BACHELOR OF SCIENCE IN NURSING

NUTRITION AND DIET THERAPY

COURSE MODULE COURSE UNIT WEEK
1 3 3
Dietary Guidelines and Food Guides

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 dietary guidelines and food guides.
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

Food and Nutrition Research Institute (FNRI) – the principal research arm of the government
in food and nutrition, is one of the research and development institutes of the Department of
Science and Technology (DOST).

Nutritive value – the nutrient content of a specified amount of food

Pinggang Pinoy – is a nutrition tool for preparing healthy food on a per meal basis. It was
developed by the Department of Science and Technology’s Food and Nutrition Research
Institute (DOST-FNRI).

The 10 Kumainments – is the popular version of the revised Nutritional Guidelines for Filipinos
(NGF). The 10 Kumainments consists of shorter and simpler messages for better recall and
understanding.

Dietary Guidelines and Food Guides

Food Pyramid

The first pyramid was published in Sweden in 1974. The 1992 pyramid introduced by the United
States Department of Agriculture (USDA) was called the "Food Guide Pyramid" or "Eating Right
Pyramid". It was updated in 2005 to "MyPyramid", and then it was replaced by "MyPlate" in 2011.

The Food Pyramid is designed to make healthy eating easier. Healthy eating is about getting the
correct amount of nutrients – protein, fat, carbohydrates, vitamins and minerals you need to
maintain good health. Grains should be taken as the major dietary source. Eat more fruit and
vegetables. Have a moderate amount of meat, fish, egg, milk and their alternatives.

The Philippines uses the daily nutritional guide pyramid and has developed pyramids for different
population groups. The healthy food plate for Filipino adults (Pinggang Pinoy) completes the
messages of the pyramid by showing adequate distribution of nutritious foods in a meal.
Pinggang Pinoy, literally translated as Filipino Plate, is a visual representation of what a person
should consume on a per meal basis. It is a plate-based food guide that features the right
proportion of food that contains the right nutrients needed by the body of an average Filipino.

Pinggang Pinoy is a new, easy to understand food guide that uses a familiar food plate model
to convey the right food group proportions on a per-meal basis, to meet the body’s energy and
nutrient needs of Filipino adults. Pinggang Pinoy serves as visual tool to help Filipinos adopt
healthy eating habits at meal times by delivering
effective dietary and healthy lifestyle messages.

The FNRI’s vision is to provide innovative and timely

food and nutrition tools that will ensure a healthy and
well-nourished Filipino population. The FNRI
recommends that each healthy meal should be
composed of 33% rice, 33% vegetables, 17% meat, and
17% fruit. The Pinggang Pinoy aims to complement and
not replace the existing Daily Nutritional Guide (DNG)
Pyramid.

The birth of Pinggang Pinoy or the Filipino food plate

came as a clamor from the nutrition community to
develop a food guide based on a per meal basis for a healthy adult. Contrary to what others
thought to be a replacement of the Daily Nutritional Guide (DNG) Pyramid for Filipinos, Pinggang
Pinoy serves as a quick and easy guide for determining the amount of food from the three basic
food groups should a Filipino eat per meal. The DNG Pyramid, on the other hand, shows at a
glance the whole day’s healthy food intake recommendation for Filipinos in order to have a
balanced diet. Both tools are based on the latest scientific findings about how food, drink and
activity choices affect people’s health. Food guides themselves are not unique. In fact, almost
every country has its own version of a food guide.

As its name suggests, Pinggang Pinoy is specially designed for Filipinos which features the GO,
GROW and GLOW foods represented by food items commonly consumed by the population. Go
food represents carbohydrates, Grow food represents protein and Glow food represents vitamins
and minerals. The three food groups are called Go, Grow and Glow because these terms
describe the function of each food group in the body. Go or energy-giving foods, such as rice,
grains and other starches, provide energy to keep one going throughout the day.

Grow or body-building foods, such as meat, fish, dairy and eggs, provide the protein and
minerals necessary for the growth and repair of tissues, muscles and bones. Recognizing the
different nutrient requirements of the different age groups, the FNRI has developed the Pinggang
Pinoy plates for children, adolescents, pregnant women and lactating mothers and the elderly.

