CALAMBA DOCTORS’ COLLEGE

Virborough Subdivision, Parian, Calamba City, Laguna

Lecture 3

Digestion, Absorption, and Metabolism

Lesson 5
The foods eaten undergo digestion, absorption and utilization. Metabolism refers to the chemical processes that
occur inside the cells as they transform nutrients into energy and body tissue. The transformation of foods into various
nutrients like carbohydrates, fats, and protein and other physiological processes are parts of the metabolic processes.

Objectives
1. To describe how foods are digested and transformed through the body
2. To identify the roles of the various digestive organs
3. To discuss how nutrients are utilized in the body

Lessons
1. The digestive organs
2. How food moves through the body
3. How nutrients are absorbed and pass along the body

Definition
 Digestion – the process by which food is broken down in the gastrointestinal tract to release nutrients in forms
that the body can absorb.
 Absorption - the process by which nutrients are taken into the cells that line the gastrointestinal tract.
 Transport the movement of nutrients through the circulatory system from one area of the body to another.
 Metabolism the sum of the vast numberof chemical changes in the cell that ultimately produce the materials
that are essential for energy, tissue building, and metabolic controls.

The appetizing sight and smell of food stimulate the digestive organs into action. The mouth waters, the
stomach contracts. Intestinal glands begin to secrete the chemicals that will act on food and break them into simple
substances.

The digestive system has the ability to turn complex food into basic nutrients. This requires a group of digestive
organs, each designed specifically to perform one role in the process. The digestive system is a long tube that starts at
the mouth, continuous down through the throat, to the stomach, and then to the small and large intestine and past the
rectum to end at the anus.

In between, with the help of the liver, pancreas, and gallbladder, the digestible parts of everything eaten are
converted to simple substances that the body can easily absorb to burn for energy or build new tissue form. The
indigestible residue is bundled off and eliminated as waste.

Digestion is a two-part process – half mechanical, half chemical

Mechanical digestion takes place in the mouth and the stomach. The teeth break food into small pieces that can
be swallowed without choking. In the stomach, a churning action continues to breakdown food into smaller particles
Muscles and nerves work together to produce constant motility. Muscle contraction and relaxation which are
rhythmic waves that mix the food mass and move it forward, which force known as peristalsis

Chemical digestion occurs at every point in the digestive tract where enzymes and other substances such as
hydrochloric acid (from stomach glands) and bile (from the gallbladder) dissolve food, releasing the nutrients contained.
Sites of secretion and absorption in the gastrointestinal tract

How body digests foods?

Each organ in the digestive system plays a specific role in the digestive process. The first act occurs in two places
that are never listed as part of the digestive tract: the eyes and nose.

The mouth
Food is lifted and put into the mouth and the teeth and salivary glands swing into action. The teeth chew,
grinding the food, breaking it into small, manageable pieces. As a result:
 The food (bolus) can be swallowed without choking.
 The indigestible sheath of fiber surrounding the edible parts of some foods is brokendown so that the digestive
enzymes can get to the nutrients inside.

At the same time the salivary glands under the tongue and in the back of the tongue secrete the watery liquid
called saliva, which performs two important functions:
 Moistens and compacts food so that the tongue can push it to the back of the mouthsending the food down into
the esophagus and into the stomach.
 Provides amylases, enzymes that start the digestion of complex carbohydrates, breakingthe starch molecules
into simple sugars. No protein or fat digestion occurs in the mouth.
The Stomach
  The stomach is pouchy part just below the esophagus that holds the chewed food. Like most of the digestive
tube, the stomach is circled with strong muscles whose rhythmic contractions - called peristalsis – move food along and
turn the stomach into a sort of food processor that mechanically breaks pieces of food into even smaller particles.

