NUTRITION AND DIET THERAPY

NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
MIDTERM EXAM - POINTERS TO REVIEW Protein
1. Nutrients  Builds and repairs body tissues
2. Characteristics of Nutritional Status  Provides energy
3. Malnutrition  4 calories per gram
4. Balance Diet, Dietary Guidelines, and Food  Only one of the six nutrients that contains
Pyramid nitrogen
5. Food Labeling and Food Customs  Sources of proteins: meat, fish, poultry, egg
6. Nutritional Guidelines and Assessments (white), milk, cheese, corn, grains, nuts, seeds.
FUNDAMENTALS OF NUTRITION Vitamins
 No calories
WEEK 1 - Linking Food and Health  Organic compound
 Regulate body processes
Nutrients  Extract energy from all the nutrients
 A chemical substance necessary for life.  Examples: Vitamin A, B, C, D, E, and K
Functions of Nutrients Minerals
 Provide energy  Inorganic Compound
 Build and repair tissues  Regulate body processes
 Regulate body processes  Examples: Calcium, Phosphorus, Sodium,
Six classes of Nutrients Magnesium, Chloride, Potassium, Iron, Zinc
1. Carbohydrates Macro-
Water
2. Fats (Lipids) nutrients -  Major constituent of any all living cells
3. Proteins given in a large  Composed of hydrogen and oxygen
amount Inorganic compound
4. Vitamins 
Micro-nutrients
5. Minerals  Body regulation
6. Water - essential nutrients; our body is
composed of 60-70% of water, so it is VITAL! WEEK 2 - Characteristics of Nutritional Status
Organic Compound
 Contains of carbon, hydrogen, and oxygen. GOOD POOR
 Examples: Carbohydrates, Fats (Lipids),
Alert expression Apathy
Vitamins, and Proteins
Inorganic Compound Shiny hair Dull, Lifeless hair
 Simplest form when ingested
 Examples: Minerals and Water Clear complexion Greasy, Blemished
Carbohydrates complexion
 Provides major source of energy Good color (Glowing) Poor color (Pale)
 4 calories per gram Bright, Clear eyes Dull, red-rimmed eyes
 Sources of carbohydrates: cereal grains,
vegetables, fruits, nuts, and sugars Pink, Firm gums, and Red, Puffy recede gums,
 Carbohydrates rich foods well-developed teeth and missing of cavity-
Fats (Lipids) prone teeth
 Provides energy Firm abdomen Swollen abdomen
 Highest kilo-calorie value
Firm, well-developed
 9 calories per gram
muscles
 Sources of fats (lipids): meats (red meat - beef
Well-developed bone Bowed legs “pigeon
and pork),milk, cream, butter, cheese, egg yolk
structure breast”
oils, nuts.
where the sea meets the shore and when there is wave, there is love. ^-^
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
Normal weight for Over- or Underweight Iron-Deficiency Anemia Iron
height (BMI)
Beriberi Thiamin
Erect posture Slumped posture
Night blindness Vitamin A
Emotional stability Easily irritated,
depressed, poor Goiter Iodine
attention span
Good stamina Easily fatigued Kwashiorkor Protein
(Characteristics:
Seldom ill Frequently ill edema, very thin
appearance)
Healthy appetite Excessive or poor
Marasmus All nutrients (S/Sx:
appetite
muscles wasting or
Healthy, Normal sleep Insomnia at night,
wasting, may not grow
habits fatigued during the day
as children.)
Normal Elimination Constipation or
Osteomalacia Calcium, Vitamin D,
diarrhea
Phosphorus,
magnesium, and
WEEK 3 - Malnutrition
Fluoride
Osteoporosis Calcium and Vitamin D
Malnutrition
2 types of Malnutrition Pellagra Niadin

Overnutrition Rickets *common Calcium and Vitamin D

 Excess energy or nutrients intake among children; soft
Undernutrition bones, muscles
 Deficient energy or nutrients intake Scurvy Vitamin C