The “Pinggang Pinoy” can be used side by side with the existing Daily Nutritional Guide (DNG)
Pyramid for Filipinos but it will not replace it. According to FNRI, Pinggang Pinoy is a quick and
easy guide on how much to eat per mealtime, while the DNG Pyramid shows at a glance the
whole day food intake recommendation. Both the “Pinggang Pinoy” and the DNG Pyramid for
Filipinos are based on the latest science about how our food, drink, and activity choices affect
our health.

The Daily Nutritional Guide (DNG) Pyramid is a simple, trustworthy guide in choosing a healthy
diet. It builds from the base, showing that we should eat more foods from the bottom part of the
pyramid like vegetables, whole grains and less from the top such as red meat, sugar, fats and
oils. When it’s time to eat, most of us use a plate. So it
is just appropriate to use the “Pinggang Pinoy” as a
guide for a typical balanced meal. Eat the right amount
of calories for the body based on age, sex, height,
weight, and physical activity level. The basic food
groups are that an individual needs in every plate are
alternation of breads, cereals, rice, pasta, noodles and
other grains, vegetables and legumes, fruit, milk,
yoghurt, cheese and/or alternatives, lean meat, fish,
poultry, eggs, and nuts.

Food Exchange List

The Food Exchange Lists (FEL) for Meal Planning is

one of the basic tools in nutrition and dietetics. It is a tool
for quick estimation of the energy and macronutrients for use in planning meals of individual
clients. Exchange lists provide a way of grouping foods together to help people on special diets
stay on track. Each group lists foods in a certain serving size.

In the food exchange list, commonly use foods are divided into seven groups or list. Each list or
group contains approximately the same amount of carbohydrates, proteins, fats and calories per
exchange. A food in any one group can thus be substituted for or exchange with another food in
the same list or sub-group. This food list can be use in meal plan but substituting each group in
the same group. Nurse can use this list to give more choices in planning a meal for a client.

The Exchange Lists is basic tool in nutrition and used in mean planning, diet instruction and
estimating the energy and macronutrient content of normal and therapeutic diets. This tool was
developed by the Food and Nutrition Research Institute, DOST.

The following sample menu for a 1200-calorie meal plan includes a total of 5 starch exchanges,
2 fruit exchanges, 2 milk exchanges, 3 non-starchy vegetable exchanges, 5 meat exchanges,
and 4 fat exchanges daily. The following sample menu for a 1500-calorie meal plan includes a
total of 6 starch exchanges, 3 fruit exchanges, 3 milk exchanges, 4 non-starchy vegetable
exchanges, 6 meat exchanges, and 4 fat exchanges daily. A diabetic exchange diet is a list of
serving sizes of foods that a client can choose to eat every day. A nurse can help control the
blood sugar by limiting the carbohydrate and total calories in the diet.

Food Labels

Food labels provide more than just nutrition facts, though. They also tell the public what's in a
packaged food (i.e., the ingredients). Food manufacturers are required to list all ingredients in
the food on the label. But some ingredients can be listed collectively as "flavors," "spices,"
"artificial flavoring," or in the case of color additives exempt from certification, "artificial colors",
without naming each one.
Some food labels also state which country the food came from, whether the food is organic, and
certain health claims. Food labels are a legal requirement and they are important for many
reasons. They help consumers make informed choices about the food they buy, help them to
store and use it safely and allows people to plan when they will consume it – all of which help to
reduce food wastage. Food labels carry useful
information to help the public make good choices about
food. The food label will tell if the food contains an
additive that the public may want to avoid. The nutrition
information panel helps to compare the nutrient profile
of similar products and choose the one that suits the
needs.

A label serves three primary functions: (1) it provides

basic product information including common name; (2)
it provides health, safety, and nutrition information
including: allergen information; (3) it acts as a vehicle for food marketing, promotion and
advertising. The first step in making food labels work for the public is to look at the entire label.
If the public focus on only one part — like calories or vitamins — public may not be getting the
full story, like how much sugar or fat is in the product.

The following is a quick guide to reading the Nutrition Facts label: Step 1: Start with the Serving
Size; Step 2: Check Out the Total Calories; Step 3: Let the Percent Daily Values Be a Guide;
Step 4: Check Out the Nutrition Terms; Step 5: Choose Low in Saturated Fat, Added Sugars
and Sodium.

