Nutrition and Diet Therapy Laboratory Manual - Docx?lmsauth 0a8fa5e7

NUTRITION
and
DIET
THERAPY
A Laboratory Manual for
Nursing Students
Prepared by:
Pauline Kate Villalobos, RND, MSND
Lorraine P. Saño, RND
Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students

Nutrition classes provide the information necessary to sort the fact from fiction about healthy eating and pass that
knowledge on to their patients. Not only must nurses be able to explain the ins and outs of a healthy diet, they must
also lead by example.
Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students

TABLE OF CONTENTS
LABORATORY EXERCISES
1 Food Habits of an Individual ………………………………………………………….…….… 1

ACTIVITY 1- Factors Affecting Food Habits………………………………………,…….…. 1
ACTIVITY 2- Food Purchases and Perceived Health Benefits………………….…….….. 2
ACTIVITY 3- My Health Goal……………………………………………………….…….….. 2
2 Height, Weight, Body Mass Index and Desirable Body Weight…….……….……….…. 3

ACTIVITY 1- Body Profile……………………………….……………………………………. 4
ACTIVITY 2- Body Mass Index (BMI)………………….……………………………………. 4
ACTIVITY 3- Desirable Body Weightl…………………………………………………………5
3 Total Energy Requirement and Carbohydrate, Protein and Fat Distribution………… 6

ACTIVITY 1- Total Energy Requirement……………………………………………………. 7
ACTIVITY 2- C,P,F Distribution………………………………………………………..…….. 8
4 Food Exchange Lists and Meal Distributions……………………………………………… 9

ACTIVITY 1- Food Exchange Lists…………………………………………………………. 12
ACTIVITY 2- Meal Ditribution……………………………………………………………….. 12
5 Meal Plan…………………………………………………………………………………………13
ACTIVITY 1- Make Your Own Meal Plan…………………………………………….……. 14
6 The Hospital Diets……………………………………………………………………………... 15

ACTIVITY 1- Case Study………………………………….…………………………………. 1
7 Weight Management………………………………………………………………………..… 22
ACTIVITY 1- Case Study…………………………………………………………………… 1
8 Sports Nutrition………………………………………………………………………………
ACTIVITY 1- Case Study………………………………………………. 1
APPENDICES…………………………………………………………………………….
REFERENCES…………………………………………………………………………
Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students I

Laboratory No. 1
Food Habits of an Individual
People decide on what to eat, when to eat, and whether to eat or not in very personal ways. Their
decisions are highly influenced by personal preferences and experiences. Identification of what
factors affect food and how these factors affect their food choices are vital to the formulation of one’s
health goal.
Objectives:
1. To identify factors affecting food habits
2. To state the health benefits of common-eaten or purchased foods
3. To formulate one’s own health goal
ACTIVITY 1. Factors Affecting Food Habits
The Following is a list of factors that affect the food habits of individuals. Rate the degree to which
each factor influences your eating behavior:
5- Always important 4- often important 3- Seldom Important
2-rarely important 1- not important at all
FACTORS RATING FACTORS RATING
A. Physiological C. Environmental Influences

Influences
Weight Customs/Traditions
Physical Activity Ethnic Background
Health Family
Hunger Peers
B. Psychological Advertisements
Influences
Safety/Security Media
Tension Beliefs
Boredom D. Food Accessibility
Depression Food Cost
Other moods Food Availability
Holidays Convenience
Special Events Time
Bayaga et.al, 2007
Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students 1

ACTIVITY 2. Food Purchases and Perceived Health Benefits
List Down 5 foods and 5 beverages that you have purchased/eaten because of a perceived health
benefit attributed to the food.
FOOD Perceived Health Benefit
1.
2.
3.
4.
5.
DRINK Perceived Health Benefit
1.
2.
3.
4.
5.
ACTIVITY 3. My Health Goal

In general, would you like to change your food habits/patterns? If so, what do you hope to achieve?
Write your specific goals in the space below.

Laboratory No. 2
Height, Weight, Body Mass Index and Desirable Body Weight
Height is measured in older children and adult. It is an assessment of linear dimension of legs, pelvis,
spine and skull. It indicates past nutrition status (chronic nutrition).
Weight is an assessment of body mass, summation of fat, body water, lean cell mass. It indicates
current nutrition (Africa et al, 2014).
Body Mass Index (BMI) is a measurement of a person’s weight with respect to his or her height. It is
more of an indicator than a direct measurement of a person’s total body fat. BMI is defined as the
body mass divided by the square of the body height and is universally expressed in units of kg/m²,
resulting from mass in kilograms and height in meters.
How to compute for BMI:
1. Measure weight in Kg
2. Measure height and convert to meters
(1 ft= 12 in, 1 in= 2.54 cm, 1m=100cm)
3. Square height in meters (m2)
4. Body weight in kg divided by height in m2
Kg
BMI= 2
m
Desirable Body Weight (DBW) is the optimal weight associated with maximum life expectancy for a
given height (Sinha et al, 2012).
How to compute for DBW (Infant):

DBW= (Age in months/2) + 3
How to compute for DBW (Child):

DBW= (Age in years x 2) + 8
How to compute for DBW (Adult):

Hamwi’s Method of determining desirable body weight for adults.
DBW for males = 106 pounds for 5 feet plus 6 pounds per inch over 5 feet.
DBW for females = 100 pounds for 5 feet plus 5 pounds per inch over 5 feet.
* Add 10% for large frame. Subtract 10% for small frame.
Objectives:
1. To evaluate one’s health status with the use of height and weight
2. To compute for Body Mass Index (BMI), Desirable Body Weight (DBW) and DBW range
ACTIVITY 1. Body Profile
Indicate the following according to the last time you took your measurements:
Weight: ____ kg Height: ____ cm (1 in=2.54 cm)
1. How often do you weigh yourself? __________

2. When was the last time you weighed yourself? ________
3. How long have you maintained your present weight?
4. My body build: round slender muscular combination of ____ and ____
5. I think I am short average tall
underweight normal overweight
6. Are you satisfied with your present height and weight? Explain why.
ACTIVITY 2. Body Mass Index

A. Compute for your BMI using your own height and weight and interpret results.
B. Compute for the BMI using the given below and interpret results.
Height Weight(kg) Age Category BMI Interpretation
5’2 85 Adult
6’0 70 Adult
4’11 45 Adult
5’8 67 Adult
5’5 56 Adult
ACTIVITY 3. Desirable Body weight

A. Compute for your DBW.
B. Compute for the DBW given the following.

Height Weight(kg) Age Category DBW
5’2 85 Adult
6’0 70 Adult
4’11 45 Adult
5’8 67 Adult
5’5 56 Adult
Laboratory No. 3
Total Energy Requirement and
Carbohydrate, Protein and Fat Distribution
Total energy requirement (TER) is the amount of food energy needed to
balance energy expenditure in order to maintain body size, body composition and a level of
necessary and desirable physical activity consistent with long-term good health (FAO, 2003).
How to compute for TER (Infant):

First 6 months of age
TER= 110-120 kcal x kg DBW
Above 6 months of age

TER= 105 kcal x kg DBW
How to compute for TER (Child):

TER= 1000 + (age in years x 100)
How to compute for TER (Adult):

TER = DBW x PAL
Table 1. Physical Activity Levels (PAL) and Values (kcal/kg body weight) by Occupational Work Intensity
Activity Level Category/ Sample Occupational Activities Kcal/ kg body weight
Work Intensity
Sedentary Mostly resting with little or no activity 30
Light Occupations that require minimal movement, mostly 35

sitting/desk work or standing for long hours and/or with
occasional walking (professional, clerical, technical
workers, administrative and managerial staff), driving light
vehicles
Housewives with light house works
Moderate Occupations that require extended periods of walking, 40

pushing or pulling or lifting or carrying heavy objects
(cleaning/domestic services, waiting table, homebuilding
task, farming, patient care)
Very Active or Vigorous Occupations that require extensive periods of running, 45

rapid movement, pushing or pulling heavy objects or
tasks frequently requiring strenuous effort and extensive
total body movements (teaching a class or skill requiring
active and strenuous participation, such as aerobics or
physical education instructor; firefighting; masonry and
heavy construction work; coal mining; manually shoveling,
using heavy non-powered tools)
Example:
An adult person with the DBW of 50 kg and with a sedentary lifestyle.

TER= 50 kg DBW x 30 kcal/ kg DBW/day
TER= 1500 kcal
Carbohydrate, protein and fat (CPF) requirements are determined based on Acceptable Macronutrient
Distribution Range as suggested in the 2015 PDRI.
Table 2. Acceptable Macronutrient Distribution Range

Nutrients % of TER
Carbohydrate 55-75%
Protein 10-15%
Fat 15-30%
Note: For clinical conditions, and for children and other age or physiological groups, modifications in the
distribution of carbohydrate, protein and fat must be made accordingly.
Example:
For a regular diet:
a. Allot 65% of the TER for carbohydrates, 15% for protein and 20% for fat
Carbohydrate = 1500 kcal x 0.65 = 975 kcal
Protein = 1500 kcal x 0.15 = 225 kcal
Fat = 1500 kcal x 0.20 = 300 kcal
b. Calculate the number of grams of carbohydrate, protein and fat by dividing the kcal for each
nutrient by the corresponding physiological fuel value (4-4-9).
Carbohydrate = 975 kcal ÷ 4 = 243.75 ~ 245 g
Protein = 225 kcal ÷ 4 = 56.25 ~ 55 g
Fat = 300 kcal ÷ 9 = 33.33 ~ 35 g
c. Round off total calories to the nearest 50, and for carbohydrates, proteins and fats, to the nearest
5 grams.
Diet Prescription: 1500 kcal in 245 g Carbohydrate, 55 g Protein and 35 g Fat
Objectives:
1. To compute for Total Energy Requirement (TER)
2. To compute for the TER of different weight and age groups
3. To compute for CPF Distribution
ACTIVITY 1. Total Energy Requirement

A. Compute for your TER.

B. Compute for the TER given the following.
Height Weight(kg) Age Category DBW TER
- - 5-month old infant
- - 9-month old infant
6’0 70 Adult
5’8 67 Adult
5’5 56 Adult
ACTIVITY 2. Carbohydrate, Protein and Fat Distribution

A. Compute for your CPF Distribution. Write down your diet prescription.
Laboratory No. 4
Food Exchange Lists and Meal Distributions
The Food Exchange Lists (FEL) is based on the principle
that good nutrition is applicable to everyone. It is
composed of seven (7) food groups containing
approximately the same amounts of carbohydrate, protein
and fat within the group, namely: vegetable, fruit, milk,
rice, meat, fat and sugar. The unit of measure for FEL is
referred to as an “exchange” wherein each food within the
list can be traded or substituted with another food for the
same energy and macronutrient contents.
Points to Consider in Using the Food Exchange Lists

1. The exchange lists may be used in estimating the carbohydrate, protein, fat and energy values of
a meal. However, it may not provide a precise estimate on the level/content of food intake for
research or similar purposes since the nutrient content of foods are average values.
2. In most cases, an exchange portion is different from a serving portion. A serving portion indicates
the amount of food that can actually be usually consumed by an individual. For example, one
medium-size banana, lakatan (14 cm), would generally be considered as one serving of fruit, but
it is actually equivalent to two exchanges of fruit. Moreover, a serving of meat or fish may consist
of two to three pieces, with each portion size being approximately the size of one matchbox, but
would be considered as equivalent to two to three meat exchanges depending on the institution
such as hotels, hospitals and restaurants.
3. For all fried and sauteed foods, one exchange of fat is considered in calculating fat and energy
contents. For example, 1/2 cup sauteed squash should include one teaspoon oil (equivalent to
one exchange of fat) in calculating fat and energy contents of the diet.
4. Nutrient contents of some products are being modified or reformulated to suit consumers’ taste
and conform to new standards. This may alter the nutritional content or the weight per exchange
portion of the food. It is advisable to check the nutrition facts on food label and make necessary
adjustments if significant deviation from FEL exists.
Table 3. Energy and macronutrient composition of food exchanges

List Food Exchange Group Carbohydrate Protein Fat Energy
(g) (g) (g) (kcal)
I Vegetable 3 1 - 16
II Fruit 10 - - 40
III Milk (Whole) 12 8 10 170
(Low fat) 12 8 5 125
(Non-fat/Skim/Fat- 12 8 - 80
free)
IV Rice A (Low Protein) 23 - - 92
Rice B (Medium Protein) 23 2 - 100
Rice C (High Protein) 23 4 - 108
V Meat (Low Fat) - 8 1 41
(Medium Fat) - 8 6 86
(High Fat) - 8 10 122
VI Fat - - 5 45
VII Sugar 5 - - 20
th
*From 4 Edition Food Exchange List for Meal Planning of DOST-FNRI
FEL Distribution
Translate the Diet Prescription into Exchanges
1. List all the foods furnishing carbohydrates starting with vegetables, fruit, milk and sugar.
a. Allow 3-5 exchanges of vegetables per day.
b. Allow 3-5 exchanges of fruit per day unless there is need for a drastic restriction of simple
carbohydrates.
c. Allow at least one exchange of milk, if tolerated. The amount and type of milk depends upon
the client’s need or health condition.
d. Allow 3-6 exchanges of sugar per day unless contraindicated.
2. Determine rice exchanges.

a. Add the amount of carbohydrates from vegetables, fruit, milk and sugar.
b. Subtract the partial sum from the prescribed amount of carbohydrates.
c. Divide the difference by 23g. This is the amount of carbohydrate per exchange of rice.
(Note: Adjust protein content depending on the Rice Group used)
d. The result is the number of rice exchanges allowed.
3. Determine meat exchanges.

a. Add the amount of protein from the food lists.
b. Subtract the partial sum from the prescribed amount of protein
c. Divide the difference by 8g. This is the amount of protein for the meat exchange.
(Note: Adjust fat allowance depending on the fat content of meat)
d. The result is the number of meat exchanges allowed.
4. For the fat exchange, follow the same steps in deriving the allowances for carbohydrate and
protein, use five (5) as the divisor since 1 fat exchange contains 5g of fat.
5. Distribute the exchange units into breakfast, lunch, supper and snacks, depending on the
individual’s eating habits
Table 4. Sample Computation and Distribution (1500 kcal, 245 g Carbohydrate, 55 g Protein, 35 g Fat)
List Food Exchange No. Of Carbo- Protein Fat Energy
Group Exchange hydrate (55 g) (35 g) (1500 kcal)

