Puroc, Liza M.

BSN II

Dietary Modification and Dietary Therapy

A. General Diets

What is a regular diet?

 A regular diet is a healthy meal plan that includes a variety of healthy foods from all the food
groups. Follow this meal plan if you do not have any health conditions that require a special diet. A
healthy meal plan is low in unhealthy fats, salt, and added sugar. It may decrease your risk of heart
disease, osteoporosis (brittle bones), and some types of cancer

What is a healthy meal plan?

 My Plate is a model for planning healthy meals. It shows the types and amounts of foods that
should go on your plate. Fruits and vegetables make up about half of your plate, and grains and
protein make up the other half. A serving of dairy is also included. The amount of calories and
serving sizes you need depends on your age, gender, weight, and height. Examples of healthy
foods are listed below:
 Eat a variety of vegetables such as dark green, red, and orange vegetables. You can also include
canned vegetables low in sodium (salt) and frozen vegetables without added butter or sauces.
 Eat a variety of fresh fruits , canned fruit in 100% juice, frozen fruit, and dried fruit.
 Include whole grains. At least half of the grains you eat should be whole grains. Examples include
whole wheat bread, wheat pasta, brown rice, and whole grain cereals such as oatmeal.
 Eat a variety of protein foods such as seafood (fish and shellfish), lean meat, and poultry without
skin (turkey and chicken). Examples of lean meats include pork leg, shoulder, or tenderloin, and
beef round, sirloin, tenderloin, and extra lean ground beef. Other protein foods include eggs and
egg substitutes, beans, peas, soy products, nuts, and seeds.
 Choose low-fat dairy products such as skim or 1% milk or low-fat yogurt, cheese, and cottage
cheese.

What foods should I limit?

 Vegetables with added fat such as French fries, or vegetables with cream sauces or topped with cheese
 Fruit with added sugar such as canned fruit in heavy syrup or frozen fruit with added sugar
 Carbohydrates high in fat and sugar such as cookies, donuts, croissants, store-bought muffins, or other
high-fat breads
 Protein foods with added fat such as fried meats, seafood, or poultry, or those served with high-fat
gravies and sauces
 High-fat protein foods such as t-bone steaks, ribs, chicken or turkey with skin, hot dogs, and sausage
 High-fat dairy products such as cream cheese, regular hard cheeses, regular and premium ice cream,
or whole and 2% milk
 Unhealthy fats such as butter, hard margarine, and shortening

What other guidelines should I follow?

 Choose and prepare foods with less salt and added sugars. Use the nutrition information on food labels
to help you make healthy choices. The percent daily value listed on the food label tells you whether a
food is low or high in certain nutrients. A percent daily value of 5% or less means that the food is low
in a nutrient. A percent daily value of 20% or more means that the food is high in a nutrient.
 Get enough fiber by regularly eating foods high in fiber. Good sources include fruits, vegetables, whole
grains, beans, and peas.
 Limit foods high in unhealthy fats such as cholesterol, saturated fat, and trans fat. Foods high in
cholesterol and saturated fat include hamburger, bacon, chicken or turkey skin, whole milk, and butter.
Foods high in trans fat include packaged foods such as potato chips and cookies. It is also found in
hard margarine, some fried foods, and shortening.
 Limit alcohol. Women should limit alcohol to 1 drink a day. Men should limit alcohol to 2 drinks a day. A
drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

Care Agreement
 You have the right to help plan your care. Discuss treatment options with your healthcare provider to
decide what care you want to receive. You always have the right to refuse treatment. The above
information is an educational aid only. It is not intended as medical advice for individual conditions or
treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it
is safe and effective for you.

B. Diets Modified in Consistency

 A modified consistency diet involves the consumption of foods that have undergone a change in their
consistency. Examples of modifications include chopped, ground up and pureed foods. A modified
consistency diet includes foods from all food groups and should adequately meet your nutrient needs.
 These diets are used in the treatment of gastro intestinal tract. They can be from a very low residue
diet to a very high fiber diet. Method of feeding is by mouth, unless otherwise indicated.

Two Types:

DIETS WITHOUT SOLIDS

Liquid Diets
 Liquid diets consist of a variety of foods that are liquid or liquefy at room temperature. These diets are
used in:
o Febrile states
o Post operative conditions
o Wherever the patient is unable to tolerate solid food.
 Liquid diets are of two types namely
o Clear fluid diet
o Full fluid diet

Clear Fluid Diet

 This diet is indicated in:
 o Acute illness
o Surgery
o Gastrointestinal disturbances
 A clear fluid diet is usually used for 1 or 2 days. After that a more liberal liquid diet is given.
 The amount per feeding is 30 – 60 ml/hour. As the patients tolerance improves, the amounts can be
increased
 Foods Permitted
o Tea with lemon and sugar
o Coffee
o Fat free broths.
o Carbonated beverages
o Cereal waters.

Full Fluid Diet

 This diet is indicated when a patient is:
o Acutely ill.
o Unable to chew or swallow solid food.
o This diet includes all foods which are liquid at room temperature.
o It is free from cellulose and irritating condiments.
o Iron is provided at inadequate levels.
 Six or more feedings can be given daily.
 The protein content of the diet can be increased by incorporating whole egg, egg white, nonfat dry
milk in beverages and soups.
 The calorie value of the diet can be increased by adding butter to cereal gruels and soups, glucose in
beverages and using ice creams, dessert.
 If decreased volume of fluid is desired, non fat dry milk can be substituted for the part of the fluid milk.

Foods Allowed
 Beverages — Cocoa, coffee or tea.
 Cereal — Fine or strained gruels.
 Dessert — Soft custard, gelatin.
 Eggs — Raw in broth with fruit juices or milk.
 Fruit — All strained juices.
 Meat — Strained in soups.
 Vegetables — Puree, soups.
 Miscellaneous — Butter, cocoa, sugar, salt

Commercial Liquid Formulas

 These are used to supplement other external diets.
 These formulas vary in composition and source of nutrients.
 Most of the formulas are milk based.
 For persons who cannot tolerate milk, protein source is meat, soy or casein hydrolysate.
 Fat and carbohydrate composition and proportions also vary to accommodate persons with different
needs and restriction.

