Philippine Christian University

Taft Avenue, Manila

NORMAL, ANEMIC

A case study to be presented to

College of Nursing and Allied Health

Philippine Christian University

In partial fulfillment of the requirements in the subject

Nutrition Therapy 2 (NUTR3202)

STUDENT’S NAME

Hyacinth M. Notarte

BSND 3

To be submitted to:

Mr. Ancel Jeff G. Beso, RND, MMHoA (ongoing)

Date:

May 20, 2022

1
 I. INTRODUCTION:

Red blood cells carry hemoglobin, an iron-rich protein that attaches to oxygen in the lungs
and carries it to tissues throughout the body. Anemia is a disorder in which there are insufficient
healthy red blood cells to transport oxygen to your body's tissues. There are various kinds of
anemia and it is usually caused by a combination of factors. Anemia can be mild to severe, and
it can be transitory or chronic. It is diagnosed when a blood test shows a hemoglobin value of less
than 13.5 gm/dl in a man or less than 12.0 gm/dl in a woman.

Here the Philippines, a big percentage suffers from one or more forms of malnutrition,
including micronutrient deficiencies. Iron deficiency (also known as anemia) is the most common
type of malnutrition in the Filipino population, particularly among adolescents. The symptoms—
hilo, pagod, putla—are relatively easy to live with in their early stages. But when left untreated,
these recurring symptoms threaten Filipinos far beyond their health, as it seeps into productivity,
education, and even economic status. Many people are at risk for anemia because of poor diet,
intestinal disorders, chronic diseases, infections, and other conditions. Women who are
menstruating or pregnant and people with chronic medical conditions are most at risk for this
disease. The risk of anemia increases as people grow older.

The overall goal of this case study is to assist an anemic young woman for her to maintain
a healthy diet and lifestyle despite of being an anemic. To avoid her from having a severe to
chronic iron deficiency anemia by eating a diet that includes a variety of vitamins and minerals. In
addition, particular goals include (a) assisting the client in maintaining and improving her lifestyle
or physical activity, and (b) recommending a low-cost, healthful, and simple-to-cook meal. This
research is only for clients who are anemic. This research will also help those who are currently
being diagnosed with anemia to prepare a simple meal for themselves, friends, or for their parents.

II. CASE PATIENT:

Personal Profile

Ms. Kristine Djoy D. Claridad is a 21-year-old 3rd year college student taking up Bachelor
of Science in Nutrition & Dietetics (BSND) in Philippine Christian University Manila, a private,
coeducational protestant university located in Ermita, Manila, Philippines. Ms. Claridad is a
Roman Catholic residing in Binondo Manila, Philippines. She is a type of a kid with a slim type of
body, as she grew up, she maintains her weight but when she started working as a call center
agent during the Covid-19 pandemic that’s the time she was diagnosed being anemic. Now, Ms.
Claridad is still working in a BPO company. She is allergic to chicken but at the same she still
allowed to eat it in a moderate way and making sure it was cooked properly.

2
 Socio Economic Data

Type of Residence: Owned; Urban

Income Bracket: Over 20,000 but not over 30,000

Name Relationship
Philippides M. Claridad Father
Ma. Cristina D. Claridad Mother
Philip Denniel D. Claridad Brother

Contact number: 09976770305

Facebook Account: https://www.facebook.com/katy.clarity

Anthropometric Data:

o Height: 4’11’’
o Weight: 50kg or 110lbs

BMI: 149.86 ÷ 100 = 1.4986

1.4986 × 1.4986 = 2.24

𝑘𝑔 50𝑘𝑔
= = 22.32 Normal
ℎ (𝑚)2 2.24

DBW: 4 × 12 = 48 = 11 = 59in

59 × 2.54 = 149.86cm

149.86 – 100 = 49.86

49.86 × .9 = 44.87 or 45kg

DBW RANGE: 45kg – 5% = 42.75kg or 43kg

45kg + 5% = 47.25kg or 47kg
43kg to 47kg

III. 3-day 24-hour Food Recall

Day 1:

BREAKFAST AM SNACK LUNCH

1 cup coffee Palabok NONE

PM SNACK DINNER MIDNIGHT SNACK

Rice Rice
NONE Hotdog Ampalaya with karne
1 cup coffee Noodles
1 cups of coffee

3
 Day 2:

BREAKFAST AM SNACK LUNCH

Rice
Fried Chicken NONE NONE
Burger Steak
Fries
PM SNACK DINNER MIDNIGHT SNACK
Mami 2 pcs chicken
Siomai Rice
NONE Coke
Coffee
Fries
Pizza
1 cup coffee