While this is going on, glands in the stomach wall are secreting stomach juices – a potent blend of enzymes,
hydrochloric acid, and mucus. Hydrochloric acid activate release of pepsin enzymes for partial digestion of protein
Other enzymes, plus stomach juices, begin the digestion of protein and fats, separating these into its basic components
– amino acids and fatty acids.

The Small Intestine

Open the hand and put it flat against the belly button, with the thumb pointing up to the waist and the pinkie
pointing down. The hand is now covering most of the relatively small space into which the 20-22 feet long small
intestine is neatly coiled. When chyme spills from the stomach into this part of the digestive tube, a  whole new set of
gastric juices are released. These include:
 Pancreatic juice
1. Pancreatic proteases – protein spliting enzymes
o Trypsin, Chymotrypsin and carboxypeptidases
2. Pancreatic amylase – convert polysaccharides into simple sugar
3. Pancreatic lipase – reduce fats into fatty acid and glycerol
 Bile, a greenish liquid (made in the liver and stored in the gallbladder) that enables fats to mix with water
 Alkaline pancreatic juices that make the chyme less acidic so that amylases (the enzymes that break down
carbohydrates) can go back to work separating complex carbohydrates into simple sugars
o Lactase
o Maltase
o Sucrase
 Peptidases - breakdown protein into amino acid
 Intestinal alcohol dehydrogenase that digests alcohol not previously absorbed into the bloodstream. Inside the
cells, nutrients are metabolized: burned for heat and energy or used to build new tissues.

The large intestine

After every useful, digestible ingredient other than water has been wrung out of the food, the rest – indigestible
waste such as fiber – moves to the top of the large intestine, the area known as the colon. The colon’s primary job is to
absorb water from this mixture and then to squeeze the remaining matter into the compact bundle known as feces.
Feces (whose brown color comes from leftover bile pigments) are made up of indigestible material from food, plus cells
that have sloughed off the intestinal lining and bacteria. In fact about 30 percent of the entire weight of the feces is
bacteria.

Absorption

When digestion is complete, carbohydrate reduced to simple sugars glucose, fructose, and galactose, fats into
fatty acids and glycerides and protein into single amino acids. And vitamins and minerals are liberated. With a water
base for solution and transport

Small Intestine - Absorbing Structures

 Mucosal folds the large, visible folds of mucous lining of the small intestine that increasethe absorbing surface
area.
 Villi small protrusions from the surface of a membrane; finger-like projections that cover the mucosal surfaces of
the small intestine and that further increase the absorbing surface area.
 Microvilli extremely small, hair-like projections that cover all of the villi on the surface of the small intestine and
that greatly increase the total absorbingsurface area.
  Each villus contain capillaries (blood vessel) and lacteal (lymphatic vessels) . Glucose, fructose, galactose, amino
acid, mineral and water soluble vitamins are absorbed by capillaries, fatty acids, glycerol and fat soluble vitamin
are absorbed by lacteal

Large Intestine

 The major task of large intestine is to absorb water

 Synthesize some Vitamin B and Vitamin K
 Collect food residue, some residue is commonly called fiber
 Undigested food is excreted as feces
 In health people large intestine absorb 99% carbohydrate, 95% fats, 92% protein

Metabolism
 Metabolism is the sum of the chemical reactions that occur within a living cell to maintain life. The
mitochondrion of the cell is the work center in which all metabolic reactions take place.
 Metabolism – process where nutrients are change into energy
1. Aerobic metabolism – nutrients are combine with oxygen within the cells this process called oxidation
Carbohydrates (CHO) reduce to carbon dioxide and water
Protein (C2H4O2N) reduce to carbon dioxide, water and nitrogen
2. Anaerobic metabolism – reduced fat without the use of oxygen
 Krebs cycle – complete oxidation of carbohydrate, protein and fats

Types of Metabolism
1. Catabolism is the breaking down of large substances into smaller units. For example, breaking down stored
glycogen into its smaller building blocks (i.e., glucose) is a catabolic reaction.
2. Anabolism is the process by which cells build large substances from smaller particles, such as building a complex
protein from single amino acids.