(245 g)
I Vegetable 3 9 3 - 48
II Fruit 5 50 - - 200
III Milk (Whole) 1 12 8 10 170
VII Sugar 3 15 - - 60
Carbohydrate partial sum = 86
245 g (prescribed carbohydrate)

- 86 g (partial sum carbohydrate)
159 g (159 ÷ 23 = 6.91 or 7 rice exchanges)
IV Rice A (Low Protein) 1 23 0 - 92

Rice B (Medium 5 115 10 - 500
Protein) 1 23 4 - 108
Rice C (High
Protein)
Protein partial sum = 25
55 g (prescribed protein)
-25 g (partial sum protein)
30 g (30 ÷ 8= 3.75 or 4 meat exchanges)
V Meat (Low Fat) 2 - 16 2 82

(Medium Fat) 2 - 16 12 172
Fat partial sum = 24
35 g (prescribed fat)
-24 g (partial sum fat)
11 g (11 ÷ 5= 2.2 or 2 fat exchanges)
VI Fat 2 - - 10 90
TOTAL 247 57 34 1522
th
*From 4 Edition Food Exchange List for Meal Planning of DOST-FNRI
Meal Distribution
Table 5. Sample Meal Distribution

Food Groups No. Of Breakfast Morning Lunch Afternoon Supper
exchanges Snack Snack
Vegetable 3 1 1/2 1 1/2
Fruit 5 1 1 1 2
Milk 1 1
Rice Low Protein 1 1
Medium 5 1 2 2
Protein
High Protein 1 1
Meat Low Fat 2 2
Medium Fat 2 1 1
Fat 2 1 1
Sugar 3 1 2
*From 4th Edition Food Exchange List for Meal Planning of DOST-FNRI
Objectives:
1. To understand the Food exchange list and use them in meal distributions and meal planning
ACTIVITY 1. FEL Distribution

Make an FEL Distribution of your own Diet Prescription
ACTIVITY 2. Meal Distribution

Make a Meal Distribution of your own exchanges.
Laboratory No. 5
Meal Plan
Meal planning means planning diets which will provide all nutrients in required amounts and
proportions, i.e. adequate nutrition. It is a challenge to every meal planner to meet it and when well
done, it proves to be a satisfying and rewarding experience.
Factors Affecting Meal Planning

1. Nutritional adequacy
2. Economy
3. Facilities
4. Satiety value
5. Personal likes and dislikes
6. Religions, traditions and customs
7. Food fads and fallacies
8. Availability of foods
9. Variety
10. Meal times
11. Occasion
Table 6. Sample One-day Meal Plan

Meal Pattern Food Group No. Of Sample Menu Household Measure
List Exchange
Fruit 1 Mango, kalabaw, ripe 1 slice
B Vegetable Omelet
R MF Meat 1 -Egg 1 pc
E -Mushroom
A Vegetable 1 -Bell pepper 1/2 cup
K -Onion
F Fat 1 Oil, coconut 1 tsp
A
Rice C 1 Pan de sal 1 1/2 pcs
S
T Milk 1 Milk, powder, full cream 5 Tbsp
Sugar 1 Sugar, brown 1 tsp
AM SNACK Rice B 1 Putong Puti 1 slice
Fruit 1 Coconut Water 1 glass
Chicken Tinola
L MF, Meat -Chicken leg
U Vegetable 1/2 -Malunggay leaves 1 cup
N -Papaya fruit, unripe
C Fat 1 -Oil, coconut 1 tsp
H Rice B 2 Boiled Rice 1 cup
Fruit 1 Pakwan 1 cup
Boiled sweet potato with sugar
PM SNACK Rice A 1 -Sweet potato, boiled 1 pc
Sugar 2 -Sugar, brown 2 tsp
Broiled Bangus
S LF Meat -Bangus, sliced
U Bulanglang
P 1 1/2 -Stringbeans 1 cup
P Vegetable -Squash
E -Tomato
R -Eggplant
Rice B 2 Boiled Rice 1 cup
Fruit 2 Banana, Lacatan 1 pc
*From 4th Edition Food Exchange List for Meal Planning of DOST-FNRI
Note: For meal planning purposes, refer to Appendix A-D
Objectives:
1. To create a meal plan that meets the nutritional needs of an individual.
ACTIVITY. Make your own Meal Plan!

Make your own meal plan based on your computations from previous activities.
Laboratory No. 6
The Hospital Diets
A therapeutic diet is a meal plan that controls the intake of certain foods or nutrients. It is part of the
treatment of a medical condition and are normally prescribed by a physician and planned by a
dietitian. A therapeutic diet is usually a modification of a regular diet. It is modified to fit the nutritional
needs of a particular person.
Common reasons for therapeutic diets may be ordered:

 To maintain nutritional status
 To restore nutritional status
 To correct nutritional status
 To decrease calories for weight control
 To provide extra calories for weight gain
 To balance amounts of carbohydrates, fat and protein for control of diabetes
 To provide a greater amount of a nutrient such as protein
 To decrease the amount of a nutrient such as sodium
 To exclude foods due to allergies or intolerance
 To provide texture modification due to problems with chewing and/or swallowing
Table 7. The Hospital Diets

DIET AIMS CHARACTERISTICS INDICATIONS
1. Normal/General To bring and maintain a Consists of any and all foods For patients whose
person in a state of eaten by a person in health but conditions do not need
nutritive sufficiency requires good menu planning dietary modifications or
restrictions, for
Used as basis for therapeutic purposes
planning therapeutic diets
MODIFICATIONS IN CONSISTENCY AND TEXTURE
1. Clear Liquid To provide an oral source Provides no nutritional In diarrheal diseases,

of fluids and small essentials; includes only those before bowel surgery or
amounts of calories and foods which are clear (with no barium enema, after
electrolytes in order to: a) residue or fiber) and are liquid colonic surgery, acute
prevent dehydration; b) or liquefy at room inflammatory conditions
relieve thirst; c) maintain temperature(e.g. fat-free broth, of GIT, first oral feeding
water balance and d) black coffee, tea, fruit juices, of severely debilitated
reduce colonic residue to flavored gelatin and carbonated patient
a minimum beverages); sugar and plain hard
candies supply added calories
Initial feeding is 30-60 ml
Used for 1 or 2 days only

2. Full Liquid or To provide oral Require the least effort for Acute illnesses,
General Liquid nourishment that is well digestion and absorption; following oral surgery or
tolerated by patients who consists of foods that are liquid plastic surgery of the
are acutely ill or are or liquefy at room/body face and neck,
unable to chew solid temperature and are free of esophageal strictures,
foods cellulose and irritating mandibular fractures,
condiments impaired chewing or
swallowing ability
Transition diet for post-
operative cases between a clear
liquid and soft diet; can be
planned to be nutritionally
adequate; supplements of folic
acid, vitamin B6 and iron are
needed if diet is used for a long
period of time
Foods allowed: those included

in clear liquid, milk, plain
frozen desserts, fruit/vegetable
juices and purees, custard,
cereal gruels, broth, pureed
strained meat, fish, soft-cooked
egg, cocoa, butter, margarine
3. Cold Liquid or To minimize pain in the Consists of cold or iced smooth Tonsillectomy,
T&A (Tonsillectomy oral cavity and avoid liquids and foods adenectomy, tooth
& Adenectomy) Diet bleeding of operated area extraction
Acidic or sour fruit juices and
hot soups are avoided
Includes plain ice-cream,

sherbets, cold milk, iced
tea/coffee, bland fruit juices,
soft drinks, bland and soft foods
which have been cooled
4. Tube Feeding To provide a source of May be administered through a When patient is unable
complete nutrition in a nasogastric tube (NGT), via a to chew or swallow due
form that will easily pass pharyngostomy or through a to deformity or
through a tube in patients gastrostomy or jejunostomy inflammation of mouth
in whom oral feeding or throat, corrosive
methods are Types: poisoning, com,
contraindicated or not 1. Homogenized or blenderized unconsciousness,
tolerated or whose mixture of foods selected from a paralysis of throat
condition warrants normal diet muscles, surgery of head
supplementation in the 2. Commercially prepared and and neck, esophageal
form of natural foods pre-sterilized feedings obstruction, surgery of
A) Milk or casein based the GIT, in severe burns,
formulas (ex. Sustagen, mental disturbances,
Meritene, Sustacal, Isocal, anorexia nervosa,
Ensure, Flexical) mandibular fractures,
B) Blenderized diet feedings following head/neck
C) Synthetic fiber-free liquid irradiation, strokes or
diets trauma to the oral
pharyngeal cavity
Foods allowed: those included
in liquid, soft or regular diets
which can be liquefied and can

pass through a polyvinyl tube
5. Soft Diet For both mechanical ease Follows the regular diet pattern Acute infections, fevers,
in eating and digestion but modified in consistency and some GI disturbances,
texture; consists of food soft in after surgery, during
To provide a nutritionally texture, easy to chew, bland in convalescence
adequate diet with the flavor, easily digested with no
use of simple, easily harsh fibers and tough
digested foods connective tissues; highly
seasoned foods, fatty and fried
foods are avoided
6. Mechanical Soft To provide foods that Similar to the regular diet Difficulties in
require minimum except that foods that are hard mastication as in dental
chewing to chew and swallow are disorders, jaw injury,
modified by grinding, mincing, dental extraction, sores
chopping and pureeing and lesions in the mouth
7. Bland To provide a chemically, Greasy, highly spiced or highly Used traditionally for
thermally and seasoned foods and condiments gastric and duodenal
mechanically non- as well as fibrous, hard and ulcers, gastritis,
irritating diet given as strongly-flavored foods are ulcerative colitis,
part of the treatment for excluded dyspepsia, diverticulitis,
duodenal ulcer and other diarrhea, gallbladder
GI disturbances; to Individualization is the rule and diseases
reduce acid secretion and only those foods known to be
neutralize acid present; to “disagreeable” to the patient are
provide rest to affected omitted
area
Foods proven to stimulate
gastric secretion are decaf
coffee, red pepper, cola
beverages; those that cause
gastric irritation include black
pepper, chili powder, caffeine,
coffee, tea, alcohol and drugs
8. High Fiber To increase the volume Contains increased amount of Atonic constipation,
and weight of the residue cellulose, hemicellulose, lignin uncomplicated
that reach the distal and pectin and provides 13 g or diverticulosis, irritable
colon; to increase GI more of crude fiber; emphasis bowel syndrome,
motility; to decrease on whole grain cereals and atherosclerosis, obesity,
intraluminal colonic breads, and fresh fruits and DM
pressures (specifically vegetables that are high in fiber
diverticulosis) content, legumes and nuts with
skins; may cause diarrhea and
flatulence
9. Fiber-restricted To prevent the formation Indigestible CHO is reduced by During acute phase of
of obstructive bolus by using young immature diverticulosis, ulcerative
high fiber foods in vegetables, ripe canned or well- colitis, infectious
patients with narrowed cooked fruits, and certain low enterocolitis, wherein
intestinal or esophageal fiber fruits and vegetables; may the bowel is markedly
lumens cause prolonged intestinal inflammed; in spastic
transit time and small infrequent constipation, diarrhea,
stools; may eventually decrease hemorrhoids, cancer of
the size of the colon and the bowel
increase in intraluminal pressure
10. Residue restricted To provide a diet that Limits the use of foods high in Acute diarrhea, spastic
leaves a minimum fiber and those that produce constipation, dysentery,
residue to rest the bulky stools: milk, potatoes, acute phase of ulcerative
intestinal tract cheese except cottage cheese, colitis, ilietis, acute
raw and soft-cooked egg, butter, diverticulitis and right
lard after colonic or rectal
surgery
MODIFICATIONS IN COMPOSITION (CALORIE)
1. Calorie restricted To provide a diet with a Calculated like a normal diet For overweight and
(Low caloric or caloric value below the except that the total caloric obese persons and for
reducing diet) total maintenance energy levels is decreased by 500 or cases wherein obesity is
requirements to bring 1000 kcal/day to effect a weight a complicating or risk
about steady weight loss loss of 1 or 2 lbs per week, factor (DM,CVD, renal
at an optimum rate yet respectively disease, HPN, gout,
supply adequate nitrogen, gallbladder disease,
minerals and vitamins High CHO and fat-rich foods surgery)
are avoided
2. High caloric To allow gain in weight; Contains more calories than the Underweight, fevers and
to provide for increase in regular diet infections,
BMR in: hyperthyroidism, burns
*fever (+13% per °C Protein remains at or above
elevation) recommended levels
*cardiac failure (+ 15-
25%) Increased amounts of vitamins
*simple post operative and minerals are needed for
states (+0-5%) metabolism
*peritonitis (+5-25%)
*severe infection or Excessive amounts of fried
multiple trauma (30- foods, those high in bulk or
50%) fiber and concentrated sweets
*multiple trauma with which tend to reduce the
patient on ventilator appetite for food are avoided
(+50-75%)
*burns over 50% of the
body (+100%)
MODIFICATIONS IN COMPOSITION (CARBOHYDRATES)
1. Low CHO To reduce available CHO comprises 40% or less of Traditional regimen for
glucose when CHO TER (but should not be less DM, weight reduction
metabolism is impaired than 100 g/day). and epilepsy;
hyperinsulinism,
Simple sugars are eliminated dumping syndrome,
celiac disease, certain
types of
hyperlipoproteinemias,
stimulative and
alimentary
hypoglycemia
2. High CHO To allow for glycogen CHO comprises 70-80% of TER Liver diseases,
formation, ensure Addison’s disease,
sufficient calories to Emphasis is on foods high in fasting hypoglycemia,
spare protein, and to available CHO such as sugar, acute
minimize tissue syrups, jellies and jams (such glomerulonephritis,
catabolism sweets however should uremia, pernicious
comprise no more than 10% of vomiting and toxemias
total calories) of pregnancy
The majority of CHO must

come from complex CHO
MODIFICATIONS IN COMPOSITION (PROTEIN)
1. High Protein To afford regeneration of Allow 1.5 g or more of Cancer, pernicious

body tissues and cells to protein/kg body weight or 50% anemia, liver cirrhosis,
compensate for improper above normal requirement infetious hepatitis, PTB,
utilization and loss of, or ulcerative colitis,
increased demand, for Diet should supply adequate fractures, severe burns,
protein calories post-operative
conditions, PEM,
Adult protein Protein synthesis will not occur nephrosis, in nephritis
requirement increases to and will be used up as energy with hypoproteinemia,
1.5 g/kg in operative unless the ratio of calories to chronic
states and 2.25 g/kg in nitrogen is 200 glomerulonephritis with
severe infection, multiple Ex. 2400 kcal is to 12 g N or 75 albuminuria, pregnancy,
trauma, burns g protein lactation and growth
[N(g) = Protein (g) ÷ 6.25, and
2400 ÷ 12 = 200]
Adequate vitamins and minerals

