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WEEK 11: EVIDENCE BASED PRACTICE
• Evidence-based practice - is a conscientious,
problem-solving approach to clinical practice that
incorporates the best evidence from well- designed
studies, patient values and preferences, and a
clinician's expertise in making decisions about a
patient's care.
• Evidence based practice (EBP) is the conscientious
use of current best evidence in making decisions
about patient care (Sackett, Straus, Richardson,
Rosenberg, & Haynes, 2000).
• EBP Guideline is a guide for nurses in their practice
that came from a integration of an exhaustive
literature review, input of clinical experts and
studies/evaluation of patient preferences. The EBP
Guideline is customized to the patients’ nutritional
needs, specific to their condition.
• The Iowa Model of Evidence-Based Practice It is a
five-step process:
1. Beginning with the identification of the
nursing problem and readings about the
situation/problem identified.
2. Reconciling with the priorities of the
Organization.
3. A core group or a team is identified;
4. Implementation of the project
5. Evaluate the project/study implemented.
• A thorough review of literatures available is done and
critiquing and synthesis follows. The following need
to be looked into:
- Consistency of the findings across the studies.
- Types and the quality of the studies.
- Relevance of the findings to clinical practice.
- Adequacy of the studies using a population similar to
that of the organization, where the findings may be
applied.
- Feasibility of the findings in practice.
- Risk-benefit ratio.
WEEK 13: LEGAL MANDATES RELATED TO NUTRITION
AND DIET THERAPY
• LOI 441
- mandated the Integration of Nutrition Education
in the school curriculum.
• Presidential Decree No. 491 (1974)
- “Nutrition Act of the PH”
- The National Nutrition Council was created as
the country’s policy-making and coordinating
body on nutrition.
- Council was reorganized through Executive Order
No. 234 s. 1987 and administrative order No. 88
s. 1988
- The month of July was designated as NUTRITION
MONTH under Section 7 to create greater
awareness among people on the importance of
nutrition.
• EXECUTIVE ORDER 51 (1986)
- “NATIONAL CODE OF MARKETING OF
BREASTMILKSUBSTITUTES, BREASTMILK
SUPPLEMENTS ANDOTHER RELATED
PRODUCTS”.
- to ensure that safe and adequate nutrition for
infants is provided, to protect and promote
breastfeeding and to inform the public about the
proper use of breastmilk substitutes and
supplements and related products through
adequate, consistent and objective information
and appropriate regulation of the marketing and
distribution of the said substitutes, supplements
and related products.
• REPUBLIC ACT 7394 (1992)
- “CONSUMER ACT OF THE PHILIPPINES”
- designed to prevent business that engage in
fraud or specified unfair practices from gaining
an advantage over competitors and provide
additional protection for the weak and those
unable to take care of themselves.
- Consumer Rights:
- Right to basic needs
- Right to safety
- Right to information
- Right to choose
- Right to representation
- Right to redress
- Right to consumer education
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- Right to a healthy environment 7, pursuant to Executive Order 382,

• REPUBLIC ACT 7600 (1992) which recognizes the persistence of
- “THE ROOMING-IN AND BREASTFEEDING ACT” micronutrient deficiencies as a
- An act providing incentives to all government public health problem that has
and private health institutions with rooming-in affected a significant proportion of
and breastfeeding practices and for other the population, resulting in adverse
purposes physical, mental, social, and
- This law is in promotion of the State policy to economic consequences to
encourage the practice of breastfeeding in the individuals, communities, and
Philippines. country.