Lesson 5: The essential nutrients (Energy macronutrients and micronutrients)

Objectives
 Describe the function and general recommendations for carbohydrate, protein, and fat in health promotion,
prevention and disease management.
 Differentiate water-soluble from fat soluble vitamins
 Recognize the function and food sources of each of the vitamin and minerals
 Describe the importance of water and explain the appropriate intake in the diet.

Lesson
 Macronutrients
 Micronutrients

Essential Nutrients
Carbohydrates
Primary source of energy (energy foods).
 Name for chemical elements composed of carbon, hydrogen, and oxygen.
 Functions
o Providing energy (4 calories/gram),
o Protien sparing action
o Normal fat metabolism
o Providing fiber.
 Sources - plant foods - cereal grains, vegetables, fruit, and sugar, animal source – milk.
 Dietary Requirement: The dietary requirement for carbohydrates is 50%-60% of recommended calorie
intake/day (250 gm/day).
 Depletion of glycogen store or with fasting cause ketoacidosis (need 50 -100 mg each day)
Classification
1. Monosaccharides ((C6H12O2)single sugars) – The simpliest form of CHO, they are sweet, require no digestion and
absorbed directly into the blood stream from small intestine.
A. Glucose (dextrose) –Most cells depends on glucose as fuel. Brain cell and nervous system depend exclusively
on glucose.
Sources are berries, corn syrup, grapes, sweet corn
B. Fructose (levulose or fruit sugar) – found with glucose in many fruits, the sweetest of all monosaccharides,
Sources are ripe fruits, honey, soft drinks.
C. Galactose – occurs mostly as part of lactose, a disaccharide also known as milk sugar. During digestion,
galactose is freed as a single sugar

2. Disaccharides – are pairs of sugar (glucose, fructose, and galactose)

A. Sucrose – (glucose and fructose - table, or white, sugar) obtained by refining the juice from sugar beets or
sugarcane to provide the brown, white, and powdered sugars. Sucrose split into glucose and fructose by
enzyme
Sources are sugar cane, sugar beets, Molasses, maple syrup, candy, jam, and jellies.
B. Maltose – (consists of two glucose units) product of hydrolysis of starch by enztme (maltase) action during
digestion. Also produced during fermentation process. I
t can be found in infant formula, malt beverage, beer. Less sweet than glucose and fructose.
C. Lactose – (glucose and galactose) sugar found in milk. Enzyme is required for digestion

3. Polysaccharides (complex carbohydrates) – are compound of many monosaccharides

A. Starch is a polysaccharide found in grain vegetables
B. Glycogen (animal starch) it is a storage form of glucose in the body (liver and muscles)
C. Fiber (roughhage) - Insoluble fiber, Cellulose – skin of fruit, the leaves, stem of vegetables and legumes.
Hemicellulose – found in whole grain cereal, Lignins – woody part of vegetable, small seed. Soluble – gums,
mucilages – form of gel
Function – acts as broom in digestive tract to prevent constipation and GI diseases. 20-30 gm/day
recommended intake. (20-35 gm/day US). Increase intake cause flatulence and diarrhea.
Recommended Sugar intakes
 The USDA Food Patterns recommendations for sugar represent about 5 to 10 percent of the day’s total
energy intake
 World Health Organization recommended less than 5 percent of total energy intake

Digestion and Absorption

 Monosaccharides (glucose, fructose and galactose) – simple sugar absorbed from intestine into the blood
stream. (Duodenum, Jejunum)
 Disaccharides (sucrose, maltose, and lactose)– require enzyme sucrase, maltase, and lactase.
 Polysaccharide – Starch – enzyme (salivary amylase) – dextrin - gastric juices – maltose - enzymes (pancreatic
amylase) – glucose – blood stream.