must be furnished to assure
optimum utilization
2. Protein- restricted To minimize sources of Supplies from 0-0.7 g In kidney diseases where
toxic nitrogenous protein/kg body weight or 0-0.4 there is nitrogenous
products and at the same g/day retention, anuria and
time supply the essential uremia, hepatic coma
amino acids and adequate Level of restrictions depends
calories upon the patient’s clinical and
biochemical status at a
particular time
3. Protein Constituents
3a. Purine- restricted To lower serum uric acid Purine content limited to 120- Uric acid, calculi, gout
levels in the treatment of 150 mg/day (normal intake is
gout 600-1000 mg) by eliminating
organ meats, anchovies,
sardines, meat extracts, gravies,
dried beans, peas, yeast,
spinach, oatmeal
Since fat prevents excretion of

urates, the diet is also low in fat
MODIFICATIONS IN COMPOSITION (FAT)
1. Low Fat To meet a specified Contains approximately 20-30 g Acute pancreatitis, acute
percentage of fat calories fat/day or 10-15% TER gallbladder diseases,
cardiovascular diseases
CHO is increased while protein and where there is
is at normal level derangement in the
digestion, absorption
May cause deficiency in and metabolism of fat
vitamins A, D, E, K since fat is
their carrier in the body
2. Moderate Fat Same as 1 Adequate in essential nutrients Liver and heart diseases,
and allows 50-65 g fat/day chronic gallbladder and
pancreatic diseases
3. High Fat Accompanies high PRO Butter, margarine, cream, salad Alimentary and
high cal diet or in diets dressing and vegetable oils are stimulative
restricted in PRO/CHO used liberally hypoglycemia, uremia
4. Low Cholesterol To effect a lowering of Contains 250-300 mg Atherosclerosis, hyper-

serum cholesterol and cholesterol cholesterolemia, Types
prevent deposition of II-V hyper-
fatty materials in the Excludes organ meats, shellfish, lipoproteinemia,
arterial walls fish roe, whole milk, cream, gallstones with
butter, cheese and animal fat cholesterol esters,
coronary artery disease
Eggs limited to 2-3 per week;
meat, fish and poultry limited to
6 oz cooked weight/day
MODIFICATIONS IN COMPOSITION (MINERAL CONTENT)
1. Sodium- restricted To restore normal Vary with degree of restriction Ascites in liver cirrhosis,
(low salt, low sodium) sodium balance to the HPN, edema
body by effecting loss of Sodium level is limited to a accompanying CHF,
excess sodium and water prescribed level ranging from adrenocortical therapy
from extra cellular fluid 200-3000 mg daily (Filipino and toxemias of
compartments diet salty condiments may have pregnancy
7-15 g Na/day)
Foods containing large amounts

of sodium are either eliminated
or restricted in amount
OTHER DIETS
1. Hypoallergenic diet To exclude a specific Food allergy

food or food group
known to produce
allergic manifestations
Note: For complete list of dietary modifications, refer to Appendix E.
Objectives:
1. To apply all the learning from previous laboratory exercises
2. To create a meal plan that meets the nutritional needs of an individual.
ACTIVITY. Case Study

INSTRUCTIONS: Meet with your group online, discuss and answer the questions below. Choose a
representative per group to present your work on a PowerPoint Presentation next
meeting for 10-15 minutes.
Carleen, a 30-year old housewife has undergone mouth and neck surgery. Her height is 5'3, her
weight is 60 kg and her current BMI is 23.1.
Questions:
1. After the surgery, Carleen was placed on NPO. What would be the appropriate diet for her when
she can tolerate some food? Explain your answer.
2. Using Pinggang Pinoy as a guide, design an appropriate one day meal plan for Carleen when she
can tolerate solid foods.
Laboratory No. 7
Weight Management

Weight management refers to a set of practices and behaviors that are necessary to keep one’s
weight at a healthful level. It is preferred to the term “dieting,” because it involves more than
regulation of food intake or reatment of overweight people. People diagnosed with eating disorders
who are not obesse or overweight still need to practice weight management. Some healthcare
professionals use the term “nutritional disorders” to cover all disorders related to weight.
Weight is affected by calorie intake, activity level, overall health, age, nutrient absorption and
economic and social factors.
Weight Loss
Most people can lose weight on almost any diet plan that restricts calories — at least in the short
term. However, the goal of weight management or weight loss programs should be long term by
encouraging smarter food choices and lifestyle change.
Unexplained weight loss, or losing weight without trying― particularly if it’s significant or persistent ―
may be a sign of an underlying medical disorder. The point at which unexplained weight loss
becomes a medical concern is not exact. Many doctors agree that a medical evaluation is called for if
a person lose more than 5% of his/her weight in six months to a year, especially if the person is an
older adult.
A healthy weight loss is 1 lb/week or 4 lbs/month . A reduction of 500 kcal/day or 3,500 kcal/week from
usual food intake leads to weight loss of 1 lb/week.
Energy Requirement for Weight Loss
 For Overweight Persons:

 Compute for Desirable Body Weight (DBW) and Total Energy Requirement (TER)
 Subtract 500 kcal from Total Energy Requirement (TER)
 For Obese Persons:

 Use Adjusted Body Weight (AdjBW) instead of Desirable Body Weight (DBW)
 Compute for Adjusted Body Weight (AdjBW) and Total Energy Requirement (TER)
 Subtract 500 kcal from Total Energy Requirement (TER)
 Adjusted Body Weight (AdjBW)

 Adjusted Body Weight is used to compute the energy requirement of obese persons. The
equation is based on the assumption that 25% of the excess weight in an obese person is
metabolically active tissue.
 Formula:
AdjIBW = DBW + 0.25 × (ABW - DBW)

Where: ABW = Actual Body Weight; DBW= Desirable Body Weight
Nutrition Management
Here are some healthy ways to lose weight:

 Eating regularly. Meal skipping often leads to snacking and possibly overeating.
 Eating smaller portions.

 Choosing nutrient-rich foods. Whole-grain breads, pastas and cereals; fruits and vegetables;
dairy products; lean protein sources; and nuts and seeds provide calories, vitamins, minerals and
fiber than other food groups which only provide empty calories.
 Healthy snacking. Snack on nuts, peanut butter, cheese, dried fruits and avocados. Have a
bedtime snack, such as a peanut butter and jelly sandwich, or a wrap sandwich with avocado,
sliced vegetables, and lean meat or cheese.
 Exercise. Being active and busy prevent a person from eating because of boredom or loneliness.
Weight Gain
Although being lean can often be healthy, being underweight can be a concern if it is the result of
poor nutrition, if a woman is pregnant, or if the person has other health concerns.
A healthy weight gain is 1 lb/week or 4 lbs/month . An addition of 500 kcal/day or 3,500 kcal/week to the
usual food intake leads to weight gain of 1 lb/week.
Energy Requirement for Weight Gain
To compute for Energy Requirement:

 Compute for Desirable Body Weight (DBW) and Total Energy Requirement (TER)
 Add 500 kcal from Total Energy Requirement (TER)
Nutrition Management
Here are some healthy ways to gain weight:

 Eating more frequently. Eating five to six smaller meals during the day rather than two or three
large meals can help avoid feeling full faster.
 Choosing nutrient-rich foods. Whole-grain breads, pastas and cereals; fruits and vegetables;
dairy products; lean protein sources; and nuts and seeds provide calories, vitamins, minerals and
fiber than other food groups which only provide empty calories.
 Healthy snacking. Snack on nuts, peanut butter, cheese, dried fruits and avocados. Have a
bedtime snack, such as a peanut butter and jelly sandwich, or a wrap sandwich with avocado,
sliced vegetables, and lean meat or cheese.
 Exercise. Exercise, especially strength training, can help a person gain weight by building up
muscles. Exercise may also stimulate the appetite.
ACTIVITY 1. Case Study (Weight Loss)

James has been gaining weight over the last five years in his group home and his doctor has said
that he needs to exercise more or he will become obese. James is 52, a large man weighing 200
pounds, who really doesn’t want to be told that he needs to exercise for his health.
When James first came to the group home he was much more active than currently. He would go for
walks in Sunrise Park by himself when the weather was good and he seemed to enjoy that. He also
bowled every week with the other men in the group home and was very good at it. A year later James
climbed Mt. Clemons with one of the staffs. Unfortunately, the staff person left his job at the group
home about three months later and no one else was interested in taking him hiking. He worked out at
the YMCA for a period of time but he didn’t find other people to workout with him and he quit. James
started eating more food within the next year as he started to gain weight.
Questions:
1. What would be a more appropriate goal and how much weight should James aim to lose? Include
an end Desirable Body Weight (DBW) goal using the Hamwi’s Method.
2. What behavioral changes does James need to make in order to control his weight? Be sure to
include at least one specific behavior modification technique that you could recommend.
3. Using Pinggang Pinoy as a guide, design an appropriate one day meal plan for James that includes
all the food groups.
ACTIVITY 2. Case Study (Weight Gain)

Mr. Glaser is 76 years old and lives alone. He has slowly been losing weight since his wife died one
year ago. At 5’8, he currently weighs 124 pounds. His previous weight was 150 pounds. In talking
with Mr. Glaser, you realize he is moody and that he does not even like to talk about food, let alone
eat it. “My wife always did the cooking before, and I ate well. Now I just don’t feel like eating.” Your
conversation with Mr. Glaser becomes disjointed as he occasionally becomes disoriented of where he
is. You do manage to find out that he skips breakfast, has canned soup and a slice of soft white bread
for lunch, and sometimes eats a coldcut sandwich for dinner. He seldom sees friends or relatives. Mr.
Glaser has also lost several teeth and does not eat any raw fruits or vegetables because he finds
them hard to chew. He was diagnosed years ago with cataracts so his eye sight is limited, thus he no
longer drives and must rely on church members to deliver grocery items every 2 weeks. He lives on a
meager but adequate income.
Questions:
1. Using the NSI Determine Checklist, what is Mr. Glaser’s Nutrition Score? What are the specific
warming signs? Should we be concerned for his nutritional health? (Note: For NSI Determine
Checklist, refer to Appendix G)
2. Consult the BMI table and judge whether Mr. Glaser is at a healthy weight. What other
assessments might you use to back up your judgment? Is his weight loss significant?
3. What factors are contributing to Mr. Glaser’s poor food intake? What nutrients are probably
deficient in his diet? Suggest ways he can improve his diet and his lifestyle.
4. What factors makes you suspect that Mr. Glaser may need help for dementia or Alzheimer’s? List
ways Mr. Glaser can improve his memory decline.
5. Using Pinggang Pinoy as a guide, design an appropriate one day meal plan for Mr. Glaser that
includes all the food groups.
Laboratory No. 8
Sports Nutrition
Sports Nutrition is a specialization within the field of nutrition that partners closely with the study of
the human body and exercise science. It can be defined as the application of the nutrition knowledge
to a practical daily eating plan providing the fuel for physical activity, facilitating the repair and building
process following hard physical work and achieve athletic performance in competitive events, while
also promoting overall health nd wellness.
The Active Body’s Use of Fuel

 Glucose is supplied by dietary carbohydrate or made by the liver.
 Glucose is stored in both liver and muscle tissue as glycogen.
 Total glycogen stores affect an athlete’s endurance.
 The more intense an activity, the more glucose it demands.
 During anaerobic metabolism, the body spends glucose rapidly and accumulates lactate.
 Physical activity of long duration places demands on the body’s glycogen stores.
 Carbohydrate ingested before and during long duration activity may help to prevent fatigue
 Carbohydrate loading is a regimen of physical activity and diet that enables an athlete’s muscle to
store larger than normal amounts of glycogen to extend endurance.
 Highly trained muscles use less glucose and more fat than do untrained muscles to perform same
work, so their glycogen lasts longer.
 Athlete’s who eat high-fat diet may burn more fat during endurance activity, but the risks to health
outweigh any possible performance benefits.
 The intensity and duration of activity, as well as the degree of training, affect fat use.
 Physical activity stimulates muscle cells to break down and synthesize protein, resulting in muscle
adaptation to activity.
 Athletes use protein both for building muscle and for energy. Diet, intensity and duration of
activity, and training affect protein use during activity.
 Although athletes need more protein than sedentary people, a balanced, high carbohydrate diet
provides sufficient protein to cover an athlete’s needs.
Table 8. American College of Sports Medicine’s Guidelines for Physical Activity

Cardiorespiratory Strength Flexibility
Type of Activity Aerobic activity that uses Resistance activity that is Stretching activity that
large muscle groups and performed at a controlled uses the major muscle
can be maintained speed and through a full groups
continuously range of motion
Frequency 5 to 7 days per week 2 or more nonconsecutive 2 to 7 days per week

days per week
Intensity Moderate (equivalent to Enough to enhance Enough to develop and

walking at a pace 3 to 4 muscle strength and maintain a full range of
miles per hour) improve body motion
composition
Duration At least 30 minutes 8 to 12 repetitions of 8 to 2 to 4 repetitions of 15 to

10 different exercise 30 seconds per muscle
(minimum) group
Examples Running, cycling, Pull-ups, push-ups, Yoga

swimming, inline skating, weight lifting
rowing, power walking,
cross-country skiing,
kickboxing, jumping
rope; sports activities
such as basketball, soccer,
tennis, volleyball
Note: For those who prefer vigorous-intensity aerobic activity such as walking, at a very brisk pace (>4.5mph)
or running (≥5mph) a minimum of 20 minutes per day, 3 days per week is recommended.
Table Specific Macronutrient Composition of the Athlete’s Meal

Macronutrient Training Day Meal Pre-competition & Post-competition or
Tournament Meal Recovery Meals
Carbohydrate 60-65% 65-70% 75%
Protein 10-20% 10-15% 10%
Fat 20% 20% 15%
Table . Vitamins and Minerals Directly Involved in Exercise and Sports