Day 3:

BREAKFAST AM SNACK LUNCH

NONE NONE NONE

PM SNACK DINNER MIDNIGHT SNACK

Rice Rice
NONE Fried Chicken Fried Chicken
Egg Sandwich
1 cup coffee

IV. Adequacy of food intake:

Day 1:

CHO PRO FAT KCAL

BREAKFAST
1 cup coffee - - - -
AM SNACK
Palabok:
Sotanghon 23 - - 92
1 Egg slices - 8 6 86
(boiled)
PM SNACK
NONE - - - -
DINNER
Rice 46 4 - 200
HF
5pcs Meat - 8 10 122
Hotdog (1 ex)
(cocktail) Sugar 10 - - 40
(2 ex)
1 tbsp cooking oil - - 5 45
MIDNIGHT SNACK
Rice 46 4 - 200
Veg. 3 1 - 16

4
 Ampalaya LF - 8 1 41
with Meat
karne
Noodles (bihon) 23 - - 92
TOTAL 151g 33g 22g 934 kcal

151𝑔 33𝑔 22𝑔 934𝑘𝑐𝑎𝑙

× 100 = 68.63%
50𝑔
× 100 = 66%
30𝑔
× 100 = 73.33% × 100 =
220𝑔 1,350𝑘𝑐𝑎𝑙
Adequacy:
69.18%
Inadequate Inadequate Inadequate Inadequate

Day 2:

CHO PRO FAT KCAL

BREAKFAST
Rice 46 4 - 200

Fried MF Meat - 8 6 86
Chicken Cooking - - 5 45
(Drumstick) oil
Burger Steak Mushroom 3 1 - 16
LF Meat - 24 3 361
French Fries Rice B 46 4 - 200
(regular) (2 ex)
Fat (4 ex) - - 20 180
Sugar 10 - - 40
(2 ex)
AM SNACK
NONE - - - -
LUNCH
NONE - - - -
PM SNACK
NONE - - - -
DINNER
Mami with Noodles, 23 2 - 100
3pcs miki
Dumpling (1 Rice B, - - 5 45
(fried) ½ Fat)
Meat - 8 10 122
(1 HF Meat,
23 2 - 100
1 Rice B)
MIDNIGHT SNACK
Fried MF Meat - 16 12 172
Chicken
(2pcs) Cooking oil - - 10 90
(Drumstick)
Rice 46 4 - 200
French Rice B 46 4 - 200
Fries (2 ex)
(regular) Fat (4 ex) - - 20 180
Sugar 10 - - 40
(2 ex)
3 1 - 16
1 Rice C 23 4 - 108
Pizza 1 HF Meat - 8 10 122
½ Sugar 2.5 - - 10.5
Coke 25 - - 100

5
 Coffee - - - -
TOTAL 306.5g 90g 101g 2,733 kcal

306.5𝑔 90𝑔 101𝑔 2,733.5𝑘𝑐𝑎𝑙

× 100 =
50𝑔
× 100 = 180%
30𝑔
× 100 = × 100
220𝑔 1,350𝑘𝑐𝑎𝑙
Adequacy:
139.31% 336.67% = 202.48%

Inadequate Inadequate Inadequate Inadequate

Day 3:

CHO PRO FAT KCAL

BREAKFAST
NONE - - - -
AM SNACK
NONE - - - -
LUNCH
NONE - - - -
PM SNACK
NONE - - - -
DINNER
Rice
Fried 1 MF Meat - 8 6 86
Chicken
Cooking oil - - 5 45
(Drumstick)
MIDNIGHT SNACK
Rice
Fried 1 MF Meat - 8 6 86
Chicken Cooking oil - - 5 45
(Drumstick)
Boiled Egg
(1 MF Meat) - 8 6 86
Egg Loaf Bread
Sandwich (1 Rice C) 23 4 - 108
Mayonnaise - - 5 45
Coffee - - - -
TOTAL 23g 28g 33g 501 kcal

23𝑔 28𝑔 33𝑔 501𝑘𝑐𝑎𝑙

220𝑔
× 100 =
50𝑔
× 100 = 56%
30𝑔
× 100 = 110% × 100 =
1,350𝑘𝑐𝑎𝑙
Adequacy: 10.45% 37.11%

Inadequate Inadequate Inadequate Inadequate

Discussion:
According to Ms. Claridad’s 3 day 24-hour food recall, the majority of the foods are
inadequate and sometimes she was exceeding for a normal kcal per day. For her dietary
recommendation, Carbohydrates, Protein, and Fat needs are 65%, 15%, and 20% respectively
for her to achieve the requirement she needed. An exact amount of carbohydrates in her regular
meals would give her energy for the rest of her duty considering she was working to a BPO
company. 15% of his protein in the diet is a key component of bones, muscles, cartilage, and
skin. It will also help her body to build and repair tissue as well as increase her iron absorption.
And lastly, 20% fats to give her body other source of energy and to support her cell function.