Metabolism and Elimination

 Carbohydrates – simple sugar (glucose) blood stream – cells – oxidation – energy (Exceed amount on cell used -
glucose converted glycogen and stored in liver and muscless – converted to fat and stored as adipose tissue).
Glucagon help release energy by converting glycogen to glucose.
 Glucose metabolism – insulin by islets of langerhans and maintain blood glucose at 70-110 mg/dl (blood glucose
more than 126 mg/dl is hyperglycemia, less than 70 mg/dl is hypoglycemia)
 The waste product of carbohydrates metabolism is carbon dioxide and water
FATS/ LIPIDS
Greek words “lipos” mean fat, greasy substances, provides 9 kcal per gram. All lipids are composed of the same
basic chemical elements as carbohydrates: carbon, hydrogen, and oxygen.
Functions-
 Provides energy
 Functioning and structure of body tissues
 Carrier of fat soluble vitamins
 Protect organs and bone
 Insulation from cold
 Provide feeling of satiety.

Food Sources
 Animal source (non-visible fat) – meat, milk, egg yolk, fish
 Plant source (visible fat)– cooking oil.

Dietary Requirement - 20%-30%, approximately 50gms in 2200 kcal (US – 33-36% RDA), Linoleic acid 2%,
Polyunsaturated 10%, monounsaturated 10%, and saturated fatty acid 10% ( US- saturated is 7%, polysaturated is 8%,
monosaturated is 15%), 30-50 gm fat is considered low fat diet.

Classification
1. Triglycerides – 3 fatty acid attached to glycerol
Glycerol – water soluble carbohydrates
Fatty acid – are organic compound of carbon atom attached to hydrogen atom
Fatty acids - are the building blocks of triglycerides can be classified by their length as short-, medium-, or long-
chain fatty acids

Classification of Fatty Acid

A. Saturated fatty acid (stearic acid) - carbon atoms carries all the possible hydrogen atoms -animal food
contain more saturated fatty acid, meat, coconut, butter, eggyolk, milk, 7%/day kcal
B. Monounsaturated fatty acid (oleic acid)- carbon atoms where there fewer hydrogen atom attached than
saturatedfats.Plant food such olive oil, canola, abocado, nuts, sardines, decrease amount of LDL,15%
kcal/day
C. Polyunsaturated fatty acid - two or more places among the carbon atoms where fewer hydrogen atoms
attached than saturated fats.
o Linolenic acid and other omega-3 Fatty acids: Omega 3 fatty acid: are thrombolitic which reduce
platelet aggregation and blood clot, and lower blood pressure which found primarily in fish oils
o Linoleic acid: an omega-6 Fatty acid: Omega 6 fatty acid slow plasma triglycerides. Sources are
sunflower, sesame seed, corn, soy bean, fish oil, vegetables

2. Phospholipid – are derivatives of phosphatide acid, or as triglyceride modified to contain phoshate group.
Phospholipid act as emulsifiers in the body, helping to keep other fats in solution in the watery blood and body
fluids
o Lecithin – a fatty substance classified as phospholipid both found in animal and plant. Help transport fat
in blood stream, and help prevent cardiovascular disease

3. Sterol
Sterols are a subgroup of steroids, and they are amphipathic in nature. Sterols made by plants are called
phytosterols, and sterols produced by animals are called zoosterols.
Cholesterol is the most familiar sterol, It is not true fat but a fat like substance (exogenous cholesterol –
animal food, endogenous – body cell). For synthesis of bile, sex hormone, cortisone, and Vitamin D, the body
manufacture 800-1000 mg/day. normal serum level = < 200 mg/day, normal daily requirement = 300 mg,
sources - egg yolk, fatty meat, shellfish, butter, cheese, whole milk and meat organ.
 4. Hydrogenation
Hydrogenation is a chemical process by which hydrogen atoms are added to monounsaturated or
polyunsaturated fats to reduce the number of double bonds. A disadvantage is that hydrogenation makes
polyunsaturated fats more saturated
o Trans-fatty acid - The one made from hydrogenation of polyunsaturated fats which change liquid to
solid fats. Can cause or a risk factor for cadiovascular diseases and TFA cause LDL and Total cholesterol
to increased