Vitamin or Mineral Functions
Thiamin, riboflavin, niacin, panthotenic acid, Energy releasing reactions in intermediary metabolism
magmesium
Vitamin B6, zinc Building muscle proteins
Folate, vitamin B12, copper Synthesis of RBC
Biotin Synthesis of glycogen and fat
Vitamin C Collagen formation, integrity of cellular linings; antioxidant
Vitamin E Antioxidant; protect cells from oxidative damage
Iron Transport of oxygen in the blood and muscle tissues
Calcium, Phosphorus, Vitamin A & D Building of bone; needed for muscle contractions and nerve
transmission
Sodium, potassium, chloride Needed for muscle contractions and nerve
transmission
Chromium Assists glucose utilization by insulin

Magnesium Aids cardiac and muscle contractions
ACTIVITY. Case Study

Simon climbs 3-4 days each week and ski (teaching and touring) another 2 days. For a long time, he
has tried to keep his weight low in order to have the best strength-to-weight ratio, but whenever he
makes gains on the strength side from his training, it doesn’t seem to transfer to his climbing. Simon
stands 5’10 and weighs 145 lbs. His weight and height gives him a BMI of 20.8, well within the
healthy range of 18.5 to 24.9. A flaw in the design of the BMI, however, is that it cannot accurately
measure fat mass vs. lean mass. Athletes tend to have greater amounts of lean mass than the
average individual whom the BMI was designed for, and so in reality Simon is likely even leaner than
the BMI indicates (in extreme cases, large athletes can appear to be “overweight” according to their
BMI due to muscle mass). Without a body fat reading we cannot know for certain, but it’s probable
that Simon has no more than 10-12 lbs of fat he could lose before dropping into an unhealthy range.
Thus, as far as strength-to-weight ratio is concerned, losing weight is not likely to yield a major
benefit, especially for the amount of work it would require to lose fat below this already low level.
In our correspondence, Simon says he eats around 2,400 calories each day. Since Simon exercises
5-6 days each week, it’s unlikely this is enough calories to support his strength goals. Instead, this
amount of energy is likely to be on the lower end of weight maintenance—a sort of metabolic limbo
where the body attempts to preserve muscle tissue but doesn’t have enough energy to support
muscle growth. Chances are good that Simon could eat significantly more calories each day and still
maintain weight, or gain only minimal weight through muscle gain. He will also have more energy to
train harder (or longer at a higher intensity), which will have even more significant effects on his
strength.
Questions:
1. Compute for Simon’s TER on his active days.
2. Since Simon is active on most days of the week, there are days when he is not. Compute for his
TER on his sedentary days.
3. Using Pinggang Pinoy as a guide, design an appropriate one day meal plan for Mr. Glaser that
includes all the food groups.
APPENDICES
APPENDIX A
WHAT DOES AN EXCHANGE LOOK LIKE?
APPENDIX B1
VEGETABLE EXCHANGE

The list of fresh and processed vegetables below contain 3 grams of carbohydrate, 1 gram of protein
and 16 kcal per exchange.
Fresh Vegetables
Filipino Name English Name
Alagaw, dahon Fragrant premma, leaves

Ampalaya, dahon Bittermelon/gourd, leaves
Artichoke Artichoke
Broccoli Broccoli
Carrot Carrot
Gabi, dahon Taro, leaves
Himbaba-o, bulaklak Himbaba-o, flower
Himbaba-o, dahon Himbaba-o, leaves
Kabuti, sariwa Mushroom, fresh
Kadyos, bunga Pigeon pea pod
Kalabasa, bunga Squash, fruit
Kalabasa, dahon Squash, leaves
Kamansi, bunga Breadnut, fruit
Katuray, dahon Sesbania, leaves
Langka, hilaw Jackfruit, unripe
Malunggay, dahon Horseradish tree, leaves
Paayap, bunga Cowpea, pod
Patani, bunga Lima bean, pod
Remolacha Beet/Sugar beet
Rimas, bunga Breadfruit
Saluyot, dahon Jute, leaves
Sibuyas, ulo (Bombay Tagalog) Onion bulb
Singkamas, bunga Turnip, pod
Sitaw, bunga String/yard long bean, pod
Sitsaro Snow/sugar pea, pod
Toge Mung bean sprout
Ubod, niyog Coconut shoot
Yakon Yacon
Source: 4th Edition Food Exchange List for Meal Planning of DOST-FNRI
Processed Vegetables
English Name Filipino Name Weight (g) EP Household Measure
Asparagus, cnd Asparagus, de lata 100 1cup

Baby corn/young corn, Mais, mura, de lata 75 2 pcs (8 x 1.5 cm)
cnd
Chickpea, cnd Garbansos, de lata 15 1 Tbsp
Green peas (cnd, Gisantes (de lata, 25 1 Tbsp
frozen) frozen)
Mixed vegetables Mixed vegetables 25 2 Tbsp
(carrot, peas and corn), (carrot, peas and corn),
frozen frozen
Mushroom (whole, Kabuti, de lata 110 3/4 cup
sliced), cnd
Tomato, cnd Kamatis, de lata 50 3 Tbsp
Tomato juice, cnd Tomato juice, de lata 65 1/4 cup
Water chestnut, cnd Apulid, de lata 40 4 pcs (2 cm diameter)
th
Source: 4 Edition Food Exchange List for Meal Planning of DOST-FNRI
The following list of vegetables contain negligible amount of calories. These can be included in the
meal as much as desired.
Filipino Name English Name
Abitsuwelas, bunga Snap bean, pod

Alfalfa sprouts Alfalfa sprouts
Alugbati, dahon Malabar nightshade, leaves
Ampalaya, bunga Bittermelon/gourd, fruit
Arugula Arugula
Asparagus Asparagus
Baby corn/young corn Baby corn/young corn
Bataw, bunga Hyacinth bean, pod
Bok choy Bok choy/Pak choi
Cauliflower Cauliflower
Kalabasa, bulaklak Squash, flower
Kale Kale
Kamatis Tomato
Kamote, dahon Sweet potato, leaves
Kamoteng kahoy, dahon Cassava, leaves
Kangkong, dahon Swamp cabbage, leaves
Katuray, bulaklak Sesbania, flower
Labanos Radish
Labong Bamboo shoot
Letsugas, dahon at tangkay Lettuce, leaves and petioles
Malunggay, bungaa Horseradish tree, pod
Mustasa, dahon Mustard, leaves
Okra Okra
Pako, dahon Fiddlehead fern, leaves
Papaya, bunga, hilaw Papaya, fruit, unripe
Patola, bunga Sponge gourd, fruit
Pechay Baguio Chinese cabbage
Pechay, dahon Pechay, leaves
Pipino Cucumber
Puso ng saging Banana heart
Repolyo Cabbage
Sayote, bunga Chayote, fruit
Sayote, leaves Chayote, dahon
Seaweed Seaweed
Sigarilyas, bunga Winged bean, pod
Sili, lara Pepper

Singkamas, ugat Turnip, tuber
Sitaw, talbos String/yard long beans, leaves
Spinach, dahon Spinach, leaves
Upo, bunga Bottle gourd/white squash, fruit
Talinum, dahon Philippine spinach, leaves
Talong Eggplant
th
APPENDIX B2
FRUIT EXCHANGE
This list contains 10 grams of carbohydrate and 40 kcal.
Fresh Fruits
Filipino Name English Name Weight (g) Household Dimension (EP)
Measure
AP EP
Alimuran Rattan fruit 119 50 13 pcs 2.5 cm diameter
Atis Sugar apple 100 50 1 pc 5 cm diameter
(AP)
Balimbing Star fruit 182 160 4 1/2 pcs
Bayabas, pula Guava, red 61 60 2 pcs 3-5 cm diameter
each (AP)
Bayabas, puti Guava, white 81 80 3 pcs 3-5 cm diameter
each (AP)
Cherries, Cherries, 76 70 7 pcs 3 cm diameter
hinog sweet, ripe each
Chico Sapodilla 54 45 1 pc 4 cm diameter
(AP)
Dalandan Orange 344 155 3 pcs 6 cm diameter
each (AP)
Dragon fruit Dragon fruit 119 75 1/2 cup or 1/4 pc 9 x 7 cm (AP)
Duhat Black/Java 80 60 12 pcs 2 cm diameter
plum each (AP)
Durian Durian 150 30 2 segments 5.5 x 3.5 x 3 cm
each
Granada Pomegranate 182 80 1/2 pc 8.5 cm diameter
(AP)
Guyabano Soursop 107 75 1 slice 8 x 6 x 2 cm (AP)
Kasuy, bunga Cashew fruit 78 70 2 pcs 5.5 x 3 cm each
Kaymito Star apple 123 65 1/2 pc 7.5 cm diameter
(AP)
Kiwifruit Kiwifruit 99 75 1 pc 5 x 6 cm (AP)
Langka, hinog Jackfruit, ripe 118 40 1 1/2 segments 5 x 3.5 cm
Lansones Lanzon 118 80 5 pcs 3 x 3 cm each
(AP)
Lechiyas Lychee 77 50 4 pcs 3 cm diameter
each (AP)
Makopa Curacao apple 188 150 9 pcs 4.5 x 4 cm each
(AP)
Mangga, Mango, Indian, 104 80 1/2 cup or 1 pc 6.5 cm diameter
Indiyan, hilaw unripe (AP)
Mangga, Mango, Manila 97 70 1/2 cup or 1 slice 12 x 6.5 cm
kalabaw, hilaw super, unripe
Mangga, Mango, Manila 97 70 1/2 cup or 1 slice 12 x 6.5 cm
kalabaw, super, medium
manibalang ripe
Mangga, Mango, Manila 104 70 1/2 cup or 1 slice 8 x 7 cm
kalabaw, ripe super, ripe
Mangga, paho, Mango, paho, 79 60 9 pcs 4 x 2.5 cm each
hilaw unripe (AP)
Mangga, piko, Mango, piko, 82 60 1 slice 9.5 x 6 cm
hilaw unripe
Mangga, piko, Mango, piko, 85 60 1 slice 9.5 x 6 cm
manibalang medium ripe
Mangga, piko, Mango, piko, 103 60 1 slice 10 x 5.5 cm
hinog ripe
Mangosteen Mangosteen 212 55 2 pcs 6 cm diameter
each (AP)
Mansanas, Apple, green 97 75 1 pc 6 cm diameter
berde (AP)
Mansanas, Apple,red 99 75 1 pc 6 cm diameter
pula (AP)
Marang Jahore oak 121 35 10 pcs N/A
Milon, honey Melon, honey 119 100 3/4 cup or 1 slice 14 x 4.5 x 4 cm
dew dew
Milon, Katsila Melon, 317 200 1 1/4 cup or 1 slice 16 x 6.5 x 2 cm
cantaloupe
Milon, Tagalog Melon, musk 278 200 1 1/4 cup or 1 slice 16 x 6.5 x 2 cm
Orange, Orange, 135 100 1/2 pc 6.5 cm diameter
Florida Florida (AP)
Orange, kiat Orange, kiat 108 80 3 pcs 4.5 cm diameter
kiat kiat each (AP)
Orange, Orange, 108 80 1 pc 7 cm diameter
ponkan ponkan (AP)
Pakwan Watermelon 242 150 1 cup or 1 slice 11.5 x 2.5 x 9cm
Papaya, hinog Papaya, ripe 141 90 3/4 cup or 1 slice 16 x 4.5 x 2 cm
Passion fruit Passion fruit 125 65 1/4 cup or 2 pcs 6 cm diameter
each (AP)
Peras Pear 130 95 3/4 cup or 1/2 pc 7.5 cm diameter
(AP)
Pinya Pineapple 138 80 1/2 cup or 1 slice 14.5 x 2.5 x 4.5
cm
Rambutan Rambutan 153 55 5 pcs 3.5 cm diameter x
4.5 cm each (AP)
Saging, Banana, 58 40 1/2 pc 14 x 3.5 cm (AP)
lakatan lacatan

Saging, Banana, 55 40 1/2 pc 12.5 x 3 cm (AP)
latundan latundan
Saging, saba Banana, saba 70 40 1/2 pc 12 x 4.5 cm (AP)
Sampalok, Tamarind, ripe 34 15 12 segments N/A
hinog
Santol Santol 110 65 1 pc 6 cm diameter
Sinigwelas Spanish plum 78 50 4 pcs 3 cm diameter
Strawberry Strawberry 168 165 1 1/4 cups N/A
Suha Pomelo 156 100 2 segments 9.5 x 2.5 x 4 cm
each
Ubas Grapes 69 55 5 pcs 2.5 cm diameter
12 pcs 2 cm diameter
Others (Fresh Juices)
Lemon juice Lemon juice 130 1/2 cup N/A
Niyog, tubig Coconut water 240 1 cup N/A
Orange juice Orange juice 90 1/3 cup N/A
Passion fruit Passion fruit 65 1/4 cup N/A
juice juice
Processed Fruits
Food Item Weight (g) Household Dimension (EP)
EP Measure
Canned:
Apple sauce, sweetened 60 4 Tbsp n/a
Apple sauce, unsweetened 100 1/2 cup n/a
Blackberries, heavy syrup, solids and 45 1/4 cup or 9 pcs
liquids
Blueberries, light syrup, drained 45 1/4 cup or 29 pcs n/a
Fruit cocktail, tropical, in syrup 45 1/4 cup n/a
Lychee in syrup 45 4 pcs 2.5 cm diameter
Peach halves in heavy syrup 65 1 pc 6.5 cm diameter
Pineapple crushed/tidbits/chunks 50 1/3 cup n/a
Pineapple slice 40 1 ring n/a
Strawberries, frozen, unsweetened 130 3/4 cup or 26 pcs 2 x 2 cm each
Strawberries, heavy syrup, solids and 45 1/4 cup or 7 pcs 2.5 x 2.5 x 2cm
liquids each
Dried:
Champoy 10 2 pcs 2 x 2 cm each
Dates 15 2 pcs 2 x 2.5 cm
Dikyam 15 2 pcs 3 x 3 x 1 cm
Mango chips 10 2 pcs 6 x 2.5 x 1 cm
each
Prunes 15 1 pc 3 x 2.5 cm
Raisins 15 2 Tbsp n/a

APPENDIX B3
MILK EXCHANGE
Filipino Name English Name Amount (mL) Household measure
Whole
Gatas, kalabaw Milk, carabao* 200 3/4 cup

Gatas, baka Milk, cow 250 1 cup
Gatas, evaporada Milk, evaporated 125 1/2 cup
Gatas, evaporada, filled Milk, evaporated, filled 125 1/2 cup
Gatas, kambing Milk, goat 250 1 cup
Gatas, pulbos, filled, Milk, powder, filled, instant 35 5 Tbsp, level
instant
Gatas, pulbos, full Milk, powder, full cream 35 5 Tbsp, level
cream
Low Fat (1-2%)
Gatas, low fat Milk, low fat 250 1 cup

