NCM105- Nutrition and Dietetics

[Magno, Angel Rica A.]

Enzymes - a substance produced by a living organism
which acts as a catalyst to bring about a specific
biochemical reaction.
NCM 105 | Nutrition and Dietetics
Amino Acids - building blocks of protein, synthesis of
I. Nutrition
hormones and neurotransmitters.
a. Principles of Nutrition
b. Nutritional Food Guidelines Essential Amino Acids - are those that are produced by
c. Nutrition Physiology the body while non-essential amino acids are not
d. Basic Tools in Nutrition produced by the body this they should be supplied in
e. Meal Management the diet.
f. Nutrition throughout the Life Cycle
Cells - the smallest structural and functional unit of an
II. Diet Therapy organism, typically microscopic and consisting of
cytoplasm and a nucleus enclosed in a membrane.
a. Modified Diets Microscopic organisms typically consist of a single cell,
b. Reducing Diets which is either eukaryotic or prokaryotic. Water
c. Diet for Specific Diseases comprise of 70% cell mass. The the positive ions of
hydrogen and negative ions of oxygen

Eukaryotic cell - have true nucleus and contain all

membrane-bound cell organelles

Prokaryotic cell- has no true nucleus and does not

contain membrane-bound cell organelles

Nucleus has 2 primary functions: It is responsible for

storing the cell's hereditary material or the DNA. It is
Definition of Terms responsible for coordinating many of the important
cellular activities such as protein synthesis, cell
Nutrition -is the study of food and how the body uses division, growth and a host of other important
it. It deals not only with the quantity of food needed to functions
nourish the body but it also pays attention to the
quality of food we choose to eat. It studies utilizations
of food from the time it is ingested, digested, absorbed, History of Nutrition
assimilated and excreted.

Diet Therapy - alteration or adoption of a diet to

prevent or treat a disease or to simply promote
optimum health. In some cases, an alternative dietary
lifestyle plan may be developed to eliminate certain
foods to reclaim health.

Nutrients - chemical elements/ substances that

provides nourishment essential for growth and the
maintenance of life
 3. Dietary nutrients and intake should be individualized
4. Nutrient requirements are known for some but has
to be determined for others
1770 - Antoine Lavoisier, the "Father of Nutrition 5 Adequate Diet is the foundation of good nutrition and
and Chemistry" discovered the actual process by it should consist of a wide variety of food
which food is metabolized. He also demonstrated 6. The physiological function of food are attributed to
where animal heat comes from. In his equation, he
the roles of the nutrients
describes the combination of food and oxygen in
the body, and the resulting giving off of heat and 7. Malnutrition is brought about by faulty diet and/or
water. conditioning factors like heredity, infection, ingestion
of certain drugs, and parasitism
Father of Philippine Nutrition 8. Nutrition Education, abundant food supply, and use
Born on June 3, 1892, National Scientist Dr. of various resources are used to improve the
Francisco O. Santos was a firm believer in nutrition's nutritional status of the population
crucial role in Philippine society.
9. The study of Nutrition is interrelated to Allied Arts
•He devoted his life to studying the nutritional and Sciences
value of Filipino food and the connection between 10. Nutrition Education is a multidisciplinary process
social class and dietary patterns. and creates a bridge between nutrition educators and
the consumer in the transport of nutritional
•He also initiated and led what is now known as the applications and principles
Food and Nutrition Research Institute.

HISTORY OF NUTRITION Basic Concepts and Principles of Diet Therapy

Post Spanish Era - most Filipinos were suffering from
BeriBeri (Thiamine deficiency disease) Tiki-tiki was System Control- when an illness is to be addressed,
discovered first modification is Diet before any medication or
surgery is considered
American Domination- many Filipino scientists were
trained to discovery food materials out of the
Diet Modification- is recommended when certain diet
indigenous materials. The National Nutrition Research
are found to be causing adverse effectson the health of
Institute was established and this addressed the
the individual
Nutritional state of the people. Other agencies were
established. Nutrition Foundation of the Philippines,
Organ Rest - if a person undergoes surgery, certain
National Nutrition Council, National Nutrition
diets are recommended to give rest to the organ
Services (DOH)

