WMSU-ISMP-GU-001.

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Effective Date: 7-DEC-2016

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Filipino Culture, Values, Practices, and Beliefs Applicable in Nutrition
Lesson 09

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Introduction:

The existence of various ethnic and regional groups in the Philippines somehow
gives rise to variations to the general diet pattern, each having its own special tastes, food
preferences and preparation techniques.
Nevertheless, there are some practices that have been observed to be common across
regions. These include the use of rice as the major staple (replaced by corn in some areas in
the Visayas and Mindanao), the use of patis (fish sauce), soy sauce in cooking or dipping
sauce, and the preference for boiling and stir-frying (sautéing in a small amount of fat) as
cooking methods.
All of these was brought about on the Filipino Culture, Values, Practices, and Beliefs
that are applicable in Food and Nutrition.
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Objectives:

At the end of the lesson, YOU can:

Discuss the importance of diet therapy on patients care.
Describe the various Filipino Culture, Values, Practices, and Beliefs applicable in Nutrition
Discuss Core Values of Nursing as applied to Nutrition Dietetics.
Determine the Entrepreneurship Opportunities on Nutrition and Diet Therapy.

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Topic Outline:

Filipino Culture, Values, Practices, and Beliefs applicable in Nutrition

A .Cultural Aspects of Dietary Planning
B. Filipino Dietary Practices
C .Core Values of Nursing as applied to Nutrition Dietetics
D. Entrepreneurship Opportunities on Nutrition and Diet Therapy.

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Try this!
Direction: List down and Discuss the following in terms of your own culture, values,
practices, beliefs, and habits RELATED TO NUTRITION.
You may ask your elders, parents, siblings, relatives, etc. about your own concept in
nutrition.
CULTURE VALUES PRACTICES BELIEF HABITS
1. 1. 1. 1. 1.
2. 2. 2. 2. 2.
3. 3. 3. 3. 3.
4. 4. 4. 4. 4.
5. 5. 5. 5. 5.

Remarks:___________________________________________________________________
___________________________________________________________________________
______________________________.

Answer Key Sheet

Name:___________________________________ Score:________
Course/Year:_______________________________ Date:_________

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Think Ahead!
Direction: Discuss the following questions below.

1.Discuss the relationship in
the study of Food, Nutrition
and Diet therapy to the
Nursing Course Curriculum.
3.How Nutrition can
protect the person during
this Pandemic Crisis of
COVID-19 Virus; or
4..Suggestions to have
2. Discuss the Challenging an alternative Source of
Role of Nurses during this Income to augment
Pandemic Crisis of COVID- financial needs for the
19 Virus. Family and not just
dependent on the
Government and Non-
Government
organizations aides,
hence, during this
Pandemic Crisis of
Or Advise to protect COVID-19 Virus.
oneself against COVID – 19
Virus relating to nutrition.

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Answer Key Sheet

Name:___________________________________ Score:________
Course/Year:_______________________________ Date:_________

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Read & Ponder!

A.Traditional Foods and Dishes

The food and culture of the Philippines are largely influenced by Spanish, Chinese and
American traditions. White rice is the main food in the diet and it is usually served three times per
day. Fish is the primary protein source in the diet. Vinegar, soy sauce, salt, fish sauce and fermented
fish are traditional flavorings used in Filipino cuisine.
Philippine adobo is often dubbed the national dish, but varies from the adobo served in
other cultures. In the Philippines, adobo refers to foods stewed in a broth of garlic, vinegar, bay leaf
and peppercorns and is made with chicken, pork or both.
Current Food Practices:
Rice and fish are still the staple foods in the Philippines. Many families have gardens.
Traditionally, a clay pot is used for steaming rice and stewing other foods. A kalawi (similar to a
wok) is commonly used for sautéing. Courses of a meal may be served consecutively, if Spanish in
origin, or simultaneously, including dessert, if the dish is of Philippine origin.
Generally, the eldest male starts the meal, and others follow. Because soups, stews and
mixed dishes are common, spoon and forks are frequently used, but knives may not be present on
the table.
Typically, three meals and two snacks, one mid-morning and one mid-afternoon, are
eaten daily.
Daily Food Selection
The food and drink that a person regularly consumed comprised what is called diet. Occasionally,
an individual follows a special diet, which is a selection of food based on health conditions or disease
management goals. Low calorie diet for weight control and low salt diet for managing blood
pressure are a few examples. Ideally, whether it is typical food consumption or a special diet, it
should follow the principle of a balanced diet. A balanced diet provides the recommended amounts
of essential nutrients.
The Dynamics of Food Choices:
Eating is more than just physiological. It is a means of meeting social and emotions` needs of
individuals and families. Health care providers who make changes in their patients': food choices
for health reason must understand the numerous factors affecting the way they eat. Food behavior
is greatly influenced by his habit, Preferences, food availability, convenience, culture and
upbringing, social pressure and advertising, health beliefs, medical conditions, body image, and
emotional state. When giving dietary advice, these factors must be kept in mind and
recommendations must be tailored accordingly.