Criteria for Selection of Appropriate Formulae

 The protein sources
 The composition and proportion of fats and carbohydrates
 The osmolality
 The palatability
 The cost.
DIETS WITH SOLIDS

Soft and Low Fibre Diets

 Soft diet is between liquid diet and normal diet.
 Soft diet includes both liquid and solid foods which contain restricted amount of indigestible
carbohydrates and no tough connective tissue. The diet can be made mechanically soft by cooking,
mashing, pureeing the foods used in a normal diet. Further reduction in indigestible carbohydrate can
be achieved by the use of refined breads, cereals immature vegetables and fruits.
 The skin and seeds of fruits have to be removed.
 Soft fruits like banana can be used as it is.
 Tough connective tissue can be reduced, by selecting tender meat and cooking very soft.
 Meat and meat broths have to be restricted because the nonprotein nitrogen products such as creatine,
creatinine, purines and other products which are present in muscle tissue is extracted into the gravy
which stimulates gastric juice.
 Strong flavoured vegetables such as onions, radish, dried beans, cabbage, cauliflower have to be
omitted if necessary.
 With proper cooking (Short cooking time, vessel uncovered, serving immediately) it is desirable to
eliminate those vegetables which the individual patient cannot tolerate.
 It is not necessary to eliminate all spices, only gastric irritants like black pepper, chilli pepper, cloves
etc., can be eliminated.
 This diet is nutritionally adequate.
 It is soft in texture and bland in flavour
 Meat should be tender or ground to reduce connective tissue

Low Residue Diets

 The diet is made up of foods which can be completely absorbed, thereby leaving little or no residue for
formation of faeces. This diet provides insufficient minerals and vitamins.
 It must be supplemented.
 Foods high in fibre should be omitted.
 Food which contain residue but not fibre such as milk are also omitted or restricted.
 Two cups of milk may be permitted per day. Strained fruits and vegetables w/o skins our prevented.

The Diet is Usually Used in

 Severe diarrhoea to afford rest to the gastrointestinal tract.
 Acute phases of diverticulitis.
 Ulcerative colitis in initial stages.
 Operations.
 Partial intestinal obstruction.
 Whenever necessary to reduce bulk in the gastrointestinal tract

High Fibre Diets

 Dietary fibre plays a significant role in colonic function.
 High fibre diet is mainly used for atonic constipation and diverticulosis.
 This is a normal diet with fibre increased to 15–20 gms daily.
 Fluid intake is also increased.
 Concentrated foods should be replaced by those of greater bulk.
 Foods which can be included in the diet are plenty of long fibered vegetables, salads, fruits and whole
cereal grains.
 Highly refined and concentrated foods, excessive amounts of rough brans and excessive seasoning
should be avoided.
 Intervals of feeding should be three meals daily
Soft Diet
 In addition to helping people with chewing and swallowing problems, the soft diet is also
recommended for people as a transitional diet from clear liquid to regular following surgery. The soft
diet includes that are low in fiber and soft in texture. Foods are also mildly seasoned on a soft diet.
Food choices include canned fruits, bananas, soft melon, soft cooked meats, potatoes, pasta, rice,
bread, cooked vegetables and lettuce.

MECHANICAL SOFT
 Foods on the mechanical soft diet are chopped, ground or blenderized, and moistened with liquids to
make them easier for chewing and swallowing.

Cut Up Food Consistency

 All foods must be cut into pieces no larger than ½” x ½” ½”

Chopped Food Consistency

 Food is cut by hand or as directed to Pea size pieces ¼” x ¼” x ¼”.
 Food must also be moist. No “Finger Foods”.
 Ground Food Consistency
 All foods must be ground in a machine to “small curd” cottage cheese consistency.
 Foods must be moist and liquids may be added to get the desired consistency

PUREED DIET
 A pureed diet includes foods that are blended into a fine paste.
 All foods are prepared to a smooth consistency by grinding and then pureeing them. Appearance is
smooth like pudding.
C. Diets Modified in Composition
DIETS MODIFIED IN COMPOSITION
 Low calorie
 High calorie
 High protein
 Low protein
 Low fat
 Low cholesterol
 Low carbohydrate
 Low salt/Sodium restricted
 Low potassium
 Low purine/Purine restricted

LOW CALORIE
 is a diet with low calorie consumption per day.
 contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids and
protein.
 Carbohydrate may be entirely absent, or substituted for a portion of the protein; this choice has
important metabolic effects
 is prescribed on a case to case basis for weight loss (eg. 3 to 5 pounds per week) in patients with Body
Mass Index of 30 and above. The health care provider can recommend the diet to a patient with BMI
between 27 and 30 if the medical complications the patient has due to overweight present serious
health risk.
HIGH CALORIE & HIGH PROTEIN
 A high protein and high calorie diet is made up of foods that are high in both protein and calories.
 Some of these health conditions include cancer, HIV, and AIDS. Other conditions that increase calorie
and protein needs include wounds (such as ulcers), trauma, burns, weight loss, and malnutrition. You
may also need to follow this diet to gain weight and get stronger after a surgery or illness
High-protein diet
 Examples of high-protein foods are tofu, dairy products, fish, and meat.
 A high-protein diet is often recommended by bodybuilders and nutritionists to help
efforts to build muscle and lose fat.

High-protein foods
 High-protein foods are:

Food Amount of protein

Soy protein isolate 80g per 100g
Boiled soybeans 12g per 100g
Whey protein isolate 78g per 100g (Average, Varies between
brands
Peanuts 24g per 100g
Hamburger patty 26g per 100g
Steak 27 to 34g per 100g
Chicken breast 31g per 100g
Tuna fillet 30g per 100g
Tuna, canned 26g per 100g

LOW PROTEIN
 A low protein diet, a diet in which people are required to reduce their intake of protein,
is used by persons with abnormal kidney or liver function to prevent worsening of their
disease.
 The low protein diet focuses on obtaining most of a person’s daily calories from complex
carbohydrates rather than from proteins. There are two main sources of protein in the
diet: higher levels are found in animal products, including fish, poultry, eggs, meat, and
dairy products), while lower levels are found in vegetable products (breads, cereals,
rice, pasta, and dried beans).
 Protein should never be completely eliminated from the diet. The amount of protein that
can be
 The purpose of a low protein diet is to prevent worsening of kidney or liver disease. The
diet is effective because it decreases the stress on the kidney or liver.
 Protein restriction lessens the protein load on the kidney or liver, which slows down the
continued development of disease.

Sample menu:
Breakfast: 1 orange, 1 egg or egg substitute, 1/2 cup rice or creamed cereal, 1 slice whole
wheat bread (toasted), 1/2 tablespoon margarine or butter, 1/2 cup whole milk, hot, non-
caloric beverage, 1 tablespoon sugar (optional).

