INSTRUCTIONAL LEARNING GUIDE

NUTRITION AND DIET

THERAPY
FIRST SEMESTER F.Y. 2022-2023

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 PREFACE

This Instructional Learning Guide for the subject Nutrition and Diet Therapy has been
prepared to address the needs of our learners in the Distance Learning Strategy. The contents
of this guide has been carefully planned and reviewed to suit the learning styles of our
students. This guide is a collection of lectures from different authors of Nutrition and Diet
Therapytextbook and references that is deemed appropriate and useful for students to acquire
knowledge and skills for the course.

How to Use this Learning Guide:

This shall serve as the students guide in the completion of the course. All lectures and activities
are given in this material for the students to follow.

The module outcomes are given in every coverage to be used by both faculty and students as a
checklist of the knowledge and skills acquired by the students upon completion of the activities
and lessons give.

Lecture Notes are also given based from the different references used for the subject
summarize by the teachers to guide the students in understanding the topics. Below the
lectures presented are teachers insights or discussion on important issues and topics your
students may explore to enhance understanding. Case analysis or case based scenario are also
presented as examples for each topic presented.

Self reflection questions are given to evaluate students understanding on the lessons
presented. The teacher may opt to include your answers to be part of your learning portfolio or
may be the basis of exchange of ideas with your classmates.

Specific Instructions are given in each activities that students are required to comply. In case
students have queries or clarifications, the students may contact the subjects teacher for
reference.

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Preliminary – COURSE DETAILS

Subject: Nutrition and Diet Therapy Units: 3

No. Of Class Hrs:
Section: Year Level: 2
Course: BSN 2
Subject Teacher:Jessica S. Paradillo, RN

Course Description:

This course is a 3-unit subject which deal with the study of basic nutrition, the concepts and
principles involve and its application, and it also helps one to be familiar with the different diets
for different age group based on a particular disease, its careful selection and preparation
which is essential in the hospital patient care and clients from community as well.

Course Outcomes:
At the end of the semester, the students should be able to:
1. Know and appreciate the importance of nutrition to the health of different age groups
such as pregnant and lactating mother, infant, child, adolescent, adults and elderly.
2. Identify and analyze the dietary needs and requirements of hospital patients and
community clients based on a particular disease.
3. Provide a know how in planning and preparation of the therapeutic diets for the
different age groups.
4. To be able to compute for the caloric requirement for different group age.

Methodology of Implementation:

This is a distance learning strategy where students and teachers are physically at a distance
with each other while the teaching and learning process is going on. The teacher shall meet
students thru different modes of communication (social network, online class, text messaging,
email, messenger etc.) to provide an orientation of the program and instructions for the
students to follow throughout the duration of the course.

Guidelines are prepared by the teachers based on institutional policies to ensure that students
will be able to follow through the different activities set for the course. There is no face to face
activity which means students are not required to report to school to attend classes, rather,
they shall interact with their teachers in different technology based communication strategies
set by the teachers for the course.

Topics shall be assigned according to the syllabus of the subject. Activities are given at pre
determined time to be completed by the students. At the completion of each topic, students
are required to take the evaluation examinations which shall be given by the teachers which
determine applicability of the lessons learned.

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During the duration of the course, students can consult their teachers from time to time to
address their difficulties or challenges they may encounter along the way.

The subjects are structured in sequential order. Course materials and references shall be
provided by the teachers in advance to facilitate teaching and learning process.

Delivery Mode:
1. Printed Text Materials or saved in USB device
2. Audio / video materials
3. Downloaded links

PRELIMINARY COVERAGE (20 hours)

Intended Learning Outcomes: At the completion of this coverage, the students shall be
able to:
1. Associate total health care of an individual with combined collaboration, coordination,
cooperation of the health care team.
2. Identify the roles of the health care team particularly the Physician, Nurses, Dietitian.
3. Discuss basic tools that are essential in the assessment of the nutritional status of the
different age group.
4. Identify specific problems in the community and hospitals by assessing the nutritional
status of various age groups.

Specific Instructions in the completion of this module:

1. Student must read and understand the Intended Learning Outcomes specified above
and make it as a checklist of acquired knowledge and skills after completing the entire
module. This shall be the basis of the teacher in the formulation of the Summative
evaluation given at the end of the module.
2. Students must carefully study the given lecture notes and take note of topics that were
not clearly stated or understood by the student. This areas can be referred to the
subject teacher during consultation hours provided for the students to contact the
teacher.
3. Study the discussions and insights given and follow instructions for activities if there
are.
4. After completely reading all the materials, open the video links of the lessons given
along with this learning package and watch the given videos to supplement your
reading. (please check your USB content).
5. Upon completion of all the lessons and topics presented, answer the self reflection
questions given to you. Check the instruction of to answer and what to do to comply
with required answers.
6. Compile you outputs in your Learning Portfolio to be submitted at specific date by your
teacher.
7. Should the student have any queries or clarifications with the topics, the student should
contact the subject teacher in the given consultation hours which can be found in the
preliminaries of this material.

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Key Terms:
 Nutrition  Recommended Dietary Allowance (RDA)
 Food  Food Composition Table (FCT)
 Nutrient  Food Exchange List
 Enzyme  Nutrient Density
 Hormones  Nutrient Labeling
 Nutritional status  Nutritional Assessment
 Scope of nutrition  Anthropometric
 Food pyramid

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 CHAPTER 1:
INTRODUCTION TO NUTRITION AND DIET THERAPY
This chapter reviews the concepts on introduction to nutrition. It helps the
learners understand and apply with the basic terminologies related to dietary measures
for individual clients.

Chapter Duration: 16 hours

TOPICS
Major Topics Sub-topics
I. Introduction a. Meaning and importance of nutrition
b. Function of nutrition
II. Terminologies a. Nutrient
b. Enzyme
c. Hormones
d. Nutritional status
e. Scope of nutrition
f. Scope of nutrition as science
III. The CCC Crew a. Health care team
IV. Basic tools in nutrition a. Food pyramid
b. Recommended Dietary Allowance (RDA)
c. Food Composition Table (FCT)
d. Food Exchange List
e. Nutrient Density
f. Nutrient Labeling
V. Nutritional Assessment a. Anthropometric
b. Clinical
c. Dietary

Before You Proceed…

 Set your learning goals. At the end of this module you are expected to attain the following

Intended Learning Outcomes:

1. Associate total health care of an individual with combined collaboration, coordination,
cooperation of the health care team.
2. Identify the roles of the health care team particularly the Physician, Nurses, Dietitian.
3. Discuss basic tools that are essential in the assessment of the nutritional status of the
different age group.
4. Identify specific problems in the community and hospitals by assessing the nutritional
status of various age groups.