Always start with the serving size amount. That's because all the information on the rest of the
label from calories to vitamins is based on that amount. Take note of how much a serving is.
Sometimes a serving size will be way less than you're used to eating — like only half a cup of
cereal. The label will also list how many servings are in the package. Even things that seem like
they'd be a single serving, such as a bottle of juice may contain more than one serving. If the
public drink the whole thing, they're getting more vitamins and minerals but they're also getting
way more calories, sugar, fat, and other stuff that the public might not want. A calorie is a way
to measure how much energy a food provides to the body. The number on the food label shows
how many calories are in one serving of that food. To get a rough idea of how many calories you
need to eat each day.

Obviously, optimal health requires a person to eat clean the majority of the time. Clean, meaning
as close to the foods natural state as possible. Here are 10 ingredients to avoid whenever
possible because they’re pure garbage: (1) Trans fats (hydrogenated oils) - used in food to
enhance the taste and extend the shelf life, trans fats are dangerous because they increase the
body’s LDL (“bad”) cholesterol while decreasing HDL (“good”) cholesterol; they also heighten
the risk of heart disease, diabetes, and a host of other health problems. (2) High-fructose corn
syrup (HFCS) is a highly refined sweetener that’s found in most processed foods. This additive
is so calorie-dense it’s one of the major contributors to the obesity epidemic. (3) Artificial
sweeteners (sucralose, aspartame, and saccharine) are made with chemicals known to be
neurotoxins and carcinogens, affecting brain function.
Some of these chemicals affect your weight by
triggering the hormone that instructs your body to store
fat, and decreasing levels of serotonin (which regulates
your mood, sleep cycle, and digestion). (4) Artificial
colors (Red no. 40, Yellow no. 6, Blue nos. 1 and 2) has
been linked to attention-deficit/hyperactivity disorder
(ADHD), chromosomal damage, and thyroid cancer,
among other conditions. (5) Sodium nitrites and nitrates
food additives are used to preserve, flavor, and add
color to processed meats like bacon, ham, and hot dogs.
They’re carcinogenic and can negatively affect the
function of the liver and pancreas, the organ responsible
for insulin production. (6) Growth hormones (rBST and
rBGH) studies have linked growth hormones, which are
given to conventionally raised dairy cows and cattle, to
early puberty and obesity. (7) Monosodium glutamate (MSG) a flavor enhancer often found in
soups, seasonings, frozen entrees, and many restaurant foods, MSG is known to overexcite
brain cells in the hypothalamus. Studies have shown this may increase hunger and trigger strong
food cravings, leading an individual to overeat. (8) Butylated hydroxyanisole (BHA) and butylated
hydroxytoluene (BHT) a preservatives in cereals, chewing gum, and potato chips. In large
quantities, both BHA and BHT can wreak havoc in the body, from disrupting the endocrine
system to producing cancer-causing compounds. (9) Antibiotics can get from aating farm
animals that have been administered antibiotics passes along those drugs to our bodies. Steady
doses of antibiotics can affect our ability to break down carbohydrates, absorb vitamins and
minerals, and synthesize hormones. (10) Pesticides with dichlorophenol or 2.5-DCP, in particular
has been linked to childhood obesity. These chemicals disrupt the endocrine system, causing
the body’s metabolic system to malfunction.

Nutrient Guidelines for Filipino

The Nutritional Guidelines for Filipinos (NGF) is a set of dietary guidelines based on the eating
pattern, lifestyle, and health status of Filipinos. The NGF contains all the nutrition messages to
healthy living for all age groups from infants to adults, pregnant and lactating women, and the
elderly. The first NGF released in 1990 was composed of five messages called “Dietary
Guidelines for Filipinos.” In 2000, a revised nutritional guidelines composed of ten messages
was released and it was called the Nutritional Guidelines for Filipinos. In 2012, the Technical
Working Group (TWG) for the revision of the NGF, led by the Food and Nutrition Research
Institute of the Department of Science and Technology (FNRI-DOST) developed a new set of
the NGF, based on the 2000 edition.
The 2012 NGF now includes the basis and justification for each of the ten nutritional and health
message. The following 2012 NGF: (1) Eat a variety of foods everyday to get the nutrients
needed by the body. (2) Breastfeed infants exclusively from birth up to six months and then give
appropriate complementary foods while continuing breastfeeding for two years and beyond for
optimum growth and development. (3) Eat more vegetables and fruits to get the essential
vitamins, minerals, and fiber for regulation of body processes. (4) Consume fish, lean meat,
poultry, egg, dried beans or nuts daily for growth and repair of body tissues. (5) Consume milk,
milk products, and other calcium-rich food such as small fish and shellfish, everyday for healthy
bones and teeth. (6)Consume safe foods and water to prevent diarrhea and other food-and
water-borne diseases. (7) Use iodized salt to prevent Iodine Deficiency Disorders. 9*0 Limit
intake of salty, fried, fatty, and sugar-rich foods to prevent cardiovascular diseases. (9) Attain
normal body weight through proper diet and moderate physical activity to maintain good health
and help prevent obesity. (10) Be physically active, make healthy food choices, manage stress,
avoid alcoholic beverage, and do not smoke to help prevent lifestyle-related non-communicable
disease.