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• . People select foods which they can afford to buy, which are readily available, and do not
require much time to prepare or cook. In today's modern lifestyle, foods that are fast and delicious
are frequently chosen.
• Social pressure. Social pressure operates in all circles and across all cultural lines. Close
friends share similar food choices. Special occasions are associated with the serving of specific
foods and it is often impolite to refuse food or drink offered by a host.
• Culture and tradition. Each area of the world and every region of a country has own typical
foods and ways of combining them into meals. Religious rules about foods can further dictate the
composition of diet. Many Muslims refrain from eating pork and beef of unknown origin. Some
Jewish people do not eat pork or serve milk products and meat at the same meal. There are also
areas of the world that have ethnic taboos. For instance, Swedish people who regard corn as food
for hogs would not enjoy an ear of sweet corn. Silk worms (in Thailand) and insects (in Africa) are
rejected almost completely as foodstuffs in the United States, whereas some other cultures regard
them as choice foods.
• Advertising. Commercial ads and packaging of the food industry are quite successful in
enticing the public to choose certain foods. Food producers spend enormous amount ro money on
marketing and promotion in order to create demand for their merchandise.
• Body image. People may opt for food that they link with ideals of body image.
• Medical conditions and health beliefs. There are health conditions and their treatments that
limit the foods a person can select. A client with hypertension might need to adopt a low sait diet.
The chemotherapy for treatment of cancer can interfere with the person's appetite.
• Emotional state. Some individuals eat in response to emotional stimuli such as boredom,
anxiety, and depression.
Regardless of reason, a person's doily food choices may benefit or harm his body's health only a
little; but when these choices are repeated over the years, the reward or cost become major. Close
attention to good eating habits throughout developmental stage of life to early adulthood can bring
health benefits later. Ideal foods should be nourishing, provides satiety value, prepared under
sanitary conditions, free from harmful and toxic agents, have aesthetic factors (i.e. color, aroma,
flavor, etc.) that satisfy a person, and offer variety and considerations of the socioeconomic status
of the individual.
Factors that affect diet:
1.Geography
This is considered one of the most important factors that play a huge role in determining what people
eat, as it dictates what they are able to access. The Philippines, being an archipelago, is surrounded
by different bodies of water making seafood one of the main dishes in Filipino diet. There is also a
great variety of land animals such as the water buffalo (carabao) and pigs that were consumed due
to the Philippine landscape. Vegetation and planting was also possible due to rich tropical soils
present.

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2.Climate/temperature
In the Philippines, even though temperature differences are minimal, it still produces significant
differences. These include vegetational differences and difference in forest species distribution as
well as some properties of wood. Vegatational differences involve tropical plants that tend to grow
in lower altitudes and plants mostly found in middle latitudes that grown in high altitudes such as
Baguio.
3.Precipitation
The quantity and seasonality of rainfall greatly affects the distributional patterns of the natural
vegetation often determining the kind of landscape as well as the species that will be present. In the
Philippines, water availability also affects the selection of crops to be planted, for example, rice
versus corn. Tropical soils are also greatly affected by differences in the availability of moisture.
Food sources:
Five crop plants form the bases for agricultural patterns in the Philippines.
Rice:
This includes rice, corn, yams and sweet potatoes, banana and coconut. Rice and banana are almost
always present in the agricultural landscape and agricultural combinations include one or both crops.
As food staples, three crops dominate - rice, corn, and yam-sweet potato group. Other crops are
considered as complements, snack foods or seasonal.
Vegetable Crops:
Much of the practice were introduced by the Spaniards, Chinese or Americans. Some of the most
popular vegetables planted are eggplant, taro (gabi), squash, mung bean, ampalaya and patola.
However archaeological evidence of charred vegetable matter on porcelain plates is possible
evidence of wide of vegetables in the Filipino diet.
Fruit and Nut Crops:
This group is composed of native plants that are found growing in wild areas and non-native plants
that have been repeatedly introduced over time. The fruits and nuts sector hasn't been a dominant
presence as a food staple but instead it has been considered a complement.
Beverage Crops:
The closest thing the Philippines has to a traditional national drink is tuba. The tuba is made by
collecting milk from green to ripe coconuts and slightly fermenting the coconut sap and variably
dying it with mangrove bark but this has to be made daily and consumed immediately.
Poultry and fish are the main sources of meat:
Pigs, chicken and water buffalos (carabao) are not only of importance to the Philippine rice economy
but are also consumed by many Filipinos. But because the Philippines is located in the Indo-Pacific
realm, the greatest center of fish life, the country is one that shares in this rich aquatic resource with
a total of more than 21,000 species of fishes known to frequent its waters.

