDA edition.
The reference weights for children are set higher
than the average weights following the
International Reference Standards except in late
adolescence. 62
PURPOSE AND APPLICATION OF
RENI
As a goal for energy and nutrient intakes of
groups and nutrient intakes of individuals
As a reference standards for the habitual energy
and nutrient intakes of the population or
population subgroups.
As a goal for agricultural production.

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PURPOSE AND APPLICATION OF
RENI
As a reference standards for assessment of the
adequacy of food supplies
As a tool for nutrition education and advocacy
As a basis for public health and food and
nutrition policies.

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LIMITATIONS OF RENI
 Not basis of evaluating nutritional status
 Not expected to replete stores in malnourished
individuals
 Not applicable for those with increased
requirements because of certain illness.

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 e. Nutritional Guidelines

 Are general but simple statements intended to

provide the general public with recommendations
about proper diet and wholesome dietary practice
to promote good health for themselves and their
families

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NUTRITIONAL GUIDELINES
 Aims to encourage the consumption of an
adequate and well – balanced diet and promote
desirable food and nutrition-related health habits
in the general population (FNRI-DOST 2000)
 Serves as handy reference for counseling and
education

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 NUTRITIONAL GUIDELINES FOR
FILIPINOS
1. Eat a variety of food everyday.
2. Breastfeed infants exclusively from birth to 4-6 months, and
then, give appropriate foods
while continuing breastfeeding.
3. Maintain children’s normal growth through
proper diet and monitor their growth regularly.
4. Consume fish, lean meat, poultry or dried
beans.
5. Eat more vegetables, fruits, and root crops.
6. Eat foods cooked in edible/cooking oil daily. 68
 NUTRITIONAL GUIDELINES FOR
FILIPINOS
7. Consume milk, milk products or other
calcium-rich foods such as small fish and dark
green leafy vegetables everyday. Use iodized
salt, but avoid excessive intake of salty foods.
8. Use iodized salt, avoid excessive intake of
salty foods
9. Eat clean and safe food.
10. For a healthy lifestyle and good nutrition,
exercise regularly, do not smoke, avoid
drinking alcoholic beverages. 69
 f. Food Composition Table

 Is a dietary tool which contains a list of foods

with numerical values corresponding to the
amount of energy. Nutrients, fibers and ash
per 100grams of any particular food in the list
 Represents total amount of the constituent of
foods rather than the amount absorbed.

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FOOD COMPOSITION TABLE
 g. Food Exchange List (FEL)

 Is a list of common foods grouped in terms of

equivalent amounts of carbohydrates, protein, fats
and calories.
 Diet prescriptions are translated into food exchanges
which are simple and easy to understand.
 “exchange” = substituted for another food in the
same group

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FOOD EXCHANGE LIST (FEL)
 BODY MASS INDEX
Body Mass Index
Ratio of Weight to Height

weight in kg
BMI = (height in meters ) 2
 BODY MASS INDEX
• BMI = Weight (kg)
Height (m)2

65 kg
(1.6 m)2
BMI = 25.4
BMI

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 PHYSICAL ACTIVITY
Caloric Expenditure for Various Types
TYPES OF ACTIVITY Calories
of the Activity
Sedentary Lifestyle 80 - 100
Reading, writing, eating, watching TV, office work, sitting
at work
Light Activities 110 – 160
Cooking, washing dishes , ironing , welding, standing at
work, rapid typing
Moderate Activities 170 - 240
Mopping, scrubbing , sweeping, gardening ,
carpentry,walking fast, standing work with moderate arm
movement , sitting works with vigorous arm movement

Heavy Activities 250 - 350

Heavy scrubbing, handwashing ,walking fast, bowling, 77
golfing, heavy gardening
Unit of energy = kilogram calorie (kcal)
o Calorie = standard unit of energy used in
Human Nutrition
= by products of food
 DESIRABLE BODY WEIGHT
Ador Dionisio’s Method
- Height
 for every 5feet allow 100lbs for female and
110 lbs for males
For each additional inch allow 2 lbs each

-Age for every 5 years between 25-50years

2 lbs additional
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EXAMPLE :
DBW OF A 45 years old Male
Height : 5ft = 110lbs
4inches x 2 = 8 lbs
118 lbs
Age : 45yo x 2 ÷ 5 = 18 lbs

DBW : 118lbs + 18lbs = 136 lbs

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TANNHAUSER’S METHOD
Height in cm - 100cm
* Take 10% of remainder and subtract
answer from remainder.

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EXAMPLE :
 DBW OF 45 yo MALE, 5’4” tall
* Height = 5’4” = 64inches = 162.56cm
162.56cm – 100cm = 62.56cm
10% of 62.56cm = 6.256cm
62.56kg – 6.256 = DBW (kg)
56.3kg = DBW
56.3kg = 123.86 lbs = DBW
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 CONVERSION
• Feet and inches to meters
• 1 foot = 0.3048 meters
• 1 inch = 0.0254 meters

• Meter to foot and inches

• 1 meter = 3.2808399 feet
• 1 meter = 39.3700787 inches
 CARBOHYDRATES – 50% ÷ 4 = grams/day
 FAT – 25% of kcal ÷ 9 = gram/day
 PROTEINS – kg x 0.8 grams = gram/day
 VITAMINS – weight in mg or mcg
 MINERALS – 100 mg/day, (4% of body weight
is minerals)