MATERIAL 2 - NUTRIENT DENSITY  If the body does not use these nutrients to fuel its current activities, it

 refers to the concentration of nutrients in a given amount of food source rearranges them into storage compounds (such as body fat), to be used
relative to its caloric content.  between meals and overnight when fresh energy supplies run low 
 consider calories from CHO, fats, protein, vits and minerals and water. The  If more energy is consumed than expended, the result is an increase in
higher the nutrient density, the greater the nutritional value in a small energy stores and weight gain. 
amount of food.   If less energy is consumed than expended, the result is a decrease in
energy stores and weight loss 
CALORIE   If alcohol can be consumed in excess can be converted to body fat and
 represents the energy measurement of nutrients that foods provide.  stored. 
 the energy released from CHO, fats and proteins can be measured in
calories.  MATERIAL 3 - CALCULATE THE ENERGY AVAILABLE:
Energy is expressed in 1000 – calorie metric units known as kilocalories To calculate the energy available from food, multiply the number of grams of CHO,
(shortended to kcalories/kcal, but commonly called “calories”  CHON and fat by 4, 4 and 9, respectively. Then add the results together. 
 Kilojoules (kj)- It is the international unit of work energy.  example:
 1 kcal is equal to 4.2 kj.   Calculate the energy available from foods. 
1 slice of bread w/ 1 tbsp of peanut butter
When CHO, FATS AND PROTEINS completely are broken down in the body: (by - which contains 16 grms CHO, 7 grms CHON and 9 gms fat. 
the process of metabolism):   From this you can calculate the percentage of kcal each of the energy
The fuel factor of CHO- is 4 kcalories/gram.  nutrients contributes to total. To determine the kcal from fat, for example,
 Protein – also yields 4 kcal/gram  divide the (kcal from fat) by the total  kcal (total calorie of the snack) 
 Fat -yields 9 kcal/gram.  ANSWER
 Alcohol – yields 7 kcal/gram  16gms CHO x 4 = 64kcal= 37% 
 Fat therefore, has a greater energy density than either CHO or CHON.  7gms CHON x  4 = 28= 16% 
9gms FAT x 9 = 81=47% 
ENERGY DENSITY Total    = 173 kcal
 is a measure of the energy a food provide relative to the amount of food.  
(kcalories per gram).  PERCENTAGE
 -Foods high in energy density help w/ wt.gain, whereas those w/ a low - divide the 81kcal by the total 173 kcal: 
energy density help w/ wt. Loss.  81 fat kcal / 173 total kcal = 0.468 
 (rounded to 0.47) Then multiply by 100   
Alcohol is not considered a nutrient bec it can interferes w/ growth, maintenance  to get the percentage: 0.47 x 100 = 47% 
and repair of the body but it does yield 7 kcal per gram when metabolized in the  Dietary recommendations that urge people to limit fat intake to 20-35 % of
body.  kcal refer to the day’s total energy intake, not to individual foods. 
 Still, if the proportion of fat in each food choice throughout a day exceeds
BOMB CALORIMETER 35% of kcal, then the day’s total surely ,will, too. 
 Bomb calorimeter can be used to determine the calorie content of a  Knowing that this snack provides 47% of its kcal from fat alerts a person to
product.  the need to make lower-fat selections at other  times that day. 
 It is used in food and metabolic studies to examine the effects of energy
content in food on humans and animals.  HOUSEHOLD MEASURES 
  -Cups, quarts and teaspoons 
ENERGY IN THE BODY 
 the body uses the energy-yielding nutrients to fuel all its activities. METRIC MEASURES 
   -Millilitres, liters, and grams
 sends electrical impulses thru the brain and nerves.
 to synthesize body compounds and to move muscles.
WEIGHT : GRAMS (g)  VOLUME   Food preference = spicy foods, sweetness of sugar and the savoriness of
1 g = 1000 mg  -1L = 1000 ml  salt. High fat foods. curry spices of Indian cuisine. 
1 g = 0.04 oz  -0.9L = 1 quart   Habits = choosing food out of habit = ex. Eating cereal every morning, bec
1 oz. = 28.35 g or 30 g  -1ml =0.03 fld. Oz  they always eat cereals for b-fast. Eating a familiar food makes them
100 g = 3 ½ oz.  -240 ml = 1 cup comfortable 
1 kg = 2.2 lbs   Evaluate dental and oral health- problems w/  eating, foods that cannot be
454 g = 1 lb  eaten, problems w/ swallowing, salivation 
 Consider economic status –income, amount of money for food each week
MATERIAL 4: NUTRITIONAL STATUS or month.= people eat foods that are accessible, quick and easy to
a measurement of the extent to w/c an individual’s physiologic need for prepare and w/ in their financial means. 
nutrients  is being met.   Evaluate physical activity level – occupation(type, hours/week,shift, energy
expenditure), Exercise(type amount, frequency), Sleep ( hours/day
NUTRITIONAL  ASSESSMENT ,uninterrupted?),handicaps. 
 Provides the information needed for identifying nutrition problems and  Determine home life and meal patterns – Number in household (eat
designing a nutritional care plan.  together?), person who buy food, person who does cooking, food storage
 It identify clients at risk for malnutrition/ those w/ poor nutritional status  and cooking facilities (stove, refrigerator), type of housing 
 This information can be obtained from  the Medical, Social and Diet (home, apartment, room) 
histories,  Anthropometric data, Biochemical data and Clinical data.   Assess gastrointestinal conditions – problems of heartburn, bloating,
 This is a part of routine exam done by a RD/other health care diarrhea, vomiting,constipation, frequency of problems, antacid, laxative or