 Prepare the following materials:

o Nutrition and diet therapy textbooks and other references
o Notebook, bond papers and writing materials
o Calculators

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  Lecture notes are provided for you. BE SURE NOT TO SKIP the lecture. Read and
understand before answering the activities. You are also given an electronic copy of this
module along with other materials such as video clips and PowerPoint to further assist
you.
 As you go on, you will encounter exercises that will test your knowledge and
understanding as well as your critical thinking. Read the instructions carefully, and write
your answers to the space provided after each module.

Let’s Begin

I. INTRODUCTION

LESSON 1: INTRODUCTION TO NUTRITION

NUTRITION
Is the study of food and how the body makes used of it. It deals not only with the quantity and
quality of food consumed but also with the process of receiving and utilizing it for growth and
renewal of the body and for the maintenance of the different body functions

Function of Nutrition
The basic function of nutrition is to maintain life by allowing an individual to grow and be in
state of optimum health

Nutrients
Are chemical substances found in food.

A. General functions:
1. to provide energy
2. to build and repair tissues
3. to regulate body/life processes

B. Classifications:

1. According to function:
 Body-building nutrients include water, protein, fat, carbohydrate and minerals
 Regulatory nutrients include the 6 groups of nutrients(water, fat, carbohydrate,
protein, minerals, vitamins)
 Furnish energy-carbohydrate, fat, protein.

2. According to chemical structure

 Organic-protein, fat, carbohydrate and vitamins
 Inorganic-minerals and water


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 3. According to essentiality - Nutrients are classified based on their significant contribution to
the body’s physiological functioning

4. According to concentration
 Macronutrients - water, protein, fat and carbohydrate
 Micronutrients - all vitamins and trace minerals.

LESSON 2:
BASIC TERMS TO UNDERSTANDS IN THE STUDY OF NUTRITION

Food
Any substance, organic or inorganic, when ingested or eaten, nourishes the body by building
and repairing tissues, supplying heat and energy, and regulating body processes. It also
sustains life, second to oxygen.

Enzymes
Organic catalysts that are protein in nature and are produced by the living cells.

Hormones
Organic substances produced by special cells of the body which are discharged into the blood
to be circulated and brought to specific organs or tissues that are remote from the source or
point of manufacture.
Eg. Insulin, thyroxine, adrenaline and progesterone

Nutrients
Is a chemical substance that is present in food and needed by the body.

 MACRONUTRIENTS – include the energy nutrients CARBOHYDRATE, FAT and PROTEIN.

 MICRONUTRIENTS – include VITAMINS, MINERALS and WATER.

 NUTRIENT DENSE FOOD – is one that has a high proportion of micronutrients in

relation to the macronutrients.

Nutrition
Is the science of the processes by which the body uses food for energy, maintenance and
growth.

 GOOD NUTRITIONAL STATUS – implies appropriate intake of the macronutrients –

Carbohydrates, Proteins and Fats and the various vitamins and minerals often referred
to as “micronutrients” because they are needed in small quantities. If there is good
digestion, absorption, and cellular metabolism of these nutrients in the diet, a person
can generally achieve good nutritional status.

 MALNUTRITION OR POOR NUTRITIONAL STATUS– is a state in which a prolonged lack

of one or more nutrients retards physical development or causes the appearance of

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 specific clinical conditions (anemia, goiter, rickets, etc.). This may occur because the
diet is poor or because of a digestion and metabolism problem. Excess nutrient intake
creates another form of malnutrition when it leads to conditions such as obesity, heart
disease, hypertension and hypercholesterolemia.

 OPTIMAL NUTRITION– a person is receiving and using the essential nutrients to

maintain health and well - being at the highest possible level.

Kilocalorie (kcal)
Is a unit of measure used to express the fuel value of carbohydrates, fats and proteins. The
large Calorie (or kcal) used in nutrition represents the amount of heat necessary to raise the
temperature of 1 kg of water or 1°C. One pound of body fat equates to 3500 kcal.
Carbohydrates, proteins, fats and alcohol are the only sources of kilocalories.

Nutritional Status (Nutriture)

Condition of the body resulting from the utilization of essential nutrients.

Optimum or Good Nutrition

Means that the body has adequate supply of essential nutrients that are efficiently utilized such
that growth and good health are maintained at the highest possible level.

Malnutrition
Condition of the body resulting from lack of one or more essential nutrients(nutritional
deficiency) or it may be due to an excessive nutrient supply to the point of creating toxic or
harmful effects (e.g. overnutrition and hypervitaminosis).

Health
Is currently recognized as being more than the absence of disease. High level health and
wellness are present when an individual is actively engaged in moving toward the fulfillment of
his or her potential.

Public Health
The field of medicine that is concerned with safeguarding and improving the health of the
community as a whole.

Holistic Health
Is a system of preventive medicine that takes into account the whole individual. It promotes
personal responsibility for well-being and acknowledges the total influences – biologic,
psychologic, and social – that affect health including nutrition, exercise, and emotional well-
being.

Medical Nutrition Therapy (MNT)

Referred to in the past as “Diet Therapy” is the treatment of disease through nutritional
therapy by registered dietitians. RDs are uniquely qualified to provide MNT because of their
extensive training in food composition and preparation, nutrition and biochemistry, anatomy

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and physiology, as well as life cycle concerns and disease states. MNT may be necessary for
one or more of the following reasons:
 To maintain or improve nutritional status
 To improve clinical or sub-clinical nutritional deficiencies
 To maintain, decrease, or increase body weight
 To eliminate particular food constituents to which the individual may be allergic or
intolerant
 To adjust the composition of the normal diet to meet the ability of the body to absorb,
metabolize, and excrete certain nutrients and other substances.

PROCESS OF DIGESTION

We all need a variety of food in our diets to provide the nutrients we need to maintain life.
After eating, food is digested. Digestion is when food is broken down into nutrients and then
absorbed and carried to cells in the body.

Mouth To understand digestion, you need to take a closer look. Digestion takes place in the
digestive tract which contains the mouth, stomach, and intestines. Let’s first take a
look at the mouth.
 Chewing crushes food then moisturizes it with saliva.
 Saliva contains an enzyme called amylase, which begins to break down food
before it leaves the mouth.
 Swallowing then moves the food from the mouth to the stomach.

Stomach Once in the stomach, food is mixed with fluid that liquefies and then digests it.
 The stomach empties in one to four hours.
 Carbohydrates digested most rapidly, followed by proteins and then fats.
 Liquids always digest faster than solids.

