NCM 105: NUTRITION AND DIET THERAPY

UNIT FOUR. DIETARY COMPUTATIONS

CHAPTER 1: BODY MASS INDEX AND CLASSIFICATIONS
Basal Metabolism –the amount of energy required by an individual in the resting state, for such
functions as breathing and circulation of the blood.

Basal Metabolic Rate – the minimum caloric requirement needed to sustain life in a resting
individual. It can be looked at as being the amount of energy (measured in calories) expended by
the body to remain in bed asleep all day.

BMR = Wt. in lbs. X 10.9 (male)

9.8 (female)

Example : 125 lbs. x 9.8 = 1,225 Cal.

BMI = Is a measure of body fat based on height and weight

BMI = weight (kg) = 47 kg ___ = 47 kg. = 20.25 = 20kg/m₂ (Normal)
(ht. meters)₂ (1.524)(1.524) 2.32

Factors that affect BMR

1.Genetics. Some people are born with faster metabolisms; some with slower metabolisms.
2. Gender. Men have a greater muscle mass and a lower body fat percentage. This means they
have a higher basal metabolic rate.
3. Age. BMR reduces with age. After 20 years, it drops about 2 per cent, per decade.
4. Weight. The heavier your weight, the higher your BMR. Example: the metabolic rate of obese
women is 25 percent higher than the metabolic rate of thin women.
5. Body Surface Area. This is a reflection of your height and weight. The greater your Body
Surface Area factor, the higher your BMR. Tall, thin people have higher BMRs. If you compare a tall
person with a short person of equal weight, then if they both follow a diet calorie-controlled to
maintain the weight of the taller person, the shorter person may gain up to 15 pounds in a year.
6. Body Fat Percentage. The lower your body fat percentage, the higher your BMR. The lower body
fat percentage in the male body is one reason why men generally have a 10-15% faster BMR than
women.
7. Diet. Starvation or serious abrupt calorie-reduction can dramatically reduce BMR by up to 30
percent. Restrictive low-calorie weight loss diets may cause your BMR to drop as much as 20%.
8. Sleep – BMR falls 10-15% below waking levels.
9. Endocrine Glands – male sex hormones increase the BMR 10-15%
10. Fever – increase 7% for each degree rise the body temperature above 98.6 F

CHAPTER 2: DESIRABLE BODY WEIGHT (DBW)

Estimating the desirable body weight

“Desirable body weight” (DBW) or “ideal body weight”(IBW) as used in nutrition and diet therapy
refers to the weight for height found statistically to be the most compatible with health and
longevity.

1. Infants:
A.1st 6 months:
DBW (gms) =Birth weight (gms) + (age in mos. X 600)
Example: 4-month old infant =
DBW (gms)= 3000 + (4 x 600)
=3000 + 2400
=5400 gms or 5.4 kg.
7-12 months:
DBW (gms) = Birth weight (gms) + (age in mos. X 500)
Example: 8-month old infant
DBW (gms)=3000 +(8x 500)
=3000 + 4000
=7000 gms or 7 kg.

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 NCM 105: NUTRITION AND DIET THERAPY
Note: If the birth weight is unknown, allow 3000 gm (full term) or 2500 gm (premature). One kilo is
2.2 pounds.

B. DBW (kg.)= (age in month ÷2) +3

Example: 8-month old infant
DBW (kg.) = (8÷2) +3
=4 + 3
=7 kg.
INFANT’S WEIGHT:
--Doubled at 5-6 mos.
--tripled at 12 mos.
--quadrupled 24 mos.

2. Children: DBW (kg.) = (No. of years x 2) + 8

Example: 7-year old child
DBW (kg.) = (7 x 2) + 8
= 14 + 8
=22 kg.

3. Adults
There are several tables or monograms’ which give the DBW of adults of given height. However, in
practice it is often necessary to compute an individual’s DBW quickly. The following are some
formulas that may be used.

