NOTRE DAME OF TACURONG COLLEGE
COLLEGE OF NURSING
Lapu-Lapu St., Tacurong City, Sultan Kudarat, Philippines
Telephone No.: (064) 200-3631 Fax No.: (064) 200-4131
Subject: NCM 105-Nutrition and Diet Therapy Schedule: Saturday 8:00-12:00pm
Placement: First Semester, BSN 2 Course Credit: 2 units lecture; 1unit lab
Instructor: Tina T. Lumanag, RN,MN
Date of Activity: Week 4 September 14-20, 2020
Deadline of Submission: September 21, 2020; 11:59am
Mode of Submission: LMS Account or Printed
LESSON GUIDE
Week 4
Dietary Computations
I. OBJECTIVES: at the end of the lesson, the students must have:
1. Discussed dietary computations such as Body Mass Index, Desired Body Weight
(DBW) determination, Resting Energy Expenditure (REE), and Total Energy
Requirement (TER).
2. Analyzed Body Mass Index (BMI) category and Distribution of Total Energy
Requirement (TER).
3. Discussed application to Food Exchange List (FEL)
II. Course Content: Dietary Computations
Topic includes the following:
1. Body Mass Index and Classification
2. Desirable Body Weight (DBW) Determination
3. Resting Energy Expenditure (REE) Determination
4. Total Energy Allowance (TEA) & Distribution of TEA
5. Application to Food Exchange List
Lesson 1. Body Mass Index and Its Classification
Body Mass Index
The body mass index (BMI), or Quetelet index, is a statistical measurement
which compares a person's weight and height.
Though it does not actually measure the percentage of body fat, it is used to
estimate a healthy body weight based on how tall a person is.
Due to its ease of measurement and calculation, it is the most widely used
diagnostic tool to identify weight problems within a population, usually
whether individuals are underweight, overweight or obese.
Body mass index is defined as the individual's body weight divided by the
square of his or her height.
The formula universally used in medicine produce a unit of measure of
kg/m2.
BMI can also be determined using a BMI chart, which displays BMI as a
function of weight (horizontal axis) and height (vertical axis) using contour
lines for different values of BMI or colors for different BMI categories
Lesson 2. Determination of Desirable Body Weight (DBW)
Desirable Body Weight
Also termed ideal or reference weight but more appropriately called healthy
weight. In children, ideal weight is the midpoint of the recommended weight
range at a specified age.
In adolescent and adults, however, DBW refers to the average
recommended weight range at a specified height for a given body frame; it is
weight found statistically to be most compatible with health and longevity.
When calculating the DBW, it is generally recommended to round it off to the
nearest whole number except for infants.
A. Determination of the Desirable Body Weight of an Infant
Formula 1.
1-6 months
DBW (gm) = birth weight (gm) + (Age in mo. X 600)
7-12 months
DBW (gm) = birth weight (gm) + (Age in mo. X 500)
Formula 2.
DBW (k) = age (mo.) ÷ 2 + 3
Note: If the birth weight is unknown, allow 3000 gm (full term) or 2500 gm
(premature). One kilo is 2.2 pounds.
B. Children
DBW (k) = (age in years x 2) + 8
C. Adolescents/ Adults
a. NDAP Method
Step 1. Allow 112 pounds for 5 feet tall (men)
Allow 106 pounds for 5 feet tall (women)
Step 2. Then: add (subtract) 4 pounds for every inch above (below) 5 feet.
Conversion aid:
1 kilo= 2.2 lb
1 foot= 12 inches
1 inch= 2.54 cm
b. Tannhauser’s Method (Broca index)
Step 1. DBW (k) = Height (cm)-100
Step 2. Deduct 10%= (Apply this method for Filipinos whose statures are
usually small, unless body frame is identified)
c. BMI-derived formula
Men: DBW (k) = height in meters² x 22.0
Women: DBW (k) = height in meters² x 20.8
Conversion aid: 1 m= 100 cm
d. the Hamwi formula (adults only)
Females:
100 lb for first 5 ft
Add 5 lb for each additional inch
Males:
106 lb for first 5 ft
Add 6 lb for each additional inch
Adjustments:
Small frame- subtract 10%
Large frame: add 10%
D. Estimating DBW of Amputees
1. Compute DBW (in pounds or in kilos) by age and sex using any method.
2. Adjust DBW according to type of amputation
Amputation DBW= DBW- (DBW x % total body weight amputated)
Body Part % of Total Body Weight
Hand 0.3
Forearm and Hand 2.6
Entire arm 6.2
Foot 1.7
Below- knee Amputation (BKA) 7.0
Above-knee Amputation (AKA) 11.0
Entire Leg 18.6
E. Adjusting DBW According to Body Frame (Adolescents and Adults)
Desirable body weight of teens and adults is more precisely estimated when
body frame is considered. To determine a person’s body frame, try using the
technique below.
Body Frame According to Wrist Size
Technique: Wrap the fingers of one hand around the opposite wrist.