Xeropthalmia Vitamin A
(Blindness)
 Overnutrition is a larger problem in the United
Stated than undernutrition Nutrional Assessment
 Anthropometric Measurements
Relation of Food to Health  Clinical Examinations
 Biochemical Tests
Cumulative  Dietary/Social History
 Excess nutrients overtime Anthropometric Measurements
 Examples: atherosclerosis, obesity,  Height
hypertension, diabetes, gallbladder disease,  Weight
and some cancers  Head circumference (children)
Deficiencies  Upper arm measurement
 Nutrients lacking for extended period  Skinfold
 Examples: iron deficient, beriberi, scurvy, Clinical Examinations
osteomalacia, osteoporosis, rickets, and goiter
Deficiency Diseases Nutrients Lacking Clinical Signs Possible Deficiencies
Iron-Deficiency Iron Pallor, blue half circles Iron
beneath eyes

where the sea meets the shore and when there is wave, there is love. ^-^
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
Edema Protein  Indicates amount of creatinine excreted in
urine over a 24-hours period.
Bumpy “Gooseflesh” Vitamin A
 Used in estimating body muscle mass
Lesion at corner of Riboflavin  Muscle mass depleted, as in malnutrition level
mouth will be low
Glossitis Folic Acid Other tests
 Hemoglobin (Hgb)
Numerous “black and Vitamin C  Hematocrit (Hct)
blue” spots tiny, and red  Red Blood Cells (RBCs)
“pin prick”  White Blood Cells (WBCs)
hemorrhages under the  Lipid profiles (high & low density lipoprotein,
skin serum triglycerides)
Emmaciation Carbohydrates, protein;  High Density Lipoprotein - HDL is
kCal considered as good cholesterol as it carries
Poorly shaped bones or Vitamin C bad cholesterol away from the arteries.
teeth or delayed  Low Density Lipoprotein - LDL is
appearance of teeth in considered as bad cholesterol as it leads to
children a build up of cholesterol in arteries.
Slow clotting time of Vitamin K  Urinalysis
blood
Unusual nervousness, Niacin Dietary/Social History
dermatitis, diarrhea in
the same patient Evaluation of Food Habits
Tetany Calcium, Potassium,  24-hours recalls client interviews by the
Sodium dietitian and asked to give types, amounts,
Goiter Iodine and preparations of all foods eaten in the past
24-hours.
Eczema Fat
 Food Diary - written record of all food and
drink ingested in a specified period
Biochemical Test  Computed diet analysis - to determine
nutrient deficiencies or toxicities.
Serum Albumin Level Social History
 Measures main protein in blood  Consider of financial resources to obtain
 Determines protein status needed food and properly store and cook food.
Serum Transferrin Level  Food-drug interactions that can lead to
 Indicates iron carrying protein in blood malnutrition
 ↑indicates iron states low
 ↓indicates body lack protein Conclusion
Blood Urea Nitrogen (BUN)  Nutrition and health are directly related
 May indicate renal failure, insufficient renal  Effects of poor nutrition are cumulative
blood supply or blockage of the urinary tract.  There are six essential nutrients:
Serum Creatinine Carbohydrates, Proteins, Fats, Minerals,
 Indicated amount of creatinine in blood Vitamins, and Water
 Used to evaluate renal function  Nutritional assessment is the best way to
Creatinine Excretion determine deficiencies that may results from
lack of nutrients.
where the sea meets the shore and when there is wave, there is love. ^-^
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
 Developed by World Health Organization
(WHO) and Harvard’s School of Public Health
WEEK 4 - 2 Designing a Healthy Diet  Encourages monosaturated fats
Food Labeling
Balance Diet  Mandatory labeling for nearly all processed
 Includes all the essential nutrients in foods started in May, 1994 as a result of the
appropriate amounts Nutritional Labeling and Education Act (NLEA)
 Preserves and promote good health  Primary objective is to ensure that labels on
Dietary Guidelines for Americans most foods provide consistent nutrition
Note: Also Applicable for Filipinos information
 Choose variety of fruits and vegetables daily  Food and Drug Administration (FDA) sets
 keep food safe to eat health claims allowed and serving sizes
 Choose a diet that is low in saturated fat and  Descriptive term standardized.
cholesterol, and moderate in total fat Nutrition Facts Required
 Aim for a healthy weight Total calories Dietary fiber
 Be physically active each day Calories from fat Sugars
 Let the Pyramid guide your food choices Total fat Protein
 Choose variety of grains daily, especially Saturated fat Vitamin A
whole grains Cholesterol Vitamin C
 Choose beverages and foods to moderate your Sodium Calcium
intake of sugars Total Carbohydrates Iron
 Choose and prepare foods with less salt
 If you drink alcoholic beverages, do so in Food Customs
moderation  Food habits may be based on nationality,
Food Guide Pyramid culture, and religion
 Bread, cereal, rice, pasta  Foods available in a certain area may be
 Vegetable favored for economic reasons
 Fruit  Economic status and social status contribute
 Milk, yougurt, cheese to food habits
 Meat, poultry, fish, dry beans, eggs, nuts Native American
 Fats, oil, sweets  Approximately half of the edible plants
commonly eaten in the United States today
originated with the Native Americans
 Corn, potatoes, squash, cranberries, pumpkins,
beans, wild rice, and cocoa beans
 Wild fruits, game, and fish
 Foods were commonly prepared as soups,
stews, or were dried
US Southern
 Popular foods: corn bread, biscuits, grits, rice,
sweet potatoes, squash, watermelon, oranges,
peaches, fried fish, lima beans, green beans
cooked with pork, barbecued/stewed meats
and poultry
Mediterranean Diet Pyramid