Lunch: 1 ounce sliced turkey breast, 1/2 cup steamed broccoli, 1 slice whole wheat bread, 1/2
tablespoon margarine or butter, 1 apple, 1/2 cup gelatin dessert, 1 cup grape juice, hot, non-
caloric beverage, 1 tablespoon sugar (optional).
Mid-Afternoon Snack: 6 squares salt-free soda crackers, 1/2 tablespoon margarine or butter,
1 to 2 tablespoons jelly, 1/2 cup apple juice.

Dinner: 1/2 cup tomato juice, 1 ounce beef, 1 baked potato, 1 teaspoon margarine or butter
(optional), 1/2 cup steamed spinach, 1 slice whole wheat bread, 1/3 cup sherbet, 4 apricot
halves, hot, non-caloric beverage.

Evening Snack: 1 banana.

This sample menu contains about 1850 calories, with a protein content of 8%.

LOW FAT DIET

 According to the USDA, a low-fat diet  – as the name implies – is a diet that consists of
little fat, especially saturated fat and cholesterol, which is thought to lead to increased
blood cholesterol levels and heart attack.
 It is important to know that dietary fat is needed for good health, as fats supply energy
and fatty acids, in addition to supplying fat-soluble vitamins like A, D, E, and K. [
 Better for Low Cholesterol and Your Heart, says the American Heart Association
 Better for Prevention of Cancers, says the World Cancer Research Fund
o Better for Your Health and Weight, says the American Dietetic Association and
the FDA.
o Saturated fats are found in high quantities in foods of animal origin. These are
converted to cholesterol by the liver,  and  should not be over-indulged in. These
fats are solid at room temperature.
o "Polyunsaturated" fats are generally from non-meat sources, and are better for
you. However, while they do lower the  bad cholesterol, they also tend to lower
the good cholesterol. These fats are liquid at room temperature.
o "Monounsaturated" fats not only lower the bad cholesterol, but tend to increase
the good cholesterol.
 The U.S. Departments of Agriculture, as well as Health and Human Services has
recommended the following for healthy Americans (Step 1 diet):
o Total fats: less than 30% of total calories
        -Saturated fats: less than 10% of total calories
         -Monounsaturated: less than 15% of total calories
         -Polyunsaturated: less than 10% of total calories
o Cholesterol: less than 300 mg daily

 For patients with problems with their cholesterol or who have manifest arteriosclerosis,
these recommendations
 (Step 2 diet) become:
o Total fats: 25-30% of total calories
              -Saturated fats: less than 7% of total calories
              -Monounsaturated: less than 10% of total calories
               -Polyunsaturated: less than 10% of total calories
o Cholesterol: less than 200 mg daily
 You have to figure your calories to figure your fat intake. Your daily caloric intake to
maintain your weight, depending on your activity, is:
 o Sedentary or inactive: Your current weight in pounds multiplied by 12.
o Moderately active. Weight in pounds multiplied by 14.
o Very active: Weight in pounds multiplied by 16 to 18
 Let’s say you weigh 150 pounds, are moderately active, and are on a Step 1 diet. Your
calorie intake should be 150 X 12 = 1800 calories. You can have 30% of your calories as
fat, or about 540 calories a day. Each gram of fat contains 9 calories, so 540 divided by
9 = 60 grams of fat.

Foods high in fat:

 Dairy foods (whole milk, ice cream, creams)
 Fatty red meats
 Butter is not only high in fat, but saturated fat as well
 Oils are fat, although some may have lower saturated fat.
 Egg yolks, which are particularly high in cholesterol.
 Cheese (sorry, there are some that are better than others, though)
 Processed meats (sausage, salami, hot dogs, bologna)
 Foods low in fat:
 Fruits
 Vegetables
 Fish and shellfish
 Cereals, rice
 Pasta
 Nuts and seeds
 Vegetable oils are preferable to butter (see below)

LOW CHOLESTEROL

Cholesterol in the Diet

 Cholesterol in the body comes from two sources. Most cholesterol is made by the liver
from various nutrients and especially from ingested fats. The liver makes just about all
the cholesterol the body will ever need. Since all animals can make their own
cholesterol, some cholesterol in the human body comes directly from eating animal
foods. These foods include meats, poultry, egg yolks, organ meats, whole milk and milk
products. This cholesterol is absorbed through the intestines and added to what the liver
makes. It is also known that a diet high in saturated fat increases cholesterol production
in the body. Therefore, reducing dietary cholesterol and fats helps to keep blood
cholesterol levels within a healthy range.  Most important of all is to significantly reduce
the amount of animal meat, meat products and trans fat in the diet
Food Groups
      Meat, Poultry, Fish, Other Protein