• REPUBLIC ACT 8172 (1995) o The key agencies in the program:
- “ACT FOR SALT IODIZATION NATIONWIDE (ASIN • Department of Health
LAW)” (DOH), responsible for the
- is to protect and promote the health of the implementation and
people, to maintain an effective food regulatory monitoring of the law;
system and to provide the entire population • National Nutrition Council
especially women and children with proper that serves as the policy-
nutrition. making body, particularly
- Contribute to the elimination of the relative to determining
micronutrient malnutrition in the country, what food vehicles should
particularly iodine deficiency disorders, through be fortified and with what
cost effective preventive measure of salt nutrients;
iodization. • Department of Trade and
• REPUBLIC ACT 8976 (2000) Industry, which assists
- “FOOD FORTIFICATION ACT” manufacturers in upgrading
- The program shall consist of (1) Voluntary Food their technologies by
Fortification and (2) Mandatory Food providing financial
Fortification. assistance and other non-
- Section 5. Voluntary Food Fortification. - Under monetary assistance;
the Sangkap Pinoy Seal Program (SPSP), the • Department of Science and
Department shall encourage the fortification of Technology, which helps in
all processed foods or food products based on developing and
rules and regulations which the DOH through the implementing
BFAD shall issue after the effectivity of this act. comprehensive programs
- Manufacturers who opt to fortify their processed for the acquisition, design,
foods of food products but do not apply for and manufacture of
Sangkap Pinoy Seal shall fortify their processed machines and technologies
food or food products based on acceptable and their transfer to
standards on food fortification set by the DOH manufacturers; and
through the BFAD. • Land Bank of the
- Section 6. Mandatory Food Fortification. - (a) Philippines and Livelihood
the fortification for staple foods based on Corporation that assist
standards sets by the DOH through the BFAD is manufacturers by providing
hereby made mandatory. preferential loans at
- National Food Fortification Day preferential rates.
o The National Food Fortification Day
is observed annually on November
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• REPUBLIC ACT 9711 (2008)
- “FOOD AND DRUG ADMINISTRATION ACT”
- An act strengthening and rationalizing the
regulatory capacity of the bureau of food and
drugs BFAD by establishing adequate testing
laboratories and field offices. Upgrading its
equipment, augmenting its human resource
complement, giving authority to retain its
income, renaming it the food and drug
administration (FDA), amending certain sections
of republic act no. 3720, as amended and
appropriating funds thereof.
• REPUBLIC ACT 10028 (2009)
- “EXPANDED BREASTFEEDING PROMOTION
ACT”
- An act expanding the promotion of
breastfeeding, amending for the purpose
republic act no.7600
- Provisions:
▪ Lactation stations in every private
enterprises, government agencies,
government-owned and controlled
corporations
▪ “Lactation periods” for
breastfeeding employees, in
addition to time-off for meals, to
allow them time to express their
breast milk.
▪ Breast milk banks in health
institutions to store pasteurized
breast milk donated by
breastfeeding mothers.
▪ Inclusion of breastfeeding in the
curriculum of schools (under
relevant subjects).
• REPUBLIC ACT 10611 (2013)
- “FOOD SAFETY ACT”
- The Food Safety Act of 2013 shall be the
framework for implementing the farm to fork
Food Safety Regulatory System.
- To strengthen the food safety regulatory system
in the country
- Food Safety Awareness Week is a yearly
campaign in the Philippines aimed at the
importance of safe and clean food. The week-
long celebration falls every October and was
proclaimed on August 1999 by virtue of
Proclamation No. 160, signed by President
Joseph Estrada.
- Food Safety is the assurance/guarantee that
food will not cause harm to the consumers when
it is prepared and/or eaten according to its
intended use.
- Food and Water-borne Diseases is a group of
illness caused by any infectious (bacteria, viruses
and parasites) and non-infectious agents
(chemical, animal and plant toxins).
- May is Allergy Awareness Month and a great
time to learn more about food allergies and how
to keep those with allergies safe.
• REPUBLIC ACT 10862 (2015)
- “NUTRITION AND DIETETICS LAW OF 2016”
- An act regulating the practice of Nutrition and
Dietetics in the Philippines recognizes the
important role of registered nutritionist-
dietitians (RNDs) in nation building and in human
development through adequate nutrition
- promote the sustained development of RNDs
whose competence has been determined by
honest and credible licensure examinations, and
whose standards of professional service and
practice are internationally recognized and
considered world-class, brought about by
regulatory measures, programs and activities
that foster growth and advancement of the
profession.
