WEEK 2: NUTRITION TOOLS, STANDARDS development in the country over the past decades.
AND GUIDELINES NUTRIENT Data from the 2013 National Nutrition Survey (2013
RECOMMENDATION
MODULE - LECTURE
TERMINOLOGIES
🦖
• Adequate Intake (AI) – is the recommended
average daily intake level based on observed or
experimentally determined estimates of nutrient
intake by a group of apparently healthy people that
are assumed to be adequate.
• Dietary Reference Intakes (DRIs) – are reference
values that are quantitative estimates of nutrient
intakes to be used for planning and assessing diets
for healthy people.
• Estimated Average Requirement (EAR) – The daily
nutrient intake level that meets the median average
requirement of healthy individuals in a particular
life stage and sex group, corrected for incomplete
utilization or dietary nutrient bioavailability.
• Philippine Dietary Reference Intake (PDRI) –
collective term comprising reference values for
energy and nutrient levels of intakes. PDRIs are to
be used as references for assessing and planning
dietary intakes for an individual or for a group or
population. Estimated Average Requirement (EAR),
Recommended Energy/Nutrient Intake (REI/RNI),
Adequate Intake (AI), and Tolerable Upper Intake
Level or Upper Limit (UL) are the components
constituting the PDRI.
• Recommended Dietary Allowance (RDA) – the
estimated amount of a nutrient (or calories) per day
considered necessary for the maintenance of good
health.
STUDY NOTES
• Nutrition in early life is crucially important for
children to grow and develop into healthy adults.
Children can reach their growth and development
potential if their nutritional needs are met in a
healthy environment. Unfortunately, the
Philippines is one of the countries in the world
where a significant number of children remain
malnourished despite the economic growth and
Page 1 of 9 NCMA215 WEEK 2
NNS) in the Philippines reported that among
children under 5 years old, the prevalence of
malnutrition measured by underweight and
stunting was 20% and 30%, respectively, and the
prevalence starts to increase at 6–11 months
DIETARY REFERENCE INTAKES (DRIs)
• Dietary Reference Intakes (DRIs) is a generic term
for a set of nutrient reference values that includes
the Recommended Dietary Allowance (RDA),
Adequate Intake (AI), Tolerable Upper Intake Level
(UL), and Estimated Average Requirement (EAR).
• This is for planning and assessing diets of healthy
groups and individuals. PDRI is the collective term
comprising reference value for energy and nutrient
levels of intakes. The components of PDRI are:
ESTIMATED AVERAGE REQUIREMENT (EAR)
• is a daily nutrient intake level that meets the
median or average requirement of healthy
individuals in particular life stage and sex group,
corrected for incomplete utilization or dietary
nutrient bioavailability.
• The estimated average requirement (EAR) is the
amount of a nutrient that is estimated to meet the
requirement for a specific criterion of adequacy of
half of the healthy individuals of a specific age, sex,
and life-stage. The amount of the nutrient
necessary to meet the appropriate criterion of
adequacy varies from one individual to the next, but
the data are usually distributed normally or can be
transformed to achieve a normal distribution. The
EAR is not useful as an estimate of nutrient
adequacy in individuals, because it is a mean
requirement for a group, and the variation around
this number is considerable. A recommended
dietary allowance (RDA) for a nutrient is derived
from an estimated average requirement (EAR),
which is an estimate of the intake at which the risk
of inadequacy to an individual is 50%..
RECOMMENDED ENERGY/NUTRIENT INTAKE (RENI)
• also known as Recommended Daily Allowances is a
level of intake of energy or nutrient which is
considered adequate for the maintenance of health
and well-being of healthy persons in the population.
Annotated by: C. Danting
 The 2015 Philippine Dietary Recommended Intake
(PDRI) shall be used for planning and assessing diets
for individuals and groups, developing food-based
dietary guidelines, formulating standards and
regulations on food fortification, nutrition labeling
and claims, and food safety, designing and
evaluating food and nutrition assistance programs,
determining food bundles, setting food production
targets, and other related uses that require
consideration of nutrient and dietary intakes.
• The average amount of a nutrient a healthy person
should get each day. RDAs vary by age, gender and
whether a woman is pregnant or breastfeeding. For
example, the RDA for vitamin C is 80 mg a day for a
pregnant teenager and 90 mg a day for men. RDAs
apply to vitamins and minerals from food and daily
supplements. The purpose of these guidelines is to
inform you how much of a specific nutrient your
body needs on a daily basis. It is important to meet
the daily recommended dietary allowances so that
your body gets everything it needs to function.
• The Recommended Dietary Allowance (RDA) is the
average daily dietary intake level that is sufficient to
meet the nutrient requirement of nearly all (97 to
98 percent) healthy individuals in a particular
gender and life stage group (life stage considers age
and, when applicable, pregnancy or lactation).
• The RDA for a nutrient is a value to be used as a goal
for dietary intake by healthy individuals. The RDA is
not intended to be used to assess the diets of either
individuals or groups or to plan diets for groups.
• PDRI 2015 updated the 2002 Recommended Energy
and Nutrition Intake (RENI) with the following
changes: (1) Adjustment of reference weights for