5. Lipoproteins
Protein combined with the product of digestion fats which carry fats to the body by way of the blood.
Lipoproteins are the major vehicles for lipid transport in the bloodstream, are combinations of triglycerides,
protein, phospholipids, cholesterol, and other fat-soluble substances

Classification
1. Chylomicrons – first lipoprotien identified after eating
2. Very low density lipoprotien – made from the liver who carry triglycerides
3. Low density lipoprotien – carry trigycirides and chlolesterol fro liver to the cell
4. High density lipoprotien – carry chlolesterol from cell to liver for excretion

Metabolism and Elimination

The liver control fat metabolism – fatty acid are brocken down - Cells (metabolism) – release energy (fat not needed is
stored as adipose tissue) – carbon dioxide and water are used or removed from the body by circulatory, respiratory, and
excretory system

Protein
 Proteios meaning “to hold first place” or “prime importance
 The word is use due to its’ function of building and repairing cell.
 Life process defends on protiens
 The basic material of every body cells.
Chemical Nature
C2 H4 O2 N = Carbon, Hydrogen, Oxygen, Nitrogen
Amino Acid = The building block of protein.
Functions
1. Building and repairing body tissue (Protein balance)
Catabolism – cell are brocken down.
Anabolism – repair other tissue.
2. Regulating body function
 Component of hormone and enzyme which is essential for digestion, metabolism, fluid and electrolyte
balance,
 Essential in development of antibodies and immune system.
3. Providing energy
 4 kcal each gram

Food Sources
 Animal food: provide high quality and complete protein, Complete protein contain all the essential amino acid in
sufficient amount for growth and maintenance of life.
 Plant food: are sources of partial and incomplete protein. Partial complete protein can maintain life but do not
support growth like wheat, legume. Incomplete protein can’t support life and growth like corn, gelatin,
Dietary Requirement:
Protein requirement is determine by size, age, sex and physical activity. Need more protein for growing child,
pregnant women, breastfeeding mother, extra protein for surgery, burn, and during infection. Adult daily requirement is
0.8 - 0.9 gram of protein for each kilogram (US standard), (Philippine standard infant = 1.5 gm/kg, toddler – preschooler=
2.15gm-2.0gm, school age = 1.8gm-1.6gm, adolescent = 1.6gm-1.3gm, and above 19 year = 1 gm – 1.14 gm for each kg)

Classification of Amino Acid

20 common amino acids have been identified, all of which are vital to life and health
1. Essential amino acid (indispensable amino acid) – one cannot synthesized by the body from material available to
keep up with normal growth rate.
Histidine, isoleucine, leucine, lysine, methionine, phenylalamine, tryptophan+++, theorinine, valine. Note: 10th
essential nutrient for growing children : Arginine
2. Non-essential amino acid also called dispebsable amino acid or not dietary essential and synthesized by the body
as long as material for synthesis are adequate.
Alanine, Aspartic acid, Asparagine, Glutamic acid, Serine, and Tyrosine
3. Semi-essential amino acid (conditionally indespensable) that can be maintain life processess for an adult.
Arginine, cysteine, glutamine, glycine, proline
Note:
Under special circumstances, a nonessential amino acid can become essential. For example, the body normally
makes tyrosine (a nonessential amino acid) from the essential amino acid phenylalanine. If the diet fails to supply
enough phenylalanine or if the body cannot make the conversion for some reason (as happens in the inherited disease
phenylketonuria), then tyrosine becomes a conditionally essential amino acid

Digestion and Absorption

Mouth (mechanical digestion) – stomach (chemical digestion – HCl – pepsin(enzyme) plus protein to
polypeptides) – small intestine (polypeptides plus enzyme(trypsin, chymotrypsin, and carboxypeptidase) – reduce to
amino acid – amino acid absorbed by villi – carried by the blood to body tissues.