Yogurt Yogurt 150 1/2 cup
Non-fat/Skim/Fat-free (<1%)
Buttermilk Buttermilk 180 3/4 cup

Gatas, skim Milk, skim 250 1 cup
Gatas, pulbos, skim Milk, powder, skim 25 4 Tbsp, level
Gatas, pulbos, non-fat, Milk, powder, non-fat, instant 25 4 Tbsp, level
instant
Yogurt, plain, skim Yogurt, plain, skim 150 1/2 cup
*Equivalent to 1 cup cow’s milk plus 2 exchanges of fat
APPENDIX B4
RICE EXCHANGES
Rice A: Low Protein Rice - contains 23 grams of carbohydrate and zero or negligible protein content
Filipino Name English Name Weight Household Dimensions (EP)
(g) Measure
EP
Rice and Rice Products
Kanin, “protein-reduced” Rice, “protein-reduced” 55 1/3 cup n/a
Ampaw, pinipig Ampaw, pinipig 25 2 pcs 7 x 4 x 1.5 cm
each
Biko Rice cake (glutinous) 40 1 slice 5 x 3.5 x 2 cm
Cuchinta Rice cake 2 pcs 5 cm diameter x
60 1.5 cm each
6 pcs 3 cm diameter x
1.5 cm each
Sapin-sapin Rice prep (glutinous) 75 1 slice 7 x 4 x 2 cm
Corn and Corn Products
Cornstarch Cornstarch 25 1/4 cup n/a
Maja blanca Corn pudding 65 1/2 slice 4.5 x 4 x 3.5 cm
Maja mais Corn pudding, yellow 75 1 slice 6 x 4 x 2.5 cm
Noodles and Pasta
Bihon Noodles, rice
Misua Noodles, wheat, thin
Sotanghon Noodles, mungbean
starch 100 1 cup n/a
Sweet potato noodles Noodles, sweet potato
Rootcrops and Products
Gabi Taro 100 3/4 cup, cubed n/a
Kamote (dilaw, murado, Sweet potato (yellow, 85 1 pc or 3/4 cup, 4 cm diameter x 9
puti) purple, white) cubed cm long
Kamoteng Cassava 85 1 pc or 3/4 cup, 6 x 5 cm
kahoy/balinghoy cubed
Kamoteng kahoy, Cassava cake, bibingka 55 1 slice 3.5 x 4.5 x 3.5 cm
bibingka
Kamoteng kahoy, Cassava, mashed, w/ 55 1 pc 7 x 3 x 3.5 cm
linupak sugar and margarine
Kamoteng kahoy, pichi- Cassava, pichi-pichi 45 1 pc 5 cm diameter
pichi
Kamoteng kahoy, Cassava, suman 45 1 pc 8.5 x 3 x 2 cm
suman
Tugi Yam, spiny 150 1 pc or 11.5 x 4.5 cm
1 1/4 cups,
cubed
Ubi Yam, purple 130 1 cup, cubed n/a
Others
Saging, saba, nilaga Banana, saba, boiled 65 1 pc 9.5 x 3.5 x 3.5 cm
Sago, nilaga Palm starch balls, boiled 120 1/2 cup n/a
Sago, tapioca Tapioca pearls 160 3/4 cup n/a
th
Rice B: Medium Protein- contains 23 grams of carbohydrate and 2 grams of protein

(g) Measure
EP
Bigas, maputi, sinaing Rice, well-milled, boiled 80 1/2 cup n/a
Bigas, mapula, sinaing Rice, undermilled, red- 80 1/2 cup n/a
boiled
Pinawa, sinaing Rice (undermilled/brown 80 1/2 cup n/a
rice), boiled
Lugaw:
Thin consistency (1/2 cup cooked + 5 cups water) 705 n/a
Medium consistency (1/2 cup cooked rice + 3 cups water) 435
Thick consistency (1/2 cup cooked rice + 2 cups water) 250
Ampaw, rice Ampaw, rice 25 2 pcs 7 x 4 x 1.5 cm
each
Bibingka, galapong Rice cake, bibingka 45 1/2 slice 7 cm diameter x 3
cm
Bibingka, malagkit Rice cake (glutinous), 40 1/2 slice 5 x 3 x 2 cm
bibingka
Bibingka, pinipig Rice cake (glutinous), 50 1 slice 5 x 4 x 2 cm
pinipig
Espasol Rice prep, espasol 35 1 slice 2.5 cm diameter x
4 cm
Kalamay, may latik Rice prep (glutinous), 50 1 slice 5 x 5 x 1.5 cm
kalamay, with coconut
curd topping
Kalamay, ube Rice prep (glutinous), 60 1 slice 4.5 x 4.5 x 2 cm
with yam
Palitaw, walang niyog Rice prep (glutinous), 50 3 pcs 6.5 x 3.5 x 0.5 cm
palitaw each
Puto, brown Rice cake, brown 50 1/2 slice 9 x 5 x 4 cm
Puto bumbong Rice cake, puto 40 2 pcs 10 x 1.5 x 1 cm
bumbong, purple each
Puto maya Rice cake, maya 60 1/2 of 9 x 10 x 2.5 cm
Puto, puti/Puto Calasiao Rice cake, puto white 50 1 slice 4.5 x 3.5 x 5.5 cm
3-4 pcs 4 cm diameter x 2
cm each
Puto seko Rice-bread prep, 25 4 pcs 3 cm diameter x
toasted, puto seko 1.5 cm each
Puto seko, may niyog Rice-bread,prep, 25 7 pcs 2.5 cm x 2 cm
toasted, puto seko with each
grated coconut
Suman marwekos, my Rice prep (glutinous), 50 1 pc 13 x 4 x 1.5 cm
niyog with grated coconut
topping
Suman sa ibos Rice prep (glutinous), 60 1 pc 11 x 2.5 x 2.5 cm
ibos
Suman sa lihiya Rice prep (glutinous), 55 1/2 11 x 5.5 x 1.5 cm
lye-treated
Tamales Rice flour prep, tamales 100 2 pcs 6.5 x 4.5 x 3 cm
each
1/2 pc of 9.5 x 7 x cm
Tikoy Rice cake (glutinous), 40 1 slice 8.5 x 3 x 1.5 cm
Chinese tikoy
Tupig Rice prep (glutinous), 35 1 pc 10.5 x 2.5 x 1.5
tupig cm
Bakery Products
Apas Cookies, apas 25 7 pcs 7.5 x 3 cm each
Brohas Cookies, lady finger 25 5 pcs 11 x 3.5 cm each
Cake, mamon, tostado Cake, mamon, toasted 25 2 1/2 pcs 7 x 3 x 2 cm
Cuapao Steamed bun 35 1/2 of 5.5 x 6.5 x 3.5 cm
Hopyang hapon Hopyang hapon 30 1 pc 5.5 cm diameter x
1.5 cm
Marie Cookies, marie 25 8 pcs 6 cm diameterx
0.5 cm each
Pasencia Cookies, pasencia 25 7 pcs 4 x 4 x 0.5 cm
each
Pianono Cake, jelly roll 35 1 slice 8.5 x 7.5 x 2 cm
Sponge cake Cake, sponge 35 7.5 x 4 x 4 cm
Corn and Corn Products
Binatog Hominy 90 1/2 cup n/a
Corn flakes Corn flakes 25 1/2 cup n/a
Mais butil, de lata Corn, whole kernel, cnd 160 1 cup n/a
Mais, cream style, de Corn,cream style, cnd 130 1/2 cup n/a
lata
Mais, durog (dilaw, puti) Corn grits (yellow, 120 1 cup n/a
white)
Mais sa busal (dilaw, Corn on cob (yellow, 65 1/2 pc of 12.5 x 4 cm (AP)
puti) white)
Rice C: High Protein- contains 23 grams of carbohydrate and 4 grams of protein

(g) Measure
EP
Bakery Products
Bread, wheat Bread, wheat 40 1 1/2 pcs 10 x 9.5 x 1.5 cm
Ensaymada Bread, sweet roll 35 1 pc 6.5 cm diameter x
4 cm
Hamburger bun Bread, hamburger bun 35 1 pc 13 x 5.5 x 3 cm
Hotdog roll Bread, hotdog roll 35 1 pc 8 cm diameter x
4.5 cm
Loaf bread/Pan Bread, white, loaf 35 2 pcs 7.5 x 6.5 x 1.5 cm
Amerikano each
1 1/2 pcs 10 x 9.5 x 1.5 cm
Pan de bonete Bread, pan de bonete 35 1 1/2 pcs 4 cm diameter x 4
cm
Pan de leche Bread, pan de leche 35 1/2 pc 8 x 3 x 6.5 cm
Pan de limon Bread, pan de limon 35 1 pc 6 x 5 x 4.5 cm
Pan de monay Bread, pan de monay 35 1/2 pc 8.5 x 8 x 6.5 cm
Pan de sal Bread, pan de sal 35 1 1/2 pcs 7 x 6 x 3.5 cm
Pinagong Bread, pinagong 35 1/2 pc of 10 x 6.5 x 4 cm
Pita bread, white Bread, pita, white 40 1/2 pc 16 cm diameter x
(enriched/unenriched) (enriched/unenriched) 1 cm
Pita bread, whole wheat Bread, pita, whole 40 1/2 pc 16 cm diameter x
wheat 1 cm
Tinapay, tosatado Bread, toast/toasted 30 5 pcs 4.5 x 3.5 x 1 cm
each

1 1/2 pcs 9 x 9 x 1 cm
Noodles and Pasta
Couscous Couscous 100 1 cup n/a
Pasta Pasta 70 1/2 cup n/a
(enriched/unenriched) (enriched/unenriched)
Udon Udon 100 1 cup n/a
Others
Balat ng lumpia Spring roll wrapper, 35 7 pcs 16.5 cm diameter
plain each
Langka, buto Jackfruit, seed 75 14 pcs n/a
Quinoa Quinoa 95 1 cup n/a
th
APPENDIX B5
MEAT EXCHANGES
Low Fat Meat - contains 8 grams of protein, 1 gram of fat and 41 kcal.
Filipino Name English Name Weight Household Dimension (EP)
( g) Measure
EP
Lean Meat
Beef
Kenchi Shank 35
Laman Lean meat 35
Pierna corta ay pierna Round 35
larga 1 slice, mbs 5 x 3.5 x 2 cm
Solomilyo Tenderloin 35
Tagiliran, gitna Porterhouse steak 35
Tagiliran, hulihan Sirloin 35
Carabeef
Hita Round 35
Kenchi Shank 35
Laman, bahagyang taba Lean meat, little fat 35
Laman, katamtamang Lean meat, medium fat 35
taba 1 slice, mbs 5 x 3.5 x 2 cm
Paypay Chuck 35
Pierna corta ay pierna Round steak 35
larga
Tapadera Rump 35
Pork
Lomo Tenderloin 35 1 slice, mbs 5 x 3.5 x 2 cm
Goat (Chevon)
Balikat Shoulder 40
Binti Leg 40 1 slice 8 x 2 x 2.5 cm
Biyas Shank 40
Dibdib Breast 35 1 slice, mbs 5 x 3.5 x 2 cm
Leeg Neck 40 1 slice 8 x 2 x 2.5 cm