Japanese Regime- operations of the Nutrition

Research Institute was stopped and Filipinos relied on
indigenous materials for survival

Post Japanese Era- Research Institutes were rebuilt

and the first National Nutrition Survey was done in
1950 to check on the Nutritional status of the
Filipinos. This survey is done every 5 years up to this
date. The last was 2018. Green Revolution,
Malnutrition Wards were set up in govt hospitals

Nutrition Concepts and Principles

1. Adequate Nutrition is essential to good Health.

2. Nutrients in the body are in dynamic equilibrium
New messages of the 2012 Nutritional Guidelines for
Filipinos (NGF):

1. Eat a variety of foods everyday to get the nutrients

needed by the body.
2. Breastfeed infants exclusively from birth up to six
months and then give appropriate complementary
foods while continuing breastfeeding for two years and
beyond for optimum growth and development.
3. Eat more vegetables and fruits to get the essential
vitamins, minerals, and fiber for regulation of body
processes.
4.Consume fish, lean meat, poultry, egg, dried beans or
nuts daily for growth and repair of body tissues.
5. Consume milk, milk products, and other calcium-rich
food such as small fish and shellfish, everyday for
healthy bones and teeth.
6. Consume safe foods and water to prevent diarrhea
and other food-and water-borne diseases.
7. Use iodized salt to prevent lodine 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

CHAPTER 1: NUTRIENTS
 Topics:
Nutrients: Structural Composition of the Body
The Digestive System
a substance that provides nourishment essential for Digestion of Carbohydrates
growth and the maintenance of life: Digestion of Protein
CARBOHYDRATES: C- PROTEIN (Amino FATS/ LIPID (Fatty Digestion of Fats
H-O Acids) Acids)
C-H-O-N C-H-O-H Kreb’s Cycle
Routes of Circulation
Mono+ High, Low Biological Saturated,
Disaccharides+ Value Unsaturated
polyssacharides BODY- BUILDING FOODS any of a class of
any of a class of
nitrogenous organic
organic compounds STRUCTURAL COMPOSITION OF THE BODY
Energy- giving Foodd compounds that consist that are fatty acids or
of large molecules their derivatives and
any of a large group composed of one or are insoluble in water
of organic more long chains of but soluble in organic
compounds occurring amino acids and are an solvents. They
in foods and living essential part of all living include many natural
organisms, especially as
tissues and including structural components
oils, waxes, and
sugars, starch, and of body tissues such as steroids.
cellulose. They contain muscle, hair, collagen,
hydrogen and oxygen in etc., and as enzymes ENERGY GIVING
the same ratio as water and antibodies: FOODS
(2:1) and typically can
Body-building
be broken down to
release energy in the
animal body:
Cell – smallest unit which performs the functions
characterised by living organisms which include
growth, reproduction, mobility, work and sensitivity to
MICRONUTRIENTS stimulus Cells are differentiated and specialized in
order to perform their specific tasks.
Vitamins
Example are muscle cells(mobility), fat cells(fat
Fat Soluble Water Soluble storage) , red blood cells(carry oxygen)

Vitamin A ( retinols) Vitamin B Vit. B1

Vitamin D (Calciferols) (Thiamine)
Vitamin E (Tocopherols) Vit. B2 (Riboflavin) Cells need energy and nutrients in order to perform
Vit B6 (Pyridoxine)
Vitamin K (Quinones) various functions
Folate (Folic Acid)
Vit B 12 (Cobalamin)
Vitamin C ( Ascorbic Oxygen and water are basic needs to burn fuel and for
Acid)
vital activities