Choose Avoid
Lean Meats: Select meats with minimal Fatty Meats: Corned beef, mutton, ham,
marbling.  Trim away excess fat.  bacon, luncheon meat, short ribs, spare ribs,
Generally, a serving size is about the size sausage, hot dogs, scrapple, sandwich
of a deck of cards.  Broil or grill to allow spreads, all organ meats
 excess fat to drip away.
Poultry: Chicken and turkey with skin
removed.
Eggs: Egg whites and low cholesterol
egg substitutes.  Whole eggs as
recommended by a physician or
nutritionist.
Seafood: Fish oils are particularly heart
healthy.  Those with the highest fish oil
include swordfish, mackerel, albacore
tuna, salmon, walleye, Pollack, and blue
fish.  Fish should be eaten at least 3
times per week.
Cheese: Select low fat cheese such as
cottage cheese, pot cheese, mozzarella,
ricotta and Swiss.
Wild Game: Elk, deer (venison), Bison,
pheasant, rabbit, wild duck and squirrel
Beans: Beans of almost any type, peas,
lentils; tofu; peanut butter
Milk: Skim, non-fat (fluid, powdered,
evaporated, condensed), buttermilk,
lactose-reduced and sweet Acidophilus
made from skim milk
Yogurt: Made from skim or non-fat milk
Creamers: Only those containing
polyunsaturated oils
Cereals, Grains, Complex Carbohydrates  
Choose
Cereals, Dry or Cooked: Oat cereals are
particularly heart healthy.  Check labels
on all cereals for total calories, sugar and
sodium.  Cereal grains are low in
saturated fat.
Pasta & Rice: Noodles, spaghetti,
macaroni, brown rice (preferred), wild
rice
Baked Goods: Whole grain breads and
rolls; low fat or homemade muffins,
pancakes, waffles and biscuits using
polyunsaturated spread or oil and non-
fat milk
Tortillas: Corn, soft flour made with
unsaturated oils
Crackers/Snacks: Unsalted crackers,
Self basted poultry; processed poultry
products such as turkey franks or bacon;
chicken frankfurters, or scrapple
Check with your physician or nutritionist
regarding how many whole eggs per week.
Any seafood that is sauteed or deep fried
Most cheeses are high in saturated fat.  Avoid
cream cheese, processed cheese and cheese
spreads.
Domestic duck or goose
Canned baked beans (sugar and extra calories
added).  Check labels.
Any milk product made with whole or 2% milk,
chocolate milk, milkshakes, eggnog, coconut
milk
Made from whole milk or custard style
Any containing coconut or palm oils; whipped,
sour, light, heavy, half & half creams
Avoid
Coconut containing cereals, instant hot cereals,
granola
Prepared with whole eggs, cream and cheese
sauces; canned or boxed noodle and macaroni
dishes; canned spaghetti dishes
Butter or cheese rolls and breads; croutons;
commercial biscuits, muffins, pancakes, pastries,
sweet rolls, donuts, croissants, popovers
Soft flour tortillas made with lard, shortening,
hydrogenated fats, coconut and palm oils
Salted crackers or snacks; fried snack foods; any
 pretzels, popcorn prepared with air
popper or mono/polyunsaturated oil
  Fruits and Vegetables  
Choose
Vegetables: Fresh, frozen or low sodium
canned; low sodium tomato and
vegetable juices
Fruit: Fresh, unsweetened dried fruits;
canned or frozen packed in water, own
juice or light syrup preferred; all fruit
juices (unsweetened preferred)
Fats            Fats in nuts, seeds and avocado are mostly unsaturated and healthy.  They are
high in vitamins and minerals, but they also contain high calories and should be limited.
Choose
Polyunsaturated Fats: Sunflower,
safflower, corn, soybean, cottonseed,
sesame oils
Monosaturated Fats: Canola, olive,
peanut oils
Spreads: Tub type vegetable spreads
made with canola or other mono- or
poly- unsaturated fats
Salad Dressings: Olive oil and balsamic
vinaigrette.  Check labels for saturated
or trans fats.
Seeds and Nuts: Unsalted, pumpkin,
sesame, sunflower and others not on
avoid list
Miscellaneous
Choose
Desserts: Homemade baked goods made
with unsaturated oils or spreads, skim or
1% milk and egg substitute or egg
whites; gelatin; angel food cake; ginger
snaps; fruit ice, fruit whips, sorbet,
snacks or crackers containing saturated fats,
coconut or palm oils, hydrogenated or partially
hydrogenated fats; cheese crackers or snacks;
potato chips; corn chips; tortilla chips; chow
mein noodles; commercial buttered popcorn
Avoid
Spaghetti sauce; creamed, breaded or deep-
fat fried vegetables; vegetables in sauces
Canned or frozen packed in syrup, sweetened
dried fruits, coconut, fried snack chips
Avoid
Butter, lard, beef tallow, salt pork, bacon,
bacon drippings, ham hock, animal fat,
shortening, suet, chocolate, cocoa butter,
coconut, coconut oil, palm and palm kernel oil,
hydrogenated fat
Hardened stick margarine or butter, any
spread made with saturated or trans fat
Made with saturated or trans fats, egg yolks
Cashews, macadamia, pistachio, Brazil
Avoid
Made with whole milk, cream, butter,
chocolate and egg yolk; commercially
prepared cakes, pies, cookies, pastries; ice
cream; chocolate desserts; frozen cream pies;
commercial dessert mixes such as cake and
 sherbet; low-fat frozen desserts;
puddings, custards or junkets made with
non-fat milk and egg allowances
Beverages: Sparkling or mineral water,
seltzer, club soda - unsweetened
preferred; coffee; tea; Postum
Soups & Sauces: Fat-free, low-salt broth,
consomme and bouillon; homemade
soup skimmed of fat; cream soup and
sauces made with non-fat milk and fat
allowance
Other: Spices, herbs, pepper, lemon
juice, garlic and onion powder, Tobasco,
catsup, mustard, vinegar, relishes, jam,
jelly, marmalade (unsweetened
preferred)
brownie mixes; chocolate; candies made with
cream fillings
Tonic, commercially or home softened water,
instant cocoa mixes, Dutch processed cocoa
Soup made with whole milk or cream; broth
containing fat; canned soups; dehydrated
soup mixes; bouillon not labeled low-sodium;
gravy and sauces made with butter, other
animal fat and whole milk
Commercially fried foods, pickles, any foods
containing items not allowed

LOW-CARB DIET
 A low-carb diet limits carbohydrates — such as bread, grains, rice, starchy vegetables
and fruit — and emphasizes sources of protein and fat. Many types of low-carb diets
exist, each with varying restrictions on the types and amounts of carbohydrates.
 Examples of low-carb diets include the Atkins diet and the Zone diet.
 A low-carb diet is generally used to lose weight.

 Typical menu
In general, a low-carb diet focuses on meat, poultry, fish, eggs and some nonstarchy
vegetables. A low-carb diet excludes or limits most grains, beans, fruits, breads, sweets,
pastas and starchy vegetables. Some low-carb diet plans allow fruits, vegetables and
whole grains. A daily limit of 50 to 150 grams of carbohydrates is typical.

Results
 A low-carb diet is likely to promote weight loss, at least at first. Contributing factors may
include:
o Loss of water weight. Low-carb diets often have a diuretic effect.
o Increased feeling of fullness. A low-carb diet is relatively high in fat and protein.
Since fat and protein take longer to digest than do carbs, you may feel fuller
longer.
o Reduced calories. A low-carb diet strictly limits the variety of foods you eat. This
generally results in fewer calories overall.
 A low-carb diet may also help lower your cholesterol level, as long as you choose
monounsaturated and polyunsaturated fats. If you eat foods high in saturated fat —
which technically fit the criteria of a low-carb diet — you may actually increase your
cholesterol.

