EVALUATION

A 65-year-old retired government employee, weighing 70 kg and standing

5’8” has a good appetite but tends to be choosy because of hid dental
problems. He keeps himself busy by managing the family’s small sari-sari
store business.

1. Compute for the desirable body weight and total energy requirement.

5’8” = 172.72cm
STEP 1: DBW = (height in cm – 100) – 10% (height in cm– 100)
= (172.72 – 100) – 0.10 (172.72 – 100)
= (72.72) – 0.10(72.72)
= (72.72) – (7.272)
DBW = 65.45 kg

STEP 2: BEE = Male kcal x DBW x 24hrs

= 1 kcal x 65.45 kg x 24hrs
BEE = 1570.8 kcal

STEP 3: SLEEP = 0.1 kcal x DBW x hours of sleep

= 0.1 kcal x 65.45 kg x 8hrs
SLEEP = 52.36 kcal

CBEE = BEE – SLEEP

= 1570.8 kcal – 52.36 kcal
CBEE = 1518.44 kcal

STEP 4: ACTIVITY = % of activity x CBEE

= 50% x 1518.44 kcal
ACTIVITY = 759.22 kcal

STEP 5: TEF = 10% x (CBEE + ACTIVITY)

= 10% x (1518.44 kcal + 759.22 kcal)
= 0.10 x (2277.66 kcal)
TEF = 227.77 kcal

STEP 6: TER = CBEE + ACTIVITY + TEF

= 1518.44 kcal + 759.22 kcal + 227.77 kcal
TER = 2505.43 kcal

STEP 7: DIETARY PRESCRIPTION

CHO (60%) = 2505.43 kcal x 0.60 / 4
= 1503.26 / 4
CHO = 375.81 g
CHON (15%) = 2505.43 kcal x 0.15 / 4
= 375.81/ 4
CHON = 93.95 g

FATS (25%) = 2505.43 kcal x 0.25 / 9

= 626.36 / 9
FATS = 69.60 g

The total daily caloric intake need by a 65 years old retired government
employee is 2505 kcal with 376 grams of carbohydrates, 94 grams of protein and
70 grams of fats.

2.

3. Prepare the assigned sample menu plan for class presentation.

Table 4-2. Sample Dinner Meal Menu for Elderly

MENU HOUSEHOLD MEASURES
Vegetable Salad that contain: 1 medium bowl size. And all are cut
into small or thin pieces
 Onions  Half of the 1 onions
 Celery  1 celery
 Carrots  Half of the 1 carrots
 Lettuce  At least 4 medium size of
 Cucumber lettuce.
 Boiled chicken breast  ¼ of the 1 cucumber
 Parmesan Cheese  ½ of the boiled chicken breast
 1 teaspoon

Green Tea 1 small cup

1 fruit [either of these choices]

 Orange  ½ of the medium size
 Pineapple  1 slice of pineapple
 Apples  ½ of the medium size
 Strawberry  4 pieces
4. Discuss the case assessment and tray presentation in class emphasizing
the rationale of the diet given, nutrient modification, and intervention.

Table 4-3. Case Assessment for Elderly

Meal Prepared Nutrient Rationale Nutrition
modification intervention
Breakfast:  Avocado  Creamy green  Drink green
toast fruit seriously tea. Polyphenols
2 slices of benefits your have been known
bread and 2  Whole-grain well-being to reduce bacteria
slices of bacon toast and wherein keeps and toxic products
yogurt with your heart of bacteria in the
pineapple, healthy due to mouth. Tea also
kiwi, mango, lowering the
tends to be rich in
and ginger amount of bad
fluoride, possibly
syrup cholesterol in the
body, keeps your the most well-
weight in check, known tooth
and slows down strengthener.
the aging
process.
 Drinking green tea
improves the
 For probiotics health of your
aiding in
teeth and gums,
digestion and
as it decreases
even helping
fight bad bacteria inflammation,
in the stomach makes your mouth
Adequate good more alkaline,
bacteria will help inhibits the growth
him have a of cavity-causing
proper good bacteria, prevents
digestion tooth loss, may
concerning his slow progression
age of oral cancer, and
freshens breath by
killing odor-
causing bacteria. It
can also help you
to lose fat, too.
 Eat mostly whole,
nutrient-dense
foods that provide
 plenty of calcium,
phosphorus,
magnesium,
vitamin K
(especially K2)
and vitamin D.
Foods like leafy
green vegetables,
nuts, seeds, hard
aged cheeses,
plain yogurt,
meats, beans,
mushrooms, fish,
eggs, and organ
meats all work
here. Make sure
you get some
sunlight.
Lunch:  Grilled  Health experts  Avoid most
salmon steak say that eating processed foods
1 cup of rice salmon as part of and limit added
and 1 piece of your diet can sugars from both
chicken thigh reduce the risk of foods and
part with soup heart disease beverages. This
includes soda, fruit
 Rich in omega-3 juice, energy
fatty acids, drinks, candies,
packed-full of
etc. Energy drinks
proteins, high in
are particularly
vitamin b and is
a great source of damaging as they
potassium combine a high
sugar load with an
incredibly acidic
ph.
 Eat some raw,
crunchy fruits and
vegetables every
day. Raw veggies
clean your teeth to
a degree (apples,
carrots, bell
peppers, etc.).
Eating an apple as
 dessert after lunch
will help to remove
material that has
adhered to the
surface of your
teeth. Plus, apples
contain naturally
occurring xylitol.
Snack :  Tofu  The fiber-rich  Do not serve them
scramble food has also spicy food,
with 1 egg been shown to excessively oily
2 slices of yolk reduce your risk food and see that
White bread of heart disease, they don't overeat.
with peanut  Oatmeal keep your blood Instead, try and
butter waffles sugar in check, see that they go
and even help for frequent, small,
you lose weight easily digestible
food portions.

