College of Nursing

NCM 105A
NUTRITION AND DIET
THERAPY
LABORATORY

LABORATORY EXERCISE
7 NO.

Macronutrients—Proteins

Name: Aquino,Julie Anne; Balasbas,Lalyn ; Ferrer,Shamae Angela Date Due: November

7,2021
Magno, Bethany; Pinlac, Ericka Mae; Tabon, Daisy Jane
Year and Section: __BSN2 A _______________________ Date Submitted:
____________________
Professor: ___Ma’am Therese Joy Cabrera______________ Score:
_________________________

Most people think of meat, fish, and poultry as good sources of protein. While they provide most
protein per serving portion in the daily diet, it is a mistake to assume that these are the only good sources
of protein. Legumes are also rich in protein, as are nuts of many kinds. Breads and cereals contain
relatively small amounts of protein.

I.Objectives
Protein is indispensable to life and its deficiency can bring about damaging effects to one's health.
Its excess, however, can also be harmful. Two groups will be required to plan meals for people with protein
malabsorption, and the planned diet will play an important role in the recovery from deficiency.
At the end of the 3-hour laboratory session, you should be able to:
1. recognize the importance of protein in the Filipino diet; and
2. plan and prepare meals for individuals requiring protein intake modification.

II. Procedures Group 3 and 4: Case # 2. An individual suffering from gouty arthritis
1. Calculate and plan a 1,800 kcal low-purine diet. Prepare a sample menu plan for dinner. See Table
below for purine content of different food items.
Purine Contents of Different Food Items
HIGH CONTENT: 150-182.5 mg/100 g
Fish/Seafood Meats
Anchovies Brains Meat extracts
Herring Gravies Wild game
Mackerel Kidney Sweetbreads
Sardines Liver Goose
Scallops
MODERATE CONTENT: 50-150 mg/100
Vegetables Fish/Seafood Poultry
Asparagus Crabs Chicken
Cauliflower Eel Duck
Green Fish (all kinds) Turkey
Peas Lobsters
Mushrooms Oysters
Spinach
Grains and Legumes Meats and Related Products
Legumes (split peas, beans, lentils) Beef
Oatmeal Lamb
Wheat bran and germ Pork
Whole-grain breads and cereals Veal
LOW CONTENT: 0-50 mg/ 100mg

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 Beverages Dairy Miscellaneous
Carbonated beverages Cheese Eggs Gelatin
Coffee Milk (all fat levels) Fats Nuts
Tea Vegetables Fish roe
Grains Fruits and juices
Breads and cereals (refined white flour) Sugar (all types) and food containing sweets

Table 7-1. Meal Plan for a Low-Protein Diet

Food No. of CHO PRO FAT ENERGY Meal

Exchange Exchanges kcal Distributions
g g G B L D Sn
I. Veg A 6 96 2 2 2
Veg B
II. Fruits 6 60 240 2 1 1 2
III. Milk 3 36 24 15 375 1 1 1
IV. Rice 6 138 12 600 2 2 2
V. Meat 3 24 57 366 1 1 1
VI. Sugar 2 10 40 1 1
VII. Fat 2 10 90 2
Total 244 11 6 7 4