LOW SODIUM
 A low sodium diet is a diet that includes no more than 1,500 to 2,400 mgs of sodium
per day. (One teaspoon of salt has about 2,300 mg sodium.) People who follow a
vigorous or moderate exercise schedule are usually advised to limit their sodium intake
 to 3,000 mg per day and those with moderate to severe heart failure are usually advised
to limit their sodium intake to 2,000 mg per day.
 The human requirement for sodium in the diet is about 69 mg per day, which is typically
less than one-tenth as much as many diets "seasoned to taste". For certain people with
salt-sensitive blood pressure, this extra intake may cause a negative effect on health.
 A low salt diet (median of approximately 4.5 g/day - approx 1800mg Sodium) in
hypertensive people resulted in a decrease in systolic blood pressure

High sodium content

 Sodium occurs naturally in most foods. The most common form of sodium is sodium
chloride, which is table salt. Milk, beets, and celery also naturally contain sodium, as
does drinking water, although the amount varies depending on the source. Sodium is
also added to various food products. Some of these added forms are monosodium
glutamate, sodium nitrite, sodium saccharin, baking soda (sodium bicarbonate), and
sodium benzoate. These are ingredients in condiments and seasonings such as
Worcestershire sauce, soy sauce, onion salt, garlic salt, and bouillon cubes. Processed
meats, such as bacon, sausage, and ham, and canned soups and vegetables are all
examples of foods that contain added sodium. Fast foods are generally very high in
sodium. Also, processed foods such as potato chips, frozen dinners and cured meats
have high sodium content.
 Other foods that are low in sodium include:
o Seasonings: Black, cayenne, or lemon pepper, mustard, some chili or hot sauces
o Herbs: Dried or fresh garlic, garlic/onion powder (no salt), dill, parsley,
rosemary, basil, cinnamon, cloves, paprika, oregano, ginger, vinegar, cumin,
nutmeg
o Fresh fruits and vegetables (celery, carrots, beets, spinach)
o Dried beans, peas, rice, lentils
o Macaroni, pasta, noodles, rice, barley (cooked in unsalted water)
o Honey, sugar
o Unsalted butter
o Unsalted dry curd cottage cheese
o Fresh beef, pork, lamb, fish, shrimp, egg
o Skim milk, yogurt
o Hot cereals
o Club soda, coffee, seltzer water, soy milk, tea

Sodium Restricted Diet Plan

Basic Meal Plan Sample Menu Calorie Sodiu Cholestero Special

s m mg. l mg. Instructions
BREAKFAST FOR
WEIGHT
CONTROL
1 serving fruit or 1/2 grapefruit  40  1    * Follow a
juice-List I regular
exercise
program as
directed by
your
physician  
1 serving cereal- 1 cup Puffed rice 60  10    * Avoid the
List I cereal 1 cup use of wine,
enriched with beer or
other alcoholic
beverages 
1 serving nonfat 1 cup Carnation 80  115.8  5 * Use only
milk-List II Instant Nonfat Milk unsweetened
or fresh fruits
for desserts;
avoid sugar,
concentrated
1 serving fruit- 1 small banana 120  1    sweets,
List I regular jelly
and jams,
regular  
1 serving salt-free 1 slice salt-free 51  5    soft drinks,
bread-List II whole wheat toast etc. Artificial
sweetener
may be used
1 serving fat-List I 1 tsp. unsalted 34  -    * Limit breads
margarine and cereals to
4 servings per
day
1 serving sweets- 1 tsp. jam 18  0.8   
List I
Beverage  coffee or tea 2 2    
NOON MEAL
2 oz. cooked fresh 2 oz. unsalted 95  36  68  * Limit
meat-List II roasted chicken margarine and
(light meet)  other fats to 4
servings per
day
2 servings salt- 2 slices salt-free 124  5    * Avoid the
free bread-List I white bread and use of
potatoes or
other  
1 serving fat-List I 1 tsp. salt-free 33  -  3  starchy
mayonnaise with vegetables
(including
corn,  
1 serving lettuce (3 small 2  1    lima beans,
vegetable-List I leaves) sweet
potatoes,
dried  
1 serving fruit- 1 box (1 1/2 oz.) 124  12    peas and
List I raisins beans)
1 serving fruit- 1/2 medium apple  40  1   
List I
1 serving nonfat 1/2 cup Carnation 80  115.8 5   
milk-List II Instant Nonfat Milk
EVENING MEAL SODIUM
VARIATIONS
1 serving 1 cup chopped 14  39    * To convert
vegetables-List I fresh spinach diet to 1,000
mg.  
1 serving 1/2 medium 11  1.5    sodium,
vegetables-List I tomato replace the 4
servings of  
2 servings fat-List 2 Tbsp. oil and 166  1    salt-free
II vinegar dressing bread with
regular
bread  
1 serving salt-free 1 slice salt-free 61  5     
bread-List I whole wheat bread
1 serving fat-List I 1 tsp. unsalted 34  -    * To convert
margarine diet to 2,000
mg.
1 serving wine- 7 oz. wine 173  10.2    sodium,
List I (optional) replace salt-
free bread
with 4
servings of
regular bread,
replace
4 oz. cooked fresh 4 oz. broiled lean 234  67.8  103  salt-free
meat-List II steak margarine
with regular
margarine,
and replace
salt-free  
1 serving 1 baked potato 188  6    cereal with
vegetable-List I regular cereal,
1 cup
maximum
2 servings fat-List 2 Tbsp. sour 57  12  16   
I cream 
1 serving 6 asparagus spears 18  1     
 vegetable-List I
1 serving 1/2 cup cooked 191 2.5     
vegetable-List I rhubarb with sugar
1 serving dessert- 1/2 cup ice cream 129  42  26  
List I
Beverage  Coffee or Tea 2  2  
BEDTIME
1 serving fruit- 1 medium orange 64  1     
List I
Total: 2255 487 226 

LOW POTASSIUM
 Potassium is a crucial component in our blood stream, and in order to avoid unwanted
side-effects, a low potassium diet should be eaten when levels need to be specifically
regulated because levels are too high, and a diet rich in potassium should be followed
when levels are too low.
 Potassium is a mineral found in significant levels in the body's blood stream. This
mineral helps regulate levels of the mineral sodium which is significant for controlling
hydration of the body. Potassium is crucial to cleansing unwanted toxins from the cells
of the body.
 It is also essential for:
o Maintaining a correct blood pH
o Stimulating the production of insulin
o Maintaining digestive enzyme efficiency
o Ensuring optimal nerve and muscle functions

Foods to Increase or Avoid

 Below are some common types of foods that contain potassium. If blood levels are too
high and a low potassium diet is required, omit them from the diet, and if a high
potassium diet is needed simply increase the intake. The first group is vegetables:
o Asparagus
o Avocado
o Broccoli
o Brussels sprouts
o Cauliflower
o Celery
o Mushrooms
o Spinach
o Sweet potatoes
 The second group is fruits:
o Bananas
o Cantaloupe melon
o Dried apricots
o Grapefruit
o Kiwifruit
o Oranges
 o Strawberries
 And thirdly non-specific foods which have been identified as rich in potassium:
o Halibut
o Cod
o Pinto beans
o Soy beans
o Kidney beans
o Natural yogurt