Intestines The liquefied food then moves from the stomach to the small and then large
intestines, where it’s mixed with more digestive juices.
 Absorption - takes place when nutrients are passed into the blood stream through
the cells that make up the walls of the intestines.
 Most absorption takes place in 3 – 10 hours.
 Large intestines then eliminate any undigested food, bacteria, and waste.

Enzymes another important part of the digestive system because they increase the rate of
chemical reaction.
 Total time for our system to digest food takes 3 – 24 hours.

Metabolism Once food is digested and absorbed, it then undergoes metabolism. Metabolism
is converting food into useful energy.

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METABOLISM AND ELIMINATION
 All Carbohydrates are changed to simple sugar glucose before metabolism can take place
in the cells.
 After the glucose has been carried by the blood to the cells, it can be oxidized.
 Frequently, the volume of glucose that reaches the cells exceeds the amount the cells can
use, glucose is converted to glycogen and is stored in the liver and muscles.
 When more glucose is ingested than the body can either use immediately or store in the
form of glycogen, it is converted to fat and is stored as adipose (fatty) tissue.
 The process of glucose metabolism is controlled mainly by the hormone insulin, which is
secreted by the Islets of Langerhans in the pancreas which maintains normal blood glucose
at 70-110 mg/dl.

Note: Glycogen is subsequently broken down only from the liver and released as glucose when
needed for energy.
COMPUTING FOR BASAL METABOLIC RATE or RESTING ENERGY EXPENDITURE
(REE)

FORMULA:
FEMALE: REE = 655 + (9.6 X weight in kg) + (1.8 x height in cm ) – (4.7 x age)
MALE : REE = 66 + (13.7 X weight in kg) + (5 x height in cm ) – (6.8 x age)

COMPUTATION:
Client: Male, 28y/old with a weight of 65 kg and height of 5’ & 6”. Compute for the REE

REE = 66 + (13.7 x weight in kg) + (5 x height in cm ) – (6.8 x age)

= 66 + (13.7 x 65 kg) + (5 x 168 cm) – (6.8 x 28)
= 66 + 891 kg + 840-190
= 957+650
= 1,607 calories

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 LESSON 3
THE CCC CREW (COLLABORATION, COORDINATION,
COOPERATION)

Nutrition is considered an integral part of health care, with physical, social, psychiatric, and
economic aspects. Nutritional care may be aimed at maintaining an already adequate
nutritional status, or the goal maybe to promote positive nutritional status.

HEALTH CARE TEAM

The Health Care Team is composed of all the health care professionals who work with a given
person and/or family toward the common goal of optimal health. This includes the medical part
of the team:
 The Physician or other health care provider
 Nurse
 Dietitian
 Physical Therapist (PT)
 Pharmacist

Social Professionals include:

 Social Worker
 Occupational Therapist (OT)
 Psychologist
 Other community resource personnel who play a role in facilitating good health

1. THE HEALTH CARE PROVIDER

 Generally, the person with the most broad-based knowledge related to health care is
the medical doctor (MD), or the physician. Health Care Providers include nurse
practitioners (NPs) and in some areas, physician assistants (PAs). The HCP is the
professional who can prescribe medication. The one who knows a person’s medical
history and has a general understanding of the relationship between disease states and
other health concerns.

2. THE NURSE
 The one who can provide other members of the health care team with good insight into
an individual’s needs because of in-depth patient contact. Ongoing assessment and
monitoring of patient eating habits and health status are important roles of the nurse.

3. THE SOCIAL WORKER

 Is the health care professional who has expertise in the area of community resources
including financial, counselling, technical support, and educational services.

4. THE PHYSICAL THERAPIST

 The one who assists in promoting mobility and physical movement, for instance, to
control pain, is part of the role of the PT.

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5. THE OCCUPATIONAL THERAPIST
 The OT emphasizes the remaining strengths of the individual and identifies adaptive
devices that would enhance independent functioning, such as large-handled spoons and
reaching devices. Through the OT, the goal is for the individual to increase the amount
or types of activities of daily living (ADL) such as personal hygiene and eating.

6. THE SPEECH LANGUAGE PATHOLOGIST

 The professional to consult when assessing the seemingly simple act of swallowing.
Swallowing, a series of interrelated steps can be seriously impaired by stroke or other
neurologic damage. Aspiration of food (inhaling of food into the lungs) is of serious
consequence and can lead to partial or full airway obstruction or to pneumonia. SLP can
help determine the degree of risk for aspiration and make appropriate care plans that
other health care professionals can use in developing their plans.

7. THE PHARMACIST
 The one who is responsible for preparing the nutritional solutions that the physician
prescribes. These solutions are administered through veins or via enteral routes.

8. THE REGISTERED DIETITIAN

 Is the health care professional best qualified to interpret the science of how food is
used by the body in health and disease states and to evaluate how MNT can promote a
positive nutritional status.

9. THE NUTRITIONIST
 Is an educator, as well as counsellor, who usually works in a public health setting and
who typically has at least a bachelor’s degree in nutrition.

Teacher’s Insight!

“For individuals, food involves a complex system of many different factors interacting. It
is more than just nutrition; for instance, food is important in families, in celebrations, in religious
contexts and in traditions. Then there are the emotional and psychological aspects of food. Not
to mention questions of production, education and policy. And none of that is about the
fundamental need to meet your basic nutritional needs.”

As a health care provider, knowing your role in a health care team will define your
responsibility in providing safe and qualitypatient care. Implicit in this role are the legal and
ethical aspects of patient care. Therefore,understanding your role is the key to be able to work
effectively with a range of people and communities.

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 LESSON 4
BASIC TOOLS IN NUTRITION

1. THE FOOD PYRAMID

 these are developed by nutrition educators or nutrition experts in a country as a qualitative

tool in planning nutritious diets for masses. Foods containing high levels of certain
nutrients are grouped together and the serving portions are stated in household measures
for the layman to understand.

DIETARY GUIDELINES (2005)

 FOCUS ON FRUIT
- Eat a variety fruits whether fresh, frozen cnned or dried rather than fruit juice
for most of your fruit choices. For 2000 kcal diet, you will need 2 cups of fruit each day.
(e.g. 1 small banana, 1 large orange)

 MAKE HALF YOUR GRAINS WHOLE

- Ear at least 3 ounces of whole grain ceereals, breads, crackers, rice, pasta
everyday. One once is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of
cooked rice or pasta

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 VARY YOUR VEGGIES
- Eat more dark green veggies such as broccoli, kale and dark leafy green
veggies. Orange veggies such as carrots, sweet potatoes and beans and peas susch as
pinto beans, kidney beans, split peas and lentils.