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Livestock and Poultry

Pigs, chicken, goats, deer water buffaloes and others dominate food consumption but there has also
been the presence of ducks and geese as these are also present in southeast Asian mainland and
therefore also the Philippines.
Fish and Other Seafoods
The traditional and basic Filipino diet is rice and fish. Fish and fish products supply the bulk of the
protein consumed and fish appears daily for more the one-half of the Filipinos.
PLANNING A HEALTHY DIET:
Principle of Planning
Eating right plays a vital role in keepiny the body healthy and active. Carefully planned meals
deliver sufficient amount of all the vital nutrients. A nutritious diet has five elements: adequacy,
balance, calorie control, moderation, and variety. A diet is well planned if it has enough essential
nutrients, is balanced with regard to food types, offers energy value that matches energy spent in
activity, is moderate in unwanted dietary constituents, and offers an array of selections.
• Adequacy. The foods chosen provide enough of each important nutrient, fiber, and energy.
• Proportionality. Any food can be part of a healthy diet as long as the overall intake
throughout the day or week gives enough of all the nutrients needed. Balance allows all foods into
a healthy diet. The choices do not overemphasize one nutrient or food type at the expense of another.
There is no such thing as good food or bad food — only healthy diets and unhealthy diets.
• Calorie control. The foods provide the amount of calories a person needs to sustain
appropriate weight.
• Moderation. This means having enough but not in excess of what is needed. The foods
should not provide extra fat, salt, sugar, alcohol, or other unwanted constituents.
• Variety. The foods chosen differ from one day to the next. Eating a variety of foods helps
ensure an adequate nutrient intake. Variety means selecting foods from different food groups as well
as choosing diverse foods from within each food group. An assortment of foods chosen each day
also makes the diet more interesting in appearance, aroma, texture, and palatability.
• Nutrient-density. Select foods that deliver the most nutrients for the least amount of food
energy.
Meat Pattern and Desirable Eating Practices
Common obstacles to people adopting healthier eating habits are lack of time, irregular work/study
hours, and a busy life. But despite of this reality, there. are still ways to make healthy food choices.
Health professionals can help a lot in empowering individuals to learn about the range of healthy
food options. Changes, however, should be taken in smell steps and stages over a few weeks to
ensure success in all efforts.
• Meal pattern is an important element of healthy eating. Meals refer to breakfast, lunch, and
supper. Food consumed in-between meals is called a snack. Meals and snacks should be eaten on a
regular basis, usually an interval of 3 to 4 hours.
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When planning meals, one must keep in mind the nutritional needs of the client, his or her likes and
dislikes, the budget, the preparation time, and variety in flavor, aroma, color, and shape of foods
(see inbox for sample menu evaluation checklist).
Proper writing of menus is essential particularly when planning meals for other people. The
following are some hints in menu-writing:
(1) capitalize all words except articles and prepositions;
(2) list the foods according to the meal pattern, or usually, in the order in which they are to be served;
3) items like butter, cream, sugar or salad dressing are not written on menu unless they are
particularly interesting, e.g., Fruits Slices with Honey and Low-fat Cream; and
(4) special accompaniment of a menu item may be written on the right side, e.g., Crispy Chicken
with Barbecue Sauce.
Menu Evaluation Checklist:
• Is there variety In food choices?
• Are the serving portions appropriate for the client?
• Is there variety in food color, texture, and shape?
• Is the choice of cooking method simple or limited to few complicated dishes?
To meet specific nutrient needs of individuals, health professionals should use dietary
recommendations, food guides, and food labels to plan menus (these tools are explained in the next
topic). Aside from promoting better choices, food guides such as the Food Pyramid, offer
information on the daily serving needs for each food group.
Starting the day with a breakfast may be particularly important. Eating nutritious breakfast is the
key to, a healthier mind and body. Evidence showed that people who eat breakfast have more
strength and stamina, better concentration and productivity throughout the morning. Even more,
they are less likely to get overweight, have lesser risks of infection,. diabetes, and cardiovascular
diseases.
Tools in Designing a Healthy Diet :
A nutritionally satisfactory diet is based on a wise selection of a variety of foods in recommended
amounts. To successfully design such diet, certain tools offer guidance in food selection. Frequently
used tools are briefly explained in the following presentations. They are applicable for healthy
individuals and often serve as a basis for diet modifications in case of illness.
Some ethnolinguistic groups and their diet:
Bontoks
Rice is considered as the main produce of the Bontoks but during the dry periods from February to
March when rain is scarce, they usually consume camote, corn and millet as alternative for rice.
Ibaloys
Because of fertile soils and climate of Benguet, the Ibaloys are predominantly farmers.
Ikalahans

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Similar with the Ibaloys, the Ikalahans plant and consume this variety of rice in limited areas.
Camote, gabi, beans, bananas, ginger and other fruit trees are also planted. Animals consumed
include wild pigs, deer, birds, wild chickens and fishes.
Ifugaos
The basic meal of the Ifugaos is composed of a staple starch, more commonly rice as it is their staple
food, served with dishes like vegetables, fish or snails, flavorings, and sometimes, cooked animal
meat like chicken and pig.
Isnegs
The isnegs traditionally only consume two meals a day; one in the mid-morning and one in the late
afternoon, or one at noon and the other in the evening.
Kalingas
Due to the availability of water, two planting seasons are possible in the kalingas rice terraces. They
plant three varieties of rice namely onoy, oyakand dikit/diket.
Kankana-eys:
Northern
Wet rice agriculture is their main economic activity with some fields toiled twice a year while other
only once due to too much water or no water at all. There are two varieties of rice called topeng
which are planted in June and July and harvested in November and December, and ginolot which
are planted in November and December and harvested in June and July.
Southern
Although southern kankana-eys also engage in wet rice agriculture, the chief mains of livelihood is
hunting and foraging.
Tingguians/Itnegs
Just like in most parts of the Philippines, rice is extensively grown in the province. There are two
types of practices for rice cultivation namely wet-rice cultivation and swidden/kaingin.