Likod Back 40
Lomo Loin 35 1 slice, mbs 5 x 3.5 x 2 cm
Tadyang Rib 40 1 slice 8 x 2 x 2.5 cm
Chicken
Laman White meat 30 1 slice 5 x 3 x 1.5 cm
Pitso Breast 30
Duck
Pakpak Wing 30 1 pc n/a
Others
Palaka, laman Frog, meat 30 1 pc, big 22 x 3 x 3 cm
2 pcs, small 18 x 2.5 x 2.5 cm
Variety meats/internal organs
Atay Liver (pork, beef, 30 1/4 cup or 1 pc n/a
carabeef, chicken)
Baga Lungs (pork, beef, 35 1/4 cup n/a
carabeef)
Balun-balunan Gizzard (chicken, duck) 25 1/4 cup or 4 pcs 5 x 2.5 x 1.5 cm
each
Bato Kidney (pork, beef, 45 1/2 cup n/a
carabeef)
Bitukang maliit Small intestine (pork, 30 1/4 cup n/a
beef)
Bituka, manok, Chicken intestine, 20 2 sticks 11 x2 x 0.5 cm
barbecue barbecue each
Dugo Blood (pork, beef, 35 1/4 cup n/a
chicken)
Lapay Spleen (pork, beef, 45 1/2 cup n/a
carabeef)
Librilyo Omasum (beef, 50 1/2 cup n/a
carabeef)
Litid Tendon (beef) 30 1 slice, mbs 5 x 3.5 x 1.5 cm
Puso Heart (pork, beef, 25 1/4 cup n/a
carabeef)
Fish
Alumahan Mackerel, striped 35 1/2 pc of 17 x 4 cm
Bakokong moro Porgy, fresh water 40 1/s slice of 9 x 3 x 4 cm
Bangus Milkfish 35 1 slice 4.5 x 6 x 1.5 cm
Dalag Mudfish/Murrel, striated 40 1/2 slice of 9 x 3 x 4 cm
Dalagang bukid Caesio/Fusilier, golden 35 1/2 pc of 11 x 4 cm
Dilis, buo Anchovy, long-jawed, 35 1/3 cup n/a
whole
Dilis, walang ulo Anchovy, long-jawed, 25 1/4 cup n/a
w/o head
Dulong Anchovy fry 50 1/2 cup n/a
Galunggong Scad, round 35 1 pc 13 x 3 cm
Hasa-hasa Mackerel, short-boiled 35 1 pc 16 x 5 cm
Hito Catfish, freshwater 35 1 slice 6 x 3 x 2.5 cm
Labahita Surgeon fish, blue-lined 40 1/2 slice of 9 x 3 x 4 cm
Lapu-lapu Grouper, spotted 40
Matang baka Scad, big-eyed 35 1 pc 15 x 4 cm
Sapsap Slipmouth, common 35 2 pcs 8.5 x 3.5 cm each
Saramulyete Goatfish, yellow-striped 35 1 pc 13.5 x 3 x 2.5 cm
Tambakol Tuna, yellow-fin 35 1/2 slice of 9 x 6 x 1.5 cm
Tamban Sardine, Indian 35 1/2 slice of 15 x 3.5 cm
Tawilis Sardine, bombon 30 2 pcs 12.5 x 3 cm each
Tilapia Tilapia 35 1/2 slice of 15.5 x 6 cm
Tulingan Tuna, frigate/bullet 35 1/2 slice of 9 x 6 x 1.5 cm
Other Seafoods
Alimango, alige Crab, mud/mangrove, 15 1 Tbsp n/a
fat
Alimango, laman Crab, mud/mangrove, 50 1/3 cup or 1/2 pc 10.5 x 7 x 4 cm
meat of (AP)
Alimasag, alige Crab, blue swimming, 25 2 1/2 Tbsp n/a
fat
Alimasag, laman Crab, blue swimming, 40 1/3 cup or 1 pc 9 x 5 cm
meat
Balatan Sea cucumber 120 6 pcs 8 x 5.5 x 0.5 cm
each
Pugita Octopus 40
Pusit Squid 50 2 pcs 11 x 3 cm
Talangka Crab, shore 25 6 pcs 3 x 3 cm each
(AP)
Hipon/Shrimp
Hipon, alamang Shrimp, sergestid 40 1/3 cup n/a
Hipon, sugpo Shrimp. giant tiger 40 1/2 pc of 23 x 2.5 x 3.5 cm
(AP)
Hipon, suwahe Shrimp, greasy back 40 4 pcs 16 cm each (AP)
Hipon, tagunton Shrimp, freshwater 40
(small)
Hipon, ulang Shrimp, freshwater 40
Shells
Batotoy Mollusks, Sakhalin surf 60 1/3 cup or 4 pcs 2 x4.5 x 4 cm
clam/cockies each
Lapas/Kapinan Abalone 30 2-3 pcs 5 x 4 x 2 cm each
Kuhol, ginto Snail, golden 45 1/3 cup or 12 pcs n/a
Paros Clam, rayed shell 60
Processed Foods
Cheese
Cottage Cottage 50 1/3 cup n/a
Fish Products
Canned
Tuna flakes, in brine Tuna flakes, in brine 45 1/4 cup n/a
Daing/Dried
Alakaak Croaker, plain 25 8 pcs 8 x 4.5 cm each
Alumahan Mackerel, striped 25 2 pcs 18 x 7 x 0.5 cm
each
Bakalaw Cod 25 1/3 pc of 21.5 x 6.5 x 2.5
cm
Bisugo Nemipterid, ribbon- 25 1 pc 12 x 7.5 cm
finned
Biyang puti Goby, flat-headed 25 1 pc or 14.5 x 9 x 0.5 cm
or
11 pcs small 9.5 x 4.5 x 0.5 cm
each
Lapu-Lapu Grouper, spotted 25 1 pc 17 x 9 x 0.5 cm
Malasug/Espada Swordfish 20 3 1/2 pcs 29.5 x 5 cm each
Sapsap Slipmouth, common 25 7 pcs 8 x 4 x 0.5 cm
each
Tamban Sardine, Indian 25 2 pcs 11 x 3.5 x 1 cm
each
Tanigi/Tangigi Mackerel,Spanish 25
Tilapia Tilapia 25 1 pc 9.5 x 8 cm
Tuyo/Dried
Alamang Shrimp, sergestid 15 1/2 cup n/a
Ayungin Theraponid, silvery 15 n/a
Dilis Anchovy, long-jawed 15 13 pcs 7 cm each
Hibe Shrimp, small, marine 25 4 Tbsp n/a
Pusit Squid 15 2 pcs 7 x 6 cm each
Sapsap Slipmouth, common 20 4 pcs 8 x 4 cm each
Tamban Sardine, Indian 20 2 pcs 10.5 x 3 cm each
Tinapa/Smoked
Galunggong Scad, round 25 1/2 pc of 15.5 x 3.5 cm
Tamban Sardine, Indian 25 3 pcs 10 x 3 cm each
Tunsoy Sardine, fimbriated
Medium Fat Meat - contains 8 grams of protein, 6 grams of fat and 86 kcal.
( g) Measure
EP
Beef
Paypay, laman Chuck, lean 35 1 slice, mbs 5 x 3.5 x 2 cm
Punta y pecho Brisket
Pork
Pata Leg 35 1 slice, mbs 5 x 3.5 x 2 cm
Chicken
Binti Leg/drumstick 35 1 pc 11 x 4 cm
Hita Thigh 35 1 pc 11.5 x 4 cm
Pakpak Wing 35 1 pc n/a
Ulo Head 50 2 pcs 5.5 x 3 x 3 cm
Duck
Hita Thigh 35 1 pc 3.5 x 6.5 cm
Likod Back 30 1 slice 5 x 3 x 1.5 cm
Pitso Breast 35 1 slice, mbs 5 x 3.5 x 2 cm
Goat (Chevon)
Tiyan Flank 35 1 slice, mbs 5 x 3.5 x 2 cm
Variety meats/internal organs
Bituka, maliit Small intestine, 35 1/4 cup
carabeef
Goto Tripe, beef 85 3/4 cup n/a
Utak Brain (pork, beef, 45 1/4 cup
carabeef)
Egg
Manok, buo Chicken, whole 55 1 pc medium 4.5 cm diameter x
Pato, maalat Duck, whole, salted 5.5 cm
Pugo Quail 55 7 pcs small n/a
Fish
Karpa Carp 35 1/2 pc of 10 x 4 x 2 cm
Procesed Foods
Cheese
Cheddar, pasteurized, Cheddar, pasteurized, 30 1 slice 5.5 x 2.5 x 2 cm
processed processed
Fish Products
Tinapa/Smoked
Bangus Milkfish 30 1 slice n/a
Canned
Salmon sa mantika Runner, two-finned, in 45 3 slices 5.5 x 3.5 x 2.5 cm
oil
Sardinas sa tomato Sardines, in tomato 80 2 pcs 5.5 x 3.5 cm each
sauce sauce
Tuna spread Tuna spread 25 2 Tbsp n/a
Meat Products
Karne norte, de lata Corned beef, cnd 45 1/4 cup n/a
Sausage, ham Sausage, ham 55 2 pcs 9 x 0.3 cm each
Nuts/Bean Products
Tofu Soy bean curd, tofu 100 1/2 cup 8.5 x 3.5 x 3 cm
Tokwa Soy bean curd, tokwa 70 1 pc 5 x 5.5 x 2 cm
Others
Chick, one-day-old, fried Chick, one-day-old, fried 35 2 pcs 8.5 x 3 x 3 cm
each
Manok paa, barbecue Chicken feet, barbecue 35 4 pcs n/a
Manok ulo, barbecue Chicken head, barbecue 35 3 pcs 5.5 x 3 x 3 cm
each
High Fat Meat - contains 8 grams of protein, 10 grams of fat and 122 kcal.
( g) Measure
EP
Beef
Camto Flank 35 1 slice, mbs 5 x 3.5 x 2 cm
Tadyang Plate
Pork
Kasim Picnic 35 1 slice, mbs 5 x 3.5 x 2 cm
Liempo, malaman Belly, less fat 35 1 slice 6.5 x 3.5 x 1 cm
Pigi Ham 35 1 slice 3.5 x 3.5 x 3 cm
Tadyang Spare rib
Variety meats/internal organ
Dila (baboy, baka) Tongue (pork, beef) 35 1 slice 5 x 3.5 x 2.5 cm
Isaw ng baboy, Pork intestine, small, 35 1 pc n/a
barbecue barbecue
Puso, manok Chicken heart 35 7 pcs 5 cm diameter
each
Tenga, baboy, barbrcue Pork ear, barbecue 50 1 slice 4.5 x 4 x 4 cm
Egg
Balut Duck, fertilized 65 1 pc medium 5.5 cm diameter x
Penoy Duck, unfertilized 4.5 cm
Pato, buo Duck, whole
Procesed Foods
Cheese
Feta Feta 50
Gouda Gouda 30
Parmesan, grated Parmesan, grated 30
Pimiento Pimiento 35
Keso de bola Edam 35 1 slice
Fish Products (canned)
Sardinas, Spanish style Sardines, Spanish style 30
Tuna flakes in vegetable Tuna flakes in vegetable n/a
oil oil
Meat Products
Longanisa, chorizo Sausage, chorizo 30 1 pc 2 cm diameter x 8
cm
Sausage, frankfurter Sausage, frankfurter 60 1 1/2 pc 2 cm diameter x
11 cm
Sausage, salami Sausage, salami 50 2 pcs 10 x 10 x 0.2 cm
each
APPENDIX B6
FAT EXCHANGES
This list contains 5 grams of fat and 45 kcal.

Filipino Name English Name Weight (g) Household Measure
Monounsaturated Fats
Avocado Avocado 65 12.5 x 6.5 x 2 cm

Mantika (olive, peanut) Oil (olive, peanut) 5 1 tsp
Nuts:
Almond Almond 8 7 pcs
Kasuy, binusa Kasuy, binusa 9 6 pcs, whole

Macadamia Macadamia 7 5 pcs
Mixed nuts Mixed nuts 7 1 Tbsp
Pili Pili 7 5 pcs
Peanut butter Peanut butter 10 1/2 Tbsp
Seeds:
Sunflower Sunflower 8 1 Tbsp
Patani Lima beans 10 5 pcs
Shortening Shortening 5 1 tsp
Polyunsaturated Fats
Fish oil, cod liver Fish oil, cod liver 5 1 tsp

Mantika/Langis (canola, Oil (canola, corn, flaxseed,
corn, flaxseed, sesame, sesame, soybean, 5 1 tsp
soybean, sunflower) sunflower)
Nuts:
Walnut Walnut 7 2 pcs
Seeds:
Flaxseed Flaxseed 8 2 1/2 tsp
Kalabasa Squash/Pumpkin 10 1 Tbsp
Linga Sesame 8 1 Tbsp
Pakwan Watermelon 10 1 1/2 Tbsp
Saturated Fats
Bacon Bacon 10 1 strip

Cream cheese Cream cheese 15 1 Tbsp
Cream, all purpose Cream, all purpose 15 1 Tbsp
Cream, fluid, whipping Cream, fluid, whipping 15 1 Tbsp
(heavy, light) (heavy, light)
Cream, whipped Cream, whipped 20
Krema Cream 20 4 tsp
Lard Lard 5 1 tsp
Latik Coconut, cream curd 10 2 tsp
Mantekilya Butter 5 1 tsp
Mantekilya, light Butter, light 10 2 tsp
Mantika/Langis, niyog Oil, coconut 5 1 tsp
Mantika/Langis, niyog (MCT) Oil, coconut (MCT) 5 1 tsp
Mantika/Langis, niyog (virgin, Oil, coconut (virgin, extra 5 1 tsp
extra virgin) virgin)
Mantika, palm Oil, palm 5 1 tsp
Margarine Margarine 5 1 tsp
Mayonnaise Mayonnaise 5 1 tsp
Mayonnaise, diet Mayonnaise, diet 20 4 tsp
Mayonnaise, light Mayonnaise, light 15 1 Tbsp
Niyog, kakang gata Coconut cream 15 1 tbsp
Niyog, magulang Coconut meat, mature 20 4 tsp
Salad dressing Salad dressing 10 2 tsp

Sandwich spread Sandwich spread 15 1 Tbsp
Sitsaron baboy/Sitsarong Pork crackling, skin 10 5 pcs
balat
Sour cream Sour cream 25 5 tsp
Beef tallow Beef tallow 5 1 tsp
th
APPENDIX B7
SUGAR EXCHANGE
This list contins 5 grams carbohydrate and 20 calories.

Filipino Name English Name Weight (g) Household Measure
Arnibal Syrup 5 1 tsp

Asukal (muscovado, pula, Sugar (muscovado, red, 5 1 tsp
puti) white)
Banana chips Banana chips 5 2 pcs
Bukayo Coconut meat, grated, 5 1 pc
sweetened
Candy (Caramel, hard, Candy (Caramel, hard, 5 1 pc
toffee) toffee)
Champoy Champoy 5 1 pc
Cherry, in syrup Cherry, in syrup 20 5 pcs
Chewing gum Chewing gum 5 1-2 pcs
Chocolate Chocolate 5 2 pcs
Coco sugar Sugar, coconut sap 5 1 tsp
Coco syrup Syrup, coconut sap 5 1 tsp
Dates, pitted Dates, pitted 5 1 pc
Dried jackfruit Dried jackfruit 5 1 pc
Dried kiwi Dried kiwi 5 1 pc
Dried mango Dried mango 5 1 pc
Dried papaya chunks Dried papaya chunks 5 1 pc
Dried pineapple Dried pineapple 5 2 pcs
Dulce de Leche Dulce de Leche 5 1 tsp
Gatas, sweetened, Milk, sweetened, 5 1 tsp
kondensada, filled condensed, filled
Gulaman, may lasang prutas Carageenan gel, assorted 15 1 pc
fruit flavor
Jam and Jellies Jam and Jellies 10 2 tsp
Kiamoy Kiamoy 15 2 pcs
Leche flan Creme custard 10 1 slice
Lokum Lokum 5 1 pc
Marshmallow Marshmallow 5 3 pcs
Matamis na bao Coco honey 5 1 tsp
Nata de coco/ nata de piňa, Nata de coco/ nata de piňa, 15 1 Tbsp
sweetened sweetened
Pakaskas/Panocha Sugar, crude 5 1 tsp
Pasas Raisins 5 1 tsp

Pastilyas Fudge 5 1 pc
Prunes Prunes 10 2 pcs
Pulot Syrup, molasses, cane 10 2 tsp
Pulot-pukyutan Honey 5 1 tsp
Sampalok, candied Tamarind, candied 5 2 pcs
Taho may arnibal at sago Soy bean curd w/ syrup and 40 1/4 cup
sago
APPENDIX C
BEVERAGE LIST
The list gives the sugar equivalent of some commonly consume beverages in amounts per single-
serve containers.
Beverage Weight (g) Measure Number of Energy

Sugar (kcal)
Exchanges
Fruit-Flavored Drink
Concentrate
Calamansi 10 2 tsp 1 20
Grape 10 2 tsp 1 20
Grapefruit 10 2 tsp 1 20
Guyabano 20 4 tsp 1 20
Mango 35 5 tsp 1 20
Orange 10 2 tsp 1 20
Strawberry 10 2 tsp 1 1/2 30
Powder (all flavors) 5 1 tsp 1 20
Tetrabrick/polyfoil/bottled
Apple, Fruit-flavored tea, Grapes, 235 5 1/2 110
Mango, Melon, Orange, Pineapple, 250 6 120
Strawberry 350 9 180
Canned
Apple 163 1 can 5 100
Orange 240 1 can 5 1/2 110
Pineapple and Grapefruit 240 1 can 7 150
Pineapple 240 1 can 7 150
Soda/softdrinks
Cola 250 1 bottle 5 100
Lemon-lime 250 1 bottle 5 100
Orange 250 1 bottle 6 120
Rootbeer 250 1 bottle 5 100
APPENDIX D
FREE FOODS