Minerals Genes determine the kind of work Enzymes and

hormones facilitate work of specific functions
Micro-minerals Macro-minerals
Blood, Lymph and Extracellular fluids carry substances
Iron Calcium needed for life
Iodine Phosphorus
Zinc Magnesium
Selenium Potassium
Manganese Sodium
Copper Chloride STRUCTURAL COMPOSITION OF THE BODY
Molybdenum Sulfur
Chromium
Flouride Tissues, organs, and glands are organized in such a way
that body systems can be differentiated according to
their various functions or physiological roles. There are
NUTRITION PHYSIOLOGY 10 systems , these are :
SPECIAL SENSES ESSENTIAL AMINO ACIDS

•Phenylalanine-meat, seafoods, poultry, eggs, dairy

•Valine- soy, tofu, meats, fish
•Tryptophan- oats, cheese, turkey,beans pumpkin
seeds
•Threonine-mushroom,leafy vegetables, sesame
seeds,
• meats
•Isoleucine-beans, cheese,sardines, fish, meats
•Methionine-meats
GENERAL OVERVIEW DIGESTION •Histidine-tuna,milk, tofu, beef, eggs
•Leucine-meats, steak, skimmed milk,tofu, eggs
•Lysine- beef, lentil, tofu, parmesan cheese

FAT DIGESTION

NCM 105 | Nutrition and Dietetics

Factors Affecting Digestion and Absorption
1. Chemical secretion. The secretory functions that
CARBOHYDRATES DIGESTION provide the necessary environment
and agents for chemical digestion
2. Age and state of health. Secretions , motility,
digestion and absorption decrease as
one reached old age.
3. Muscle activity. The neuromuscular functions and
their structures that provide the
necessary motility and mechanical action for digestion
4. Absorbing mucosa. The absorptive functions which
enable the end product of
PROTEIN DIGESTION digestion to enter the body circulation and nourish the
cells is decreased with certain
diseased conditions.
5. Psychologic factors. The emotional make-up of a
person and his coping mechanism
to stress affect the digestion and absorption
6. Effects of drugs. There are medical drugs that
stimulate digestion and peristalsis;
some drugs cause constipation and interfere with
nutrient absorption. Alcohol and
street drugs are examples.

Special role of the kidney

1. Remove from the blood the metabolic and end-
products from cells,
harmful products detoxified by the liver and drugs
2. Reabsorb water, vitamins, minerals, amino acids and
glucose or may
excrete them, depending on the body’s needs thus
helping with metabolic
balance Routes of Circulation
3. Extra nitrogen from protein catabolism, mainly as This is an auxiliary circulatory system that primarily
urea is excreted by the collects fat particles and fat-soluble substances in the
kidneys for of chylomicrons.
4. If kidneys are not working properly, nutrients are lost
and toxic
substances and drugs are retained which results to a Eventually they will reach the general
diseased condition circulation through the thoracic duct. The Heart is the
5. Kidney function is affected by certain medications driving force for the continuous blood circulation. From
like diuretics, fluid the liver the nutrients will flow to the heart. The heart
balance and renal disease pumps the blood further into the general circulation
6. Adequate fluid intake helps the kidney in its and the nutrients are distributed all over the body.
filtration, reabsorption and Nutrients are brought to the cells of tissues and organs
excretory processes and the whole body is provided with its required
nutrients
Routes of Circulation
Metabolism
Blood Circulation through the portal veins. • Metabolism, the sum of the chemical reactions that
The absorbed water-soluble nutrients enter the small take place within each cell of a living organism and that
blood vessels ( Capillaries) surrounding the intestines. provide energy for vital processes and for synthesizing
The small capillaries of the intestines merge into large new organic material.
vessels and finally into the hepatic portal vein leading
to the liver. The liver is the organ where all nutrients
pass through. Monosaccharides, amino acids,
minerals, water-soluble vitamins, short chained fatty
acids and glycerol will pass through the portal vein of
the liver where metabolism begins
 pyruvate, glutamate to 𝝰- ketoglutarate, aspartate to
Anabolism oxaloacetate on deamination

involves building larger, complex molecules from •Fatty acids undergo 𝞫-oxidation to form acetyl CoA,
smaller, simpler ones, and requires an input which enters the Krebs cycle
of energy.
•It is the major source of ATP production in the cells. A
large amount of energy is produced after complete
Catabolism breaks down larger, more complex oxidation of nutrients
molecules into smaller ones, releasing energy that
can be used by the organism.