B.Core Values of Nursing as applied to Nutrition Dietetics:

Nutrition is a vital component of care and thus a programme of nutritional education
should be evident in all pre-qualifying educational programmes. Relevant aspects of nutrition
should also be included within post-qualifying programmes. Nutritional care is a multidisciplinary
undertaking and the roles of other health care professionals need to be emphasised. Indeed, a post-
qualifying programme of nutritional care, open to all health professionals, would serve to underline
its importance to the improvement and maintenance of health and patient care.
Registered Nurses:
The registered nurse coordinates patient care, works with the dietitian and other health care
team members to identify nutrition problems, and reinforces the importance of nutrition
interventions. The registered nurse may also provide less complex nutrition care, such as counseling
on preventing chewing and swallowing difficulties or contributing to the nutritional assessment.
Nurses can be certified as a Certified Nutrition Support Nurse by the National Board of
Nutrition Support Certification, associated with the American Society of Parenteral and Enteral

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Nutrition. Depending upon their level of preparation, experience, and practice area, research
indicates that nurses have variable amounts of nutrition knowledge.
The role of the nurse in nutritional support:
The role of the nurse in the nutritional care of patients and clients is extremely diverse and
can range from promoting a healthy diet in a client with learning disabilities to the provision of
parenteral nutrition to a critically ill patient.
Nurse Education and Nutrition:
Education is the key factor in enabling nurses to instigate nutritional care appropriately.
Nursing students need be educated in the screening and assessment, planning, implementation and
evaluation of nutritional care. A firm grounding in the principles of nutritional science is essential
to understand the rationale behind the components of nutritional care.
Interdisciplinary education:
The importance of joint education for health professionals from all disciplines is highlighted
as a desirable, as this helps to ensure consistency in curriculum content and acts to promote
interdisciplinary working.
The presence of a nutritional education can help to ensure that the issues raised and
addressed and that nutrition is integrated into the curriculum.
Nutritional Education for All Nurses
All branches of nursing should receive the same basic nutrition education. There is perhaps
a tendency to ensure that aspects of nutritional care, and the skills associated with this, feature in the
adult and child branch but not in others.
C.Entrepreneurship Opportunities on Nutrition and Diet Therapy.

NURSES/NUTRIPRENEUR DITETIANS DITETICS NUTRITIONIST NUTRITION:

• Nurses/Nutripreneurship is the practice and process that results in creativity, innovation,
development and growth of nutrition businesses.
• Nurses/Nutripreneurs are nutritionists innovators who use a process of changing the
current situation of the existing products and services, to set up new products and new
services.

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Nutripreneurs are the trained and skilled entrepreneurs who may engaged in a field such as:
Private Nutrition/ Diet Clinics.
Researcher firms.
School Nutrition.
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See if you can do this!

Directions:Assume you are about to open your food establishment. Plan and make one recipe
that is economical/budget friendly and nutritiuosly palatable not commonly served from other
food establishments..
RECIPE.
Ingredients:
Procedures:
Utensils/Material needed:
Total Cost:
Selling Price.
*Picture of the product is a plus points.
Note: Please refer to the previous modules for the mode of submission.
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REFERENCE:
Books:
Ruiz, A.R. & Serraon-Claudio. V. (2010). Basic Nutrition for Filipinos, 6th edidition. Merriam and Webster Bookstore,
INC.
Ruiz, A.R. et al, (2010). Medical Nutrition for Filipinos. Merriam and Webster Bookstore, INC.

Dellova, C.V. RND & Roxas, M.D. et all. (2009) .ABC’s of Nutrition and Diet Therapy, For Nursing Students and
Healthcare Practitioners. Mutya Publishing House, INC.

Manual/Reviewer/Handouts:
Santos, L.M., de Leon, S.T.K.& Unga, N.H. et al. (2019). Reading and Laboratory Manual in NCM-105 (Nutrition
and Diet Therapy for B.S. Nursing and Allied Courses. UPRESS, WMSU.
Nutrition and Dietetics Reviewer, WMSU, CHE, Department of Nutrition and Dietetics in Collaboration of NDAP,
Zamboanga Chapter. 2016. Medical Nutrition Therapy & Nutritional Biochemistry. WMSU, CHE, Department of
Nutrition and Dietetics.
Zamboanga City Medical Center. Nutritional assessment Forms. Zamboanga Peninsula, Hospital Dietary Department
Services.