a. Body Mass Index-based formula

Body mass index (BMI) is widely used to identify lean, overweight or obese individuals. It is
computed as weight in kilograms divided by height in meters squared (W/H 2), and has been found
to be relative weight index that shows the highest correlation with independent measures of body
fat. The BMI range of 20 to 24.9 is generally considered normal.
• For men 5 feet (1.52m) tall, DBW= 112 lbs (51 kg)
• For women 5 feet (1.52m) tall, DBW = 106 lbs (48 kg)
• For both sexes, add 4 lbs (1.8 kg) for every inch above 5 feet.
Sample calculation:
Male, 5’3” tall: DBW = 112 +(3 x 4) =124 lbs (56 kg)
Female, 5’1” tall: DBW = 106 + (1 x 4) = 110 lbs (50 kg)

b. Derived formula based on body mass index

DBW (kg) = Desirable BMI X H (m) 2

Desirable BMI for men = 22
Desirable BMI for women =20.8 or 21

Sample calculation:
Male 5’3” (1.6 m) tall
DBM (kg.) =22 x 1.6 m 2
=22 x 2.56 m
=56.32 or 56

c. Tannhauser’s method:
Measure height in centimeters. Deduct from this factor 100 and the answer is the DBW in kg. The
DBW obtained applies to Filipinos stature by taking off 10%

Step 1. DBW (k)= Height (cm)-100

Step 2. Deduct 10%= (To apply this method for Filipinos whose statures are usually small, unless body
frame is identified).
Examples:
Height: 5’2”= 62”
62” x 2.54 cm.= 157.48 cm. –100 = 57.48 kg.
= 57.48 kg. - 5.74 (10% of 57.48)
= 51.74 or 52 kg.

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 NCM 105: NUTRITION AND DIET THERAPY
d. Using the Hamwi formula (adults only)
Females:
100 lb for first 5 ft
Add 5 lb for each additional inch

Males:
106 lb for first 5 ft
Add 6 lb for each additional inch

Adjustments:
Small frame- subtract 10%
Large frame: add 10%

e. “Adopted” Method:
For 5 ft. use 105 lbs. for every inch above 5 feet, add 5 lbs.
Examples:
Ht.5’2”
5 feet = 105 lbs.
2 inches = 5 x 2 = + 10
115 lbs. or 52 kg.

CHAPTER 3: TOTAL ENERGY REQUIREMENT AND ITS DISTRIBUTION (TER)

Estimating of Total Calorie Requirement Per Day or Total Energy Requirement (TER)/day:

TER = DBW x activity level

Ex. 5'3 student = 54 x 35 = 1,890 Cal.

1) Infants= DBW x 120 Cals./Kg.

1-6 months
TEA (kcals/day)= 120 kcal/kg DBW/day

7-12 months
TEA (kcal/day)= 110 kcal/kg DBW/day

Ex. 4 month old infant

TER = 5.4 kg. x 120 Cals/kg = 648 0r 650 Cals.

8-month old
TER- 7 kg. (DBW) x 110 Cals/Kg. 770 or 750 Cals.

2) Children = 1000 + (100 x age in yrs.)

a. By Narins and Weill
TEA= 1000 + (100 x Age in years)

b. According to Age and DBW

TEA/day= DBW (kg) x calorie allowance based on age

Age (Years) 1989 RDA kcal/k 1989 RDA CBMRG(cooper,

DBW/ day burber, ect.)
Cals/KDBW
1-3 105 102 100
4-6 90 89.6 90
7-9 75 73.2 80
10-12 65 (boys) 65.3 70
55 (girls) 54.6 60=13-15 yrs.
50= 15 yrs. and
above

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 NCM 105: NUTRITION AND DIET THERAPY
Examples:
7-years old child—
TER/day = 22 kg (DBW) x 80 = 1760 or 1750 Cals.

3) Adolescents

a. TEA/day= DBW (k) x calorie allowance based

Age (Years) 1989 RDA kcal/k DBW/ 1998 RDA

day
13-15 55 (boys) 53.2
45 (girls) 45.7
>15-19 45 (boys) 46.9
40 (girls) 42.1
Average (all ages, both sexes) 45

4) Adults
a. Estimation of TEA based on the level of physical activity.
TEA= DBW (kg) x Physical activity

Activity KRAUSE NDAP

kcal/ k DBW/day kcal/k DBW/ day
Bed rest but mobile 27.5 Female Male
Sedentary 30.0 30 35
Light 35.0 35 40
Moderate 40.0 40 45
Very Active 45.0 45 50

Ex. 5'3 student = 54 x 35 = 1,890 Cal.