•It plays an important role in gluconeogenesis and

lipogenesis and interconversion of amino acids

•Many intermediate compounds are used in the

synthesis of amino acids, nucleotides, cytochromes
and chlorophylls, etc.

•Vitamins play an important role in the citric acid cycle.

Riboflavin, niacin, thiamin and pantothenic acid as a
Kreb’s Cycle
part of various enzymes cofactors (FAD, NAD) and
coenzyme A
The Kreb’s cycle or Citric acid cycle is a series of enzyme
catalyzed reactions occurring in the mitochondrial
•Regulation of Krebs cycle depends on the supply of
matrix, where acetyl-CoA is oxidized to form carbon
NAD+ and utilization of ATP in physical and chemical
dioxide and coenzymes are reduced, which generate
work
ATP in the electron transport chain.
•The genetic defects of the Krebs cycle enzymes are
Significance of Kreb’s Cycle
associated with neural damage
•Krebs cycle or Citric acid cycle is the final pathway of
oxidation of glucose, fats and amino acids
•As most of the biological processes occur in the liver
to a significant extent, damage to liver cells has a lot of
•Many animals are dependent on nutrients other than
repercussions. Hyperammonemia occurs in liver
glucose as an energy source
diseases and leads to convulsions and coma. This is
due to reduced ATP generation as a result of the
•Amino acids (metabolic product of proteins) are
withdrawal of 𝝰-ketoglutarate and formation of
deaminated and get converted to pyruvate and other
glutamate, which forms glutamine
intermediates of the Krebs cycle. They enter the cycle
and get metabolised e.g. alanine is converted to
 This is part of the questionnaire that gets the frequency
NCM 105 | Nutrition and Dietetics food is taken by the patient where patient is ask for the
MODULE 3 frequency. This indicates the quality of food that is
taken by a patient for a period of time.
ASSESSMENT OF NUTRITIONAL STATUS

3. Dietary History
OBJECTIVES
This is more complete than the 24-hour and food
1. Identify methods of assessing nutritional status frequency because it contains additional information
2. Explain the significance and purposes of nutritional such as:
assessment
1. Economics
a. Income
DEFINITION OF TERMS
b. Food Budget
2. Physical Activity
1. Nutritional Status - the degree to which the
a. Occupation
individual's psychological need for nutrients is being
b. Exercise
met by the food the person eats. It is the state of
c. Sleep hours
balance in the individual between the nutrient intake
3. Ethnic and Cultural Background
and the nutrient expenditure or need
a. Eating habits
b. Religion
2. Dietary Intake - refers to the daily eating patterns of
c. Education
an individual, including specific foods and calories
4. Home Life and Meal Pattern
consumed and relative quantities.
a. No. of household members
b. Person who markets
Aspects involved in Nutritional Status c. Person who cooks for the family
Assessment d. Food storage/facility
e. Type of housing
- 1. Dietary history and intake data f. Ability of shop and prepare food
- 2. Biochemical data 5. Appetite
- 3. Clinical examination a. Good.poor, any changes
- 4. Anthropometric data b. Factors that affect appetite
- 5. Psychosocial data c, Taste and smell preparation
6. Allergies
a. Foods avoided
7.Dental and Oral health
Methods of Assessing
a. Problems with eating
Dietary Intake
b. Quality of food eaten
c. problems with swallowing
1. 24-hour Food Recall 8. Gastrointestinal concerns
a. Problems with digestion
The individual is interviewed by a Dietitian or nurse b. Home remedies
who is trained to do dietary interviews and is asked to 9. Chronic Diseases
recall everything that he/she ate within the last 24 a. Length of time of treatment
hours or the previous day. b. Dietary modification
10. Medication
2. Food Frequency Questionnaire a. Vitamin/mineral supplement
b. Medications
 for energy and nutrients including protein,
carbohydrates, fat, vitamins and minerals and for
4. Food Diary or Record other important food components such as fib
This involves time, understanding and motivation.