Frame
Size
If the thumb and middle finger overlap by 1 cm Small
If the thumb and middle finger touch Medium
If the thumb and middle finger cannot touch by 1 Large
cm
Build Adjustment DBW Range
Small Less 10% of computed DBW ± 10% of adjusted DBW
Medium As computed ± 10% of adjusted DBW
Large Add 10% of computed DBW ± 10% of adjusted DBW
Lesson 3. Determination of Basal Metabolic Rate (BMR) or Resting Energy
Expenditure (REE)
A. Krause and Mahan (Persons with height and weight)
REE = Adult Female - 0.90 kcal/kg DBW/hr
= Adult Male = 1 kcal/kg DBW/hr
B. WHO/FAO/UNU Formula
REE = 11.6 x wt in kg + 879
Lesson 4. Methods of Determining the Total Energy Allowance (TEA)/ day
Voluntary (muscular) and involuntary (metabolic processes) activities of the body
require energy.
Energy comes from the oxidation of foods and is measured in terms of calories or
kilojoules.
Energy needs are estimated by considering the age, sex, physical activity and
state of health such as pregnancy, pathologic conditions, etc.
To simplify construction of daily food plan, the estimated energy allowance is
rounded-off to nearest 50 kcal.
A. Infants
1-6 months
TEA (kcals/day) = 120 kcal/kg DBW/day
7-12 months
TEA (kcal/day) = 110 kcal/kg DBW/day
B. Children
1. Narins and Weill
TEA= 1000 + (100 x Age in years)
2. According to Age and DBW
TEA/day= DBW (kg) x calorie allowance based on age
Age (Years) 1989 RDA kcal/k DBW/ day
1-3 105
4-6 90
7-9 75
10-12 65 (boys)
55 (girls)
C. Adolescents
TEA/day= DBW (k) x calorie allowance based
Age (Years) 1989 RDA kcal/k DBW/ day
13-15 55 (boys)
45 (girls)
>15-19 45 (boys)
40 (girls)
Average (all ages, both sexes) 45
D. Adults
Estimation of TEA based on the level of physical activity.
TEA= DBW (kg) x Physical activity
Activity KRAUSE NDAP
kcal/ k DBW/day kcal/k DBW/ day
Bed rest but mobile 27.5 Female Male
Sedentary 30.0 30 35
Light 35.0 35 40
Moderate 40.0 40 45
Very Active 45.0 45 50
E. Adjustments of Caloric Expenditure for Healthy Elderly
Energy needs often decrease with advancing age. For one thing, the
number of active cells in each organ decreases, reducing body’s overall
metabolic rate. For another, older people usually reduce physical activity
and so their lean tissue diminishes.
a. Computed calorie value is rounded-off to the nearest 50 kcal
b. Reduce caloric allowance by 10% for adult aged 50-59 y/o.
c. Reduce caloric allowance by 20% for adult aged 60-69 y/o.
d. Reduce caloric allowance by 25% for adult aged 70 y/o and above.
F. Estimation of TEA by Cooper, et al
TER= BMR (or BEE) + Physical Activity by Cooper, et al
Step 1: BMR= 1 kcal/k DBW/ hour
Step 2: Add Physical Activity (PA) = % above basal
Step 3: Add Specific dynamic action (SDA) = 10% of BMR
Physical Activity %
Bed rest 10
Sedentary 30
Light 50
Moderate 75
Heavy 100
G. Classifying Level of Physical Activity (for Krause, NDAP and Cooper Methods)
Physical Activity Level (sedentary, light, etc.) is based on the actual effort
given for a particular activity.
It should be judged after considering not only the occupation but also all
of the off-the job activities including exercise program taken regularly (if
there is any).
Activity Level
Example of Work and Activities
Sedentary/ Very Light (Mostly Sitting Activities)
Cashier, secretary using computers, clerk, typist, bank teller, computer
programmer, administrator, cooking, ironing
Light
Student, teacher, technician, engineer, wife with maids, nurse, doctor,
housecleaning, golf and table tennis
Moderate
Wife without maids, vendor running on streets, jeepney drivers, carpenters,
dancing.
Heavy
Walking activities carrying load uphill, heavy manual activities, coal miners,
heavy equipment operator, heavy manual digging
Lesson 5. Application to Food Exchange List
Food Exchange List (FEL)
A list of common foods grouped in terms of equivalent amounts of CHOs,
CHONs, fats and calories.
“EXCHANGES” – a food item may be replaced or substituted with, or
“exchanges” for another food item belonging in the same list since food in the
same amounts of energy and energy-giving nutrients.
Examples:
1 cup noodles/ pasta = 3 pcs. Pandesal = ½ cup rice cooked, packed
A. Uses of Food Exchange List
1. Meal planning
2. Diet instruction
3. Estimating the energy & macronutrient (normal & therapeutic diets)
4. Teaching tool (principle of basic nutrition, nutrient composition, & caloric
density)
5. Reference for expressing household measures of food into approximate
weight in grams.
B. Food Exchange: Vegetables
One serving for vegetables in food exchange list contains 25 calories and 5
grams of carbohydrate. One serving of vegetables equals to:
1/2 cup Cooked vegetables (carrots, broccoli, zucchini, cabbage,
etc.)
