By : Mohammed Sadiq

1000 cal = 1 kilocalorie (kcal)= 1 Cal

1 kcal = 4.184 kilojoule (kj) = 4.2 kj
1 kg of adipose tissue contain 850g ( TG )
850g x 9 kcal/g = 7650 kcal ~ ( 7500 kcal )

BASAL METABOLIC RATE (BMR)

BMR = weight (kg) X 24 (Cal/kg)
 ENERGY REQUIREMENTS FOR ACTIVITY DURING DIFFERENT CONDITIONS

Comparison between Kwashiorkor and Marasmus

ASSESSMENT OF OBESITY
𝑾𝒕 (𝒌𝒈)
𝟏 − 𝑩𝒐𝒅𝒚 𝑴𝒂𝒔𝒔 𝑰𝒏𝒅𝒆𝒙 (𝑩𝑴𝑰) =
𝑯𝒕 (𝒎𝟐)
2 - Ideal body weight :
Male ideal body weight = 50 kg + 2.3 kg x ( ht (in) – 60 )
Female ideal body weight = 45.5 kg + 2.3 kg x ( ht (in) – 60 )
Ideal body weight : 100 % of normal
Over weight : 101 - 119 % of normal
Obesity : ≥ 120 % of normal

ABDOMINAL OBESITY
1- Waist : Height Ratio
An increased ratio ( > 0.5 ) indicate the presence of abdominal obesity

2- Waist circumference (WC) measurement

1- Measuring ( W:H ratio )

W: waist circumference (cm)
Distance halfway between the superior iliac crest and the lower
margin of the rib cage in the mid axillary line.

H: Hip circumference (cm)

Measured 1/3rd distance between superior iliac spine and
the patella.

A risk of abdominal obesity IF :

W:H ratio is > 0.95 in Men
W:H ratio is > 0.80 in Women
1- Estimate the TER for an adult lactating women weighting 70 kg, living
sedentary lifestyle.
ANSWER :
BMR = 70 X 24 = 1680 Cal
Activity = 1680 X 0.3 = 504 Cal
Lactation = 500 Cal
Total = 1680 + 504 + 500 = 2684 Cal
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2- Estimate the TER for an adult man weighting 85 kg, working as a laborer in
a steel factory.
ANSWER :
BMR = 24 X 85 = 2040 Cal
Activity = 2040 X 0.5 = 1020 Cal
Total = 2040 + 1020 = 3060 Cal
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3- Estimate the TER for a pregnant women in the first trimester, living
sedentary lifestyle, her weight is 60kg.
ANSWER :
BMR = 24 X 60 = 1440 Cal
Activity = 1440 X 0.3 = 432 Cal
Pregnancy (1st trimester): No additional caloric
requirement
Total = 1440 + 432 = 1872 Cal
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4- Estimate the TER for an adult weighting 90 kg, he is at bed rest recovering
from surgery.
ANSWER :
BMR = 90 X 24 = 2160 Cal
Bed rest/surgical = 2160 X 0.2 = 432 Cal
Total = 2160 + 332 = 2592 Cal
5- Calculate the TEI by 75 kg man consume 350 g carbohydrate, 85 g protein
and 75 g fat , 25 g fiber.
Answer :
350 x 4 = 1400 Cal
85 x 4 = 340 Cal
75 x 9 = 675 Cal
25 x 0.0 = 0 Cal
1400+ 340 + 675= 2415 Cal
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6- An adult with morbid obesity has been kept on diet aiming for a daily
energy deficit of 500 Cal. For 3 months. What is the expected weight loss
in that period if all the lost weight is adipose tissue.
Answer :
500 x 90 = 45000 Cal
850 x 9 = 7650 Cal = 7500 Cal
45000 / 7500 = 6 kg
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7- A 3 year old boy. His mother has brought to the primary health center. She
said that the boy appears ’swollen’ and she mention that she had wean him at
the age of 1 year on examination Generalized oedema and abdominal
distension.
Lab investigation :
Serum albumin 2.5 g/dl (3.6 – 5.3 g/dl)
Serum glucose 85 mg/dl
What is the most likely diagnosis ?
A. Marasmus
B. Kwashiorkor
C. Marasmic kwashiorkor
D. None of the above
Answer :
B. Kwashiorkor
8- Comment on an adult with weight : 80 kg, height : 170cm
ANSWER :
𝒘𝒕 ( 𝒌𝒈 ) 𝟖𝟎
𝑩𝑴𝑰 = 𝒉𝒕 ( 𝒎𝟐 )
= ( 𝟏.𝟕 )𝟐
= 27.7
Over weight
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9- Calculate the Required dietary daily intake of a man weighting 75 kg living

moderately active lifestyle.
Answer :
1.
24 x 75 = 1800 Cal
1800 x 0.4 = 720 Cal
1800 + 720 = 2520 Cal