 GO LEAN AND PROTEIN

- Choose lean meats and poultry. Bake it, broil it or grill it. Vary your protein
choices- with more fish, beans, peas, nuts and seeds.

 GET YOUR CALCIUM RICH FOODS

- Get 3 cups of low fat or fat free milk or equivalent amount of low fat yogurt
and a low fat cheese (1 1/2 ounces of cheese equals 1 cup of milk) every day. For kids
aged 2-8, consume 2 cups of milk. If you don’t or can’t consume milk, choose lactose
free milk products and/or calcium fortified foods and beverages.

2. RECOMMENDED DIETARY ALLOWANCES (RDAs)

 The Recommended Dietary Allowances (RDA) refer to the recommended daily levels of
nutrients to meet the needs of nearly all healthy individuals in a particular age and
gender group. These data consist of the minimum requirements plus a safety factor
called “margin of safety” to allow for individual variations of body storage, state of
health, nutrient utilization, and other day-to-day variations within a person. The RDAs
are always higher than the minimum dietary requirements as much as 100%.

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3. FOOD COMPOSITION TABLES (FCTs)
 the chemical composition of a food, whether of animal or plant origin, varies according
to kind or breed, maturity or age, part of plant or carcass, soil fertility, climate, handling
and storage conditions, marketing and agricultural practices and a host of other
uncontrollable factors.
 This edition of the table of food composition includes a wide variety of foods. It is
updated with each edition to reflect current nutrient data for foods, to remove outdated
foods, and to add foods that are new to the marketplace.* The nutrient database for
this appendix is compiled from a variety of sources, including the USDA Standard
Release database and manufacturers’ data. The USDA database provides data for a
wider variety of foods and nutrients than other sources. Because laboratory analysis for
each nutrient can be quite costly, manufacturers tend to provide data only for those
nutrients mandated on food labels. Consequently, data for their foods are often
incomplete; any missing information on this table is designated as a dash. Keep in mind
that a dash means only that the information is unknown and should not be interpreted
as a zero. A zero means that the nutrient is not present in the food. Whenever using
nutrient data, remember that many factors influence the nutrient contents of foods.

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 These factors include the mineral content of the soil, the diet fed to the animal or the
fertilizer used on the plant, the season of harvest, the method of processing, the length
and method of storage, the method of cooking, the method of analysis, and the
moisture content of the sample analyzed. With so many influencing factors, users should
view nutrient data as a close approximation of the actual amount.

 TERMINOLOGIES

• Fats

Total fats, as well as the breakdown of total fats to saturated, monounsaturated,

polyunsaturated, and trans fats, are listed in the table. The fatty acids seldom
add up to the total in part due to rounding but also because values are derived
from a variety of laboratories.

• Trans Fats

Trans-fat data has been listed in the table. Because food manufacturers have
only been required to report trans fats on food labels since January 2006, much of
the data is incomplete. Missing trans fat data is designated with a dash. As
additional trans fat data becomes available, the table will be updated.

• Vitamin A and Vitamin E

In keeping with the 2001 RDA for vitamin A, this appendix presents data for
vitamin A in micrograms (μg) RAE. Similarly, because the 2000 RDA for vitamin E is
based only on the alpha-tocopherol form of vitamin E, this appendix reports vitamin
E data in milligrams (mg) alpha-tocopherol, listed on the table as Vit E (mg).

• Bioavailability

Keep in mind that the availability of nutrients from foods depends not only on
the quantity provided by a food, but also on the amount absorbed and used by the
body— the bioavailability. The bioavailability of folate from fortified foods, for
example, is greater than from naturally occurring sources. Similarly, the body
can make niacin from the amino acid tryptophan, but niacin values in this table
(and most databases) report preformed niacin only.

• Using the Table

The foods and beverages in this table are organized into several categories,
which are listed at the head of each right-hand page. Page numbers are provided,
and each group is color-coded to make it easier to find individual foods.

•Caffeine Sources

Caffeine occurs in several plants, including the familiar coffee bean, the tea leaf,
and the cocoa bean from which chocolate is made.

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4. THE FOOD EXCHANGE LISTS (FELs)
 The food exchange list system is a grouping of common foods that have practically the
same amount of protein, carbohydrate and fat. Within a group, one food item can be
exchanged with another provided the specified serving portion is followed.

 The Food Exchange Lists and Meal Planning for Filipinos is designed for the average
normal adults between the ages of 20-65 to encourage every Filipino people learn to
have their meal planning based on common Filipino foods. Because meal planning
has vital importance both in the consideration of proper nutrition and in the family’s
real enjoyment of food. Knowledge of the food nutrients, their sources and functions
will help ensure the choice of nutritionally enough meals.

FOOD EXCHANGE LIST MyPyramid Guide

Group foods primarily on the amounts of Places more emphasis on amounts of
macronutrients micronutrients
Counts cheese in the Meat group Counts equivalent amounts of milk and cheese
based on calcium content
Counts legumes in the starch and bread group Counts legumes in the meat group

Calculate 15 grams of CHO for one serving of Carbohydrate content of the fruit group is not
fruit considered
Counts fat serving as 5 grams of fat (equivalent Does not specifically state portion sizes for fats
to 1 tsp of added fat) and includes nuts in the meat group and
avocados in the fruit group

5. NUTRIENT DENSITY
 is a relative measure of nutrients in a food in proportion to its caloric content. When a
person says “this food is nutritious,” s/he is implying that the food contains more nutrients
other than calories or it is a food that has high nutrient density.
6. NUTRITION LABELING
 description intended to inform the consumer of nutritional properties. It consists of
two components :nutrient declaration and supplementary nutrition information:
 Nutrition declaration- a standardized statement or listing of the nutrient content
of food.
 Nutrition claim-representation which states or implies that a food has some
particular nutritional properties.

 Mandatory Nutrition Labeling went into effect in 1994 with the goal of helping
consumers adhere to the Dietary Guidelines for Americans. The change is aimed at
reducing the prevalence and complications of chronic illnesses such as heart disease,
hypertension, and diabetes.

 Valuable tool for for learning to apply nutrition information in a practical way. A health
conscious shopper uses the percentages shown in the label to determine how well
each serving of the food fulfills recommended nutritional requirements .

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Purposes of Nutrition Labeling - To ensure that nutrition labeling is effective,
 consumers must make a wise choice by reading the label
 manufacturer or producer must convey the nutrient content or information on the label.
 manufacturer not to mislead or deceive consumers and that, no nutrition claims are made
without approval by appropriate authorities.