There is no single food that contains all the nutrients that our body needs so eating a variety of
food ensures that daily nutritional needs are met. Vegetables and fruits are the main sources of
vitamins, minerals, and fiber, while milk is a good source of calcium. Low urinary iodine excretion
is still a prevalent problem among pregnant and lactating mothers, indicating to low iodine intake.
Iodine is important during pregnancy because it is needed for the brain development of the infant
while lactating mothers must have adequate supply of iodine in their breast milk. High cholesterol
level may be attributed to the high consumption of sodium rich foods by Filipinos. Salt and soy
sauce were among the top 10 widely used miscellaneous food items used by Filipinos. Excessive
intake of salt and soy sauce can result to high blood pressure especially to salt-sensitive
individuals. Persistent high blood pressure can result to cardiovascular diseases. There is also
a decreasing trend of physical inactivity among Filipinos and also a large percentage of Filipino
smokers at 31.0% and drinkers at 26.9%. People are always encouraged to exercise at least
thirty minutes a day, three to five times a week. Limit alcohol drinking to one drink per day for
women and two drinks for men is also advised. One alcoholic drink is equivalent to one and half
ounce distilled beverage such as gin or 12 ounces or a bottle of beer or four ounces wine or half
glass wine or an ounce of 100 proof whiskey.

The Guidelines further enhances that all Filipinos must adhere to follow a healthy eating pattern
across the lifespan. All food and beverage choices matter. Focus on variety, nutrient density,
and amount. Limit calories from added sugars and saturated fats and reduce sodium intake.
Shift to healthier food and beverage choices and support healthy eating patterns for all.

USDA Food Guide

The Dietary Guidelines for Americans (Dietary Guidelines) is the cornerstone for Federal
nutrition programs and a go-to resource for health professionals nationwide. The Dietary
Guidelines provides food-based recommendations to promote health, help prevent diet-related
chronic diseases, and meet nutrient needs.

Serving Up MyPlate is a collection of classroom materials that helps elementary school

teachers integrate nutrition education into Math, Science, English Language Arts, and Health.
This yummy curriculum introduces the importance of eating from all five food groups using the
MyPlate icon and a variety of hands–on activities. Students also learn the importance of
physical activity to staying healthy.

The Healthy Eating Index is a summary measure of

overall diet quality. It provides a picture of the types
and quantities of food people eat and the degree to
which diets comply with the recommendations set forth
in the Dietary Guidelines and the Food Guide Pyramid.

Half of Americans (53 percent) feel like food labels are

sometimes misleading, new research suggests. In fact,
mistrust in food labels extends to 11 percent of
Americans who find food labels to be completely
untrustworthy. But it's not just sugar that tops the list of
concerns for Americans. The Food and Drug
Administration (FDA) is responsible for assuring that
foods sold in the United States are safe, wholesome and properly labeled. This applies to foods
produced domestically, as well as foods from foreign countries.

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

https://www.doh.gov.ph/node/223
https://pia.gov.ph/news/articles/1002803
https://www.fnri.dost.gov.ph/index.php/publications/writers-pool-corner/57-food-and-nutrition/204-
nutritional-guidelines-for-filipinos-a-prescription-to-good-nutrition

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 14th 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

Compute your food exchange list based on what you have eaten in your
breakfast, lunch and dinner.
Download a research article on any topic about Food Pyramid, Food
Exchange List, Food Labels, and Nutritional Guidelines for Filipinos from
ScienceDirect. Submit a 200-300-word essay reflection.