Websites:
FDA Food and Drugs Administration Philippines. (2020). Mandate. Retrieved from the FDA
Food and Drugs Administration Philippines website:
https://ww2.fda.gov.ph/index.php/mandate-functions-and-officials/mandate.

Nursing Times. (2002, August 20). Nutrition and Nurse Education. Retrieved from Nursing Times
website: https://www.nursingtimes.net/clinical-archive/nutrition/nutrition-and-nurse-education-20-
08-2002/
Wikipedia, The Free Encyclopedia. (2018, November 9).Ancient Filipino Diet and Health.
Retrieved from Wikipedia, The Free Encyclopedia website:
https://en.wikipedia.org/wiki/Ancient_Filipino_diet_and_health.

Wikipedia, The Free Encyclopedia.(2020, August 23).Health Insurance Portability and

Accountability Act. Retrieved from Wikipedia, The Free Encyclopedia website:
https://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act.

Wikipedia, The Free Encyclopedia.(2020, August 9). National Nutrition Council (Philippines).
Retrieved from Wikipedia, The Free Encyclopedia website:
https://en.wikipedia.org/wiki/National_Nutrition_Council_(Philippines).

Wikipedia, The Free Encyclopedia. (2020, August 12). Dietary Reference Intake. Retrieved
from Wikipedia, The Free Encyclopedia website:
https://en.wikipedia.org/wiki/Dietary_Reference_Intake.

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APPENDICES

Appendix I- A
Table of Weight and Measure

3 tsp = 1 Tbsp

1 Tbsp = 15 g = 15 ml = 15 cc = 1/2 oz.

30 gm = 30 cc = 1 oz = 2 Tbsp

1 gm = 1 cc = 1 mi

1 tsp = 5 cc = 5 ml = 5 gm

16 tsp = 240 cc = 240 ml = 8 oz = 1 cup

2 cups = 480 cc = 480 ml = 480 gm = 16 oz = 1 pint

2 pints= 960 cc = 960 ml = 960 gm = 32 oz = 1 quart

1 inch = 2.54 cm =
1 liter = 1.0567 quarts

1 k calorie = 4.180 joules

1 milliequivalent = one thousandth of an equivalent

1 microgram (ug) = one thousandth of a milligram

1 milligram (mg) = one thousandth of a gram

1 gram (gm) = one thousandth of a kilogram

4 quarts = 1 gallon 1 pound = 454 gm 2.2 pounds = 1

kilogram (kg)

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Appendix I-B
ACRONYMS
1. AP 29. TER
2. AW
3. BMI
4. BW
5. DBW - As Purchased
6. DOH - Actual Weight
7. DOST - Body Mass Index
- Body Weight
8. EAA - Desirable Body Weight
9. EFA - Department of Health
10. EP - Department of Science &
11. FCT Technology
12. FEL - Essential Amino Acids
13. FNRI - Essential Fatty Acids
- Edible Portion
14. IBW - Food Composition Table
15. IRS - Food Exchange List
16. IU - Food and Nutrition Research
17. NC Institute
18. NDAP
- Ideal Body Weight
19. NE - International Reference Standard
20. NGF - International Unit
21. NPC - - Nutrient Content
22. NS - Nutritionist Dietitian Association
23. NV of the Philippines
24. PRS - Niacin Equivalent
25. RE - Nutrition Guidelines for Filipinos
26. RENI - Non-Protein Calories
27. RND - Nutritional Status
28. TEA - - Nutrient Value

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- - Philippine Reference Standard

- Retinal Equivalent
- Recommended Daily Allowance
- Registered Nutritionist Dietitian
- Total Energy Allowance
- Total Energy Requirements

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 Appendix I - C
DIETARY COMPUTATION GUIDE

I. Dietary Computations

A. ESTIMATION OF DBW

1) INFANTS

i) First 6 months of age

DBW (g) = Birth weight (g) + (age in months x 600)

5 months old whose birth weight6 lbs. and 1 oz.

ii) After 6 months of age

DBW (g) = Birth weight + (age I months x 500)

Example:

8 months old whose birth weight = 2.5 kg.

a) Convert BW to grams
1 kilogram = 1000 gram

BW g = 2.5 kg x 100g/kg = 2500 grams

b) DBW = 2500 G + (8 MONTHS X 500) = 6500g

or 6.5 kg.

■ If the birth weight is not known, use 3000g Example:

6 months old

DBW (kg) = (6/2) + 3

= 6 kg.

iii) Age 13 years old and above

Based on the Height using Tannhausers Method

Conversion:
1 feet = 12 inches
1 inch = 2.54 ems
1 kg = 2.2 lbs
17
 Example; 5'0"

5 feet x 12 inches/feet = 60 in. x 2.54 cm/in

= 152.40 cm

= 152.40 cm — 100 (F)