Example 1: If one serving of a food has 25% of a particular nutrient listed, it means that each
serving is good for one fourth of a person’s recommended daily intake for that nutrient.

Ingredients are also listed in order of content in a product. If sugar is listed as the first
ingredient, the amount of sugar in the product is greater than the amount of any of the other
ingredients.

Example 2: 1 tsp of sugar equates to 4 grams on the Food Label. A can of softdrink
containing 40 grams of sugar contains the equivalent of 10 tsp of sugar.

To help the consumer calculate the kilocalories in a given food, the food label on larger food
packages also list the conversion factor to change the grams into kilocalories that is

FAT – 9 kcal/g CARBOHYDRATE – 4 kcal/g PROTEIN – 4 kcal/g

1 tsp of sugar = 4 grams x 4 = 16 kilocalories

1 tsp fat/oil = 5 grams of FAT (45 kilocalories)
1 tsp sugar = 4 grams SUGAR (16 kilocalories)
 ¼ cup sugar = 50 grams SUGAR/50 grams CARBOHYDRATE (200 kilocalories)
 IF FIBER IS less than 5 grams, subtract from CHO

 15 grams CHO = 1 slice bread

= ½ cup fruit 60 KILOCALORIES
= 1 cup milk
 ½ cup beans = less than 8 grams fiber + 7 grams PROTEIN
 ¼ cup meat (1 oz)/1 cup milk = 7 grams PROTEIN + 1-10 grams FAT
 Chicken/Fish = 1 gram FAT (9 kilocalories)
 ½ cup beans = 1 gram FAT (9 kilocalories)
 Red meat = 5 grams FAT (45 kilocalories)
 Cheese = 10 grams FAT (90 kilocalories)
 Nuts = 20 grams fat (180 kilocalories)

 A new addition to the Food Labels is the amount of Trans Fats. Trans Fats are found in
hydrogenated fats and shortenings. This type of fat is now known to contribute to
cardiovascular disease.

 If consumers use the food labels when making food purchases, they will be promoting their
health through the inclusion of appropriate nutrient intake (proteins, carbohydrates,
vitamins and minerals) while reducing their risk of chronic illness through a reduction of
fat, salt and sugar and increase in fiber. Food labels used in conjunction with MyPyramid
can be a highly effective and ultimately simple means to promote health.

19
 The health claims that can be made on food labels under the labeling law are as follows:
 Foods high in fiber may reduce the risk of cancer and heart disease
 A low fat diet may reduce the risk of cancer and heart disease
 A low sodium diet may help prevent high blood pressure
 Foods high in calcium may help prevent osteoporosis
 Folate leads to decreased neural tube defects
 Sugar alcohols reduce dental caries
 Soy protein reduces cardiovascular disease.

LESSON 5
NUTRITIONAL ASSESSMENT

Nutritional Screening-process of identifying characteristics known to be associated with

nutritional problems.

METHODS:
 Anthropometric Assessments-determination of height and weight.
 HAMWI METHOD-short cut in determining IBW for adults:
 IBW for males-106 pounds for 5 feet plus 6 pounds per inch over 5 feet
 IBW for females-100 pounds for 5 feet plus 5 pounds per inch over 5 feet

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Note: Add 10% for large frame. Subtract 10% for small frame.
Percent of IBW=current weight/ideal weight x 100
Percent of Weight Loss=usual weight-present weight/usual weight x 100
- Unplanned and/or recent weight loss of 10% in a period of 30 days is a risk factor for
malnutrition, while weight loss exceeding 20% is a high risk factor for surgical patients.

 Body Mass Index (BMI) - ratio of weight to height:

BMI = weight in kg____
(height in meters)2

CALCULATING DBW of INFANTS

METHOD 1:
First 6 months
DBW (gm) = birth weight(gm) + (age in mo. X 600)
7 months up to 1 year
DBW (gm) = birth weight(gm) + (age in mo. X 500)

NOTE: if birth weight is unknown, allow 3000gm (full term) and 2500 gm (premature)
Ex. 9-month old infant whose birth weight is 3.5kgs . Answer. 8000 gms or 8 kilos
METHOD 2:
DBW(k) = (age in mo. / 2) + 3
CALCULATING DBW OF CHILDREN
DBW(k) = (age in years x 2) + 8
Example:
6 month old infant = 6/2 +3=6kg
7 year old child = 7x2=14+8= 22kg

1. BIOCHEMICAL ASSESSMENT
 many of the routine blood and urine laboratory tests found in patients’ charts are useful in
providing an objective assessment of nutritional status. Care should be taken in
interpreting test results for a number of reasons:
 There is no single available test for evaluating short-term response to medical nutritional
therapy.
 Some tests are not applicable to a person, e.g., serum albumin cannot be used to evaluate
protein status in patients with liver failure, because this test assumes normal liver function.

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 Lab tests are to be conducted several times over a certain period to give more accurate
information compared to a single test.
ADVANTAGES:
1) They can detect early sub-clinical status of nutrient deficiency.
2) They identify specific nutrient deficiency.
3) They are independent of the emotional and subjective factors that usually affect the
investigator or reliability of the patient’s recollection.

DISADVANTAGES
1) They are expensive and time-consuming
2) Standards could vary with wide range
3) There may be problems in interpreting results. The significance and accuracy of results
of biochemical tests are related to standards of collection, method of transport/storage
and the actual technique used.

2. CLINICAL ASSESSMENT
 is the physical examination (P.E.) of an individual for signs and symptoms suggestive of
nutritional health and/or clinical pathology. Signs usually come late in the pathogenesis of
a disease, unlike biochemical tests that can detect early malnutrition states.
ADVANTAGES:
1)They can be performed in a large number of individuals in a short period of time.
2)They are less expensive; do not require
3)special equipment or laboratory set up.
4)Other clinical staff may perform physical examinations, given the proper training.

DISADVANTAGES:
1) Deficiencies may not be clearly manifested and specific; thus, needing further
investigation
2) Overlapping of deficiency states: the signs and symptoms may not be directly
attributable to a specific nutritional deficiency disease but may be produced by others
3) Bias of the observer: the interpretation might not be reliable due to high inter and
intravariability.
4) Bias of the observed or person being examined.

3. DIETARY ASSESSMENT
 There are several methods for collecting information regarding actual and habitual dietary
intake. Most commonly used data collected are food recalls and food frequency
questionnaire (retrospective) and food records (prospective).
 THE 24 HOUR FOOD RECALL
 in this method, the individual is asked by the interviewer to report all foods and beverages
consumed during the past 24 hours.