 Potassium is a mineral that is found in many foods. It keeps the heart beating regularly,
helps to maintain fluid balance, and allows the nerves and muscles to work properly.
 The kidneys maintain the correct level of potassium in the blood. People who take
certain medicines or who have chronic kidney disease must limit the amount of
potassium in their diet to keep their potassium level close to normal.
 Reducing potassium levels in vegetables — It is possible to remove some of the
potassium in certain vegetables with high potassium levels. Leaching is a process of
soaking raw or frozen vegetables in water for at least two hours before cooking to "pull"
some of the potassium out of the food and into the water. You should not eat these
vegetables frequently because there is still a lot of potassium in the food after leaching.
o Wash and then cut the raw vegetable into thin slices. Vegetables with a skin (eg,
potatoes, carrots, beets, rutabagas) should be peeled before slicing.
o Rinse the cut vegetables in warm water.
o Soak the vegetables for at least two hours or overnight. Use a large amount of
unsalted warm water (approximately 10 parts water to 1 part vegetables). If
possible, change the water every four hours. Drain the soaking water.
o Rinse the vegetables again with warm water.
o Cook vegetables as desired, using a large amount of unsalted water
(approximately 5 parts water to 1 part vegetables). Drain the cooking water.
Nutrition Education and Counselling: Behavioural Change
A. Behaviour Theories Used in Nutrition Education and
Counselling

THREE OVERLAPPING TRENDS

APPROACH FOCUSING ON

INFORMATION DELIVERY THE KNOWLEDGE THE FIELD COVERAGE

BEHAVIOUR CHANGE SPECIFIC PRACTICES MEASURABLE

BC / BCC / CBC /SBC / SBCC CHANGE RAPID RESULTS

BEHAVIOUR-ORIENTED HEALTH/ THE WHOLE PERSON THE COMMUNITY

NUTRITION PROMOTION THE ENVIRONMENT & CONTEXT SELF-
DETERMINATION

INFORMATION DELIVERY
1. Knowing and telling
 Aim: to make information available (long-term?)
 Examples: posters, labels, talks, PPP, websites, TV, radio
 Learning model & roles: One-way communication: all supply side. Educator tells,
explains, illustrates; audience receives, and is expected to understand (?) and to
apply (?)
 Language: “one-way vector metaphors” - deliver, disseminate, impart, convey,
transmit, transfer, provide, equip, and even communicate *
 Evaluated as knowledge, Q&A, usually verbally
 Evolution: language adapted, content relevant, well illustrated, different modalities,
entertaining, visual, video; from information to advice (FBDGLs, codes of practice),
picturing action (drama, stories)

2. Education theory
 Concept of understanding /comprehension
o Bucket theory (Locke) vs interaction (e.g. schema theory)
o Knowledge before understanding before application (Bloom’s tx)
o Retention from pure “telling” very low (Knowles)
o Source matters – who says it (social learning theory - Bandura)
  Relationship of knowledge and action: separate kinds of learning: knowledge does
not necessarily lead to action
o Declarative vs procedural knowledge (Anderson)
o Most performance without knowledge (Skinner/commonsense)
o Plenty of learning without performance (Bandura)
o Big question: role of knowledge in performance?

3. Application to nutrition education

 Mistaken assumptions
o Telling = understanding
o Verbal expression = understanding
o Understanding = application in real life (KAB)
 Effect for NE Little effect on practices, repeatedly recognized for NE, confirmed by
major review by Contento et al. 1994. A critical factor in bringing about BC” is
“having BC as the clear aim of the programme”.
 Spread ID is the default approach in most settings

BEHAVIOUR CHANGE
1. Message & Medium
 Inspired by failure of ID/CAB
 Aim: To improve key nutrition-related practices urgently
 Learning model/roles (social marketing and early BC): Systematic and elaborated
extension of ID
o formative audience research
o small, manageable ,measurable behavioural objectives
o comprehensible, convincing, consistent, pre-tested messages
o appropriate media & channels
o implementation/dissemination
Roles: researchers, media experts + monitored targets
 Language of logframe & marketing: audience research, baselines, SMART
objectives, measurable targets, pretesting
 Evaluated by “reach” or by impact on practices
 Cost Expensive, usually based on campaigns or projects
 Mostly front-end

2. Later evolution
Social and Behaviour Change Approach (USAID 2010)
 Researching “the full range of factors (incl. social and environmental influences) at
multiple levels to promote change, incl. behavioral change, effectively”
 Implementation now has
o More interpersonal communication
o Community participation, consultation, mobilisation
o Many features of social learning, e.g. demonstrations, role-modelling,
exploring obstacles, group feedback, mutual support, self-monitoring
o Roles: also managers and facilitators; active participants
Examples
o Negotiated change through group counselling sessions (Linkages 2003)
 o Care Group approach (e.g. Food for Hungry Annual Results Report 2009)
o SUN IYCF activities
o TOPS training course in BC which also deals with nutrition - Alive and Thrive
TV spots

3. Education theory
 Behaviour change theories - supported by own movement, e.g.
o Stages of change model (P&D 1986)(most popular)
o Health belief model (Janz et al 2002)
o Theory of planned behaviour (Fishbein 2000)
 Very useful as checklists of motivations and influences

 Recognized limitations and challenges

o Deal more with “motivation end” than with change mechanisms
o Need attention to social/environmental influences, affective factors
o Some doubts about validity and applicability (e.g. very individual )
o Still largely receptive
 Other behaviourist theory, called on more or less
o Operant conditioning (classic behaviourist theory, Skinner et al.) – still
operational. S-R-R + habituation. Supports small manageable targets &
stepwise approach. But gives more weight to tail end (R +hab).
o Social learning theory (Bandura et al.) in later BC interventions.
o Mastery learning – gives much more attention to “realistic practice”

4. Application to nutrition education

 Behaviour focus Essential for shifting the focus to action, defining what needs
doing and developing clear messages
 Extensive formative research highly desirable. Possibility of sharing more
with actors?
 Methodology still evolving Needs a theory for designing the “tail” (activities,
socialisation, participation, follow-up etc.).
 Long-term maintenance of new practices has been difficult to assess in
project environments. Effects of media campaigns?
 Role of knowledge Not much room for knowledge. Baby with bathwater? How
much knowledge is needed e.g. to maintain and perpetuate good handwashing
practices? Situated learning Narrow focus . Sometimes lacking wider context,
social action, and other environmental influences and actions.
 Ownership Believes in programming behaviour, hence doesn’t adapt easily to
social ownership