infants and children based on the World Health
Organization Child Growth Standards (WHO-CGS)
and Growth Reference, and those for adults based
on the weight to achieve Body Mass Index (BMI) of
22 using the 2013 National Nutrition Survey (NNS)
height data; (2) Revision of age groupings to reflect
established biological patterns and recent
international feeding guidelines; (3) Updating of
reference values arising from new scientific
evidence on human milk volume and on nutrient
requirements; (3) Inclusion of additional nutrients
like polyunsaturated fatty acids and removal of
manganese; (4) Inclusion of Acceptable
Macronutrient Distribution Ranges for protein, total
Page 2 of 9 NCMA215 WEEK 2
fat, and carbohydrates for the reduction of chronic
disease risk; (5) Recommendation on maximum
intake levels of sodium and free sugars for the
reduction of risk of cardiovascular disease, obesity
and dental caries; and (7) Clarification on the
appropriate Dietary Reference Intakes (DRI) values
for different uses and applications.
ADEQUATE INTAKE (AI)
• a daily nutrient intake level that is based on
observed or experimentallydetermined
approximation of the average nutrient intake by a
group (groups) of apparently healthy people that
are assumed to sustain a defined nutritional state.
• The AI is based on observed or experimentally
determined estimates of nutrient intake by a group
(or groups) of healthy people. For example, the AI
for young infants, for whom human milk is the
recommended sole source of food for the first 4 to
6 months, is based on the daily mean nutrient
intake supplied by human milk for healthy, full-term
infants who are exclusively breastfed. The main
intended use of the AI is as a goal for the nutrient
intake of individuals. For example: if an individual
has a total calorie in a day of 1,500, that individual
can take at least 75% of the total calorie for a day
which is 1,125 calorie is allowable.
• Adequate Diet is composed of various nutrients
which body needs for maintenance, repair, and for
growth and development. An essential of an
adequate diet are milk group that provide most of
the calcium requirements; meat group that
provides generous amounts of protein in high
quality; bread and cereal group that furnishes
carbohydrates, minerals and vitamins at a relatively
at low costs; and vegetable fruit group that
important supplier of fiber, vitamins and minerals
particularly Vitamin A and C.
TOLERABLE UPPER INTAKE LEVEL OR UPPER LIMIT (UL)
• is a highest average daily nutrient intake level likely
to pose no adverse health effects to almost all
individuals in the general population.
• As intake increases above the UL, the risk of adverse
effects increases. The term tolerable intake was
chosen to avoid implying a possible beneficial
effect. Instead, the term is intended to connote a
level of intake that can, with high probability, be
Annotated by: C. Danting
 tolerated biologically. The UL is not intended to be Adults (Tanhausser’s Method)
a recommended level of intake. There is no
established benefit for healthy individuals if they DBW = ht. in cm – 100 – (10%)
consume nutrient intakes above the RDA or AI. ULs TOTAL ENERGY REQUIREMENT (TER) PER DAY
are useful because of the increased interest in and
availability of fortified foods and the increased use INFANTS = 0 – 6 MONTHS
of dietary supplements. ULs are based on total
intake of a nutrient from food, water, and TER = DBW x 120 kcal/day KDBW
supplements if adverse effects have been
INFANTS = 7 - 12 MONTHS
associated with total intake. However, if adverse
effects have been associated with intake from TER = DBW x 110 kcal/day KDBW
supplements or food fortification only, the UL is
based on nutrient intake from those sources only, CHILDREN = 2 - 12 YEARS
not on total intake. The UL applies to chronic daily
TER = 1000 = (100 x no. of years)
use.
• For many nutrients, there are insufficient data on ADOLESCENT = 13 - 17 YEARS
which to develop a UL. This does not mean that
there is no potential for adverse effects resulting TER = DBW x 45 kcal
from high intake. When data about adverse effects
are extremely limited, extra caution may be
ADULTS (Krause Method)
warranted. TER = PA Value
DIETARY FORMULATION PHYSICAL ACTIVITY (PA)
BODY MASS INDEX (BMI) • calorie requirements depend upon the type and
BMI = kg/m2 amount of exercise or work engaged into.
• The more vigorous the physical work, the greater
CLASSIFICATION OF BODY MASS INDEX the calorie cost
BODY MASS INDEX INTERPRETATION SAMPLE PHYSICAL ACTIVITY
< 18.5 Underweight
18.5 – 24.9 Healthy / Normal BMI Bed Rest Comatose, Bed-ridden
25.0 – 29.9 Overweight (27.5)
30.0 – 34.9 Obese 1 Sedentary: 30 Secretary, Clerk, Typist,
35.0 – 39.9 Obese 2 Administrator, Cashier,
>40.0 Extremely Obese Bank teller
Light: 35 Teacher, Nurse, Student,
Lab Tech, Housewife with
DESIRABLE BODY WEIGHT (DBW) maid
Moderate: 40 Vendor, mechanic, public
Infants = 0 – 6 months utility vehicle and car
DBW = Birth weight (kg) + (age in mos. X 600) driver
Heavy: 45 Farmer, laborer, coal
Infants = 7 – 12 months miner, fisherman, heavy
equipment operator,
DBW = Birth weight (kg) + (age in mos. X 500) wrestler, sports player
BASAL METABOLISM
* If the birth weight is unknown used 3000 grams
• measure of energy needed by the body at rest for
Children its internal chemical activities like respiration,
DBW = age in years x 2 + 8 cellular metabolism, circulation, glandular activity
Page 3 of 9 NCMA215 WEEK 2 Annotated by: C. Danting
 and maintenance of body temperature;
approximately 1 calorie per kg of body weight per
hour
• BASAL METABOLIC RATE - rate of basal metabolism
in a given person at a given time and situation