ADVANTAGES:
1) It is quick, takes about half an hour and it can be used with any age group.

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2) Since it is retrospective, the patient does not modify his or her actual intake.
3) The information can be obtained by interview, telephone, or by self-reporting.

DISADVANTAGES:
1) They rely on the memory, motivation, and awareness of the person.
2) It is limited to 24 hours of intake, which may be not typical of his/her daily diet.
3) FOOD FREQUENCY QUESTIONNAIRE(FFQ)-is an easy form to follow, although it could be
time-consuming, depending on the number of pages listing foods and beverages to study
the food habits and choices of a person.

4. FOOD RECORDS
 these can provide a more realistic picture of a patient’s usual intake. All food items,
beverages, snacks, and supplements are recorded by the patient, usually over a period of 3
to 7 days using household measures. This method cannot be used for quantitative analysis
of daily diets.
 A 7-day food record is considered to be optimal for gathering this kind of information,
because it includes weekends. However, it tends to be rather tedious. Shorter periods like
a 3-day record ( two weekdays and one weekend day) may be acceptable.

Teacher’s Insight!

You’ve just learned about the Introduction to Nutrition and Diet Therapy that may help you
understand the total health care of an individual with combined collaboration of the health care team
in providing client’s proper dietary management. This information was taken from various references
which may help you as a health care provider in the future to any level of clienteles.

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 APPENDIX A-1

APPENDIX B

This guide to good nutrition helps you select the right kind of food to eat every day. It suggests
amount of the different food groups that normal adults need to maintain their health. It also
provides tips to plan, select, and prepare adequate meals for the family.

24
To use this guide, check lightly in pencil the foods you serve each day. You can easily erase the
marks fpr re-use of the chart. Be sure to include the suggested amount of food from each
group in the diet everyday.
Foods within the group have similar nutritive values and may be substituted for one another.

ENERGY FOODS
RICE AND OTHER STARCHY FOODS
Average Daily Allowance for a Normal Adult
Rice 5 to 7 cups
Corn 5 1/3 to 8 3/4 cups, cooked
Rice-corn mix 4 1/3 to 7 1/8 cups, cooked
Root crop 1 small
Sugar 5-9 level teaaspoons

 Rice  Gabi, kamote, and other rootcrops

 Corn  Peanuts
 bread  Panusta
 bihon and other noodles  Candied fruits
 Suman, palitaw, etc

These are the main sources of energy for body activities and body heat.

FAT-RICH FOODS
Average daily Allowance for a Normal Adult
 Butter  Coconut oil
 Enriched margarine  Coconut milk
 Lard  Others

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These foods supply concentrated form of energy for bodily or physical activities.

BODY-BUILDING FOODS
PROTEIN-RICH FOODS
Average daily allowance for a Normal Adult
Fish/meat/poultry 1 3/4 to 2 servings
Dried beans/ Nuts 1/2 cup, cooked
Eggs 1/2 peace
 Beef  Whole milk, cheese and other milk
products
 Pork (lean)
 Shrimps, snails, tulya, and other
 Chicken shellfish
 Liver, heart, kidney, and other  Dried beans
internal organs
 Munggo
 Sausages and other prepared meat
 Paayap
 Other types of meat
 Utaw or balatong
 Dilis and other kinds of fish
 Abitsuwelas and others

PROTECTIVE FOODS
You need these foods listed according to their vitamin C content to increase your
resistance to infections and common illnesses. They are also necessary for healthy gums and
teeth.
OTHER FRUITS AND VEGETABLES
Average Daily Allowance for a normal Adult

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 1 serving fruit and 1/2 cup cooked vegetables
 Mabolo  Abitsuwelas  Kadyos
 Pineapple  Ampalaya  Malunggay
 Chico  Banana bud  Okra
 Jackfruit  Bataw  Paayap
 Santol  Watermelon  Sigarilyas
 Kaimito  Avocado  Sili (fruit)
 Granada  Banana  Sitaw
 Duhat  Makopa  Eggplant

These foods likewise aid in digestion and removal of waste. They also contain vitamins and
minerals but in smaller amounts when compared to green, leafy, and yellow vegetables and
vitamin-rich foods.
Remember that fruits and vegetables:
 Help regulate bowel movement
 Have cholesterol-lowering effects
 Provide roughage and bulk for normal functioning of your digestive organs

USE GUIDE TO GOOD NUTRITION IN PLANNING DAILY MEALS

Breakfast
Protein dish (fish, meat, or poultry)
Rice and Bread
Coffee or salabat for adults
Lunch or Dinner
Protein dish
Leafy yellow and other vegetables
Rice
Fruit for dessert

Regulating Foods

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You need these foods to build and repair body tissues. Pregnant women need them to better
prepare themselves for Childbirth and lactation. Nursing mothers need them to nourish the
growing baby. Children need them for optimum growth. These foods also keep the blood red
and nerves healthy, and make bones, teeth, and nails hard and strong.
GREEN AND YELLOW VEGETABLES
Average daily Allowance for a Normal Adult
3/4 cup, cooked
 Cashew  Pomelo  Atis
 Guava  Papaya  Green mango
 Datiles  Tiesa  Siniguwelas
 Kamatsili  Ripe mango  Melon
 Strawberry  Tomato  Guyabano
 Anonas  Durian  Dalanghita

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 APPENDIX C

Nutritional Guide For Adults

29
NUTRITIONAL GUIDE FOR PREGNANT

30
31
32
 APPENDIX D

Suggested Menu for Adults

RECOMMENDED AMOUNT FOR

Sample Family Menu Reference Man (25 years old) Reference Woman (25 years old)

BREAKFAST

Toasted dilis 1/4 cup dilis (10g) 1/4 cup dilis (10g)

Fried egg 1/2 egg 1/4 egg

Fried Rice 2 cups rice 1 1/4 cups rice

Coffee with Sugar Coffee with 3 tsp brown sugar Coffee with 2 tsp brown sugar

MID-MORNING SNACKS

Fried yellow kamote with brown 1 small-sized kamote 1 small-sized kamote

sugar
6 tsp brown sugar 1 tsp brown sugar

LUNCH

Tulya with malunggay leaves Broth as desired Broth as desired

Tambaninihaw with fresh tomato 2 1/2 tbsp or 37.5g shelled tulya 1 tbsp or 15g shelled tulya