• REPUBLIC ACT 11148 (2018)
- "KALUSUGAN AT NUTRISYON NG MAG-NANAY
ACT"
- President Rodrigo Roa Duterte signed on 29
November Republic Act 11148 “An Act Scaling up
the National and Local Health and Nutrition
Programs through a Strengthened Integrated
Strategy for Maternal, Neonatal, Child Health
and Nutrition in the First One Thousand (1,000)
Days of Life”
- strengthens the national and local health and
nutrition programs for pregnant and lactating
women, adolescent girls, infants and young
children in the first 1,000 days.
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WEEK 14: ETHICO-MORAL PRINCIPLES AND
CULTURAL/SPIRITUAL PREFERENCES
• National Genomic defined as the study of genes and
their functions, and related techniques that further
address all genes and their inter relationships in
order to identify their combined influence on the
growth and development of the organism.
• Nutritional science considers the studies of
individuals with nutrient deficit and its consequential
effect to the overall health status of the people.
• According to the Department of Health,
cardiovascular diseases and diabetes mellitus ranks
as one of the ten leading causes of mortality in the
Philippines.
• Ethico-moral Principles: Nutritional Support and
End-of-Life (EOL) Decision Making
- Scope of nursing practice as mandated by the
Republic Act9173, “Philippines Nurses Act of
2002” stated in Article VI, Sec. 28 that “...nurses
shall collaborate with other health care providers
for the curative, preventive, and rehabilitative
aspects of care, restoration of health, alleviation
of suffering, and when recovery is not possible,
towards a peaceful death.” Furthermore, it
stated that in the practice of nursing in all
settings, the nurse is duty-bound to observe the
Code of Ethics for nurses and uphold the
standards of safe nursing practice. This applies in
the “end-of-life” care of patient.
• Cultural and Spiritual Influences related to
Nutritional Support
- In a thesis conducted by Cynthia S. Klement
entitled “Intercultural Competence for the
Nutrition Professional”, the author believes that
the diversity training for nutrition care
professionals is essential in order to provide
patients with culture-specific strategies that
allow them to succeed with their health
programs. Knowledge of intercultural nonverbal
and verbal behaviors is becoming increasingly
necessary, as is who ultimately makes medical
decisions for the patient.
Cultural - Spiritual variation in relation to nutritional
and dietary support
• Cultural Variations:
- Filipino - Filipinos believe ill health is a result of
an imbalance brought about by personal
negligence or immorality and that caring for the
body with rest, nutrition, exercise, and sleep will
result in balance. Until the illness becomes
advanced, typically they will not seek health care
and tend to be stoic regarding pain. It's important
to consult with family members in the decision-
making process. A belief in the hot and cold
theory of healing persists among Filipinos.
Adherence is common as they highly respect
health practitioners and will not question the
program. They believe life is controlled by
supernatural forces, as well as by the will of God.
- African Americans – Beliefs vary from illness
being the work of the devil, a spell that has been
cast, God's punishment, or exposure to cold air.
Often seen as essential for health, greens are
frequently consumed. Literacy may be an issue if
they refuse to sign a form. The family
spokesperson is typically the eldest male or
father of the family.
- Korean – They closely follow the Chinese
principles of yin and yang, the five elements, and
chi. Koreans also adhere to health beliefs
regarding cold, damp, heat, and wind causing
symptoms of ill health. It is believed that the
intervention of ancestors, the supernatural, or
excessive emotions can also result in disease or
illness. It is thought that a good appetite is an
indicator of good health. The male head of
household makes decisions regarding health care
and should be present at appointments, but the
entire family is also seen as being responsible for
all its members. Family is highly valued and is
viewed as more important than an individual's
needs. Koreans are very close to their children
and may fear being a burden to them.