The most important part of this method is the daily

record of an individual's intake for the whole day.

From the food to the drinks and other miscellaneous

items taken in for the whole day.
FOOD GUIDE

5. Observation of Food Intake

This is a more accurate method of dietary intake
assessment but mostly time-consuming.expensive and
difficult. It requires the amount and kind of food
presented to the person and the record of the amount
actually eaten.
CALORIE CONTENT OF FOOD

NCM 105 | NUTRITION AND DIETETICS Calorie- is a unit of measuring energy that is supplied
by the macronutrients. Amount of the nutrients differ
NUTRITIONAL ASSESSMENT in the amount of energy released in the body

Tools in Nutrition Education 1 gram of carbohydrates = 4 Kcalories

Food Guide 1 gram of Protein = 4 Kcalories
Food Pyramid 1 gram of Fat/Lipids = 9 Kcalories
My Plate
Food Composition Table
Food Labels SAMPLE PROBLEM
Caloric Content of Food
Tools in Nutritional Assessment Laura drank a glass of milk which contained 1
Body Mass Index tablespoon of full cream milk, 10 gm fat, 1 tsp of sugar,
Anthropometric Measurement and 12 oz of water. How many calories does it contain?
Ideal Body Weight,
Weight for Height for Filipinos
Total Energy Requirement 15 gm milk x 4 = 60 calories
Nutrient Allocation 5gm sugar x 4= 20 calories
Food Exchange List 10 gm fat x 9 = 90 calories
Basal Metabolic Rate 170 calories

FOOD COMPOSITION TABLE TOOLS IN NUTRITION ASSESSMENT

Detailed sets of information on the nutritionally

important components of foods and provide values
Anthropometry - the scientific study of the
measurements and proportions of the human body.
Also it uses body measurements to assess nutritional
status. It is a practical and applicable technique for
assessing children's development patterns during the
first years of life. An evaluation of their growth also
provides useful insights into the nutrition and health
situation of entire population groups.

Weight Height IDEAL BODY WEIGHT

Arm circumference
Wrist circumference Ideal Body Weight - is the optimal weight associated
(For Infants and toddlers) with maximum life expectancy for a given height.
Head Circumference
Chest circumference
Short cut Method:
Methods of Assessing For men, ideal body weight is calculated by using 106
Dietary Intake
pounds for the first 5 feet of height and adding 6
additional pounds for each inch.
Weight Height
Arm circumference
Wrist circumference For women, the ideal body weight calculation starts
(For Infants and toddlers) with 100 pounds for the first 5 feet of height, then you
Head Circumference add 5 pounds for each additional inch. If you're under
Chest circumference 5 feet tall, subtract 2 pounds for each inch under 5 feet.

HEAD CIRCUMFERENCE
Head circumference is Measurement of head Tannhauser's Method:
circumference measured over the most prominent Height in ft /12 inches = ht in inches x 2.54 = ht in cm -
part of the occiput and just above supraorbital ridge 100 (-10%) = IBW in kg x 2.2 =
• Use a flexible, non stretchable tape IBW in lbs
• Position the tape just above the eyebrows, above the
ears & around the biggest part on the back of the head
Pull tape snugly to compress the hair SAMPLE COMPUTATION FOR IBW

Short cut Method:

Derek is 5'9 tall. What is his IBW

for the first 5ft. = 106

6 lbs/in of ht (×9) = 54
160 lbs

Short cut Method:

Lorie is 5'2" tall. What is her IBW

For the first 5 ft = 100

5 lbs/in. of ht (x2) = 10
110
 61%-75% = 2nd degree undernourished
Tannhauser's Method: 60% and below = severely undernourished

Sample problem:

Derek's IBW is 160 lbs and his actual weight is 175 lbs.