= 52.40 — (10%)
= 52.40 - .10
= 5.24
= 52.40 — 5.24

DBW (kg) = 47.16 kg

= 47 kg x 2.2 lb/kg
= 103.4 lbs
3) CHILDREN

DBW (kg) = (age in years x 2) + 8 Example: 7 years old

DBW(kg) = (7x2) + 8

=22 kg

B. ESTIMATION OF TER

1) INFANTS

1— 6 months = 120 Kcals./kg. DBW 7 —12 moths = 110

Kcals/kg. DBW

Formula: TER = DBW x Kcal/kg

2) CHILDREN

i. TER = 1000 + (age in years x 100)

ii. Age Range Kcal/kg DBW
1— 3 years 100
4 — 6 years 90
7 — 9 year 80
10 —12 years 70 — boys
60 — girls
Formula: TER = DBW x kcals./kg DBW

18
 3) ADOLESCENTS Age Range
13 — 15 years Kcal/kg DBW
55 — boys
16 —19 years - 50 — —years
5059 girls old
- 60 — —years
5069 boys old
- 70 years above
45 - girls

4) PREGNANCY
TER = N TER + 300 kcals (2" and 3rd Trimesters)

5)LACTATION

TER = N TER + 500 KCALS

(1sT 6 months and 2" 6 moths)

Convert to Months:
12 months/years x 4 years = 36 months + 21 months + 57 moths
Note:
1) If the number of days is less than 30 days, disregard
2) If it is 30 days or would exceed, add 1 moth to the number of months.

Total Energy Requirement (TER)

Activity Cals/KDBW

Bed Rest - 27.5 cals.

Sedentary - 30 cals.

Light 35 cals

Moderate 40 cals
Heavy 45 cals.

6) ADULT

TER = N TER — 7.5%

= N TER — 15%

= N TER— 10%

19
 To compute in terms of Age in Months

Formula: Date of weighing

Date of Birth

Example: DW = January 27, 1993

DB = February 3, 1988

DW = 1993 — 01 — 27 DB = 1988 — 02 — 03 Age = 04 — 21 — 24

20
 Appendix II
Dietary Reference Intake

21
 Appendix III
Nutritional
NUTRITION DIAGNOSTICAssessment Forms
TERMINOLOGY
INTAKE NI Fat and Cholesterol (51) Biochemical (2)
Defined as "actual problems related  Inadequate fat intake Defined as "change in capacity to
to intake of energy, nutrients, metabolize nutrients as a result of
 Excessive fat intake NI-51.2 medications, or surgery, or as indicated by
fluids, bioactive substances through altered lab values"
oral diet or nutrition support"  Inappropriate intake NI-51.3
 Impaired nutrient utilization NC-
Energy Balance (1) of food fats
2.1
Defined as "actual or estimated (specify) _________________
 Altered nutrition-related NC-2.2
changes in energy (kcal)" Protein (52) laboratory values
 Hypermetabolism NI-1.1  Inadequate protein intake NI-52.1  Food-medication interaction NC-
(Increased energy needs) 0 Excessive protein intake NI-52.2 2.3 Weight (3)
 Increased energy expenditure NI- Inappropriate intake NI-52.3 Defined as "chronic weight or changed
1.2 weight status when compared with usual or
of amino acids desired body weight"
 Hypometabolism NI-1.3 (specify) _________________ 0 Underweight NC-3.1
(Decreased energy needs) Carbohydrate and Fiber (53) 0 Involuntary weight loss NC-3.2
 Inadequate energy intake NI-1.4  Inadequate carbohydrate NI-53.1  Overweight/obesity NC-3.3
El Excessive energy intake NI-1.5 intake 0 Involuntary weight gain NC-3.4
Oral or Nutrition Support  Excessive carbohydrate NI-53.2 BEHAVIORAL
Intake (2) intake ENVIRONMENTAL NB
Defined as "actual or estimated food Defined as "nutritional findings/problems
 Inappropriate intake of NI-53.3 identified that relate to knowledge,
and beverage intake from oral attitudes/beliefs, physical environment,
diet or nutrition support compared types of carbohydrate
access to food, or food safety"
with patient goal" (specify) _________________ Knowledge and Beliefs (1)
 Inadequate oral food/ NI-2.1  Inconsistent NI-53.4 Defined as "actual knowledge and beliefs as
carbohydrate intake related, observed or documented"
beverage intake
 Inadequate fiber intake NI-53.5  Food- and nutrition-related NB-
 Excessive oral food/ NI-2.2 1.1 knowledge deficit
beverage intake 0 Excessive fiber intake NI-53.6
 Harmful beliefs/attitudes NB-1.2
0 Inadequate intake from NI-2.3 Vitamin (54)
about food- or nutrition -
0 Inadequate vitamin NI-54.1
enteral/parenteral nutrition related topics (use with caution)
intake (specify)______________  Not ready for diet/ NB-1.3
0 Excessive intake from NI-2.4
 Excessive vitamin NI - 54.2 lifestyle change
enteral/parenteral nutrition
intake (specify)______________ 0 Self-monitoring deficit NB-1.4
0 Inappropriate infusion of NI-2.5
0A OC Disordered eating pattern NB-1.5
enteral/parenteral nutrition  Limited adherence to NB-1.6
(use with caution) El Thiamin ❑D nutrition-related
Fluid Intake (3)  Riboflavin 0 E recommendations
Defined as "actual or estimated 0 Niacin  Undesirable food choices NB-
fluid intake compared with patient 1.7 Physical Activity and
 Folate _ _ _ _ ❑ Other ____
goal" Function (2)
 Inadequate fluid intake NI-3.1 Mineral (55) Defined as "actual physical activity, self-
 Inadequate mineral intake NI- care, and quality-of-life problems as
0 Excessive fluid intake NI-3.2 reported, observed, or documented"
Bioactive Substances (4) 55.1 (sPecifY)  Physical inactivity NB-2.1
Defined as "actual or observed intake  Calcium ❑ Iro n  Excessive exercise NB-2.2
of bioactive substances, including
0 Potassium ❑ Zinc 0 Inability or lack of desire NB-2.3
single or multiple functional food to manage self-care
components, ingredients, dietary  Other ______
 Impaired ability to NB-2.4
supple ments, alcohol" 0 Excessive mineral intake NI- prepare foods/meals
El Inadequate bioactive NI-4.1 55.2 (specify) 0 Poor nutrition quality of life NB-
substance intake  Calcium 0 Iron 2.5 0 S e l f - f e ed in g d i f f i cu lty
 Excessive bioactive NI-4.2 0 Potassium ❑ Zinc N B - 2 . 6 Food Safety and Access
substance intake (3)
 Other. _ _ _ _ _ _ Defined as "actual problems with food
0 Excessive alcohol intake NI-4.3 access or food safety"
Nutrient (5) CLINICAL NC  Intake of unsafe food NB-3.1
Defined as "actual or estimated intake Defined as "nutritional 0 Limited access to food NB-3.2
of s pe ci fi c n utr ien t gr ou p s or findings/problems identified as
si ng le nutrients as compared related to medical or physical Date Date Resolved
with desired levels" conditions"
Functional (1) Identified
 Increased nutrient needs NI-5.1
(sPecifY) _________________ Defined a s "chan ge in physi c al
or mechanical functioning that
0 Evident protein-energy NI-5.2
interferes with or prevents desired
malnutrition nutritional consequences"
 Inadequate protein- NI-5.3 0 Swallowing difficulty NC-1.1
energy intake  Chewing (masticatory) difficulty