- Russian - Relatives are involved in treatments. Be
guarded yet positive about treatment plans as
patients may overreact. They will not discuss
mental illness or sexual history. These patients
prefer alternative treatments. They may request
hot, soft or warm foods when ill. The decision
maker for the family is usually the member with
the strongest personality. They may believe
illness to be God testing their faith, punishment
NCMA 215- NUTRITION AND DIET THERAPY FINALS
by God, or the will of God. To speed the healing
process, a spiritual leader may be important to
consider.
- South African – Balance with nature is stressed
in their health belief system while also believing
illness may befall a person from God, or nature,
or malicious forces through the living or dead.
They may believe the evil eye can bring illness to
or harm another person and that powers a
person obtains from evil can be directed at
another and cause pain or illness. They may also
be of the belief system that something they term
"excess blood" (high blood pressure) is caused by
eating beets, carrots and pork, or drinking grape
juice or red wine. Likewise, they may believe
"low blood" (anemia) can occur by including too
many pickled foods, lemon juice or vinegar in the
diet, and not eating enough red meat. "Bad
blood" is caused by supernatural forces,
contamination, or unclean blood that
accumulates during the winter. Pica can also be
an issue when nonnutritive objects are
consumed, such as laundry starch or dirt.
- Asian Indian – Illness may be viewed as being
caused by God punishing someone for sin
whether in the present life or past life. Dead
ancestors or jealous living relatives can also
cause illness. Illness can result from body
imbalances, but can also wash away a person's
sins. Some Indians may hold a strong belief in
Ayurvedic medicine that classifies foods and
conditions as pitta, kapha, or vata. The decision
maker in the Asian Indian family is typically the
mother-in-law, grandmother, or eldest son. They
may be stoic in regards to health conditions and
not reveal all the facts. They believe spirituality is
as important as rest and a good diet.
• Spiritual Variations:
- Christianity – Avoidance of meat during season
of lent by Catholics and orthodox Christian.
- Seventh Day Adventists and Mormons evade
consumption of alcoholic, caffeinated and hot
beverages. Others restrict diets including meat,
pork, fish, shellfish or dairy products. There are
approximately
- Islam – Muslims are prohibited pork and
products made from animal fat in their diet.
Other forbidden (haram) foods containing meat,
shellfish, bread fermented with yeast, gelatin
from pork used in making cheeses, alcohol,
caffeinated beverages, and coffee. Baked goods
made with vanilla extract are not allowed, unless
the vanilla is alcohol-free. The month of
Ramadan mandates fasting from dawn until
dusk. Other religious observances may also
require fasting. There are approximately 1.5
billion people practicing the Islamic faith around
the world.
- Hinduism - Common in those of Indian descent,
vegetarianism is the norm but is not required.
Beef is strictly forbidden, while other prohibited
foods can range from other types of meat, eggs,
pork, duck, fish or crab. Alcohol, turnips, leeks,
mushrooms, red-colored foods (tomatoes,
beets) onions, and garlic are sometimes avoided.
Several days of fasting might also be observed.
There are approximately 900 million people
worldwide who practice Hinduism.
- Confucianism and Taoism – These traditional
Chinese religions do not impose dietary
restrictions or prohibitions on adherents. There
are approximately 394 million people who
practice in the traditional Chinese religions.
- Buddhism – Common in people from Southeast
Asia. Many are vegetarians. Some avoid beef,
while others may avoid all meat, fish, shellfish,
eggs and dairy products. Approximately 376
million people are Buddhists around the world.
- Judaism - Strictly forbidden foods are pork and
shellfish. Meat and dairy products are not to be
mixed or consumed at the same meal. Fasting
may be observed on Yom Kippur, Rosh Hashanah
and Passover, while certain foods may be
avoided during Passover such as unleavened
bread, wheat, barley, rye, oats, beans, peas,
lentils, maize, millet and mustard. Some
followers may adhere to keeping Kosher. There
are approximately 14 million practicing Jews
around the world.