BMR CALCULATION

Rule of thumb
1 kcal per kg per hour (Male)

0.9 kcal per kg per hour (Female)

Example:

BMR (Male)

Male 75 kg = 1 kcal X 75 X 24 = 1,800 kcal

BMR (Female)

Female 65 kg = 0.9 kcal X 65 X 24 = 1,404 kcal

CPF COMPUTATION IN GRAMS

• Computation of CPF in grams

Example: TER X methods 1-5 (depending on the case of

the client – DM can use method 5)

TER = 2,000 X .50 = 1,000 / 4 = 250 grams of

carbohydrates/day

= 2,000 X .20 = 400 / 4 = 100 grams of protein/day

= 2,000 X .30 = 600 / 9 = 67 grams of fat/day

TER of 2,000 kcal/day with diet prescription of C = 250

grams; P = 100 grams; and F = 67 grams

METHODS CARBOHYDRATE PROTEIN FATS

Method 1 60 15 25
Method 2 70 10 20
Method 3 65 15 20
Method 4 60 10 30
Method 5 50 20 30

Calorie (kilocalorie)

• is a unit of heat energy

1 gram of CHO 4 calories

1 gram of CHON 4 calories
1 gram of Fats 9 calories

Page 4 of 9 NCMA215 WEEK 2 Annotated by: C. Danting

 LIST FOOD EXCHANGE HOUSEHOLD CHO(g) PRO (g) FAT (g) ENERGY
GROUPS
MEASURE (CALORIES)