Actual Weight/IBW = 175 1bs/1601bs = 1.094 x 100 =

109.4% (N)

BODY MASS INDEX

TOTAL ENERGY REQUIREMENT

Body Mass Index - a value that is derived from the mass
and height of a person. It is an estimate of body fat that Total Energy Requirement of an individual is the
is based on your weight and height. Flaws of the BMI is
number of K cal necessary to replace daily basal
that it does not take into account age, sex, race and metabolic loss in addition to loss from exercise and
muscle mass. other physical activities.
Compute with actual weight.
Activities per level of activity

Sedentary - bedridden
Very light (standing, walking)
Light (walking up to 3mph; housecleaning)
Moderate (walking 3.5-4 mph), teaching f2f, clerical
jobs, nurses, Executives
Heavy (heavy house cleaning, sports, stevedoring,
farmers, fishermen and doing hard labor

Meaning of BMI Score:

Underweight <19
Normal 9-<25
Overweight 25-<30
Mild Obesity 30-<35
Moderate Obesity 35 - <40 FACTORS AFFECTING TER
Extreme Obesity >40
1 Age-during the growth period, the BMR is high,
therefore during infancy the energy need per kg of
body weight are highest than at any phase in life
2.Sex - BMR is higher in adolescent boys and adult
NUTRITIONAL STATUS BASED ON IBW
males as compared to adolescent girls and adult
females. It is not due to direct influence of sex
Nutritional Status = Actual Weight/ IBW
differences, but is due to the differences in body
composition.
Reference Table:
3. Body size -It will have an important effect on energy
90%-110% = Normal
needs because a larger body has a greater amount of
76%-89% = 1st degree Underweight/undernourished
muscles and glandular tissue to maintain, thus
requiring higher energy allowances TER = 3,400 calories
4. Climate-It is known that the BMR is lower in tropics СНО = 3400 x 65% = 2,210/4 calories = 550 calories
than in temperate zones. Hence the energy cost of Pro = 3,400 x 20% = 680/4 calories = 170 gm
work is slightly higher when the temperature falls Fat = 3,400 x 15% = 510/9 calories = 55 calories
below 140C
5. Secretion of endocrine glands-The thyroid gland in EXCHANGE LIST

particular exerts a marked influence on the energy

requirement. If it is over active (hyperthyroidism), the
BMR will increase
6.Status of health-liness involving an elevation of body
temperature markedly increases the basal heat
production thus increasing the BMR, hence increased
energy requirement.
7. Altered physiological activity- During pregnancy and
lactation, the energy needs are increased because of
an elevated BMR.
Food -the increased heat production as a result of the
ingestion of food is known as the specific dynamic
action of the food.
EXERCISE
Any kind of physical activity increases the energy
expenditure above the basal energy need. Tony Esquivel is currently the Chief Executive Office of
the Ayala Construction Corporation. As the CEO, the
BASAL METABOLIC RATE
Chief Operating Officer with the Construction
Engineers report to him directly. He establishes
Basal Metabolic Rate- the rate at which the body uses network for the company. He is 5'8 " in height but a bit
energy while at rest to keep vital functions going, such stocky because he socialises and drinks a lot. He is 195
as breathing and keeping warm. lbs.

Male: (88.4 + 13.4 x weight in kilograms) + (4.8 x height

in centimeters) - (5.68 x age) Requirements:
● Compute his BMI and check the corresponding
score
•Female: (447.6 + 9.25 x weight in kilograms) + (3.10 x ● Compute his IBW using the short and
height in centimeters) - (4.33 x age) Tannhauser's method
● Identify his Nutritional Status
Sample Problem: ● Compute his Total Energy Requirement
Allocate his macronutrient
Male (88.4 +13.4 x68 kg) + (4.8 x 69)- (5.68 x 54) 999.6
+(331.2 -306.72) 999.6+ 24.48 = 1,024.08
NUTRIENT ALLOCATION

Total Energy Requirement is allocated to the 3 macro

nutrients

For a normal person : CHO 65%, Pro 20% Fat 15%

For the diabetic diet : CHO 55%, Pro 25%, Fat 20%