Boiled rice 1/4 cup malunggay 1/4 cup malunggay

Pineapple 1 small-sized tamban 1 small-sized tamban

1 medium-sized tomato 1 medium-sized tomato

2 1/2 cups rice 2 cups rice

1 slice pineapple 1 slice pineapple

MID-AFTERNOON SNACK

Boiled Peanuts 1/2 cup shelled peanuts 1/ 2 cup shelled peanuts

DINNER

Pork sinigang (lean pork, kangkong, Broth as desired Broth as desired

sitaw, tamarind)
1 pc 3-cm cube lean meat 1 pc 3-cm cube lean meat

1/2 cup kangkong 1/2 cup kangkong

1/2 cup sitaw 1/2 cup sitaw

2 1/2 cups rice 1 3/4 cups rice

1/2 slice papaya 1/2 slice papaya

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EVENING SNACKS

Whole milk with sugar

APPENDIX E

34
 Recommended Diet Modifications to Decrease Dietary Fat
(25 Grams or 50 Grams Fat)
Food Groups Choose Decrease

BEVERAGES

2 or more servings of milk and Skim milk (liquid, powdered, 1% - 2% whole milk, buttermilk
dairy products per day and evaporated) skim made from whole milk,chocolate
buttermilk, skim chocolate milk, milk, evaporated milk, cream
coffee, tea, other non-dairy
products

BREAD AND CEREALS

6 to 11 servings per day Whole-grain breads, enriched Biscuits, bread containing eggs
breads, saltiness, soda crackers, or cheese, sweet rolls,
English muffins, whole-grain or pancakes, french toast,
enriched bagels, flour tortillas doughnuts, waffles, fritters,
muffins, egg bagels, popovers,
snack crackers with added fat,
snack chips, stuffing, fried
tortillas
Whole-grain cereals except
regular granola-type cereals, Granola-type cereals, buttered
low-fat granola cereals, popcorn
unbuttered popcorn

FRUITS

2 or 4 servings per day Fresh, frozen, canned or dried Avocado

fruit; fruit juices

VEGETABLES

3 to 5 servings per day All fresh, frozen or canned Buttered, au gratin, creamed, or
vegetables prepared without fried vegetables unless made
fats, oils, or fat-containing with allowed fat allowance
sauces

POTATOES

Potatoes, rice, barley, noodles, Fried potatoes, fried rice, potato

spaghetti, macaroni and other chips, chow mien noodles
pastas

MEATS AND MEAT

SUBSTITUTES
Poultry: breast meat without Any fried, fatty or heavily
For 50 g fat diet- 6 oz skin marbled meat, fish, or poultry

For 35 g fat diet- 5 oz Veal: all cuts Poultry: Duck, Goose

Recommended preparations are Lean Beef: USDA good or choice Beef: most USDA prime cuts of
boiling, roasting (on rack), cuts ( round, sirloin, flank steak, beef, ribs, corned beef
grilling or boiling; weigh meat tenderloin, and chopped beef);
after cooking roast (rib, chuck, rump); steak Pork: spareribs, ground pork,

35
 (cube, porterhouse, T-bone); sausage (patty or link), ham
meatloaf made with ground hocks, pigs’ feet, chitterlings
beef (95% lean)
Lamb: patties (ground lamb)

Fish: Tuna (packed in oil),

salmon (packed in oil)

Most luncheon meats including

bologna,salami, pimiento loaf

MEATS AND MEATS

SUBSTITUTES
Lean pork: fresh,canned, cured Sausage: Polish, Italian,
For 50 g fat diet- 6 oz or boiled, ham; Canadian bacon; knockwurst
tenderloin; chops; loin roast;
For 25 g fat diet- 5 oz Boston butt; cutlets Smoked bratwurst, frankfurter;

Recommended preparations are Lean lamb: Chops, leg, or roast Legumes cooked with added fat
boiling, roasting (on rack),
grilling or boiling; weigh meat Fish: all fresh, frozen, or canned
after cooking in water; crab lobster, scallops,
shrimp, clams, oysters, tuna;
herring (uncreamed or smoked),
sardines (canned, drained)
salmon (canned in water)

Luncheon meats; 95% fat-free;

lean, ham, turkey, or beef

DESSERTS AND SWEETS

In moderation Sherbet, fruit ice, gelatin, angel All other cakes, cookies, pies,
food cake, vanilla wafers, and pastries, puddings made
graham crackers, meringues, with white milk or eggs; cream
pudding made with skim milk, puffs, butter, coconut,
fat-free commercial made chocolates, and cream candies
products, non-fat ice cream,
frozen yogurt, sugar, honey,
jelly, jam, marmalade,
molasses, maple, syrup,
sourballs, gumdrops, jelly bean,
marshmallows, hard candy,
cocoa powder

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 APPENDIX F

Medical Nutrition Therapy for Diabetes

Steps Purpose Information Needed Desired Outcome

Assessment Helps identify goal; Clinical data: height/ weight; blood Dietitian will: Identify
determines types of pressure; results of patient’s self- nutrition problems and
nutrition monitoring of blood glucose levels, misinformation; provide
intervention to be and glycosylated hemoglobin; daily positive feedback on
used; establishes medications (insulin, or oral patient’s current eating
rapport with patient hypoglycemic agents) daily energy habits and lifestyle
needs activities

Dietary history: Usual food intake,

attitudes toward nutrition and health,
previous nutrition education and
outcomes.

37
 Nutrition intake: Overall Nutritional
adequacy, kcalorie intake, nutrient
distribution (type of carbohydrate,
protein and fat)

Goal Setting Enables patient to The following questions may help Patient will: Establish
use assessment negotiate goals and obtain realistic and specific
information to information about patient’s goals to make positive
identify his/her understanding of his/ her willingness changes in eating and
needs in relation to and interest in making changes: exercise behaviors;
overall diabetes goals are not
management What are you expecting to gain from permanent and change
nutrition counseling is desired for a variety
What is the most important goal for of reasons.
you in managing your diabetes in
terms of the way you eat?
Regarding your present eating habits,
what are some changes you are
willing to make?
What would you do to make these
changes?
Among the changes we have
discussed, what could you do first?

