BACHELOR OF SCIENCE IN NURSING

NUTRITION AND DIET THERAPY

COURSE MODULE COURSE UNIT WEEK
1 2 2
Nutrition Tools, Standards and Guidelines Nutrient Recommendation

Read course and unit objectives

Read study guide prior to class attendance
Read required learning resources and refer to unit terminologies for jargons
Proactively participates in chat room discussions
Participate in weekly discussion
Answer and submit course unit tasks

Module, Reference Books, Laptop, Internet, Headset

At the end of the course unit, learners will be able to:

Cognitive:
1. Integrate relevant principles of nutrition tools, standards and guidelines on nutrient
recommendations.
2. Apply appropriate concepts of nutrition and diet therapy holistically and comprehensively.
Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and graciously.
4. Develop heightened interest in studying Nutrition and Diet Therapy

Psychomotor:
1. Participate actively during class discussions and group activities
2. Express opinion and thoughts during class

Adequate Intake (AI) – is the recommended average daily intake level based on observed or
experimentally determined estimates of nutrient intake by a group of apparently healthy people
that are assumed to be adequate.

Dietary Reference Intakes (DRIs) – are reference values that are quantitative estimates of
nutrient intakes to be used for planning and assessing diets for healthy people.

Estimated Average Requirement (EAR) – The daily nutrient intake level that meets the median
average requirement of healthy individuals in a particular life stage and sex group, corrected for
incomplete utilization or dietary nutrient bioavailability.

Philippine Dietary Reference Intake (PDRI) – collective term comprising reference values for
energy and nutrient levels of intakes. PDRIs are to be used as references for assessing and
planning dietary intakes for an individual or for a group or population. Estimated Average
Requirement (EAR), Recommended Energy/Nutrient Intake (REI/RNI), Adequate Intake (AI),
and Tolerable Upper Intake Level or Upper Limit (UL) are the components constituting the PDRI.

Recommended Dietary Allowance (RDA) – the estimated amount of a nutrient (or calories)
per day considered necessary for the maintenance of good health.

Nutrition in early life is crucially important for children to grow and develop into healthy adults.
Children can reach their growth and development potential if their nutritional needs are met in a
healthy environment. Unfortunately, the Philippines is one of the countries in the world where a
significant number of children remain malnourished despite the economic growth and
development in the country over the past decades. Data from the 2013 National Nutrition Survey
(2013 NNS) in the Philippines reported that among children under 5 years old, the prevalence
of malnutrition measured by underweight and stunting was 20% and 30%, respectively, and the
prevalence starts to increase at 6–11 months.
Dietary Reference Intakes (DRIs)

Dietary Reference Intakes (DRIs) is a generic term for a set of nutrient reference values that
includes the Recommended Dietary Allowance (RDA), Adequate Intake (AI), Tolerable Upper
Intake Level (UL), and Estimated Average Requirement (EAR).

This is for planning and assessing diets of healthy groups and individuals. PDRI is the collective
term comprising reference value for energy and nutrient levels of intakes. The components of
PDRI are:

Estimated Average Requirement (EAR) is a daily nutrient intake level that meets the median
or average requirement of healthy individuals in particular life stage and sex group, corrected for
incomplete utilization or dietary nutrient bioavailability.

The estimated average requirement (EAR) is the amount of a nutrient that is estimated to meet
the requirement for a specific criterion of adequacy of half of the healthy individuals of a specific
age, sex, and life-stage. The amount of the nutrient necessary to meet the appropriate criterion
of adequacy varies from one individual to the next, but the data are usually distributed normally
or can be transformed to achieve a normal distribution. The EAR is not useful as an estimate of
nutrient adequacy in individuals, because it is a mean requirement for a group, and the variation
around this number is considerable. A recommended dietary allowance (RDA) for a nutrient is
derived from an estimated average requirement (EAR), which is an estimate of the intake at
which the risk of inadequacy to an individual is 50%..

Recommended Energy/Nutrient Intake (RENI) also known as Recommended Daily

Allowances is a level of intake of energy or nutrient which is considered adequate for the
maintenance of health and well-being of healthy persons in the population. The 2015 Philippine
Dietary Recommended Intake (PDRI) shall be used for planning and assessing diets for
individuals and groups, developing food-based dietary guidelines, formulating standards and
regulations on food fortification, nutrition labeling and claims, and food safety, designing and
evaluating food and nutrition assistance programs, determining food bundles, setting food
production targets, and other related uses that require consideration of nutrient and dietary
intakes.

The average amount of a nutrient a healthy person should get each day. RDAs vary by age,
gender and whether a woman is pregnant or breastfeeding. For example, the RDA for vitamin C
is 80 mg a day for a pregnant teenager and 90 mg a day for men. RDAs apply to vitamins and
minerals from food and daily supplements. The purpose of these guidelines is to inform you how
much of a specific nutrient your body needs on a daily basis. It is important to meet the daily
recommended dietary allowances so that your body gets everything it needs to function.

The Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is
sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in
a particular gender and life stage group (life stage considers age and, when applicable,
pregnancy or lactation).
The RDA for a nutrient is a value to be used as a goal for dietary intake by healthy individuals.
The RDA is not intended to be used to assess the diets of either individuals or groups or to plan
diets for groups.

PDRI 2015 updated the 2002 Recommended Energy and Nutrition Intake (RENI) with the
following changes: (1) Adjustment of reference weights for infants and children based on the
World Health Organization Child Growth Standards (WHO-CGS) and Growth Reference, and
those for adults based on the weight to achieve Body Mass Index (BMI) of 22 using the 2013
National Nutrition Survey (NNS) height data; (2) Revision of age groupings to reflect
established biological patterns and recent international feeding guidelines; (3) Updating of
reference values arising from new scientific evidence on human milk volume and on nutrient
requirements; (3) Inclusion of additional nutrients like polyunsaturated fatty acids and removal
of manganese; (4) Inclusion of Acceptable Macronutrient Distribution Ranges for protein, total
fat, and carbohydrates for the reduction of chronic disease risk; (5) Recommendation on
maximum intake levels of sodium and free sugars for the reduction of risk of cardiovascular
disease, obesity and dental caries; and (7) Clarification on the appropriate Dietary Reference
Intakes (DRI) values for different uses and applications.
Adequate Intake (AI) is a daily nutrient intake level that is based on observed or experimentally-
determined approximation of the average nutrient intake by a group (groups) of apparently
healthy people that are assumed to sustain a defined nutritional state.

The AI is based on observed or experimentally determined estimates of nutrient intake by a

group (or groups) of healthy people. For example, the AI for young infants, for whom human milk
is the recommended sole source of food for the first 4 to 6 months, is based on the daily mean
nutrient intake supplied by human milk for healthy, full-term infants who are exclusively
breastfed. The main intended use of the AI is as a goal for the nutrient intake of individuals. For
example: if an individual has a total calorie in a day of 1,500, that individual can take at least
75% of the total calorie for a day which is 1,125 calorie is allowable.

Adequate Diet is composed of various nutrients which body needs for maintenance,
repair, and for growth and development. An essential of an adequate diet are milk group that
provide most of the calcium requirements; meat group that provides generous amounts of
protein in high quality; bread and cereal group that furnishes carbohydrates, minerals and
vitamins at a relatively at low costs; and vegetable fruit group that important supplier of fiber,
vitamins and minerals particularly Vitamin A and C.

Tolerable Upper Intake Level or Upper Limit (UL) is a highest average daily nutrient intake
level likely to pose no adverse health effects to almost all individuals in the general population.

As intake increases above the UL, the risk of adverse effects increases. The term tolerable
intake was chosen to avoid implying a possible beneficial effect. Instead, the term is intended to
connote a level of intake that can, with high probability, be tolerated biologically. The UL is not
intended to be a recommended level of intake. There is no established benefit for healthy
individuals if they consume nutrient intakes above the RDA or AI. ULs are useful because of the
increased interest in and availability of fortified foods and the increased use of dietary
supplements. ULs are based on total intake of a nutrient from food, water, and supplements if
adverse effects have been associated with total intake. However, if adverse effects have been
associated with intake from supplements or food fortification only, the UL is based on nutrient
intake from those sources only, not on total intake. The UL applies to chronic daily use.
For many nutrients, there are insufficient data on which to develop a UL. This does not mean
that there is no potential for adverse effects resulting from high intake. When data about adverse
effects are extremely limited, extra caution may be warranted.

Caudal, Maria Lourdes C. (2019). Basic nutrition and diet therapy : textbook for nursing
students 2nd Edition. QC: C&E. F 613.2 C31 2019
www.fnri.dost.gov.ph

https://www.fnri.dost.gov.ph/index.php/tools-and-standard/philippine-dietary-reference-intakes-
pdri

Grodner, Michelle (2020). Nutrition Foundations and Clinical Applications: A Nursing

Approach.
Pullman, Dan (2019). Essentials of Nutrition and Dietetics for Nursing.
Dudek, Susan G. (2018). Nutrition Essentials for Nursing Practice, 8 th edition. Wolters Kluwer.
Lean, Mike. (2017). Barasi's human nutrition: a health perspective, 3rd ed. Boca Raton: CRC
Press. 613.2 L47 2017
Sizer, Frances (2017). Nutrition concepts and controversies 14 th edition. Cengage.
Stephenson, Tammy J. (2016). Human nutrition: science for health living. New York: McGraw-
Hill Education. 613.2 S4 2016,c1
Check with Googles for further readings

Study Questions

Download a research article on the topic about Dietary Reference Intakes,

can choose from EAR, RENI,AI, UL from ScienceDirect. Submit a 200-300-
word essay reflection.