6
 V. Meal Distributions

Dietary Recommendation:

TER = 45kg × 30 = 1,350 kcal/day

GOAL: To maintain her weight and to includes plenty of foods rich in iron and other
foods that help the body to absorb iron.

CHO: 1,350 kcal × .65 = 877.6 ÷ 4 = 219.3g

PRO: 1,350 kcal × .15 = 202.5 ÷ 4 = 50.6g

FAT: 1,350 kcal × .20 = 270 ÷ 9 = 30g

Diet Prescription 1,350kcal; CHO 220g; CHON 50g; Fat 30g

VI. DISTRIBUTION TO EXCHANGES

Day 1:

NO. CHO PRO FAT KCAL

220g 50g 30g 1,350
FOOD EXCHANGES
kcal/day

Vegetable 4 12 4 - 64

Fruit 5 50 - - 200

Whole
Low Fat
MILK Non-
fat/Ski/Fat- 1 12 8 - 80
free
Sugar 1 5 - - 20
A 2 46 - - 184

RICE B 4 92 8 - 400

C
Low Fat 2 - 16 2 82

MEAT Med. Fat 2 - 16 12 172

High Fat

Fat 3 - - 15 135

24g 217g 52g 29g 1,337

TOTAL: exchanges ±5 ±5 ±5 kcal/day

±50

7
 DAY 1 Sample Meal Plan:

BREAKFAST AM SNACK LUNCH PM SNACK DINNER MIDNIGHT

SNACK
Fried Rice Rice Rice Mix Fruits:
with Spinach (Banana,
Beef Pares: Pork Steak Apple,
Scrambled (Sugar) with Bok Pineapple,
Egg: NONE (Cooking oil) NONE Choy & Kiwi,
(Tomato, Potato Grapes)
Carrot) Water (Cooking oil)
(Cooking Oil) Coffee with
Coffee Skim milk
Water

Day 2:

NO. CHO PRO FAT KCAL

220g 50g 30g 1,350
FOOD EXCHANGES
kcal/day

Vegetable 6 18 6 - 96

Fruit 3 30 - - 120

Whole
Low Fat
MILK Non-
fat/Ski/Fat- 2 24 16 10 160
free
Sugar 2 10 - - 40
A 2 46 - - 184

RICE B 4 92 8 - 400

C - - - - -
Low Fat 1 - 8 1 41

MEAT Med. Fat 2 - 16 12 172

High Fat - - - - -

Fat 2 - - 10 90

24 220g 54g 33g 1,303

TOTAL: exchanges ±5 ±5 ±5 kcal/day

±50

8
 DAY 2 Sample Meal Plan:

BREAKFAST AM SNACK LUNCH PM SNACK DINNER MIDNIGHT

SNACK
Rice Rice Rice Mamon

Lima Bean Beef Broccoli Ginisang Coffee with

Pod Soup with Carrots Munggo with Skim milk
with Sausage (Cooking Oil) Mallunggay
& Spinach leaves & Orange
(Cooking Oil) NONE Saba con NONE Anchovies
yelo with (Cooking Oil)
Water tapioca &
coco syrup Banana &
Apple
Water Smoothie
(Coco Syrup)

Day 3:

NO. CHO PRO FAT KCAL

220g 50g 30g 1,350
FOOD EXCHANGES
kcal/day

Vegetable 4 12 4 - 64

Fruit 4 40 - - 160

Whole
Low Fat 1 12 8 5 125
MILK Non-
fat/Ski/Fat-
free
Sugar 3 15 - - 60
A 2 46 184

