MENU PLANNING

(Simplified)

STEPS IN MENU PLANNING:

STEPS 1. Get the DBW using Tannhauser’s Method.

2. Know the caloric requirement or the Total Energy Allowance (TEA)
of the patient
3. Know the nutrient or diet distribution of the patient.
(regular/modified)
4. Calculate the diet Rx in grams.
5. Make a table for the computation of exchanges.
6. Make a meal plan distribution of exchanges for a day.
7. Convert the meal plan distribution to household measurements.

Modified Diet
Nutrients Regular Diet
DM CVA/Stroke Post- GIT
Renal op prob.
CHO 60% 50% 70% 60% 60% 60%
CHON 15% 20% 10% 25% 20% 15%
Fats 25% 30% 20% 15% 20% 25%

STANDARD TER (TOTAL ENERGY REQ’T)

1. Bed rest – 27.5 kcal/kg/DBW
2. Sedentary – 30 kcal/kg/DBW (sitting, secretary)
3. Light activity – 35.0 kcal/kg/DBW (nurses, driver)
4. Moderate – 40 kcal /kg/DBW (carpenter, painter)
5. very active – 45 kcal x DBW (swimmer. sportsman)

Examples:

1. Given: 5’5”, Filipino, female, nurse

STEP 1. DBW- Tannhauser’s m.

Given: TER= 35 kcal/g

5’5”= 65”
x 2.54 cm
165.1cm
- 100
65.1 kg
- 10% (6.51)

58.59 or 59 kg

STEP 2. Caloric Req’t or TEA of the patient

59 kg x 35 kcal/kg
= 2, 065 kcal or 2, 100 kcal

Note: round off to nearest hundreds

STEP 3. Diet/ Nutrient Distribution (Regular Diet)

Nutrient Distribution Energy from Nutrient

CHO – 60% -- 1g = 4 kcal
CHON – 15% -- 1g = 4 kcal
Fats – 25% -- 1g = 9 kcal

STEP 4. Diet Distribution in grams

Final ans.
CHO – 2, 100 x 0.6 ÷ 4 kcal = 315g - 315g
CHON – 2, 100 x 0.5 ÷ 4 kcal = 79g - 80g
Fats – 2, 100 x 0.25 ÷ 9 kcal = 58g - 60g

Note: Round off to whole number, “divisible by 5”; ending no. must be 5 or 0.

Considerations:

1. Vegetable A don’t change nutrient value if served ½ cup cooked or 1 cup

raw.
e.g. ½ cup cooked – no value; with value only if doubled (1 cup, 2 cups, 3
cups..)
1 cup raw – no value; with value if 2, 4, 6, 8, 10… cups.
2. Normal consumption of sugar of healthy persons is 5-8 exchanges; maximum
of 9 unless contraindicated
3. 3 exchanges of vegetable are allowed per day; maximum of 4
4. 2-3 exchanges of fruits are allowed unless restricted; maximum of 4
5. Condiments have no value (pepper, salt, soy sauce…);
with value only if consumed in large amounts (e.g.catsup, gravy).
 STEP 5. COMPUTATION OF EXCHANGES STEP 6. DISTRIBUTION OF EXCHANGES

Food # of CHO CHON Fats kcal Breakf Lunch Dinner Snack Snack
Items Ex. ast (am) (pm)
Veg A 2 3 1 - 16 1 1
B 1 3 1 - 16 1
Fruits 3 30 - - 120 1 1 1
W. Milk 1 12 8 10 170 1
Sugar 5 25 - - 100 1 2 2
Rice 73-
315=24 21
10. 2 - 1, 050 2 3 2 2 1.5
5 ÷23=10.
5
31-
242 80=49
÷8=6.1
5 or 6
Meat 3 - 24 3 123 1 2
LF 3 - 24 18 258 1 2
MF 31-
60=30÷
5
=5.8 or
6
Fat 6 30 270 3 3
TOTAl 315 79 61 2, 123

STANDARD TOLERANCE:
+/-5 grams – in each nutrient
+/-50 – in total calories

Computation on rice, meat & fat exchange

1. Rice exchange
a. add the value of carbo
b. subtract the amount of Rx carbo
c. Divide it by 23 (1exchange of rice=23)

2. Meat exchange
a. add the value of CHON
b. subtract the amount of Rx CHON
c. Divide it by 8 (1exchange of meat=8)

3. Fat exchange
a. add the value of fats
b. subtract the 2x amount of fats
c. divide it by 5 (1exc. of fat=5)
STEP 7. CONVERSION OF EXCHANGES INTO HOUSEHOLD MEASUREMENT

Breakfast
1 piece apple, 65 gms.
1 cup fresh carabao’s milk
1 cup rice cooked
1 pc. sardines in tomato sauce

Lunch
Ginisang Gulay (w/ 3 tsp. oil)
1/8 tomato, 1/8 onion (cup/cooked)
¼ baguio beans (cup/cooked)
¼ togue (cup/cooked)
¼ carrot (cup/cooked)
2 pcs. tokwa (cup/cooked)
1 matchbox size pork (cup/cooked)
1 ½ cup rice cooked
1 pc. latundan banana

AM Snack
4 tsp. strawberry jam
4 slices wheat

PM Snack
4 tsp. cocojam
3 pcs. pandesal (5x5 cm)
3 pcs. apas

Dinner
½ cup cooked nilagang okra
2 pcs fried galunggong (w/ 3 tsp oil)
1 cup cooked rice
¼ cup sweetened mango juice
1 pc yema

Example # 2

5’2”, male, Filipino, student

5’x12” = 60”
+ 2”
62 x 2.54 = 157.48 – 100 = 57.48 – 10% = 51.732 or 52kg

52 kg x 35 kcal/kg = 18.200/ 1800 kcal

1,800 kcal/day CHO – 1800 x 0.6 ÷ 4 = 270 or 270g

CHON – 1800 x 0.15 ÷ 4 = 68 or 70g
Fats – 1800 x 0.25 ÷ 9 = 50 or 50g
Food # of CHO CHON Fats kcal Breakfast Lunch Dinner Snack Snack
Items Ex (am) (pm)
Veg 2 3 1 - 16
A 1 3 1 - 16
B
Fruit 4 40 - - 160
Milk 1 12 8 10 170
Sugar 5 25 - - 100
Rice 8 184 16 - 800
Meat 2.5 - 20 2.5 102.5
LF 3 - 24 18 258
MF
Fat 4 - - 20 180
267 70 50.5 1802.5

Where?
1. exc. of rice
270 – 83 = 187 ÷ 23 = 8.1 or 8

2. exc. of meat
70 – 26 = 44 ÷ 8 = 5.5

3. exc. of fat
50 – 30.5 = 19.5 ÷ 5 = 3.9 or 4