2.
Daily CHO intake : 2520 × 0.58 = 1462 Cal
1462÷ 𝟒 = 366 g

Daily Fat intake : 2520 × 0.3 = 756 Cal

756 ÷ 𝟗 = 84 g

Daily Protein intake : 2520 × 0.12 = 302 Cal

302 ÷ 4 = 76 g
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10- An adult women weighting 89 kg, while her optimal weight is 65 kg. what is
your comment ?
Answer :
𝟖𝟗
× 𝟏𝟎𝟎% = 𝟏𝟑𝟔. 𝟗%
𝟔𝟓
( obese )
11- A diet of obese person has daily energy deficit of 300 Cal, how much
weight reduction could occur in 20 days if all weight loss is in adipose tissue ?
Answer :
20 × 300 = 6000 Cal
𝟔𝟎𝟎𝟎
= 0.8 kg ( 800 g )
𝟕𝟓𝟎𝟎
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12- Calculate the total energy intake by 70 kg man consume : 275g of CHO, 75g
of protein, 63g of fat, 10g of fibers ?
Answer :
275 × 𝟒 = 𝟏𝟏𝟎𝟎 𝑪𝒂𝒍
75 × 𝟒 = 𝟑𝟎𝟎 𝑪𝒂𝒍
63 × 𝟗 = 𝟓𝟔𝟕 𝑪𝒂𝒍
10 × 𝟎 = 𝟎 𝑪𝒂𝒍
1100 + 300 + 567 = 1967 Cal
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13- Calculate the energy requirement of 70 kg man on weekend who have

heavy exercise ?
Answer :
BMR = 70 x 24 = 1680 Cal/day
Activity = 1680×0.5 =840 Cal/day
Total = 1680 +840 = 2520 Cal/day
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14- A 25-years old mine worker weighing 60Kg 10 hours/day. Was kept on a diet
containing 100g carbohydrate, 300g protein and 100g fat.
does this diet meet his energy requirement ?
Answer :
BMR= 60 × 24 = 1440 Cal
Activity = 1440 × 0.5 = 720 Cal
Total = 1440 +720 = 2160 Cal
CHO = 100 × 4 = 400 Cal
protein = 300 × 4 = 1200 Cal
Fat = 100 × 9 = 900 Cal
400 +1200 + 900 = 2500 Cal
his diet is enough for energy requirement
15- An adult man weighting 84kg, while his optimal weight is 72kg. what is
your comment ?
Answer :
𝟖𝟒
× 𝟏𝟎𝟎% = 𝟏𝟏𝟔. 𝟕% 𝒐𝒗𝒆𝒓 𝒘𝒆𝒊𝒈𝒉𝒕
𝟕𝟐
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16- Estimate the TER for an adult weighting 65 kg, he is at bed rest recovering
from serious infectious illness.
Answer :
BMR = 65 × 24 = 1560 Cal
Bed rest/surgical = 1560 X 0.35 = 546 Cal
Total = 2160 + 546 = 2106 Cal
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17- Estimate the TER for a pregnant women in the 3rd trimester, living
sedentary lifestyle, her weight is 75kg.
Answer :
BMR = 24 X 75 = 1800 Cal
Activity = 1800 X 0.4 = 720 Cal
Pregnancy (3rd trimester) : 300 Cal
Total = 1800+ 720 + 300 = 2820 Cal
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18- Estimate the total energy requirements (TER) for an adult man weighting
95 kg, living active lifestyle.
Answer :
BMR = 95 X 24 = 2280 Cal
Activity = 2280 X 0.5 = 1140 Cal
Total = 2280 + 1140 = 3420 Cal
19- Which of the findings in the child shown at right would support a diagnosis
of kwashiorkor ?
A. Shows increased serum albumin.
B. Shows a good appetite.
C. Appears plump due to increased adipose tissue.
D. Displays abdominal and peripheral edema.
E. Has markedly decreased weight for height.
Answer :
D. Displays abdominal and peripheral edema.