RICE B 4 92 8 400

C
Low Fat 2 16 2 84

MEAT Med. Fat 2 16 12 172

High Fat

Fat 2 10 90

24 217g 52g 29g 1,339

TOTAL: exchanges ±5 ±5 ±5 kcal/day

±50

9
 DAY 3 Sample Meal Plan:
BREAKFAST AM SNACK LUNCH PM SNACK DINNER MIDNIGHT
SNACK
Rice Rice Rice Yogurt with
banana &
Tinapa Tinolang Boiled pinipig
(galunggong): Beef: sayote Shrimp
(Cooking oil) & malunggay (suwahe) Cuchinta
NONE NONE
Pipino & Coconut Mango Coffee
Kamatis water Shake
slices (2 cheeks):
coco syrup

Water Leche flan

One Day Sample Menu Plan:

BREAKFAST

Rice

Tinapa (galunggong)

Pipino & Kamatis slices

Water

LUNCH
Rice
Tinolang Beef with Sayote
& Malunggay Leaves
Coconut water

DINNER

Rice

Boiled Shrimp (suwahe)

Mango Shake with Coco syrup

Leche flan

10
 MIDNIGHT SNACK

Yogurt with banana & pinipig

Cuchinta

Coffee

Recommendation:

There is no single diet that can cure anemia. However, eating a balanced diet that includes
dark, leafy greens, nuts and seeds, fish, meat, beans, and vitamin C-rich fruits and vegetables
might help you obtain the iron you need to control anemia. Ms. Caridad’s diet will contribute to
her iron deficiency disorder in the safe way that she can benefit to it. I’ve increased her intake of
non-heme iron as well as heme iron to help her body more easily absorbs iron and also, she may
take supplements that was prescribed by her doctor. I would also recommend some minimal
exercises that she definitely can do in her rest day like, walking and jogging. In this way, she could
have stronger muscles, and a healthier heart. And lasty, I would endorse to reduce her intake of
caffeine, sugar and alcohol to keep her energy levels up and more making sure that she drinks
enough water. Because some studies have indicated that this will help keep hemoglobin levels
up. I recommending this for 4 months. After 4 months I hope to see changes in her physically but
most importantly to recognize her new lifestyle and after that I can be able to assess her in
whether what to increase and what to balance in her diet.

Summary:

Ms. Kristine Djoy D. Claridad who weigh 50kg with the height of 4’11” is normal with the
result of her BMI (Body Mass Index). She was diagnosed with anemia when she started working
as a call center agent. Her nature of work can be very demanding, but also extremely rewarding.

Some kinds of anemia, such as those that are inherited, cannot be prevented. With
anemia, making good food choices is important. Eating junk food means you are getting calories
without nutrients. The lack of Ms. Claridad’s food intake has been one the factors that lead her to
be anemic and also considering she have to work in the night and so some errands at their house,
having not enough sleep and rest are also some of the factors. Seeing the result of her 3-day 24-
hour food recall in the page 5 to 7, as you can see the quantity of heme and non-heme iron are
not appropriate. She was consuming food that high in carbohydrates with the absence of nutrients
that she needed and yet still it is inadequate.

Recommending a whole new diet to her that rich in iron (heme & non-heme) and other
nutrients (vitamins & minerals) will definitely improve her ideal food intake. In accordance to what
she can and eat and what she cannot. I’ve made sure that every meal will make her full and let
her body absorb adequate nutrients.

11
 VII. REFERENCES

• Anemia
https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-
20351360#:~:text=Anemia%20is%20a%20condition%20in,each%20with%20its%20own
%20cause.

• Best Diet Plan for Anemia

https://www.healthline.com/health/best-diet-plan-for-anemia

VIII. PERSONAL PROFILE

Name: Hyacinth M. Notarte

Birthday: November 20, 1999

Contact number: 09274722703

Nutrition Experience:

While studying Nutrition and Dietetics in Philippine Christian University I’ve already
experienced doing a nutrition assessment in children. This course allows us to see the bigger
picture of how nutrition should be taken seriously. Amidst of the pandemic, we couldn’t be able to
perform or to experience some of the practices to help us strengthen our knowledge. But I hope
after all of this, we can be able to help more people assessing them with their nutritional status.

What keeps you going?

The value of life for me has been treasuring every moment that comes my way. To make
sure that each and every experience is taken seriously and that I acquire something from it.
Setting and attaining goals are important to me. Other times, life will be so easy, fun, and nice.
But once we experienced failure, we may assume that the only alternative choice is to give up, to
stop rising and lose all of our courage to pursue. That's when our friends and family come to help
us, to pick us up and to inspire us to keep going. All of the challenges that I kept experiencing
motivates me to keep going. And just 1 more year, and we (not just me) are one step closer to
our dream (to become a Registered Nutritionist-Dietitian).

12