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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
 Diet may be high in fat and carbohydrates;
limited in protein, iron, calcium, and vitamins
A and C.
Mexican
 Popular foods: beans, rice, chili peppers,
tomatoes, tortillas made of corn meal or flour
 Beans and corn make a complete protein
 Milk, green and yellow vegetables and vitamin
C-rich foods would improve these diets
Puerto Rican
 Popular foods: rice, beans, peppers, plantains,
tomatoes, bananas, pineapple, mangoes,
papayas, chicken, beef, pork
 Lacking milk nutritionally
Italian
 Popular foods: pastas, tomato sauces, cheese,
fish, meat, root vegetables
 Excellent sources of nutrients includes: eggs,
cheese, tomatoes, green vegetables, and fruits
 Fat-free milk and low-fat meat would improve
diet
Northern and Western European
 Popular foods: beef, pork, cooked vegetables,
breads, and dairy products
 Fewer green vegetable salads and greater use
of dark breads, potatoes, and fish than US
Midwest; otherwise similar
 Fresh vegetables and fruits would add vitamins,
minerals, and fiber to these diets
Central European
 Popular foods: potatoes, grain (especially rye
and buckwheat), pork, cooked cabbage, carrots,
onions, turnips
 Eggs and diary products used abundantly
 To improve diet, limit number of eggs, use fat-
free or low-fat dairy products, and add fresh
vegetables and fruits
Middle Eastern
 Popular foods: grains, wheat, rice, chickpeas in
form of hummus, lamb, yogurt, cabbage, grape
leaves, eggplant, tomatoes, dates, olives, and
figs
where the sea meets the shore and when there is wave, there is love. ^-^
 May contain insufficient amounts of protein
and calcium depending on the amounts of
meat and calcium-rich foods eaten
 Fresh fruits and vegetables should be added to
increase vitamins, minerals, and fiber
 Black, very sweet coffee is a popular beverage
Chinese
 Popular foods: rice, soybeans, eggs, pork, and
tea
 Low-fat diet
 Soy sauce is high in salt-problematic for
proteins on low-salt diets
Japanese
 Popular foods: rice, soybean paste and curd,
vegetables, fruits, fish
 Tempura style (fried)
 Soysauce (shoyu) and tea are common
 Diet lacks milk
 May be deficient in calcium and excessive in
salt
Indian
 Popular foods: eggs, diary products, rices, peas,
beans, spices (curry)
 Diet may be vegetarian
 Eating with fingers is acceptable
Thai, Vietnamese, Laotian, Cambodian
 Popular foods: rice, curries, vegetables, fruit
 Fish and meats are used in small amounts
 Diet may lack adequate protein and calcium
Jewish
 Orthodox follow dietary rules
 Conservative follow rules in home
 Reform may not follow dietary laws
Jewish Dietary Laws
 Kosher - foods prepared following rules:
 Quality person slaughters animals
 Meat not prepared with milk or milk
products
 Dished used for meat and dairy kept
separate
 Dairy and meat not eaten together
 Mouth rinsed between fish and meat
 Observe days for fasting
 No cooking on Sabbath
Roman Catholic and Eastern Orthodox
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
 Roman Catholic  A registered dietitian can help plan diets
 Meat not allowed Ash Wednesday and  Gradual corrections in dietary habits are easier
Fridays during Lent to make and more effective when the reasons
 Eastern Orthodox for the food habits are understood
 Includes Christians from Middle East,
Russia, and Greece WEEK 5 - PART 2: Designing a Healthy Diet
 Meat, poultry, fish, dairy products Nutrition Guidelines and Assessment
restricted Wednesdays, Fridays, and
during Lent and Advent Linking Nutrient, Foods, and Health
Seventh Day Adventist and Mormon  Choosing a healthful diet
 Seventh Day Adventist  Moderation
 Lacto-ovo vegetarians: use milk products  Variety
and eggs, but no meat, fish, or poultry  Balance
 Nuts, legumes and meat substitutes, tofu Food Guide Pyramid
 Coffee, tea, and alcohol considered harmful
 Mormon
 Coffee, tea, and alcohol prohibited
Islamic and Hindu
 Islamic
 Adherents of Islam are called Muslims
 Pork and alcohol prohibited; other meat
slaughtered by specific laws
 During the month of Ramadan, Muslims do
not eat or drink during daylight hours
 Hindu
 All life sacred; animals and eggs not eaten
Vegetarian
 Lacto-ovo: use dairy products and eggs, but no
Daily Food Guide
meat, poultry, or fish
 Lacto: use dairy products but no meat, poultry,
or eggs
 Vegans: avoid all animal foods
 Diets should be carefully planned to include
essential amino acids
Zen-Macrobiotic Diets
 Developed from Zen Buddhism
 System of 10 diet plans
 Gradually give up foods as follows: desserts,
salads, fruits, animal foods, soups, and
ultimately vegetables, until only cereals-
usually brown rice-are consumed.