Dinner:  Vegetable  Iron and calcium  Pay strict attention

Beef Soup For strong teeth to medical
Mashed potato and 1 glass and bones conditions and diet
with spaghetti of milk  Helps reduce the restrictions should
risk of muscular be imposed
degeneration accordingly. Make
sure salt is
restricted for
people with
hypertensive and
heart issues, fat
intake for persons
with
atherosclerotic
heart disease and
also fried sweets
and savories.

QUESTIONS FOR DISCUSSION

1. What nutritional advice is recommended for a healthy pregnancy?

Lactation?

Maternal nutrition during pregnancy and lactation influences the growth

and potential development of the fetus and contributes to the maturity of a
healthy baby. The lack of sufficient calories, of macro- and micronutrients, can
lead to deficiencies in building materials for the development and growth of the
fetus.

In the first trimester, as long as the woman does not begin pregnancy with
insufficient energy stores, she doesn’t require more than the total recommended
daily energy intake for non-pregnant women, while during the second and third
trimester the additional intake is 365 kcal/day for underweight women, 300
kcal/day for normal weight women and 200 kcal/day for overweight/obese
women.

Moreover, we should encourage the consumption of foods rich in macro-

and micronutrients, and not only calories, because of heightened demand during
gestation: healthy eating in pregnancy should also exclude food sources which
might contain teratogens, or be the source of food-borne illness such as
toxoplasmosis (undercooked meat or vegetables contaminated with soil) or
listeriosis and brucellosis (mold-ripened soft cheeses, unpasteurized milk or
pates).

CHO should represent 45-60% of the total daily amount (TDA) of calories
per day: as part of an overall healthy diet, the intake of starch and fibers should
be chosen over simple and added sugars, which must be limited to no more than
15-25% of energy. Dietary fat intake (through butter, vegetable oils, whole milk,
visible fat on meat, oily fish, seeds and nuts) during pregnancy should be 20-35%
of the TDA of calories. Also, during pregnancy the daily protein intake for a
normal weight woman should increase to 0.5-1 g in the first, 7-9 g in the second,
and 23-29 g in the third trimester.

Furthermore, the recent WHO guidelines recommend daily oral iron

supplementation with 30-60 mg of elemental iron as part of antenatal care to
reduce the risk of low birth weight, maternal anemia and iron deficiency.
Moreover, the RDA for calcium is 1,000 mg/day; 10 mcg daily for vitamin D; and
for folic acid, supplementation of 0.4 mg/day is needed. Besides, the American
Thyroid Association and the Endocrine Society recommend supplementation with
100 to 200 micrograms of iodine throughout pregnancy.

Throughout lactation, the energy cost of exclusive breastfeeding from birth

to 6 months postpartum is 500 kcal/day. As well, an increase of about 700 ml/day
of water is recommended. The maternal requirement for iron is not increased
during lactation, because of post-partum amenorrhea, which prevents its loss.
Additionally, breastfeeding mothers should not eat shark, swordfish, king
mackerel, or tilefish because they contain high concentrations of mercury which
can develop nervous system alterations, since both inorganic and organic
mercury are transferred from maternal serum to human milk.

2. What are the different factors to consider in planning a menu for growing
children?

When planning meals for children, consider the children's nutritional

needs; preferences and allergies; the appearance and cost of foods; and the time
and skill of the meal preparer. Growth requirements combined with physical
activity also play a role in determining a child's nutritional needs. Genetic
background, gender, body size and shape are likewise, some other factors.

To give a child a nutritious meal, MedlinePlus recommends filling half of

the child's plate with fruits and vegetables, a little more than one-quarter of the
plate with whole grains, and a little less than one-quarter of the plate with healthy
sources of protein, such as lean meat, nuts or eggs. Within these guidelines, the
meal preparer can select food that appeals to the child in terms of taste and
texture. A variety of colors and shapes also makes the meal more inviting.

Families with a tight food budget can buy grains in bulk, shop at farmer's
markets for fruits and vegetables, and choose less expensive sources of protein
such as tuna and ground beef. Because children are more likely to develop
healthy eating habits if their meals are made well and served at the same time
every day, meal preparers need to plan recipes that suit their cooking skills and
available time. Thus, balancing these factors can ensure meals that are healthy,
appealing, and affordable.
REFERENCES:

Mecacci, F., Biagioni, S., Ottanelli S., & Mello, G. (2015). Nutrition in pregnancy
and lactation: how a healthy infant is born. Retrieved
fromhttp://www.jpnim.com/index.php/jpnim/article/view/040236

Thomas Williams (2019). What Factors Do You Consider in Planning Meals for
Children?. Retrieved from https://www.reference.com/family/factors-
consider-planning-meals-children-d0f3c9e7eb4f3a86