0 Decreased nutrient needs NI-5.4 NC-1.2

(specify) _________________  Breastfeeding difficulty NC-1.3
0 Imbalance of nutrients NI-5.5  Altered GI function NC-1.4

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Nutrition Diagnostic Terminology:

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 E.CHECKLIST FOR DOCUMENTATION OF NUTRITION CARE

Items Yes No
Format: used proper place for notes
Recorder date, time, signature
S. Included the diet history information
As appropriate included patient statements
Included diet followed at home (if any), e.g. symptoms, food habits
Statement about recent appetite, nausea
Checked for eating problems, chewing difficulties, swallowing
0.Ht., Wt., and DBW, SF, MAC, MAMC, Blood Pressure, BMI, WHR
Lab data
Diet order stated
Weight changes
BMR factors — fever, tachycardia, exudates
BEE, protein and kcal needs for age, sex, etc.
Calorie counts or estimated intake
A. Acceptable body weight or % usual weight
Nutrient deficiencies in diet as ordered
Evaluation of diet history
Client acceptance/tolerance of diet
Client understanding of diet instructions
Verification of diet as appropriate for client
Recommendation for anticipated problems
P. Instructions/Recommendations
Consult/refer to other professional/agency
Obtain weight; obtain calorie counts
Recommend snacks/supplements
Request change in diet
Indicate short-term and long-term goals
I-E Nutritional breakdown of calculated diet or other modification recorded
Meal 'Ian written handouts given to client or significant other
Stated plans for continued nutritional care

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 NUTRITIONAL ASSESSMENT FORM:
I. PATIENT INFORMATION:

Patient’s Name (Last, First, Middle):_____________________________

Date:__________________

Age:_________________ Sex: F ⎕ M ⎕
Status:_______________________

Address:_______________________________________________________________________________

Religion:______________________________ Occupation:__________________________

Height:_______ Actual Weight:______BMI:_____Underweight⎕ Overweight⎕ Obese⎕

DBW:________

Food Preferences:________________________________________________________________________

Attending Physician:___________________________________ Medical

Diagnosis:__________________

Diet Rx:________________________________________________________________________________

II. PHYSICAL DATA:

Weight Change: None⎕ ≥ 10% of usual weight ⎕ ≤ 10% of usual weight ⎕

Food Intake/Appetite: Excellent ⎕ Good ⎕ Fair ⎕ Poor ⎕
Bowel Movement: Regular ⎕ Irregular ⎕
Gastro symptoms in the last 2 weeks: No change⎕ Nausea,Vomiting⎕ Anorexia,Severe Diarrhea ⎕
Physical activity prior to admission: Bedridden ⎕ Sedentary ⎕ Light ⎕ Moderate ⎕ Active ⎕