Conclusion
 Tools can be used to help patients plan a
healthy diet
 Individual food customs must be respected
where the sea meets the shore and when there is wave, there is love. ^-^
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
Nutritional Guidelines for Filipinos
 Posted February 3, 2020, DOST-FNRI facebook
page.
 Below are the new messages of the 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
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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,
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.
8. 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
The revisions were made based on the result of the
2008 National Nutrition Survey (NNS) conducted
by FNRI-DOST.
Exchange Lists
 Used for meal planning for people with
diabetes
 Foods grouped by macronutrient content
 Starches
 Fruits
 Milk
 Other carbohydrates
 Vegetables
 Meats and meat substitutes
 Fats
 Updated Exchange List for Filipinos DOST-
FNRI
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3

Recommendation for Nutrient Intake

Dietary Reference Intake (DRIs)

Four Basic Elements

1. Estimated Average Requirements (EAR)
2. Recommended Dietary Allowance (RDA)
3. Adequate Intake (AI)
4. Tolerance Upper Intake Levels (UL)
Estimated Average Requirements (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
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3
Tolerance Upper Intake Level (UL)
 Intake above the UL can be considered harmful

Recommended Dietary Allowance (RDA)

 Amount that meets the needs of most people
Using the DRIs
in a life stage/gender group
 Population groups
 Estimated amount of nutrient or calories
 Assess adequacy of intake
 Per day considered necessary for maintenance
 Plan diets
of good health
 Set policy and guidelines
 Individuals
 Use RDA and AI as target levels for intake
 Avoid intake greater than UL
Food Labels
 Mandatory information on food labels
 Statement of identity
 Net content of the package
 Name and address of manufacturer, packer,
distributor
 Lists of ingredients
 Listed in descending order by weight
Adequate Intake (AI)  Nutrition Information
 The recommended average daily intake level Food Labels: Daily Values
based on observed or experimentally  Compare amount in one serving to the amount
determined estimated of nutrient intake by a recommended for daily consumption
group of apparently healthy people that are
assumed to be adequate

where the sea meets the shore and when there is wave, there is love. ^-^
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NUTRITION AND DIET THERAPY
NCM105A - LECTURE
DIZON, KRISTINE ELLAINE M. - 2BSN3

Food Labels: Claims

 Nutrient content claims
 Descriptive terms, e.g., lowfat, high fiber
 Health claims
 Link one or more dietary components to
reduced risk of disease
 Must be supported by scientific evidence
 Structure/Function claims
 Describe potential effects on body structure
or function

where the sea meets the shore and when there is wave, there is love. ^-^
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