WEEK 15: LIFELONG LEARNING ACTIVITIES
• Lifelong learning is a method of self-initiated
edification that is concentrated on individual
development. It is a learning that occurs outside a
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formal education. It is best described as voluntary ▪ Developed into informed citizens

educating oneself with the determination of and lifelong news readers
achieving personal fulfillment. It recognizes the ▪ Can help teachers teach media
education that can be learned outside the classroom, literacy skills, which are the three R’s
these life-learning activities are consist of library ▪ Offer ideal opportunities for
search, access on-line resources, current events and cooperative-group instruction,
information technology of nutrition and dietetics classroom discussion
• LIBRARY SEARCH ▪ and debates, purposeful follow-up
- Library search is a search engine wherein an writing
individual has given access to all resources in the ▪ Cover a wide range of subject and
library. It allows to search across all resources connect to all areas of curriculum
instead of being limited to other resources. • INFORMATION TECHNOLOGY ON NUTRITION AND
These resources are: articles, books, journals, DIETETICS
images, newspaper and etc. - Information technology has incorporated into
- Resources that can be found in Library Search: the teaching program of Nutrition and Dietetics
▪ Books, e-books as the development of the technology has
▪ Journals, become a growing influence on the workplace.
▪ Full-text articles - Emerging technologies:
▪ Library content, including the Library ▪ 1. Stand-alone applications
Catalogue, • Nutrient Analysis
▪ E-Journals Catalogue • Clinical Nutrition
▪ Database collections • Food and nutrition
• ACCESS ON-LINE RESOURCES education instructional
- On-line resources are resources that are programs and games
accessible via the internet and world wide web. • Production tools
It is an exemplary data and educational as it ▪ 2. Linkage applications and the
provides useful information. Web pages, global information highway
documents, and any support software available • E-mail or Electronic mail
on the internet can be considered as resource. • Regional networking tools
- Resources that can be found online • Food and nutrition on-line
▪ Online Newspaper services
▪ Online Magazine • Electronic bulletin-board
▪ Television Website systems.
▪ Peer-reviewed Journals
▪ Webpages WEEK 16: FILIPINO CULTURE, VALUES PRACTICES AND
▪ Forums and blogs BELIEFS RELATED TO NUTRITION AND THERAPY.
• CURRENT EVENTS
• Filipino Culture
- Current events are information about what are
- Huge part of Filipino culture
happening in the world. To help the students - Fusion of Oriental, European and American
understand the importance of events, current
culinary that became adapted to local
events is studied to encourage them to explore
ingredients
and learn more about the news. It motivates the
- The traditional Filipino diet is higher in total fat,
students to pay attention to the news they see - saturated fat, and cholesterol.
and hear outside of school.
- Pork, fish and vegetables – top consumed foods
- Benefits of studying current events
for adults
▪ Can open communication between
students and parents
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- Love to attend fiestas and birthday parties. - Main meal of the day is at NOON time
Celebration during religious festivals and saint’s
RELIGIONS AND DIETARY PRACTICES
day
- Abundant food served buffet style with roasted • Catholics
pig as the centerpiece. Love to eat in fast food - NO MEAT – Ash Wednesday and Good Friday
and restaurants with eat all you can promos - OPTIONAL FASTING during Lent Season
- Three meals a day with a mid-morning and late • Islam
afternoon meriendas - NO PORK, ALCOHOL, DRUGS
- A typical Filipino meal consists of a main seafood - DAYTIME FASTING during RAMADAN
or meat dish served with soup, vegetables and • Buddhist
rice, with tea or coffee. - NO ALCOHOL and DRUGS
- Breakfast, lunch and dinner are the same where - VEGETARIANS
it is usually a Filipino-style rice with some pieces • Hinduism
of meat and vegetables in it. - NO BEEF and VEAL
NUTRITIONAL PRACTICES AND PREFERENCES AMONG - COW is a sacred animal
DIFFERENT CULTURES - VEGETARIANS
• Jehovah
• African American - NO food with BLOOD
- Gifts of foods are common and should not be - ALLOW animal flesh that has been drained
rejected - from blood
- High in fat, cholesterol and sodium • Judaism
- Overweight is viewed as positive - NO MEAT and MILK combination
- Most persons are LACTOSE INTOLERANT - (Kosher diet)
• Arab Heritage - NO PORK
- Many spices and herbs are used - NO SCAVENGER FISH (shrimps,
- Meats are roasted or simmered (lamb or chicken) - squids, crabs and fisher with no
- Bread is served at every meal - scales)
- MUSLIMS do not eat pork, every meat should be • Seventh day Adventist
WELL DONE - NO ALCOHOL, COFFEE, TEA, MEAT and
- Food is eaten with the right hand - SCAVENGER FISH
- Beverages are drunk after meal, not during - NO PROCEDURES on SATURDAYS.