Metabolism and Elimination

When amino acid is brocken down – the nitrogen containing amine group is stripped off this process called
deamination. Deamination produced ammonia which release to blood stream by the cell. Liver pick ammonia convert to
urea, then return blood stream for the kidney to filter out and excrete.
The remaining part are used for energy or converted to carbohydrate or fats and stored as glycogen.

Nitrogen Balance
The body’s nitrogen balance indicates how well its tissues are being maintained. The intake and use of dietary
protein are measured by the amount of nitrogen supplied by food protein and the amount of nitrogen excreted in the
urine, feces and sweat. When nitrogen intake equals nitrogen output, a person is in nitrogen equilibrium, or zero
nitrogen balance.
 Positive nitrogen balance - nitrogen intake exceeds than nitrogen output as in growing infants, children, and
adolescents , pregnant women; and people recovering from protein deficiency or illness;
 Negative nitogen balane - nitrogen output exceeds their nitrogen intake as seen in people who are starving or
suffering from severe stresses such as burns, injuries, infections, and fever

Protein Malnutrition
Protein-energy malnutrition (PEM ) – described condition develops when the diet delivers too little protein, too
little energy, or both. Children are at the highest risk for experiencing malnutrition because of their high needs during
rapid growth and development

Early signs are weakness, weight loss, reduce resistance to infection, lethargic and pallor, Late signs are edema,
dry and scaly skin. (Growth retardation in children), liver is enlarged.
Form Protein energy malnutrition (PEM)
1. Marasmus – severe malnutrition, hair is dull, thin skin, old man’s face (wrinkled), thin muscle, thin fat, very
underweight. (chronic form of energy and protein deficiency)
2. Kwashiorkor – Present of edema, some adipose tissue left, enlarge abdomen, weight loss is not significant
(common in ages of 18 and 24 months)
 Kwashiorkor is a Ghanaian word meaning a “sickness that infects the first child when the second child is
born.”

Excessive intake of Protein

1. Extra load on kidney, liver, and circulatory system.
 Excess dietary protein results in inflammation and apoptosis (cell destruction) in the glomerular cells of the
kidney.
 Most protein sources are animal foods and processed meats which are high in saturated fats and cholesterol
affect liver and cardiovascular system.

2. Extra protien and calories can be stored as body fat.

 Eating excess protein does not build muscle; only exercising with enough protein to support growth.
 Having higher body weights and a greater risk of obesity, heart disease, and diabetes
 CALAMBA DOCTORS’ COLLEGE
Virborough Subdivision, Parian, Calamba City, Laguna

NCM 105 – Nutrition and Diet Therapy

Activity No: 3
Name: ___________________________ Date: ____________________
Year and Section: __________________

Multiple Choice: Encircle the letter that corresponds to the correct answer
1. Mr. X 20 year old was brought to hospital with second degree burn and affecting 40% of his body surface then
he was admitted to burn unit. Upon admission Mr X would most likely be in a state of:
A. Glycolysis C. Positive nitrogen balance
B. Catabolism D. Anabolism
2. This is a chemical digestion secreted that in the mouth.
A. Mucus C. Options A and B are correct