IA Veg A 1 1 cup raw or ½ 0 0 0 0

cup cooked

IB Veg B 1 ½ cup raw or ½ 3 1 0 16

cup cooked

II Fruit 1 varies 10 0 0 40

III Milk 1 varies 12 8 10 170

Full Cream 12 8 5 125

Low Fat 12 8 trace 80

Skimmed

IV Rice 1 varies 23 2 0 100

V Meat & Fish 1 varies 0 8 1 41

Low Fat 0 8 6 86

Medium 0 8 10 122

High Fat

VI Fat 1 1 teaspoon 0 0 5 45

VII Sugar 1 1 teaspoon 5 0 0 20

Page 5 of 9 NCMA215 WEEK 2 Annotated by: C. Danting

 VEGETABLE EXCHANGE FRUIT EXCHANGE
2 EXCHANGE VEGETABLE A = 16 1 EXCHANGE FRUIT = 40 Kcalories
Kcalories
4 cups raw or 1 cup cooked (single or mixed
1 /2 piece (Apple, Banana, Bungulan, Marang,
VEGETABLE A Singkamas Tuber, Star Apple)
Acelgas(Chinese Cabbage), Alagaw Leaves, Alugbati 1 piece (Guyabano, Green-Medium-Ripe Mango, Ripe
Leaves, Ampalaya Leaves, Balbalulang (seaweed), Baguio Melon, Ripe Papaya, Pineapple, Watermelon)
Beans (abitsuelas), Bamboo shoot (labong), Banana 2 pieces (Dalanghita, Guava)
Heart (Puso ng Saging), Bataw Pods, Beets, Cabbage, 3 pieces (Makopa, Mangosteen)
Cassava Leaves and Tops, Cauliflower, Camote Leaves, 20 pieces Duhat
Celery, Chayote Leaves, Cucumber, Eggplant, Gabi 10 pieces Grapes
Leaves, Garlic Leaves, Himbabao, Kangkong, Katuray 9 Pieces Mango Paho
Flower, Katuray Leaves, Lettuce, Malunggay Leaves, 8 pieces Rambutan
Malunggay Pods, Mushroom Fresh, Mustard Leaves, 7 pieces (Lansones, Kamachile)
Okra, Onion Bulb, Pako, Papaya Green, Patola, Pepper 5 pieces (Lychees, Sineguelas)
Leaves, Petsay, Pokpoklo (seaweed), Radish, Saluyot, 3 segments Ripe tamarind
Sigarilyas Pods, Spinach, Squash Flowers, Squash Leaves, 1 segment Durian
Stringbeans Leaves (Sitaw, Dahon), Sweet Pea Pods 1 1 /3 cups Strawberry
(Sitsaro), Talinum, Tomato, Unsoy, Upo CANNED

1 EXCHANGE VEGETABLE B = 16 3 Tablespoons (Apple Sauce, Fruit Cocktail, Crushed

Kcalories Pineapple)
1 slice Pineapple, sliced
1/2 cup raw or 1/2 cup cooked (single or mixed 1 1 /3 halves Peach halves
VEGETABLE B DRIED
Fresh 2 Tablespoons Seedless Raisins
Carrot, Coconut Shoot (Ubod), Cowpea Pods (Paayap, 2 pieces (Mango Chips, Dikyam)
bunga), Kamansi, Langka Hilaw, Lima Bean Pods (Patani, 3 pieces (Seedless Prunes, Pitted Dates)
Bunga), Mungean Sprout (toge), Pigeon Pea Pods 4 pieces Salted Champoy
(Kadyos, Bunga), Rimas, Singkamas Pods (Bunga), JUICES, CONCENTRATE
Singkamas Tuber (Lamang Ugat), Squash Fruit,
Stringbean Pods (Sitaw, Bunga) Canned 1 /2 cup Sweetened
Bottled 1 /3 cup Sweetened
Processed
OTHERS
1 cup Asparagus Tips
2 pieces Baby Corn 1 /2 piece (Banana Cue, Turon)
1 Tablespoon Green Peas, canned (Gisantes, Nakalata) 1 /3 piece Maruya
2 Tablespoon Golden Sweet Corn, canned/ 1 cup Buko Water
1 /3 cup Mushroom, canned 3 Tablespoons Sherbet
1 /2 cup undiluted Tomato Juice, canned
3 pieaces Water chestnut, canned