A “free food is any food or drink that contains few calories (<16 kcal) per serving. The following food
items may be used freely unless specifically prohibited.
FREE FOODS
Bagoong Hot pepper, sauce

Bouillon (fat free soup) Kalamansi
Candy, hard (sugar free) Kamias
Carbonated drinks (sugar free) Lemon
Chili powder Miso
Cinnamon Mustard
Clear broth Oregano
Coffee, powder Paprika
Curry powder Pepper corn
Drink mixes (sugar free) Pimiento
Fish sauce Saffron
Flavoring extract Soy sauce
Flavored/Tonic water (sufar free) Spices
Garlic Tea
Gelatin (unsweetened) Turmeric
Ginger Vinegar
Gum (sugar free) Worcestershire sauce
Herbs
This list may be considered as free food if taken in the amount specified below. However, taking two
or more servings of these condiments will have corresponding calories that needed to be considered.
Food Item EP Weight (g) Household Measure

Barbecue sauce 15 1 Tbsp
Catsup, banana 10 2 tsp
Catsup, tomato 15 1 Tbsp
Gravy, commercial 15 1 Tbsp
Lechon sauce 15 1 Tbsp
Pickle (dill or sour) 30 2 Tbsp
Sweet chili sauce 10 2 tsp
Tomato paste 30 2 Tbsp
Tomato sauce 60 2 Tbsp
th
APPENDIX E
DIETARY MODIFICATIONS
DIET AIMS CHARACTERISTICS INDICATIONS
1. Normal/General To bring and maintain Consists of any and all foods For patients whose
a person in a state of eaten by a person in health conditions do not need
nutritive sufficiency but requires good menu dietary modifications
planning or restrictions, for
Used as basis for therapeutic purposes
planning therapeutic
diets
MODIFICATIONS IN CONSISTENCY AND TEXTURE
1. Clear Liquid To provide an oral Provides no nutritional In diarrheal diseases,

source of fluids and essentials; includes only before bowel surgery
small amounts of those foods which are clear or barium enema,
calories and (with no residue or fiber) and after colonic surgery,
electrolytes in order to: are liquid or liquefy at room acute inflammatory
a) prevent dehydration; temperature(e.g. fat-free conditions of GIT, first
b) relieve thirst; c) broth, black coffee, tea, fruit oral feeding of
maintain water balance juices, flavored gelatin and severely debilitated
and d) reduce colonic carbonated beverages); patient
residue to a minimum sugar and plain hard candies
supply added calories
Initial feeding is 30-60 ml
Used for 1 or 2 days only

2. Full Liquid or To provide oral Require the least effort for Acute illnesses,
General Liquid nourishment that is digestion and absorption; following oral surgery
well tolerated by consists of foods that are or plastic surgery of
patients who are liquid or liquefy at room/body the face and neck,
acutely ill or are unable temperature and are free of esophageal strictures,
to chew solid foods cellulose and irritating mandibular fractures,
condiments impaired chewing or
swallowing ability
Transition diet for post-
operative cases between a
clear liquid and soft diet; can
be planned to be nutritionally
adequate; supplements of
folic acid, vitamin B6 and iron
are needed if diet is used for
a long period of time
Foods allowed: those

included in clear liquid, milk,
plain frozen desserts,
fruit/vegetable juices and
purees, custard, cereal
gruels, broth, pureed
strained meat, fish, soft-
cooked egg, cocoa, butter,
margarine
3. Cold Liquid or To minimize pain in the Consists of cold or iced Tonsillectomy,
T&A (Tonsillectomy oral cavity and avoid smooth liquids and foods adenectomy, tooth
& Adenectomy) Diet bleeding of operated extraction
area Acidic or sour fruit juices and
hot soups are avoided
Includes plain ice-cream,

sherbets, cold milk, iced
tea/coffee, bland fruit juices,
soft drinks, bland and soft
foods which have been
cooled
4. Tube Feeding To provide a source of May be administered through When patient is
complete nutrition in a a nasogastric tube (NGT), unable to chew or
form that will easily via a pharyngostomy or swallow due to
pass through a tube in through a gastrostomy or deformity or
patients in whom oral jejunostomy inflammation of mouth
feeding methods are or throat, corrosive
contraindicated or not Types: poisoning, com,
tolerated or whose 3. Homogenized or unconsciousness,
condition warrants blenderized mixture of foods paralysis of throat
supplementation in the selected from a normal diet muscles, surgery of
form of natural foods 4. Commercially prepared head and neck,
and pre-sterilized feedings esophageal
D) Milk or casein based obstruction, surgery of
formulas (ex. Sustagen, the GIT, in severe
Meritene, Sustacal, Isocal, burns, mental
Ensure, Flexical) disturbances, anorexia
E) Blenderized diet feedings nervosa, mandibular
F) Synthetic fiber-free liquid fractures, following
diets head/neck irradiation,
strokes or trauma to
Foods allowed: those the oral pharyngeal
included in liquid, soft or cavity
regular diets which can be
liquefied and can pass
through a polyvinyl tube
5. Soft Diet For both mechanical Follows the regular diet Acute infections,
ease in eating and pattern but modified in fevers, some GI
digestion consistency and texture; disturbances, after
consists of food soft in surgery, during
To provide a texture, easy to chew, bland convalescence
nutritionally adequate in flavor, easily digested with
diet with the use of no harsh fibers and tough
simple, easily digested connective tissues; highly
foods seasoned foods, fatty and
fried foods are avoided
6. Mechanical Soft To provide foods that Similar to the regular diet Difficulties in
require minimum except that foods that are mastication as in
chewing hard to chew and swallow dental disorders, jaw
are modified by grinding, injury, dental
mincing, chopping and extraction, sores and
pureeing lesions in the mouth
7. Bland To provide a Greasy, highly spiced or Used traditionally for
chemically, thermally highly seasoned foods and gastric and duodenal
and mechanically non- condiments as well as ulcers, gastritis,
irritating diet given as fibrous, hard and strongly- ulcerative colitis,
part of the treatment flavored foods are excluded dyspepsia,
for duodenal ulcer and diverticulitis, diarrhea,
other GI disturbances; Individualization is the rule gallbladder diseases
to reduce acid and only those foods known
secretion and to be “disagreeable” to the
neutralize acid present; patient are omitted
to provide rest to
affected area Foods proven to stimulate
gastric secretion are decaf
coffee, red pepper, cola
beverages; those that cause
gastric irritation include black
pepper, chili powder,
caffeine, coffee, tea, alcohol
and drugs
8. High Fiber To increase the Contains increased amount Atonic constipation,
volume and weight of of cellulose, hemicellulose, uncomplicated
the residue that reach lignin and pectin and diverticulosis, irritable
the distal colon; to provides 13 g or more of bowel syndrome,
increase GI motility; to crude fiber; emphasis on atherosclerosis,
decrease intraluminal whole grain cereals and obesity, DM
colonic pressures breads, and fresh fruits and
(specifically vegetables that are high in
diverticulosis) fiber content, legumes and
nuts with skins; may cause
diarrhea and flatulence
9. Fiber-restricted To prevent the Indigestible CHO is reduced During acute phase of
formation of by using young immature diverticulosis,
obstructive bolus by vegetables, ripe canned or ulcerative colitis,
high fiber foods in well-cooked fruits, and infectious
patients with narrowed certain low fiber fruits and enterocolitis, wherein
intestinal or vegetables; may cause the bowel is markedly
esophageal lumens prolonged intestinal transit inflammed; in spastic
time and small infrequent constipation, diarrhea,
stools; may eventually hemorrhoids, cancer
decrease the size of the of the bowel
colon and increase in
intraluminal pressure
10. Residue To provide a diet that Limits the use of foods high Acute diarrhea,
restricted leaves a minimum in fiber and those that spastic constipation,
residue to rest the produce bulky stools: milk, dysentery, acute
intestinal tract potatoes, cheese except phase of ulcerative
cottage cheese, raw and colitis, ilietis, acute
soft-cooked egg, butter, lard diverticulitis and right
after colonic or rectal
surgery
MODIFICATIONS IN COMPOSITION (CALORIE)
1. Calorie restricted To provide a diet with a Calculated like a normal diet For overweight and
(Low caloric or caloric value below the except that the total caloric obese persons and for
reducing diet) total maintenance levels is decreased by 500 or cases wherein obesity
energy requirements to 1000 kcal/day to effect a is a complicating or
bring about steady weight loss of 1 or 2 lbs per risk factor (DM,CVD,
weight loss at an week, respectively renal disease, HPN,
optimum rate yet gout, gallbladder
supply adequate High CHO and fat-rich foods disease, surgery)
nitrogen, minerals and are avoided
vitamins
2. High caloric To allow gain in Contains more calories than Underweight, fevers
weight; to provide for the regular diet and infections,
increase in BMR in: hyperthyroidism,
*fever (+13% per °C Protein remains at or above burns
elevation) recommended levels
*cardiac failure (+ 15-
25%) Increased amounts of
*simple post operative vitamins and minerals are
states (+0-5%) needed for metabolism
*peritonitis (+5-25%)
*severe infection or Excessive amounts of fried
multiple trauma (30- foods, those high in bulk or
50%) fiber and concentrated
*multiple trauma with sweets which tend to reduce
patient on ventilator the appetite for food are
(+50-75%) avoided
*burns over 50% of the
body (+100%)
MODIFICATIONS IN COMPOSITION (CARBOHYDRATES)
1. Low CHO To reduce available CHO comprises 40% or less Traditional regimen for
glucose when CHO of TER (but should not be DM, weight reduction
metabolism is impaired less than 100 g/day). and epilepsy;
hyperinsulinism,
Simple sugars are eliminated dumping syndrome,
celiac disease, certain
types of
hyperlipoproteinemias,
stimulative and
alimentary
hypoglycemia
2. High CHO To allow for glycogen CHO comprises 70-80% of Liver diseases,
formation, ensure TER Addison’s disease,
sufficient calories to fasting hypoglycemia,
spare protein, and to Emphasis is on foods high in acute
minimize tissue available CHO such as glomerulonephritis,
catabolism sugar, syrups, jellies and uremia, pernicious
jams (such sweets however vomiting and toxemias
should comprise no more of pregnancy
than 10% of total calories)
The majority of CHO must

come from complex CHO
3. Galactose - free Control of Free of all sources of Galactosemia
galactosemia and galactose: all foods
prevention of severe containing lactose, organ
mental retardation, meats such as liver,
cataracts and other pancreas, brain, MSG
symptoms
Infants are started on
soybean milk at birth
4. Lactose-free Treatment of severely Milk and milk products, foods Primary lactase
affected individuals in that naturally contain small deficiency as in Holzel
whom the intestinal amounts of lactose or have Syndrome and Durand
enzyme lactase is small amounts added in Syndrome; secondary
almost completely processing are eliminated lactose intolerance
absent due to damaged
intestinal mucosa in
celiac disease,
kwashiorkor, GI milk
allergy, irritable bowel
syndrome, regional
enteritis, ulcerative
colitis; transient
lactose intolerance
after viral enteritis
5. Lactose- To prevent the Contains less than 8-10 g Less severe and adult
restricted occurrence of lactose daily; should be forms of lactose
symptoms in patients specialized to accommodate intolerance
with less severe forms individual tolerance levels
of lactose intolerance
Milk beverages, creamed
foods and ice cream may
have to be avoided while
fermented forms of milk such
as cheese in which lactose is
converted to lactic acid are
not restricted
6. Sucrose-
restricted
MODIFICATIONS IN COMPOSITION (PROTEIN)

1. High Protein To afford regeneration Allow 1.5 g or more of Cancer, pernicious
of body tissues and protein/kg body weight or anemia, liver cirrhosis,
cells to compensate for 50% above normal infetious hepatitis,
improper utilization and requirement PTB, ulcerative colitis,
loss of, or increased fractures, severe
demand, for protein Diet should supply adequate burns, post-operative
calories conditions, PEM,
Adult protein nephrosis, in nephritis
requirement increases Protein synthesis will not with hypoproteinemia,
to 1.5 g/kg in operative occur and will be used up as chronic
states and 2.25 g/kg in energy unless the ratio of glomerulonephritis
severe infection, calories to nitrogen is 200 with albuminuria,
multiple trauma, burns Ex. 2400 kcal is to 12 g N or pregnancy, lactation
75 g protein and growth
[N(g) = Protein (g) ÷ 6.25,
and 2400 ÷ 12 = 200]
Adequate vitamins and

minerals must be furnished
to assure optimum utilization
2. Protein- restricted To minimize sources of Supplies from 0-0.7 g In kidney diseases
toxic nitrogenous protein/kg body weight or 0- where there is
products and at the 0.4 g/day nitrogenous retention,
same time supply the anuria and uremia,
essential amino acids Level of restrictions depends hepatic coma
and adequate calories upon the patient’s clinical
and biochemical status at a
particular time
2a. Zero protein A very unpalatable and Acute anuria, hepatic
monotonous diet consisting coma
mostly of sugars and fats;
very inadequate and should
be used for 2-3 days as a
temporary measure
As the patient’s condition

improves, the protein intake
should be gradually
increased to 5, 10,15 g/day
and so on
The inclusion of fruits and

fruit juices gives a total of 2-4
g protein and increases the
potassium content of the diet
2b. 20 g Protein Contains limited amount of Chronic renal failure,
high biological value protein; acute
egg is preferred over milk glomerulonephritis
since the latter contains
higher sodium, calcium,
phosphate and fluid
3 1/2 exchanges of rice, one
exchange of vegetables and
1 1/2 exchanges of meat
(include egg) will provide 20
g of protein of which 2/3 are
of HBV
Sugars, fruits and fats are

used to meet caloric needs
2c. 40 g Protein Can be planned to have Chronic uremia,
variety of foods; 26 to 30 g chronic
should come from animal glomerulonephritis
sources and hepatic coma
3. Protein
Constituents
3a. Purine- To lower serum uric Purine content limited to 120- Uric acid, calculi, gout
restricted acid levels in the 150 mg/day (normal intake is
treatment of gout 600-1000 mg) by eliminating
organ meats, anchovies,
sardines, meat extracts,
gravies, dried beans, peas,
yeast, spinach, oatmeal
Since fat prevents excretion