B. Salivary amylase D. Chemical digestion start in the stomach

3. Which of the following nutrients passes through the large intestine mostly absorbed?
A. Alcohol C. Iron
B. Vitamin K D. All of the above
4. What is the main function of bile in digestive process?
A. Breaking down lipid into simple fatty acid C. Increase pH to make intestine reduce acidity
B. Dissolve fats and oil for digestion D. Stimulate secretion of pancreatic enzymes
5. Increase dietary fiber may help to prevent or control:
A. Cardiovascular diseases C. Anemia
B. Constipation D. Options A and B are correct
6. The main energy source needed by the body is:
A. Glucose C. Amino acid
B. Fructose D. Options A and B are correct
7. Saturated fat intake increase the risk of heart disease. Which of the following dietary recommendation is
appropriate?
A. Eat less meat and meat product C. Select fat-free milk
B. Eat non-hydrogenated fat D. All of the above
8. These are 3 major classes of lipids in the body are:
A. Glycerol, fatty acid and triglycerides C. Lipoprotein, fatty acid and cholesterol
B. Triglycerides, phospholipids, and sterols D. Glycerol, fatty acid and cholesterol
9. The basic building blocks for protein
A. Nitrogen C. Amino acids
B. Carbon D. Pepsin
10. The RDA for protein to a healthy adult per kilogram of appropriate body weight for height of 50 kg.
A. 100 gm – 150 gm C. 50 gm - 70 gm
B. 75gm – 100 gm D. 25 gm – 50 gm
 CALAMBA DOCTORS’ COLLEGE
Virborough Subdivision, Parian, Calamba City, Laguna

NCM 105 – Nutrition and Diet Therapy

Name: ___________________________ Date: _________________Year and
Section: __________________ Score: _________________

Meal Planning

Direction: Design a meal plan for individual base on their nutritional requirements

Carbohydrate diet – Meal for client frequently vomit with lack of appetite
Meal Pattern Sample Menu (Food)
Meat/Fish/Poultry
Rice/Bread
Vegetables
Fruit/Dessert
Soup
Beverage/Drinks

Fat diet – Meal for client who is overweight and diagnosed with diabetes
Meal Pattern Sample Menu (Food)
Meat/Fish/Poultry
Rice/Bread
Vegetables
Fruit/Dessert
Soup
Beverage/Drinks

Protein diet – Meal for client requiring enough protein but his/her budget for food is limited
Meal Pattern Sample Menu (Food)
Meat/Fish/Poultry
Rice/Bread
Vegetables
Fruit/Dessert
Soup
Beverage/Drinks
 CALAMBA DOCTORS’ COLLEGE
Virborough Subdivision, Parian, Calamba City, Laguna

NCM 105 – Nutrition and Diet Therapy

Name: ___________________________ Date: _________________
Year and Section: __________________ Score: _________________

Meal Planning for Macronutrient

Objectives:
1. To make a meal plan for individual requiring modification in carbohydrates, fats and protein
2. To discuss diet plan and its implication for certain disease condition or situation

Direction: Answer 1 situation/case only according to you surname/last name

Case 1: Calculate and prepare a diet plan for client who is underweight using 2,500 Kcal with 75% carbohydrates
allowance. Prepare a 1 sample menu plan and discuss it base on client’s needs. (For surname start with letter A – C)

Case 2: Prepare a diet plan for client who is suffering from acute kidney disease. Calculate and prepare a low protein diet
meal (10% less) using 2000 Kcal. Prepare a 1 sample menu plan and discuss it base on client’s needs.(For Surname start
with letter D – M)

Case 2: Prepare a diet plan for client who is suffering from obesity. Calculate and prepare a low fat diet meal (25 % less)
using 2000 Kcal. Prepare a 1 sample menu plan and discuss it base on client’s condition (For surname start with letter N
– Z)

Meal plan for ___________________

Food No. of CHO CHON FATS Energy Meal Distribution
Exchange Exchange gm gm gm Kcal Breakfast Lunch Dinner Snack
Vegetable A
Vegetable B
Fruits
Milk: Whole
Low fat
Skimmed
Sugar
Rice
Meat: Low fat
Medium
High fat
Fat
Total

Meal ___________________
Meal Pattern Sample Menu
Meat/Fish/Poultry
Rice/Bread
Vegetables
Fruit/Dessert
Soup
Beverage/Drinks
Question for Discussion
1. What are the purposes or benefits of your menu according to client condition?