BEHAVIOUR-ORIENTED HEALTH PROMOTION

1. DIY with a lot of help from your friends
 Aims Healthy people in healthy communities (see icon), long- and short-term
 Scope The “ecological model”. Five mutually supportive action domains (Ottawa
Charter 1986):
o build healthy public policy
 o create supportive environments (now also FS initiatives?)
o strengthen community action
o develop personal skills (education) - interacting and influencing
o reorient health services (e.g. from curative to preventive)
 Learning model and roles
o Skills learning, practice and action
o Self-determination & participation

EXAMPLES
 Many multi-component interventions, community programs and wellknown
nutrition initiatives call on aspects of the HP model. E.g.
o PD Hearth has several kinds of modeling & practice (McNulty 2006))
o Barrier analysis (Dickins et al. 1997) systematizes participatory
exploration of constraints.
o TIPS calls on direct experimentation & feedback in its formative research
o Child-to-Child works with peer teaching
o Some school initiatives embed activities in the school environment and
community, e.g. Health-Promoting Schools (WHO 1997), the FRESH
initiative (UNESCO 2000), the FAO manual for nutrition education
curriculum development (FAO 2006)

2. Education theory
 Stresses the potential of self-determination in a supportive context
 Suggests the “ecological” field to explore
 Proposes a framework for activating learning
 Situated learning (Lave and Wenger 1991) Learning practices is best done within
its own context and community of practice “embedded in a particular social and
physical environment” Social learning theory (Bandura 1977) focuses on social
dimensions and participants: constraints and social impact; prioritises participants’
experience, knowhow, concerns and motivations
 Learner-centred approaches (based on constructivism (Vygotsky 1978) and long
experience) aim to start where people are and help them to move forward under
their own steam.
 Life skills (e.g. self-awareness, self-management, helping others, making decisions)
UNICEF and WHO stress their central importance in self-determination (as with
HIV/AIDS)
 Skills acquisition and experiential learning(e.g. Anderson 1982, Kolb 1984)
identify core activities for changing practice
o Observing, discussing and imitating practices, own and others
o Seeing and discussing examples and models (stories, role-models,
demonstrations etc.) o Repeated hands-on practice in real/realistic
context
o Getting and giving feedback and encouragement, reflecting
o Building learning incrementally
o Discussing how to maintain it
o Self-monitoring and self-evaluation
o Passing it on
 3. Application to nutrition education
RECIPES FOR SUSTAINABILITY AND PUBLIC POLICY:
 Health promotion philosophy endorses the “ecological” approach (policy,
environment, community action, health service support) and the participatory
approaches recommended for nutrition and NE.
 Skills learning, life skills and social learning Together these approaches
provide the action framework for building and sustaining dietary capacity.
 Long-term and short-term Health promotion in public services /institutions
has potential for raising popular nutrition awareness long term Systematic health
promotion Health promotion can be built into systematic focused programs (e.g.
baby-friendly hospitals, FRESH)

 Dangers
o Can easily retreat to simple ID (“promotion” a dangerous word)
o Integration not yet very successful. On the one hand, NE is dealt with
separately, on the other, not evaluated separately.
o Participatory and learner-centred approaches are still rare, perhaps felt to
undermine established authority
o “Health promotion” packages traditionally neglect nutrition.

B. Programs and Service available in GO’s or NGO’s

What is the National Nutrition Council?
 The National Nutrition Council was created by Presidential Decree 491 (1974) as
the country's highest policy-making and coordinating body on nutrition.
 The NNC Governing Board is the collegial body that is chaired by the Secretary of
Health. The Board is composed of ten government organizations (DOH, DA,
DILG, DepED, DSWD, DTI, DOLE, DOST, DBM and NEDA) represented by
their secretaries, and three representatives from the private sector who are
appointed by the President for a two-year term with possible reappointment.
 
What are the functions/mandates of NNC?
1. Formulate national food and nutrition policies and strategies;
2. Coordinate planning, monitoring, and evaluation of the national nutrition
program;
3. Coordinate the release of funds, loans, and grants from government
organizations and nongovernment organizations; and
4. Call on any department, bureau, office, agency and other instrumentalities of
the government for assistance in the form of personnel, facilities and resources
as the need arises.

Additional mandates:
Salt Iodization Advisory Board for policy and planning and coordination of salt
iodization program (RA 8172, 1995)

 Review and recommend levels and vehicles for fortification (RA 8976)
  Prioritize hunger and malnutrition (EO 472, 2006)
 Oversight of the Accelerated Hunger-Mitigation Program (EO 616, 2007)
 What is the current nutrition situation of the country?
 The National Nutrition Survey is conducted by the Food and Nutrition Research
Institute every five years.
 Results of the 8th National Nutrition Survey conducted in 2013 showed that:
o Among preschoolers, 0-5 years old
o 20 out of every 100 preschoolers are underweight
o 30 out  of every 100 preschoolers are stunted
o 8 out of 100 preschoolers are wasted or thin
 Among school-age children, 6-10 years old
o 30 out of every 100 children are underweight
o 30 out of every 100 children are stunted

 The 2013 NNS also showed that anemia affected

o 40 out of every 100 infants, 6-11 months old
o 11 out of every 100 children, 6 to 12 years old
o 25 out of every 100 pregnant and 17 out of every 100 breastfeeding
women

What is the Philippine Plan of Action for Nutrition?

 The Philippine Plan of Action for Nutrition (PPAN) is the country's response to
malnutrition. It is an integral component of the Medium-Term Philippine
Development Plan. PPAN provides the framework for improving the nutritional
status of Filipinos. It also contributes to the achievement of the UN Millennium
Development Goals as well as poverty reduction and hunger-mitigation.

What is the Barangay Nutrition Scholars Program?

 The Barangay Nutrition Scholar (BNS) Program is a human resource development
strategy of the Philippine Plan of Action for Nutrition, which involves the training,
deployment and supervision of volunteer workers or barangay nutrition scholars
(BNS). This strategy was mandated with the promulgation of Presidential Decree
No. 1569 on 11 July 1978, which requires the deployment of one (1) BNS in
every barangay and for the National Nutrition Council (NNC) to administer the
program in cooperation with local government units (LGUs).
 
What are the qualifications of a BNS?
 A BNS is a trained community worker who links the community with service
providers, with the following qualifications:
1. bonafide resident of the barangay for at least four years and can speak
the dialect well;
2. possess leadership potentials as evidenced by membership and leadership
in community organizations;
3. willing to serve the barangay, part-time or full-time for at least one year;
4. at least elementary graduate but preferably has reached high school
level;
5. physically and mentally fit;
 6. more than 18 years old, but not more than 60 years old.

What are the basic tasks of a BNS?