of urates, the diet is also low
in fat
3b. Phenylalanine- To provide protein, Natural foods low in phenylketonuria
restricted phenylalanine, phenylalanine and
tyrosine, energy and Lofeenalac (a protein
other essential hydrolysate form the basis
nutrients in amounts for the diet
sufficient for growth
and development; to
prevent mental
retardation by
controlling excessive
accumulation of
phenylalanine and its
metabolites in the
plasma
3c. Gluten restricted To eliminate toxic Excludes wheat, rye, oat and Celiac disease, non-
Gliadin free glutens for patients barley tropical sprue
with celiac disease
4. Vegetarian Diets To furnish all the For ecological,
essential amino acids religious and health
4a. Vegan diet or while replacing part or Excludes all foods of animal concerns
strict vegetarian diet all animal sources of origin
protein with plant
sources Protein comes from
vegetables, breads, cereals,
dry peas, beans, lentils, nuts,
peanut butter
4b. Lactovegetarian Excludes meat, poultry and
diet fish
Allows dairy products in

addition to those included in
vegan diet
4c.Lactoovovegetari Excludes meat, poultry and
an diet fish
Allows eggs and dairy

products in addition to those
included in vegan diet
4d. Pescovegetarian Includes plant foods and fish
diet but does not include milk,
egg, meat or poultry
4e. fruitarian diet Restricts the variety of plant
foods to fruits and nuts with
or without the addition of
grains and legumes
4f. Zen macrobiotic Vegetarian diets must be
diet supplemented with vitamin
B12 which is lacking in plant
foods
MODIFICATIONS IN COMPOSITION (FAT)
1. Low Fat To meet a specified Contains approximately 20- Acute pancreatitis,

percentage of fat 30 g fat/day or 10-15% TER acute gallbladder
calories diseases,
CHO is increased while cardiovascular
protein is at normal level diseases and where
there is derangement
May cause deficiency in in the digestion,
vitamins A, D, E, K since fat absorption and
is their carrier in the body metabolism of fat
2. Moderate Fat Same as 1 Adequate in essential Liver and heart

nutrients and allows 50-65 g diseases, chronic
fat/day gallbladder and
pancreatic diseases
3. High Fat Accompanies high Butter, margarine, cream, Alimentary and

PRO high cal diet or in salad dressing and vegetable stimulative
diets restricted in oils are used liberally hypoglycemia, uremia
PRO/CHO
4. Ketogenic Diet To maintain a Rarely prescribed high fat Erilepsy, convulsive
ketogenic:antiketogeni (80% of TER) low CHO (10- seizures
c ratio that will produce 30g/day) diet
a state of ketosis
Drug therapy has replaced
this diet
5. Low Cholesterol To effect a lowering of Contains 250-300 mg Atherosclerosis,
serum cholesterol and cholesterol hyper-
prevent deposition of cholesterolemia,
fatty materials in the Excludes organ meats, Types II-V hyper-
arterial walls shellfish, fish roe, whole milk, lipoproteinemia,
cream, butter, cheese and gallstones with
animal fat cholesterol esters,
coronary artery
Eggs limited to 2-3 per week; disease
meat, fish and poultry limited
to 6 oz cooked weight/day
MODIFICATIONS IN COMPOSITION (MINERAL CONTENT)
1. Sodium- To restore normal Vary with degree of Ascites in liver

restricted (low salt, sodium balance to the restriction cirrhosis, HPN, edema
low sodium) body by effecting loss accompanying CHF,
of excess sodium and Sodium level is limited to a adrenocortical therapy
water from extra prescribed level ranging from and toxemias of
cellular fluid 200-3000 mg daily (Filipino pregnancy
compartments diet salty condiments may
have 7-15 g Na/day)
Foods containing large

amounts of sodium are either
eliminated or restricted in
amount
1a. 200-300 mg Na No salt used in cooking; Liver cirrhosis with
(extreme Na careful selection of foods low ascites, CHF, if higher
restriction) in sodium; regular milk, Na level is ineffective
bread, butter or margarine
are omitted; eggs and meat
are limited
1b. 500-700 mg Na Allows limited amounts of Pulmonary edema in
(severe Na regular milk, bread and CHF, renal disease
restriction) butter with edema and
cirrhosis with ascites
Uses no processed foods
containing sodium nor salt in
food preparation but a
measured amount of table
salt ( 1 tsp salt = 200 mg Na)
may be added on the
patient’s tray if the total
inherent sodium of the foods
used does not meet the
sodium allowance for the day
1c. 1000-1500 mg Measured amount of salt is Patients with
Na (moderate Na added or foods with relatively borderline HPN, or
restriction) higher sodium content are those with strong
used more generously family histpry of HPN
1d. 2000-3000 mg Some salt may be used in Maintenance diet in
Na (mild Na cooking but no salty foods cardiac and renal
restriction) are permitted; no salt is used diseases
on the table
2. Potassium- To prevent Restricts potassium intake to CHF with
restricted hyperkalemia 1000-2000 mg/day (or 25-51 hyperkalemia,
mEq/day) Addison’s disease
The average diet contains

50-150 mEq K/day
Dark green vegetables,

tomatoes, fruits (except
kaimito, lychees and canned
pineapple), dried peas and
beans, unrefined cereals,
root crops, nuts, crustaceans
and brown sugar are avoided
3. Calcium- Used in combination Provides a maintenance Calcium oxalates
restricted with oxalate and fat level of Ca ranging from 200- stones, hypercalcemia
restrictions to prevent 400 mg/day (normal adult in hyper-
renal stones requirement is 500 mg/day) parathyroidism, acute
immobilization, milk
Foods high in calcium are alkali syndrome,
avoided hyperthyroidism, acute
adrenal insufficiency
MODIFICATIONS IN COMPOSITION (ASH CONTENT)
1. Acid-ash To bring about a Emphasis is on the use of Renal stones

reduction in the pH of large amounts of acid- consisting of Ca, Mg,
urine (normal range= forming foods phosphates,
4.5 - 7.5) carbonates and
oxalates
2. Alkaline-ash To bring about an Uric acid and cystine
increase in the pH of stones
urine
OTHER DIETS
1. Hypoallergenic To exclude a specific Food allergy

diet food or food group
known to produce
allergic manifestations
2. BRAT diet To provide sources of Consists of banana, rice, Diarrhea
calories, fluid, apple and tea
electrolytes ad pectin
Crackers may be used
instead of rice
3. Prudent diet To lower blood lipid A kind of diet that follows the Atherosclerosis
levels and possibly guidelines suggested by the
prevent coronary heart Inter-Society Commission on
disease Heart Disease Resources,
The American Heart
Association
4. Formula diet To allow for weight Commercial low-calorie meal Obesity, overweight
reduction substitutes in liquid, powder
or solid form
APPENDIX F
PURINE CONTENT OF DIFFERENT FOOD ITEMS
HIGH CONTENT: 150-82.5 mg/100g

Fish/Seafood Meats
Anchovies Brains
Herring Gravies
Mackerel Kidney
Sardines Liver
Scallops Meat extracts
Sweet breads Wild game
Goose
MODERATE CONTENT: 50-150 mg/100g

Vegetables Fish/Seafood
Asparagus Crabs
Cauliflower Eel
Green Peas Fish (all kinds)
Mushrooms Lobsters
Spinach Oysters
Grains and Legumes Meat and Related Products

Split peas Beef
Beans Lamb
Lentils Pork
Oatmeal Veal
Wheat bran and germ
Whole grain breads and cereals Poultry
Chicken
Duck
Turkey
LOW CONTENT: 0-50 mg/100g

Beverages Miscellaneous
Carbonated beverages Eggs
Coffee Fats
Tea Fish roe
Fruits and juices
Grains Gelatin
Breads and cereals (refined white flour) Nuts
Sugar (all types) and food containing sweets
Dairy Vegetables
Cheese
Milk (all fat levels)
APPENDIX G
DETERMINE YOUR NUTRITIONAL HEALTH
NUTRITION SCREENING INITIATIVE (NSI)
Background

The Nutrition Screening Initiative (NSI) was developed in order to address the prevalence of
malnutrition among older adults. This initiative represents the work of the American Academy of
Family Physicians and the American Dietetic Association to create a coalition whose goal is to
promote the integration of nutrition screening and intervention into healthcare for older adults. NSI
helps to increase older adults' awareness about nutrition and health. It differentiates among adequate
nutritional status, malnutrition risk and malnutrition. The checklist is based on the following warning
signs for poor nutrition:
Disease
Eating Poorly
Tooth Loss/Mouth Pain
Economic Hardship
Reduced Social Contact
Multiple Medicines
Involuntary Weight Loss/Gain
Needs Assistance in Self- Care
Elder Years Above Age 80
DETERMINE was designed by the American Academy of Family Physicians, the National Council on
the Aging and others as part of the Nutrition Screening Initiative. This tool can be used by
professionals working with elders in order to assess their risk for poor nutritional status or
malnutrition. The DETERMINE questionnaire can also be used to measure an individual's change in
level of nutritional risk over time. If DETERMINE scores taken prior to beginning a new nutrition
program are compared with scores later in the program, a decrease in the resulting score would
indicate a corresponding decrease in the elder's nutritional risk. In this way, the effectiveness of the
program for the individual can be evaluated.
Completing the Paper Form
This form may be completed by the consumer or, when needed, it can be completed through an
interview with the consumer. When this assessment is conducted by telephone by AAA staff the
completed checklist and the “Determine Your Nutritional Health Handout” must both be provided to
the consumer assessed and, as appropriate, documented in the consumer’s file.
1. Enter the name of the provider or nutrition center. If the AAA is providing nutrition counseling
directly, enter the name of the AAA.
2. Enter the consumer’s name.
3. Enter the consumer’s client identification number, if known. The consumer’s Social Security
Number should not be used for the client identification number.
4. Enter the date the DETERMINE Your Nutritional Health was completed. This assessment must
be completed annually for all consumers receiving congregate meals, home delivered meals or
nutrition counseling.
5. Circle the number in the “Yes” column if the statement applies to the consumer.
6. Total the score by summing only the numbers circled.
7. Enter the date and total score on the Handout for the DETERMINE Your Nutritional Health. The
Handout should be given to the consumer for educational purposes and for future reference.
8. Enter the responses into SAMS. When the response is “Yes,” SAMS will automatically apply the
correct DETERMINE Your Nutritional Health score. The system will also automatically total the
nutritional risk score and indicate the consumer’s nutrition risk status in the SAMS client record.

REFERENCES

Bayaga, C. and Panlasigui, L. (2007). Fundamentals of Nutrition: A Laboratory Manual. Manila,
Philippines: C & E Publishing, Inc.
Food and Nutrition Research Institute, Department of Science and Technology. (2019). Food
Exchange Lists for Meal Planning 4th revision. Food Exchange Lists. Taguig City, Philippines FNRI-
DOST.
W.L. Haskell and coauthors, Physical activity and public health: Updated recommendation for adults
from the American College of Sports Medicine and the American Heart Association, Medicine &
Science in Sports & Exercise 39 (2007): 1423-1434.
https://www.cdss.ca.gov/agedblinddisabled/res/VPTC2/9%20Food%20Nutrition%20and
%20Preparation/Types_of_Therapeutic_Diets.pdf
https://www.encyclopedia.com/medicine/divisions-diagnostics-and-procedures/medicine/weight-
management
http://www.fnri.dost.gov.ph/index.php/publications/nutritional-handbooks

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NUTRITION

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students

1 Food Habits of an Individual ………………………………………………………….…….… 1

2 Height, Weight, Body Mass Index and Desirable Body Weight…….……….……….…. 3

3 Total Energy Requirement and Carbohydrate, Protein and Fat Distribution………… 6

4 Food Exchange Lists and Meal Distributions……………………………………………… 9

6 The Hospital Diets……………………………………………………………………………... 15

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students I

ACTIVITY 1. Factors Affecting Food Habits

5- Always important 4- often important 3- Seldom Important

2-rarely important 1- not important at all

FACTORS RATING FACTORS RATING

A. Physiological C. Environmental Influences

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students 1

FOOD Perceived Health Benefit

ACTIVITY 3. My Health Goal

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students 2

How to compute for BMI:

How to compute for DBW (Infant):

How to compute for DBW (Child):

How to compute for DBW (Adult):

Weight: ____ kg Height: ____ cm (1 in=2.54 cm)

1. How often do you weigh yourself? __________

ACTIVITY 2. Body Mass Index

ACTIVITY 3. Desirable Body weight

B. Compute for the DBW given the following.

How to compute for TER (Infant):

Above 6 months of age

How to compute for TER (Child):

How to compute for TER (Adult):

Light Occupations that require minimal movement, mostly 35

Moderate Occupations that require extended periods of walking, 40

Very Active or Vigorous Occupations that require extensive periods of running, 45

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students 6

Table 2. Acceptable Macronutrient Distribution Range

Diet Prescription: 1500 kcal in 245 g Carbohydrate, 55 g Protein and 35 g Fat

ACTIVITY 1. Total Energy Requirement

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students 7

ACTIVITY 2. Carbohydrate, Protein and Fat Distribution

Points to Consider in Using the Food Exchange Lists

Table 3. Energy and macronutrient composition of food exchanges

2. Determine rice exchanges.

3. Determine meat exchanges.

Nutrition and Diet Therapy: A Laboratory Manual for Nursing Students 10

245 g (prescribed carbohydrate)

IV Rice A (Low Protein) 1 23 0 - 92

V Meat (Low Fat) 2 - 16 2 82

Table 5. Sample Meal Distribution

Meat Low Fat 2 2

ACTIVITY 1. FEL Distribution

ACTIVITY 2. Meal Distribution

Factors Affecting Meal Planning

Table 6. Sample One-day Meal Plan

Note: For meal planning purposes, refer to Appendix A-D

ACTIVITY. Make your own Meal Plan!

Common reasons for therapeutic diets may be ordered:

Table 7. The Hospital Diets

MODIFICATIONS IN CONSISTENCY AND TEXTURE

1. Clear Liquid To provide an oral source Provides no nutritional In diarrheal diseases,

Initial feeding is 30-60 ml

Used for 1 or 2 days only

Foods allowed: those included

Weight: kg Height: cm (1 in=2.54 cm)