Page 6 of 9 NCMA215 WEEK 2 Annotated by: C. Danting

 MILK EXCHANGE (Kastanyas)
1 /2 cup Breakfast Cereals
1 EXCHANGE WHOLE MILK = 170 1 1 /4 cups Corn/ Rice Curls and the likes
Kcalories 5 teaspoons Cornstarch
3 Tablespoons All Purpose Flour
1 /3 cup Regular Ice Cream
1/2 cup undiluted Filled, recombines or Evaporated Milk 1 /2 cup cooked Sago
1 cup Fresh Milk (Cow or Carabao) 1 /2 slice Cassave Cake
4 Level Tablespoons or 1/4 cup Powdered Milk 1 slice (Bibingka, Biko, Kalamay, Puto Puti, Sapin-sapin,
Tikoy)
1 EXCHANGE LOW FAT MILK = 125 2 pieces (Espasol, Puto Bumbong)
Kcalories 1 piece (Kutsinta, Suman sa Ibos, Suman sa Lihiya)
3 pieces Palitaw, walang niyog
1 /2 of Tupig
4 Level Tablespoons or 1 /4 cup Low fat Powdered Milk
1 Tetra-brick Lite Low Fat Milk MEAT AND FISH EXCHANGE

1 EXCHANGE SKIMMED/NON-FAT/ 1 EXCHANGE LOW FAT MEAT AND

VERY LOW FAT MILK = 80 Kcalories FISH = 41 Kcalories

4 Level Tablespoons or 1/4 cup Powdered Buttermilk 1 matchbox slice or 30 grams cooked Lean Meat (Beef,
2 /3 cup Liquid Buttermilk Carabeef, Pork, Chicken)
1 /2 cup Yogurt 1 small piece Chicken Leg (30 grams cooked)
1 cup Long Life skimmed milk 1 /4 Chicken Breast (30 grams cooked)
3 /4 cup (30 grams cooked) Variety Meats or Internal
RICE EXCHANGE
Organs
1 EXCHANGE RICE = 100Kcalories 1 slice (35 grams cooked) (Bangus, Dalag, Lapu-lapu,
Labahita)
1 piece (35 grams) cooked (Hasa-hasa, Dalagang Bukid,
1 /2 cup, packed Cooked Rice Galunggong)
1 cup Thick Lugaw (Rice Gruel) 1 /2 piece (35 grams) cooked Dilis
1 piece (Pan de Bonete, Pan de Leche, Pan de Limon, 1 1 /4 Tablespoons (30 grams) cooked Alamang,
Pan de Monay, Hotdog or Hamburger Roll) Tagunton
2 slices (Tasty Bread, Whole Wheat Bread) 1 /4 cup or 1 /2 piece medium (20 grams cooked)
3 small pieces Pan de Sal 22 pieces (Pasensiya, Marie) Alimango, Alimasag Meat
5 pieces Lady Fingers 2 Tablespoons (30 grams cooked) Lobster 7
3 pieces Mamon Tostado 5 pieces (30 grams, cooked) Talangka, as purchased
1 1 /2 diced or 1 /2 round Hopia Hapon 25 grams cooked Shrimps (5 pieces Puti, 2 pieces Sugpo,
1 Ensaymada 5 pieces Suwahe)
1 /2 cup Binatog (Hominy) 3 pieces (25 grams cooked) Squid
1 cup (Corn flakes, Baby Corn, Canned Golden Corn)
1 slice Corn Pudding (Maha, Mais) DRIED FISH PRODUCTS
1 cup cooked Noodles (Bihon, Macaroni, Sotanghon,
20 grams cooked Daing (Lapu-lapu, Sapsap, Tanigi)
Spaghetti)
30 grams cooked Tinapa (Bangus, Galunggong)
1 /2 cup Sweet Potato
15 grams cooked Tuyo (Alamang, Pusit)
1 cup (Cassava, Gabi)
1 - 1 /3 cups (Potato, Ubi)
11 large or 20 small pieces Roasted Chestnut
Page 7 of 9 NCMA215 WEEK 2 Annotated by: C. Danting
CANNED PROCESSED MEAT

