Tutorial: Answer all questions

1. Siti is a 28-year-old university student who has tried numerous weight-loss programs.
Siti mentioned that she tried numerous diets while a teenager, when she weighed 55 kg
for 3 years. She found that weight loss get harder with age, especially when she lived a
sedentary lifestyle. In order for her to achieve her ideal body health, she seeks advice
from a nutritionist. She aims to lose fat weight while maintaining muscle mass.

i) What are the nutritional assessments that determine whether her nutrition is
adequate?

ii) Currently she weighs 70 kg with a height of 160 cm. Determine her ideal weight
and anthropometry and body composition status.

Normal range Value Status

Ideal body weight (kg)
Body Mass
Index(kg/m2)
Body fat (%) 41.0
Waist circumference 85.0
(cm)
Skeletal muscle (%) 20.5
Total Body Water (%) 41.8

iii) As a PhD student, Siti has a hectic lifestyle. Propose recommended daily intakes
for individual nutrient requirements based on the Recommended of Nutrient
Intakes (RNI) of Malaysia.

2. Based on question 1, a 24-hour recall was administered to measure Siti’s dietary intake.
The 24-hour recall provides a complete record of all food and drink eaten on the
previous day between midnight and midnight.

i) A 24-hour recall exhibited the daily amount of calories and nutrients consumed
by Siti. Identify if the nutrient intakes meet the Recommended Nutrient Intakes
(RNI) of Malaysia.

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 Nutrien/Nutrient Jumlah/ Saranan Meet the
Amount nutrien/ % RNI RNI, below
Nutrient the RNI,
recommenda exceed the
-tions, RNI RNI
Tenaga/Energy 3700
(kcal)
Protein (g) 140
Kalsium/Calcium 100
(mg)
Zat besi 11.3
Iodin/ Iodine (µg) 40
Zink/ Zinc (mg) 4.2
Selenium (µg) 12
Thiamin (mg) 0.8
Riboflavin (mg) 0.7
Niacin (mg NE) 10
Folate (µg) 351
Vitamin C (mg) 230
Vitamin A (µg) 900
Vitamin D (µg) 8.3
Vitamin E (mg) 10.1

ii) Calculate her energy expenditure of physical activity in a day.

Aktiviti/Activity Kos tenaga/ Masa (minit)/ Tenaga/

Energy cost Time (minute) Calorie
(kcal/kg/min) (kcal)
Tidur/ Sleeping 1.0 360
Baring/ Lying 1.2 30
Memakai pakaian/ 3.3 10
Dressing
Makan dan minum/ 1.6 100
Eating and drinking
Basuh baju (cangkung)/ 2.8 30
Washing clothes
(squat)
Gosok pakaian/ Ironing 1.7 15
clothes
Menyapu/ Sweeping 2.3 20
Solat/ Praying 1.3 60
Keperluan diri/ 2.9 60
Personal necessities
(ex: Bathing)
Menonton TV/ 1.72 180
Watching TV
Membaca/ Reading 1.25 60

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 Mendengar 1.43 30
radio/muzik/ Listening
to radio/music
Duduk/ Sitting at desk 1.3 300
Berdiri/ Bergerak 1.6
/Standing/moving
around
Menaip/ Typing 1.8 45
Menulis/ Writing 1.4 50
Berjalan/ Walking 2.5 60
around/strolling
Berjalan perlahan/ 3.0 30
Walking slowly
1440

iii) Determine her total energy expenditure (TEE), the total energy expended in a
day from the basal metabolic rate, energy expended in physical activity and the
thermic effect of food.

Wanita umur 18-30 tahun dan lebih berat (BMI≥25 kg/m2)/

Female age 18- 30 years and overweight (BMI≥25 kg/m2)

1. BMR (MJ/day) = 0.0535 (W) + 1.994

(1 MJ= 239 kcal).

2. Physical activity level (PAL)= Energy physical activity ÷ BMR

3. Physical activity coefficient (PA)

PA=1.0 if PAL is estimated to be ≥ 1.0 < 1.4 (Sedentary)
PA=1.16 if PAL is estimated to be ≥ 1.4 < 1.6 (Low active)
PA=1.27 if PAL is estimated to be ≥ 1.6 < 1.9 (Active)
PA=1.44 if PAL is estimated to be ≥ 1.9<2.5 (Very active)

4. TEE=448 - 7.95 × Age (year) + PA ×(11.4 × Weight[kg] +

619 × Height [m])

iv) Identify her energy balance in a day whether it is positive or negative energy
balance.

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3. Based on question 2, Siti desires to achieve her healthy weight within a set time frame
by eating the right amount of food according to her daily energy requirements.

i) Determine a reasonable time frame to achieve her ideal body weight, given that
an ideal weight to lose per week is 2.2 kg (with a deficit of 500 kcal per day).

ii) Plan a 1-day of healthy menu with 2000 kcal daily calorie intake at least 55 to
70% from carbohydrate, 10 to 15% from protein and less than 30% of calorie
from fat (refer to APPENDIX Nutrient Composition Table).

iii) Evaluate percent (%) of energy nutrient in the planned menu to verify if the menu
is balanced according to 55 to 70% of carbohydrate, 10 to 15% of protein and
less than 30% of fat.

4. Based on question 3, Siti knew that she had to exercise in order to balance the energy
intake from foods for weight loss.

i) Compare the duration needed to exercise for each of Siti’s favorite weight loss
workouts (ideal calorie deficit a day is 500 kcal) and suggest the quickest
exercise to burn the calorie.