III. PERTINENT LABORATORY DATA:

Albumin:____________ FBS:__________ Triglycerides:___________ SGPT-ALT:__________

SGOT-ALT:__________ Na:___________ Creatinine:_____________ BUN:_____________
Uric Acid:____________ K:___________ Ionized Ca:____________ Phosphorus:___________
Cholesterol:___________ Others:________________________________________________________

IV. MEDICAL NUTRTION

TER: ____________Kcal CHO: _________gm CHON: _________gm Fats: ________gm

Other Restrictions: ______________________________________________________________________

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 V. PLANS/RECOMMENDATIONS:

_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
_________________________________________________________________________________________________________

Assessed by: __________________________________________

Name of Dietitian over Signature

Date :
_____________________________________________

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 CLINICAL NUTRITION SERVICE NDSC Form No. 9
NUTRITION SCREENING & ASSESSMENT FORM
Name: Room No: Age:______ Sex:____ File No:___________
Diagnosis:
SCREENING CRITERIA FOR POTENTIAL NUTRITIONAL RISK (check appropriate box)
Food Intake Burns Chronic Pain
Weigth Loss Sepsis Old Age
Physical Signs of malnutrition Multi Trauma Depression
Radiation theraphy Peritonitis Dentures
Expected Hospital Stay > 2weeks Fistulae Frequent diarrhea/vomitting
Malabsorption Cancer Anorexia
On tube feeding
SUBJECTIVE DATA OBJECTIVE DATA

Food Intake: ____ No change Heigth: ______(cm) Weight: ______(kg)

____ Mostly Liquids
____ Sub-Optimal
____ Starvation
____ Poor intake prior to
admission
Functional Capacity: ______ In bed
______ Ambulatory
______ Needs assistance
Chewing / Swallowing Difficulties: ________
Constipation: ______ Diarrhea:________
Food Allergies:_____________________
Present Diet Px : __________________
Usual Weight: ______kg. BMI
BML:______
: _________
Weight Change:___% over___ months/week
% IBW: ______
Significant Labs:
Albumin_____ Total Lym Count ______
HCT______ HGB _______
Others:_________________________________
______________________________________
____________________________________
Medications : ________________________
___________________________________
___________________________________

SCORING OF NUTRITIONAL RISK RELATED RISK FACTORS

Screening criteria for potential nutritional risk Mechanical / Digestive
Digostive Problem
problem(1pt)
(1)
one check or more ( 1-2 points) Depressed Albumin (1point )
<85%or > 130 % Ideal Body Weight (1 point) Significant Lab Result (1 point)
Unintentional Weigth Loss _____% over ____ Other:________________________
months or weeks ( 2 points ) Total Points : __________________
A nutrition risk factor with the following total score indicates:
Low risk 2-3 Moderate > 3 High risk

Nutritional Status: Normal Moderate Severe Malnutrition

Malnutrition
DIETITIAN'S RECOMMENDATION
Shift diet to _____________________________ Monitor Caloric Intake
Nutrition Education Total Caloric Reqt._____________________
Request for Laboratory Data Total Protein Reqt._____________________
Other:________________________________________________________
_______________________________________________________
Name of Dietitian / Signature Date :_____________
License Number :________________
DIETITIAN’S PROGRESS NOTES
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Name of patient:
_________________________________________________________________

DATE/TIME P-problem E-Etiology S-Signs and Symptoms

PROGRESS NOTES RECOMMENDATION

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 _______________________________________
Name of Dietitian / Signature / PRC License No.

SAMPLE MENU
(24 Hours Food Recall-Food Intake)
MEALS QUANTITY MENU ITEM
BREAKFAST

AM SNACK

LUNCH

PM SNACK

DINNER

BEDTIME SNACK

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Note: Additional SALT for cooking per day is ______ tsp ONLY

Prepared By: _____________________________ RND

License #: _______________________________
Source:Zamboanga City Medical center
Nutrition and Dietetics ServicesZamboanga City, 2016

Food Plan/Menu pattern:

Breakfast: A,M. Snacks Lunch: A,M. Snacks Dinner: Bedtime

(Optional)
Fruits Rice Soup Rice Soup Rice
Meat Meat Meat Meat Meat Meat
Vegetables Vegetables Vegetables Vegetables Vegetables Vegetables
Rice/Cereals Beverages Rice Beverages Rice Beverages
Beverages Fats Fruits Fats Fruits Fats
Fats Sugar Beverages Sugar Beverages Sugar
Sugars Fats Fats
Sugar Sugar

Note: This serve as a guide in writing Sample Menu.

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 Appendix IV.
RUBRICS (Essay)

Criteria: Description: Ratings 1 2 3 4 5

Content The writer attempts to address the guiding
question/prompt about his/her comprehension or
reflection manner.
Organization The essay’s content reflects basic organization,
clear transitions of paragraph and thoughts.
Development of The writer uses relevant details or ideas in the
Ideas writings.
Clarity The essay is clear and focusses, that is easy to
understand by the reader/s.
Mechanics The essay is articulate and uses language structure
that reflects sophisticated manners.
Total score:
25 points

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