1. The BNS identifies, locates underweight children through a community survey
called Operation Timbang. This survey involves weighing all preschoolers and
interviewing mothers to determine how the child is cared for, and the resources
available in the family for their participation in nutrition and related interventions.
2. The BNS moves the community to organize into networks of 20-25
households, or into community-based organizations working for the improvement
of their nutrition situation.
3. In the presence of other barangay-based development workers, the BNS may
not necessarily deliver direct nutrition services to the community but serve as
linkage-builder, to ensure that members of the community, especially those with
underweight children, avail of nutrition and related services. The BNS must be
aware of the services available and of those who need these services, and
establish a system through which those needing certain services are referred to
the appropriate service provider.
4. The BNS assists in delivering nutrition and related services which include:
a. Organizing caregiver's class or community nutrition education
b. Providing nutrition counseling services, especially on exclusive
breastfeeding and appropriate complementary feeding, through home
visits
c. Managing community-based feeding programs under the supervision of
a nutritionist-dietitian;
d. Distributing seeds, seedlings, and small animals from the local
agriculture office and other government organizations and
nongovernment organizations to promote home or community food
gardens; and
e. Informing the community on scheduled immunization and other health
activities but always together with the local midwife, agriculture officer,
social welfare officer, and other workers.
5. To help other barangay workers and the local officials, the BNS keeps a record
of the results of the regular weighings as well a record on the nutrition and
health profile of families in the barangay. The BNS also formulates a BNS Action
Plan as guide in managing the different tasks assigned to him/her. The BNS also
prepares a record of monthly accomplishments to monitor his or her
performance in relation to the action plan. The record helps identify adjustments
in the plan of action to meet targets set. The BNS also keeps track of his or her
daily activities through a diary. The diary should list not only the BNS's activities
but also observations and insights as may be appropriate.
 
What are the benefits given to BNS?
 The BNS can avail of a second grade civil service eligibility, after completing two
consecutive years of satisfactory service, by filing the proper application with the
regional office of the Civil Service Commission. This gives the BNS a chance to
become a full-pledged civil servant should the BNS qualify for a vacant position
in the local government.
  The BNS receives a very meager monthly traveling allowance from the NNC, with
counterpart from the provincial, city, municipal or barangay governments. The
amount of the allowance varies depending on the financial capability of the
LGUs. In addition, BNSs from LGUs that submit a request to the NNC Manila are
covered by a GSIS accident insurance.
 Newly trained BNSs also receive (from NNC) a bag, a T-shirt and a set of
nutrition information materials to be shared with the other members of the
community. BNSs also receive various material incentives like uniform, jacket,
etc, from the LGU.
 When the BNS does his/her work well, he/she could be chosen as an outstanding
BNS in the municipality, city, province or region; and may even be a national
outstanding BNS.
 

What is the Promote Good Nutrition (PGN) Component of the Accelerated Hunger-
Mitigation Program?
 The Promote Good Nutrition component of AHMP aims to improve the nutrition
knowledge, attitudes and practices of families to increase demand for adequate,
nutritious and safe food.

What are the objectives of the PGN component?

 Increase the number of infants 0-6 months who are exclusively breastfed;
 Increase the number of infants 6-11 months old who are given calorie and
nutrient-dense complementary foods; and
 Increase the number of families with improved diets in terms of quality and
quantity and involved in food production activities.

What are the key messages being promoted in the PGN?

 For primary targets (i.e. pregnant women and mothers of 0-2 years old children)
– to practice proper infant and young child feeding (IYCF)
o Initiate breastfeeding within 1 hour from birth
o Practice exclusive breastfeeding for the first 6 months
o Introduce appropriate complementary foods not earlier than 6 months
o Continue breastfeeding up to 2 years and beyond
 For the general population to practice the Nutritional Guidelines for Filipinos
 
How is the PGN component managed?
 The National Nutrition Council provides overall program management. At the
local level, the inter-agency, multi-sectoral local nutrition committees chaired by
the local chief executives implements the PGN component. The nutrition action
officer coordinates the implementation of the PGN within the LGU. The NNC
Regional Offices provides technical and administrative support to the AHMP
provinces.

What is OPT Plus (Operation Timbang Plus) and what are their uses?
 Operation Timbang Plus is the annual weighing and height measurement of all
preschoolers 0-71 months old in a community to identify and locate the
 malnourished children. Data generated through OPT Plus are used for local
nutrition action planning, particularly in quantifying the number of malnourished
and identifying who will be given priority interventions in the community.
Comparing results of OPT Plus against previous years help provide verifiable data
for evaluating effectiveness of nutrition and nutrition-related interventions.
 Annually, the National Nutrition Council processes OPT Plus results and
generates a list of nutritionally depressed cities/municipalities which are
disseminated to government and non- government organizations so that these
areas are given priority attention in nutrition programming planning and
intervention.
 
How are the data aggregated?
 OPT data are aggregated by Province, City, Municipality and by sex
 

What is the WHO Child Growth Standard and why should we shift to its use?
 The WHO Child Growth Standard provides a "single international standard that
represents the best description of physiological growth for all children from birth
to five years of age".
 The WHO convened a group of experts to conduct a multi-center growth
reference study (MGRS) to develop a new international growth standard for
infants and young children. The study identified the breastfed child as the
normative model for growth and development. The study included children from
a diverse set of countries to consider ethnic, genetic and cultural variations on
how children were nurtured.
 
What are the key features of the new WHO-CGS?
1. It shows how every child in the world should grow. It sets the benchmark for
growth and development of all children from birth to age 5, as opposed to
describing growth of just a sample of children at a particular time and place.
2. It shows that every child in any part of the world regardless of ethnicity has
the potential to grow and develop as described in this standard as long as the
child's basic needs are met.
3. It can help detect undernutrition, overweight, obesity at an early stage in a
child's life.
4. The standard is based on the breastfed infant as the normative growth model,
consistent with national and international guidelines that recognize breastfeeding
as the best source of nutrition for infants.
5. The standard serves as a powerful tool in informing parents, doctors and
policymakers on what constitutes good nutrition, health and development.
 
What is the basis for its adoption?
 The NNC Governing Board issued Resolution No. 2 S.2008 adopting the new
WHO-CGS for use for children 0-5 years old in the Philippines.

What are the implications of adopting the new WHO-CGS?

 A change in the magnitude of under- and overnutrition
 is expected. Prevalence of overweight, stunting and wasting/thinness will
increase while underweight will decrease.
 Previous years' nutrition data should be converted to allow comparison with new
data using the WHO CGS.