= ( Ht. cm – 100 ) – 10%
Ex. 5’3”= (63 inches x 2.54) = (160.02 – 100) = (60.02- 6.002 [10%]) = 54 kg.

a. Method l (cooper, et. all)

Basal Metabolic Needs= 1 cal/KDBW/hr + physical activity = % above basal

Physical Activity %
Bed rest 10-20
Sedentary 30
Light 50
Moderate 75
Heavy 100
Examples: Method l
DBW = 52 kg.
A. Activity= moderate (housewife without maid)
52 x 24(hr) =1248 Cals. For basal metabolic needs
1248 x .75= Cals for activity
1248 +936=2184 or 2200 Cals/day
Calories are rounded off the nearest 50

B. Activity Bed Patient

52 x 24(hr) = 1248 Cals. For basal metabolic needs
1248 x .20 =249.6 Cals. For activity
1248 x 250 =1500 Cals.

b. Method ll (Krause)
Cals/KDBW/Day

Examples: Method ll
a. Using the same individual(moderately active)
52x 40 cals =2080 or 2100 Cals/day

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 NCM 105: NUTRITION AND DIET THERAPY
b. Activity= Bed patient
52x 27.5= 1430 or 1450 Cals

c. Harris-Benedict Energy expenditure

HBEE (males) =66.47 + 13.75(W) + 5.0 (H) - 6.75 (A)
(female) =655.1 + 9.56(W) + 1.85 (H) - 4.67 (A)
Where:
W =Kg Body Weight
H =Height (cm)
A =Age (years)

Example: Method lll

Weight 50 kg.
Height = 165.1 cm.
Age =45 yrs.
HBEE(males) =66.47 +13.75(50)+5.0(165.1)—6.75(45)
=66.47 +687.5 + 825.5—303.75
= 1275.72 or 1275 cals

d. NDAP Formula
Examples of activities:
Bed rest - 27.5 hospital patients
Sedentary- 30 secretary, clerk, typist (using electric typewriter) administrator, cashier, bank teller
Light- 35 teacher, nurse, student; lab. Technician, housewife with maids
Moderate- 40 housewife without maid, vendor, mechanic jeepney and car driver
Heavy- 45 farmer, laborer, cargador, coal miner, fisherman, heavy equipment operator

5. Pregnant women:
TEr/day = normal requirement + 300 cals

6. Lactating women:
TER/day = normal requirement + 500 cals

C. distribution of total energy requirement (TER) into Carbohydrate, protein and Fat:
Method l —by percentage distribution
% of TER
1. Carbohydrates 50-70 % or average of 60%
2. Proteins
Infants— 10%
Children—
Adolescents—
Adults— 10-12
3. Fats
Normal adults,
Moderately active 20-25
Children, adolescents;
Very active individuals 30-35%

Example: 7-year old child

TER/day = 1700 Cals
CHO/day = 1700 x .60 = 1020 Cals ÷4 = 255 gms.
P/day = 1700 x .10 = 170 cals ÷ 4 =42.5 or 45 gms.
F/day = 1700 x .30 = 510 cals ÷ 9 = 56.6 or 55 gms.

C,P, & F are rounded off to the nearest 5

Rx Diet = 1700 CalsC255P45F55
Example: moderate active housewife,DBW of 52 kg.
TER/day = 2200 Cals
CHO/day = 2200 x .60 = 1320 cals ÷4 = 330 gms.
P/day = 2200 x .10 = 220 Cals ÷ 4 = 55 gms.
F/day = 2200 x .30 = 660 Cals ÷ 9 = 73.3 or 75 gms.
Rx Diet = 2200 CalsC330P55F75
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 NCM 105: NUTRITION AND DIET THERAPY

Method ll: determine the protein calories first according to the normal allowance in gm/KDBW and
provide the non-protein calories (NPC) into:
CHO: 55-80% or an average of 70%
Fats: 20-45% or an average of 30%
Normal protein allowances/day:
Gm/KBDW
Infants 1.6
Children 1.5
Adolescents 1.2
Adults 1.1

Examples:7- year old child with TER of 1700 kcal

P/day =22(DBW) x 1.5 = 33 g or 35 g
= 35 x 4 =140 protein calories
= 1700 – 140 = 1560 non-protein calories
CHO/day =1560 x .70 = 1092 ÷ 4 = 273 or 275 g
F/day =1560 x .30 = 468 ÷ 9 = 52 or 50 g
Rx Diet =1700 C275P35F50

Examples: Moderate active housewife, DBW of 52 kg.

TER/day= cals
P/day =52x 1.1 = 57.2 or 55gms
= 55x 4 = 220 protein calories
= 2200—220 = 1980 NPC
CHO/day = 1980 x .70 = 1386 ÷ 4 = 345 gms.
F/day =1980 x .30 = 594 ÷ 9 = 64.9 or 65 gms.
Rx Diet =2200 CalsC345P55F