• Chinese Heritage
- Foods are served at meals in a specific order
- NO ICE in their drinks WEEK 17: ENTREPRENEURSHIP OPPORTUNITIES ON
- Each region in China has their own traditional NUTRITION AND DIET THERAPY
diet
• Jewish Heritage NUTRIPRENEURSHIP/ DIETITIAN ENTREPRENEURSHIP
- Meat and milk are not eaten at the same time • Nutripreneurship is the practice and process that
- NO PORK results in creativity, innovation, development and
- NO BLOOD. It must be drained from meats growth of nutrition businesses.
- Handwashing before eating
• Entrepreneurship is a self-willing and approached
• Mexican Heritage business firm which starts with a limited investment
- RICE, BEANS and TORTILLAS are core, essential where they paved their own pathway with their
foods efforts and ideas in their corresponding field.
- Many persons are LACTOSE INTOLERANT
- Being overweight is viewed as positive
- Sweet fruit drinks are popular
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• Nutripreneurs 4. Cyndi O’Meara–Changing Habits

- a person in the field of nutrition and dietetics - Cyndi is the nutritionist that lets you eat
entrepreneurship chocolate and can be good for you. She founded
- are nutritionists’ innovators who use a process of Changing habits that provide information on
changing the current situation of the existing nutrition and healthy eating. The goal is to make
products and services, to set up new products a significant and lasting impact on people’s
and new services. health by improving lives through education and
• Nutripreneurs are the trained and skilled nutrition. Her approach is to empower people
entrepreneurs who may engaged in a field such as: through knowledge, allowing people to eliminate
1. Private Nutrition/ Diet Clinics unhealthy habits on their own.
2. Researcher firm
3. School Nutrition Facilitators
4. Gyms and Workout firms
5. Nutrition Counselor, Bloggers, Webinars
6. Consultant Nutraceutical based firms
7. Nutritionists and Dietitians in private practice
8. Innovators in providing nutrition products
(functional foods) and services to consumers,
industry, media, and businesses.

THE GREATEST ENTREPRENEUR IN NUTRITION

1. Steph Lowe –The Natural Nutritionist

- Steph Lowe is a sports nutritionist that offers a
gluten-free diet to increase wellness and
optimum personal wellness. She specializes in
natural and gluten-free food to fuel for high
performance sports. Her role is to break through
the clutter and guide individuals to a
personalized nutrition plan.
2. Kate Freeman –The Healthy Eating Hub
- Kate Freeman is a registered nutritionist, author
and consultant. She is the founder & managing
director of The Healthy Eating Hub that offers
consultation on a range of areas including weight
management, meal planning, family and sports
nutrition.
3. Jessica Sepel –JSHealth
- Jessica Sepel is a clinical nutritionist, blogger and
founder of JSHealth, that promotes healthy
eating, healthy body image, healthy travel and
healthy living. Jessica teaches the “diet
mentality,” that practices carbohydrates
restricting and calorie counting to girl and young
women thinking they are eating well but actually
doing more harm than good.