Types of workout Energy cost Energy cost for Duration of

of workout her weight, 70 exercise to
(kcal/kg/hour) kg (kcal/hour) burn 500 kcal
(hour)
Angkat berat litar/ 6.1 427
Circuit weight lifting
Latihan litar/ 6.29 440
Circuit training
Regangan 2.0 140
static/Static stretching
Regangan dinamik/ 3.0 210
Dynamic stretching
Berenang/ 8.0 560
Swimming
Menari/ 5.09 356
Dancing
Berlari/ 6.55 459
Running
Bola tampar/ 6.06 424
Volleyball

4
 Tenis/ Tennis 5.92 414
Menari aerobic/ 6.9 483
Aerobic dancing
Berjalan laju/ 3.0 210
Brisk walking
Turun naik tangga/ 7.6 532
Walk up the stairs
Berjalan ke kelas/ 2.5 175
Walk to the class
Mencabut rumput/ 2.9 203
Weeding garden
Menyapu/ 3.6 252
Sweeping
Kerja rumah/ 2.8 196
Housework chores
Mengemas katil/ 3.4 238
Bed making
Cuci lantai/ 4.4 308
Mopping/washing
floor
Mencuci tingkap/ 2.8 196
Window cleaning

ii) Explain how you may help to achieve her exercise goal as specified by the
Physical Activity Pyramid from the Malaysian Dietary Guideline based on
duration, recommendation and types of activity listed in question 4 (a).

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 APPENDIX: Jadual Komposisi Makanan/ Nutrient Composition Table

Makanan/ Food Saiz Jumlah Karbohidrat/ Protein Lemak/

hidangan/ tenaga/ Carbohydrate (g) Fat
Serving size Total (g) (g)
calories
(kcal)
SARAPAN/ BREAKFAST

1. Bubur ayam/Chicken 1 mangkuk/1 214 30 10 7

porridge bowl
(95 g)
2. Mihun sup ayam/ Chicken 1 mangkuk/1 189 44.5 7.4 2.87
soup meehoon bowl
(95 g)
3. Nasi goring bilis/Fried rice 1 plate/1 637.8 86.9 16.2 25.1
with anchovies pinggan
(345 g)

MAKAN TENGAH HARI DAN MAKAN MALAM/ LUNCH AND DINNER

Nasi/Rice 1 mangkuk/1 195 45 3.6 0.3

bowl
(150g)

Lauk/Entree
1. Ayam kurma/Kurma chicken 1 ketul/1 piece 186.6 3.7 15.7 12.1
(100g)
2. Ayam goring 1 ketul/1 piece 197.4 1.58 20.42 12.1
berempah/Goreng (166g)
berempah chicken
3. Daging masak hitam/Masak 5 kotak 198.7 14.23 20.7 6.632
hitam beef mancis/ 5
match boxes
(153.7g)
4. Daging masak 4 kotak 197.5 8.2 20.97 9.14
merah/Masak merah beef mancis/4
match boxes
(127.1g)
5. Ikan kembung goreng 1 ekor 225.74 1.055 23.05 14.323
kunyit/Fried mackerel sedersiti/1
spiced with turmeric medium piece
(121.89g)
6. Ikan bawal putih asam 1 ekor/1 piece 91.83 3.59 12.36 3.13
pedas/ Asam pedas white 77(149.21g)
pomfret

Sayuran/Vegetables
1. Sayur campur/ Mixed 1 cawan/1 cup 107.48 13.027 2.708 4.88
vegetables (93.64g)
2. Ulam raja 1 cawan/ 1 15.3 0.51 2.46 0.33
cup
(85.04g)
3. Ulam selom/ Pennywort ½ cawan/ ½ 7.79 1.32 0.33 0.12
cup

6
 (30g)
4. Timun/Cucumber 1 cawan/1 cup 13.6 2.89 0.426 0
(85.04g)

Snek/ Snacks
1. Kismis/Raisins 1 sudu 62 15 0.5 0.1
makan/1 table
spoon (21g)
2. SUBWAY sweet onion 1 sandwich 6- 370 59 26 5
chicken teriyaki sandwich 6 inch
inch (281g)
3. SUBWAY classic tuna 1 sandwich 6- 530 45 22 31
sandwich 6 inch inch
(250g)
4. Sandwich salad 2 keping/2 405.5 16 32 23.4
ayam/Chicken salad pieces
sandwich (141.7g)
5. Sandwich salad telur/ Egg 2 keping/2 278.462 27.9 10.6 13.5
salad sandwich pieces
(126.1g)
6. Roti bun ikan bilis/ 1 bungkus/1 222 189 34.6 7 6.1
Anchovies bun piece
(65g)
7. Kuih bingka ubi 1 biji/1 piece 88.6 17.8 0.4 1.8
(40g)
8. Kuih apam 1 biji/1 piece 52.1 12.2 0.6 0.11
(27g)

Minuman/Beverages (1 gelas/1 glass)

1. Mineral water 0 0 0 0 0
2. Teh cina/ Chinese tea 0 0 0 0 0
3. Jus jambu batu/ Guava juice ½ biji 65 14.1 1.56 0.28
(141.7 g)
4. Jus epal/ Apple juice 1 biji/1 whole 55.5 12.9 0.42 0.28
(141.7 g)
5. Jus betik/ Papaya juice 1 potong/1 49.6 10.05 2.12 0.14
slice
(141.7 g)
6. Jus celery/Celery juice 2 batang/ 2 11.2 2.3 0.5 0.13
stalks
(80 g)
7. Jus salad/ Salad juice 3 helai/3 14.2 2.7 1.0 0.2
leaves
(84 g)
8. Jus lemon/ Lemon juice 1 biji/1 whole 21.6 11.5 1.2 0.3
(108 g)
9. Jus oren/ Orange juice 1 biji/1 whole 64.3 16.097 1.2 0.16
(136.9 g)
10. Jus timun/Cucumber juice 1 batang/1 13.6 2.89 0.426 0
whole
(85.04 g)