Nutrition Provide the patient Information on metabolic After basic nutrition

intervention with knowledge and abnormalities of patient, literacy level intervention, the
skills necessary to of patient, type of audio-visual patient will be able to
change or maintain materials to use (handouts, videos, state overview of
eating habits audio tapes, flip charts, or food nutrition and nutrient
models requirements, diabetes
nutrition management
guidelines, and other
appropriate information
(label reading, sick-day
management, travel
tips)

After in-depth nutrition

intervention, the
patient will be able to
plan meals with more
structure (menus,
calorie counting, fat
counting, exchange
lists, and carbohydrate
to insulin ratio)

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 APPENDIX G

Medical Nutrition Therapy to Lower Cholesterol:

Guidelines for Step 1 and Step 2 Diets

Food Group and Avoid Decrease Use Instead

Serving per
Day/Week

MILK AND DAIRY Whole milk (regular, 2% milk, ice milk, Skim or 1% milk, non-fat
PRODUCTS evaporated, condensed), creamed cottage cheese yogurt, non-fat or fat-free
cheese, yogurt made from (4%), part skim milk cheese*, low-fat cottage
Step 1: whole milk, custard-style, cheeses, low-fat yogurt cheese (1%-2%)*, pot cheese
3 servings/day yogurt, cream, half-and-half, (1%-2%)
most non-dairy substitutes,
Step 2: whole milk ricotta, Neufchatel,
brie, hard cheeses (Swiss,
2 servings/day American, mozzarella, feta,
cheddar, Muenster), cream
cheese, sour cream

MEAT, POULTRY, Organs meat, fatty and heavily Prime grade meats, Lean meats with fat trimmed
FISH AND SHELLFISH marbled meats (corned beef, peanut butter, nuts, fish (beef round, sirloin, chuck,
brisket, regular ground beef, canned in oil, oysters, loin; pork tenderloin, leg,
Step 1: short ribs, pork spareribs, blade shrimp shoulder; lamb leg, arm, loin,
6 oz/day (cooked) roll), goose, domestic duck, rib; all cuts of veal except
regular cold cuts, frankfurters, ground), poultry without the
Step 2: fried meats, sausage, bacon, skin, fish, water-packed tuna
canned meats or meat mixes or salmon, low-fat cold cuts*,

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 6 oz/day and low-fat frankfurters*
(cooked)

BREADS, CEREALS, Egg, noodles Crackers, cakes, Whole-grain bread and

PASTA, RICE, DRIED cookies, muffins, and cereals, English muffins,
PEAS AND BEANS other bakery products bagels, bread sticks, rice
made with unsaturated pasta, macaroni, potatoes,
Step 1: fat and less than 3 g fat low-fat crackers (such as
4-7 servings/day per serving (check the matzo, zwieback, soda,
(cooked) label) graham, rye, plain)*, dried
beans and peas (split peas,
Step 2: black-eyed peas, chickpeas,
kidney beans, navy beans,
5-8 servings/day lentils, soybeans, soybean
(cooked) curd {tofu})

EGGS None Egg yolks Egg whites or egg substitutes

Step 1:

3 yolks/week

Step 2:

1 yolk/week

FRUITS AND Coconut, fruits and vegetables Avocado, olives Fresh, frozen, canned, or
VEGETABLES in cream or cream sauces, dried fruits and vegetables
butter, and dips
Step 1:

3 fruit or 4
vegetable
servings/day

SWEETS AND Ice cream, frozen Crackers, cakes, Sherbet, sorbet, Italian ice,
SNACKS tofu;commercially prepared cookies, muffins, and frozen yogurt, popsicles, angel
pies, cakes, cookies, other bakery products food cake, fig bars,
Step 1: doughnuts, sweet rolls, pastries made with unsaturated gingersnaps, jelly beans, hard
2 servings/day and muffins; potato and corn fat and less than 3 g fat candies, plain popcorn,
chips prepared with saturated per serving (check the pretzels; carbonated drinks,
Step 2: fat; buttered popcorn; frappes; label); chocolate; most juices, tea, coffee
milkshakes; floats; and eggnogs candies
2 servings/day

FATS AND OILS All fats especially saturated fats Mayonnaise, creamy Polyunsaturated oils
(butter, lard, bacon, bacon fat, salad dressings, (safflower, corn, sunflower,
Step 1: gravy and cream sauces, reduced-calorie sour soybean, sesame, or
5-7 servings/day hydrogenated margarine and cream or cream cheese cottonseed);
shortening, cocoa butter, (non fat-free) monounsaturated oils (olive,
Step 2: coconut oil, palm oil, palm canola, peanut oil); salad
kernel oil, most non-dairy dressings made with
4-6 servings/day creamers; dressings made with unsaturated oil, margarine

40
 egg yolks from polyunsaturated oil or
margarine where the first
ingredient listed is liquid oil;
non-fat or fat0free spreads,
dressings, cream cheeses, and
sour cream
APPENDIX H

Purine Contents of Different Food Items

HIGH CONTENT: 150-182.5 mg/100 g

Fish/ Seafood Meats

Anchovies Brains

Herring Gravies

Mackerel Kidney

Sardines Liver

Scallops Meat extracts

Wild game

Sweetbreads

Goose

MODERATE CONTENT: 50-150 mg/ 100 g

Vegetables Fish/Seafood

Asparagus Crabs

Cauliflower Eel

Green Peas Fish (all kinds)

Mushrooms Lobsters

Spinach Oysters

Grains and Legumes Meats and Related Products

Legumes (split peas, beans, lentils) Beef

Oatmeal Lamb

Wheat bran and germ Pork

Whole-grain breads and cereals Veal

Poultry

Chicken

41
 Duck

Turkey

LOW CONTENT: 0-50 mg/ 100 mg

Beverages Miscellaneous

Carbonated beverages Eggs

Coffee Fats

Tea Fish roe

Grains Fruits and Juices

Breads and cereals (refined white flour) Gelatin

Dairy Nuts

Cheese Sugar (all types) and food containing sweets

Milk (all fat levels) vegetables

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 APPENDIX I

National Renal Diet

Milk Choices Per Day
Average per choice: 4 grams protein, 120 kcalories, 80 mg sodium, 100 mg phosphorus
Milk (non-fat, low-fat whole 1/2 cup
Lo Pro 1 cup
Buttermilk, cultured 1/2 cup
Chocolate milk 1/2 cup
Light Cream or half and half 1/2 cup
Ice milk or ice cream 1/2 cup
Yogurt, plain or fruit-flavored 1/2 cup
Evaporated milk 1/4 cup
Sweetened condensed milk 1/4 cup
Cream cheese 3 tbsp
Sour cream 4 tbsp
Sherbet 1 cup

Non-dairy Milk Substitutes Per Day

Average per choice: 0.5 gram protein, 140 kcalories, 40 mg sodium, 30 mg phophorus
Desserts, non-dairy frozen 1/2 cup
Dessert topping, non-dairy frozen 1/2 cup
Liquid non-dairy creamier, polyunsaturated 1/2 cup

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44