1 cup Raw vegetables or salad greens
1/2 cup Vegetable juice
C. Food Exchange: Medium Fat Proteins One serving has 75 calories and 5 grams of
fat. One serving equals to:
1 ounce Beef (any prime cut), corned beef, ground beef
1 ounce Pork chop
1 each Whole egg (medium)
1 ounce Mozzarella cheese
1/4 cup Ricotta cheese
4 ounces Tofu (note this is a Heart Healthy choice)
D. Food Exchange List Table
FOOD MEASURE KCAL/GROUP CHON PROTEIN FAT
GROUP (GRAM) (GRAM) (GRAM)
Vegetable A 1 cup raw - - - -
½ cup
Vegetable B cooked ½ 16 3 1 -
cup raw
Fruit ½ cup 40 10 - -
Milk cooked
Whole milk Varies 170 12 8 10
Low fat 125 12 8 5
milk Varies 80 12 8 Tr
Skimmed 4 100 23 2 -
Rice tablespoon
Meat and Varies
Fish Varies 41 - 8 1
A. Low fat 86 - 8 6
B. Medium 122 - 8 10
fat Varies 45 - - 5
C. High fat Varies 20 5 - -
Fat Varies
Sugar 1 teaspoon
1 teaspoon
III. Interactive Links
1. Calculate your own body mass index
https://youtu.be/5RXRr8PKunk
2. How to Calculate Ideal Body Weight || How to Calculate Desirable Body
Weight
https://youtu.be/ZNdnxeET6f4
IV. Research Studies/Supplemental Readings
1. Food Exchange List for Meal Planning
https://www.nhlbi.nih.gov/health/educational/lose_wt/eat/fd_exch.htm
2. The Exchange List System for Diabetic Meal planning
https://www.uaex.edu/publications/pdf/FSHED-86.pdf
V. Evaluation
To pass the subject, you must:
1. Read all subject readings and answer the pre-assessment quizzes, activities,
expected output and assignments.
2. Submit the expected output from the modules on time.
3. Pass the midterm and final exam.
Grading System:
Assignment = 20%
Quizzes/Module Outputs = 40%
Examination = 40%
100%
Appendix A - Quiz 3
Appendix B - Criteria for Grading
VI. References
Caudal, Maria Lourdes (2008). Basic Nutrition and Diet Therapy Textbook
For Nursing Students
Carmela A. Dellova (2006). ABC’s of Nutrition and diet therapy
Whitney & rolfes.(2005). Understanding Nutrition. 10th edition.
Eleanor Noss Whitney and Sharon Rady Rolfes. (2002). Understanding Nutrition,
9th edition.
Hogan Wane. (2005). Nutrition and diet Therapy, 1st edition.
Prepared by ANDREA CELESTINE C. REYES, RN, MAN
Clinical Instructor
Noted by: ELMER G. ORGANIA, RN, MAN
Dean, College of Nursing
NOTRE DAME OF TACURONG COLLEGE
COLLEGE OF NURSING
Lapu-Lapu St., Tacurong City, Sultan Kudarat, Philippines
Telephone No.: (064) 200-3631 Fax No.: (064) 200-4131
APPENDIX A
Name of Student: _________________________________Year/Level: _________
Date Submitted: __________________________________ Score: ____________
Quiz 3. Dietary Computations
1. Mr. Dela Rosa is an athlete, his weight is 180 lbs and his height is 5”9. Compute
his BMI, DBW, and BMR. What is the classification of Mr. Dela Rosa’s BMI?
2. Ms. Lisa is a sales agent, her weight is 130 lbs and her height is 5’4. Compute for
her BMI, DBW, and BMR. What is her BMI classification?
3. Ms. Lisa is a sales agent, her weight is 130 lbs and her height is 5’4. Convert Ms.
Lisa’s weight to kilograms then compute for her BMI, DBW, and BMR.
4. Ms. Marian weighs 160 lbs and her height is 5’5. Convert her weight into kg then
compute for her BMI, DBW, and BMR.
5. Mr. Glen is a body builder who weighs 200 lbs and his height is 6 ft. Convert Mr.
Glen’s weight to kg then compute for his BMI, DBW, and BMR.
NOTRE DAME OF TACURONG COLLEGE
COLLEGE OF NURSING
Lapu-Lapu St., Tacurong City, Sultan Kudarat, Philippines
Telephone No.: (064) 200-3631 Fax No.: (064) 200-4131
Name of Student: _________________________________Year/Level: _________
Date Submitted: __________________________________ Score: ____________
Nutrition Laboratory Activity No. 3
Week 4
Dietary Computation: BMI Computation and Classification
1. Compute your own BMI and Interpret
2. Encircle the body shape you have based on the result.
Women: 1 2 3 4 5 6 7 8 9
BMI: 18.3 19.3 20.9 23.1 26.2 29.9 34.3 38.6 45.4
Men: 1 2 3 4 5 6 7 8 9
BMI: 19.8 21.1 22.2 23.6 25.8 28.1 31.5 35.2 41.5
3. What insights did your learn from the activity?
4. Are you willing to share about your BMI? Why or why not?