professionals trained in the diagnosis of at risk individuals – doctors/ other drugs. 
nurses.   Consider presence of chronic disease – treatment, length of tx, dietary
modification including physician prescription, date of modification,
DIET HISTORY education, compliance w/ diet. 
 dietary evaluation would provide information w/ regards on client’s food  Evaluate recent weight change – loss or gain, how much, over what length
habit, usual food pattern, likes and dislikes and type of meals eaten for a of time, intentional or non-volitional 
long period of time, because these information would help the examiner to
determine any nutritional deficiencies or excesses.  FOOD FREQUENCY 
 a record of how often the diff foods are eaten. The types (and sometimes
Contents of Diet History of Adults:  the amount, its preparation) of foods a person routinely consumed in a
 Check appetite – good, poor, any factors that affect appetite, taste and week or a month can be taken. 
smell perception 
 Ask for allergies, intolerances or food avoidances – foods avoided and 24-HOUR RECALL – done by dietician. Listing the types, amounts and
reasons, length of time of avoidances  preparation of all foods eaten in past 24 hours 
 Anthropometry – ht, wt, skin-fold, etc. 
 Take 24 hour dietary recall or food frequency checklist  FOOD DIARY – written record of all food and drink ingested in a specified period-
 Consider ethnic and cultural background – eating habits and food for about 3-4 day period. 
preferences and religion  - but some clients are not truthful and tend to forget the food they had eaten. 
= people eat the foods they grew up eating. Every country or every region - may include records of behaviours / emotions and symptoms, physical activities
of a country, has its own typical foods and ways of combining them into meals.  and medications 
=American diet or even Filipino diet includes many ethnic foods from diff - Medications may decrease the desire of food, absorption of nutrients, metabolism
countries, all adding variety to the diet. Ex. Chinese, Italian, Korean, Japanese.  of nutrients . 
 consider religion = for examples, some religious sect forgo meat during e.g antihistamines-dec saliva causing dry mouth and loss of appetite. 
lent, the period prior to easter.  e.g aspirin (controls pain and fever and for blood thinning) – a gram of which
Muslims fast between sunrise and sunset during Ramadan.  increases the taste perception of bitterness.
  FORMULA : BMI = W (in kilos) 
ANTHROPOMETRIC MEASUREMENT                           H (in meters)² 
= the science of measuring the size, weight and proportions of the human body.   Constant: 5 ft = 1.524m 
= may reveal a failure to thrive in children                    4 ft = 1.2192m 
= it reflects a nutrient deficiencies or excesses.                  1 inch = 0.0254m 
= includes the height, weight, head circumference, upper arm, skin fold and chest  Example : H = 5’ 3” 
circumference (for children).                   W= 62kgs 
 HEIGHT AND WEIGHT – useful in determining nutritional status in adults     62kg/(1.6)²  = 62/2.56 = BMI = 24.22 
- It is a good indicator of satisfactory diet and recent food intake. 
 HEIGHT – is a less sensitive indicator of current nutritional status than WHO TABLE
weight – for – age  since height does not decrease but simply slows down CLASSIFICATION BMI (kg/m2 ) RISK OF
in times of nutrient deprivation.  COMORBIDITIES
 WEIGHT – is a sensitive marker of current nutritional status.  Underweight <18.5 Low (^ risk of other
- Reflects an immediate inability to meet nutritional requirements clinical problems)
and this may indicate nutritional risk.  Normal >18.5 – 24.9 Average
Overweight > 25
DESIRABLE BODY WEIGHT  Pre-obese 25 – 29.9 Increased
– is also known as Ideal or reference weight but it is more appropriately Obese I 30 – 34.9 Moderate
called the healthy weight. Obese II > 30 Severe
- It is the weight found statistically to be most compatible w/ health Obese III 40+ Very severe
longevity. 
BMI OF ADULT
VALUES CATEGORY
MATERIAL 6 :TANNHAUSER’S METHOD 
>20 Normal
     Procedure : 
- 20.0 Marginal
 Step 1 : DBW (K) = HEIGHT (CM) – 100 
> 17 – 18.5 Mild Malnutrition
 Step 2 : Deduct 10% - if a Filipino unless frame size is known 
      Example:  Subject: 5’2”female (5’2”- 157.48cm)                          16 - 17 Moderate Malnutrition
  Step 1 : DBW (K)=157.48cm – 100 = 57.48 kilos  < 16 Severe Malnutrition
Step 2: 57.48 kilos less 5.748(10%) = 51.7 or 52kg 
OBESITY CATEGORIES INTO 3 BMI GRADES:
CONVERSION AID:      GRADE I – 25 to 29.9
1 foot – 12 inches            1 inch – 2.54 cm                                            GRADE II – 30 TO 40
1 m – 100cm  GRADE III – 40+
ACTUAL BODY WEIGHT: IN GENERAL : OBESITY - IS BMI of 27 or more.
 May be influenced by changes in the person’s fluid status.  - indicates high risk of developing health problems.
 weight measurement obtained at the time of examination  - weight 20% above average.
DESIRABLE BODY WEIGHT:
  UNDERWEIGHT – BMI less than 18.5 – 10 to 15% below ave
– is also known as Ideal or reference weight but it is more appropriately
 OVERWEIGHT - BMI between 25-29 – 10 to 20% above ave.
called the healthy weight.
 HEALTHY – BMI between 18.5 – 24.9
- It is the weight found statistically to be most compatible w/ health
 BMI TEND TO INCREASE WITH AGE.
longevity. 

OTHER PARAMETERS OF ASSESSING NUTRITIONAL  STATUS

 BMI is computed thru METRIC FORMULA