1 /3 cup flaked (Salmon, Tuna in brine) 1 piece Longanisa, Chorizo Style

1 1 /2 piece Frankfurters
PROCESSED MEAT
3 slices Salami
1 slice or 45 grams cooked Lean Tocino 4 slices Vienna sausage

OTHERS FATS EXCHANGE

1 /3 cup dried Pigeon Pea Seeds (Kadyos, 55 grams
1 EXCHANGE FAT = 45 Kcalories
cooked)
1 /3 cup (60 grams) Cottage Cheese
SATURATED FATS

1 strip Bacon
1 EXCHANGE MEDIUM FAT MEAT 1 teaspoon (Butter, Coconut oil, Margarine,
AND FISH = 86 Kcalories Mayonnaise)
2 teaspoon Latik
1 tablespoon (Coconut Cream, Cream Cheese, Sandwich
1 matchbox slice Beef (Kabilugan, Punta y Pecho, Spread, Heavy/Light Whipping Cream)
Tadyang, Paypay) 2 tablespoons Grated Coconut
1 matchbox slice (30 grams cooked) Pork leg or pata
3 /4 cup or 35 grams cooked Brain (Pork, Beef, POLYUNSATURATED FATS
Carabeef)
1 teaspoon Vegetable Oil (Corn, Marine, Soybean,
1 slice (35 grams cooked Karpa)
Rapeseed, Canola, Rice, Sesame, Sunflower)
1 piece Chicken egg, Salted Duck’s Egg
9 pieces Quail’s Egg MONOUNSATURATED FATS
1 slice (35 grams) Cheddar Cheese 1 medium or 2 small
1 teaspoon Peanut Oil, Olive Oil, Shortening
pieces Chicken Wings 2 pieces Chicken Head
2 teaspoons Peanut butter
1 /2 cup (40 grams) cooked Soybean
5 pieces Pili nut
PROCESSED FOODS 1 /2 piece Avocado

1 piece Sardines in Oil or Tomato Sauce SUGAR EXCHANGE

1 1 /2 piece Tuna Sardines
2 Tablespoons canned Tuna Spread 1 EXCHANGE SUGAR = 20 Kcalories
3 Tablespoons Corned Beef
3 pieces Ham Sausage
1 /2 cup soft Soybean Curd (Tofu)
1 slice Soft Soybean Cheese (Tokwa) 1 piece (Banana Chip, Bukayo, Caramel, Champoy,
Bubble Gum, Hard Candy, Tira-tira, Toffee candy,
Mashmallow, Yema)
1 EXCHANGE HIGH FAT MEAT AND 1 teaspoon (Sugars, Honey, Pakaskas, Grated Panutsa,
FISH = 122 Kcalories Matamis na Bao)
2 teaspoons (Condensed Milk, Jams, Jellies, Preserves)
2 tablespoons (Nata de Coco, Nata de Pinya)
1 slice Ham (Pigue)
3 /4 cup Tongue (Pork, Beef)
1 piece Duck’s egg (Balut Penoy)
1 /3 cup Roasted Peanuts
1 slice (Filled Cheese, Cheese pimiento)

Page 8 of 9 NCMA215 WEEK 2 Annotated by: C. Danting

 FREE FOODS
FREE FOODS (unless prohibited by
physician)
Bagoong, Mustard, Bouillion, Onkon, Carbonated Water,
Oregano, Candy (Hard, Sugar free), Paprika, Chili Powder,
Pepper, Cinnamon, Pickle, Dill or Sour (unsweetened),
Clear Broth, Coffee, Pimiento, Curry, Spices, Drink Mixes
(Sugar Free), Soy sauce, Fish Sauce, Tomato Juice,
Flavoring Extract, Tomato paste, Garlic, Tomato sauce,
Gum (Sugar free), Tonic water (Sugar free), Herbs, Tea,
Hot pepper (sauce), Vinegar, Kalamansi, Worcestershire
Sauce, Kamyas, Karamay, Lemon, Unsweetened Pickle
(dill or sour), Pimiento

Page 9 of 9 NCMA215 WEEK 2 Annotated by: C. Danting