Table 7-2. Sample Dinner Menu

Menu Household Measure

Broccoli 2 cups
Apple 1 piece
Milk 1 cup
Rice 2 cups
Adobo 1 cup

2. Discuss the following and write the answers in Table 7-3.

2.1 Protein-related diseases
2.2 Symptoms
2.3 Causes
2.4 Prevalence
2.5 Dietary changes

Table 7-3. Worksheet for Protein-related Diseases

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 Diseases Symptoms
Recurring infections
Kwashiorkor or more serious or
long-term diseases;
loss of muscle mass;
an inflated
midsection ("pot
belly"); red,
inflammatory skin
that darkens, peels,
and rips apart. Dry,
brittle hair that is
prone to shedding
and color loss.
incapacity to get
taller Irritability or
tiredness
Marasmus In children, severe
protein and calorie
deficit can result in
fat and muscle mass
loss. The most
prevalent symptom
of marasmus is
malnutrition-induced
underweight. Several
symptoms include
the following:
* Weight loss
* Stunted growth
* Dry skin and eyes
* Brittle hair
* Diarrhea
Impaired Feeling sad or
Mental Health depressed.
Significant tiredness,
low energy, or
sleeping difficulties.
Excessive worries or
fears, as well as
extreme feelings of
guilt.
Thinking that is
jumbled or has a
reduced ability to
concentrate.
Extreme mood
swings between
highs and lows.
Withdrawal from
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Causes Prevalence Dietary Changes
The major cause of Kwashiorkor is a Kwashiorkor can be
kwashiorkor is a lack condition that mostly treated by increasing
of protein and other affects young protein and calorie
important vitamins children in areas with intake in general,
and minerals. It is endemic food particularly if
especially frequent in insecurity or famine; treatment begins
impoverished nations prevalence varies by early. To begin with,
with a low food geographic region, you may be given
supply, poor with reported rates more calories in the
cleanliness, and a ranging from 6% in form of
lack of understanding some chronically carbohydrates,
about the necessity food-insecure sweets, and fats. You
of feeding newborns communities to 1% in will be fed protein-
and children a exceptional cases. rich meals once these
sufficient diet. calories have
provided you with
energy.
The primary cause of Marasmus can affect Although any
marasmus is nutrient adults and children protein- and calorie-
insufficiency. It similarly, but it is rich meal can be
occurs in children most prevalent in utilized to prevent
who do not consume young children in marasmus based on
an enough amount of underdeveloped what is available,
protein, calories, nations. According to skimmed milk,
carbohydrates, or UNICEF, about half of salmon, eggs, and
other critical all deaths in children nuts are the best
nutrients. This is under the age of five, sources of energy
frequently the result or around 3 million and growth.
of poverty and food per year, are due to
scarcity. Malnutrition malnutrition.
manifests itself in a
variety of ways.
Long-term protein Approximately 450 High protein diets
deficiency can have a million people that provide energy,
variety of effects on currently suffer from such as almonds,
your psychological such conditions, eggs, nuts, beans,
well-being. making mental and meat.
disorders one of the
leading causes of
illness and disability
worldwide.
 social activities and
friends
Wasting and • having one arm or
shrinkage of muscle leg that is noticeably
tissue smaller than the
others.
• experiencing
weakness in one limb
or generally.
• having difficulty
balancing.
• remaining inactive
for an extended
period.
Oedema Swelling or puffiness
in different zones of
the body like feet,
hands, and stomach.
Increased abdominal
size
Stretched or shiny
skin
Skin that retains a
dimple (pits), after
being pressed for
several seconds
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Not getting enough Wasting and The advised diet for
protein and lack of shrinkage of muscle this disease is food
physical activity for tissue affects 1 per rich in calcium and
an extended period 8,000 to 10,000 vitamin D that can
of time and people worldwide. help muscle and
malnutrition can Age-related muscle bone health.
cause wasting and loss, called Calcium-rich food
shrinkage of muscle sarcopenia, is a includes dairy
tissue natural part of aging. products like milk,
After age 30, you cheese, yogurt, etc.,
begin to lose as much leafy green
as 3% to 5% per vegetables such as
decade. Most men broccoli and spinach,
will lose about 30% calcium-added food
of their muscle mass such as orange juice
during their lifetimes. and cereals, and fish
This involuntary loss such as sardines and
of muscle mass, salmon.
strength, and
function is a
fundamental cause of
and contributor to
disability in older
people. This is
common among
adults and children
who doesn't take
adequate proper
nutrition and physical
activity.
Swelling or puffiness Swelling or puffiness Eat natural diuretic
in different zones of in different zones of vegetables such as
the body like feet, the body like feet, asparagus, parsley,
hands, and stomach. hands, and stomach. green beans, leafy
Increased abdominal Increased abdominal greens, pineapple,
size size pumpkin, onion,
Stretched or shiny
Stretched or shiny garlic
skin
skin Eat foods high in
Skin that retains a
dimple (pits), after Skin that retains a vitamin B such as
being pressed for dimple (pits), after whole grains, sea
several seconds being pressed for vegetables
several seconds Reduce salt intake
Avoid refined foods
such as breads,
 pasta, sugar
Avoid alcohol and
tobacco
Exercise lightly 5 days
a week

III. Questions for Discussion

1. Differentiate biological value (BV) from net protein utilization (NPU)?

Net protein utilization is similar to the biological value except that it involves
a direct measure of retention of absorbed nitrogen. Biological value measures
protein quality by calculating the nitrogen used for tissue formation divided
by the nitrogen absorbed from food. Net protein utilization and biological
value both measure the same parameter of nitrogen retention, however, the
difference lies in that the biological value is calculated from nitrogen
absorbed
Whereas net protein utilization is from nitrogen ingested

2. What are the health effects of protein?

Many adults or even adolescents (especially athletes or body builders) self-prescribe
protein supplements and overlook the risks of using them, mainly due to misguided
beliefs in their performance-enhancing abilities. Individuals who follow these diets are
therefore at risk. Extra protein is not used efficiently by the body and may impose a
metabolic burden on the bones, kidneys, and liver. Moreover, high-protein/high-meat
diets may also be associated with increased risk for coronary heart disease due to
intakes of saturated fat and cholesterol or even cancer

3. Differentiate acute protein-energy malnutrition (PEM) from chronic PEM. _

Energy malnutrition (PEM) from chronic PEM Protein energy malnutrition (PEM) is defined
as "an imbalance between protein and energy supply and the body's demand for them to
ensure optimal growth and function." Kwashiorkor, marasmus, and marasmic
kwashiorkor are the three clinical manifestations of severe PEM. Kwashiorkor is caused
by a relative protein deficiency in the presence of adequate energy intake, and it is
characterized by hypoproteinemia, pitting edema, varying degrees of wasting and/or
stunting, dermatosis, and fatty liver infiltration. Marasmus is characterized by wasting,
fatigue, and apathy as a result of both an energy and protein deficiency. Marasmic
kwashiorkor is a condition characterized by edema, wasting, stunting, and mild
hepatomegaly caused by acute or chronic protein deficiency and chronic energy deficit.
The line between kwashiorkor and marasmus is frequently blurred, and many children
exhibit symptoms of both.
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 1

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