NUTRI LAB QUIZZES

It is the simple act of taking some time to plan any number of your meals for the week.
Meal Planning

It is an outline of the courses that have to be prepared for one meal.

Meal Pattern

Meals should be planned to have a variety of shapes, textures, colors, flavors and temperatures.
True

Storing dry goods (flour, cornmeal) in air-tight containers prolongs their shelf life.
True

Planning psychologically and physiologically satisfying meals requires a basic knowledge of

all of the above

Effective meal planning includes efficient management of

All of the above

What is the reasonable allowance of food exchange in fruits?

3-4

How many grams of carbohydrate content of 2 food exchanges of fruits?

10

A dairy milk is categorized as a low-fat milk product. How many grams of fat does it
contain.
5

1 exchange of rice has___grams of carbohydrate and___grams of protein.

23, 2

1 food exchange of a high fat meat contains ___ grams of carbohydrate, ___ grams of proteins,
and ___ grams of fats
0, 8, 8

3 food exchanges of vegetable

contains ___ grams of carbohydrate, ___ grams of proteins, ___ grams of fat.
9, 3, 0
2 food exchange of fats is ___ grams
10

If you are preparing a food containing 3 exchanges of sugar, how many grams of carbohydrates
is it?
15

Ideally, the percentage of kcalories from carbohydrates in a portion size of food should be
approximately
45 to 65 %

The "temperature" rule of meal appeal suggests that

foods should be at the proper temperature when served

A patient with marasmus usually will have

skeletal muscle wasting.

Dianne is planning to serve pork chops, brown rice, sauerkraut, and applesauce. To improve the
meal appeal of this menu, Dianne should:
include more colorful foods

A 45-year-old man presents to clinic today for a yearly physical examination. His weight is 250 lb
(114 kg), and his height is 5 ft, 10 in.
He complains of lack of energy and admits to getting no exercise on most days. His body mass
index (BMI) is
64 kg/m2

A gram of carbohydrate yields

approximately ___calories
4

What is the main function of carbohydrates

To provide fuel for the body cell

Which of these is the substance found in certain vitamins that helps protect the body cells from
damage
antioxidants

Mang Ambo is a carpenter and 1 point needs food that can provide him with sufficient energy to
perform his job. Which of the meal planning principles should be followed to ensure that Mang
Ambo has sufficient energy to perform his job?
Adequacy

Mang Ambo should balance the amount of energy being used by the body to sustain its
metabolic and physical activities. What meal planning principle will be used to meet this need.
Kcalorie control

In order to provide all the nutrients the body needs, people should select foods from each of the
food groups daily and vary their choices. What meal planning principle is this?
variety

Different foods within the same group contain different arrays of nutrients
True

By alternating fruit choices, a person will ingest very little of either contaminant
True

Ana, a mother of 3 young children is a working mom, is seeking advice from in preparing meals
for her family. Which of the following advice if given to Ana would require further teaching?
it's nice to have softdrinks to promote family bonding at night.

The following needs to be considered in meal planning. (SATA)

Variety of meals
satiety
season
family composition

We need to consider variety of meals in planning a meal. this would include: (SATA)
includes daily food guide
vary your choice of meat, veggies everyday.
be sensitive to color combination
in planning meals include also nutrients needed by each member

A food labeled 5 grams of fat per serving has ___ calories from fat
45

Which of the following suggestions would NOT help a family plan economical meals around busy
schedules?
eat out as much as

Which of the following does NOT affect a family's food expenditures?

number of people who plan the menus
 METHODS OF NUTRITION
ASSESSMENT
⚫ Anthropometric methods
⚫ Biochemical methods
⚫ Clinical methods
⚫ Dietary methods
2. PHYSICAL ASSESSMENT
ANTHROPOMETRIC MEASUREMENT
⚫ the science of measuring the size, weight
and proportions of the human body.
= may reveal a failure to thrive in
children
= it reflects a nutrient deficiencies or
excesses.
= includes the height, weight, head
circumference, upper arm, skin fold and
chest circumference (for children).
⚫ HEIGHT AND WEIGHT – useful in
determining nutritional status in adults
- It is a good indicator of satisfactory
diet and recent food intake.
⚫ HEIGHT – is a less sensitive indicator of
current nutritional status than weight – for – age
since height does not decrease but simply slows
down in times of nutrient deprivation.
⚫ WEIGHT – is a sensitive marker of current
nutritional status.
- Reflects an immediate inability to meet
nutritional requirements and this may indicate
nutritional risk.
 OTHER PARAMETERS OF ASSESSING
NUTRITIONAL STATUS

⚫ BMI or BODY MASS INDEX

⚫ Or the Quetelet index is a good
estimate of the degree of obesity or
amount of total body fat.
⚫ It also helps to determine how much risk
people have of developing certain health
problems because of their weight (e.g.
diabetes, heart problems)
⚫ It can indicate over or under nutrition
 BMI is computed thru METRIC
FORMULA
⚫ FORMULA : BMI = W (in kilos)
H (in meters)²
⚫ Constant: 5 ft = 1.524m
4 ft = 1.2192m
1 inch = 0.0254m
1 lb = 0.454 kg 1kg = 2.2lbs
⚫ Example : H = 5’ 3” = 1.6 m
W= 62kgs
= 62kg/(1.6)²
= 62/2.56 = BMI = 24.22
Classification of Weight status in
adults according to BMI By WHO
Classification BMI (kg/m²) Risk of c0-morbidities

Underweight < 18.5 Low (but risk of other

clinical problems
increased)

Normal Range ≥ 18.5 – 24.9 Average

Overweight ≥ 25
Pre-obese 25 – 29.9 Increased

Obese I 30.0 – 34.9 Moderate

Obese II ≥ 30 Severe

Obese III 40+ Very severe

⚫ CLASSIFICATION OF MALNUTRITION IN ADULTS BY BMI

BMI VALUES CATEGORY

>20 Normal

– 20.0 Marginal

>17 – 18.5 Mild malnutrition

16 – 17 Moderate Malnutrition

<16
Severe Malnutrtion
 OBESITY CATEGORIES INTO 3 BMI
GRADES:
GRADE I – 25 to 29.9
GRADE II – 30 TO 40
GRADE III – 40+
IN GENERAL : OBESITY - IS
BMI of 27 or more.
- indicates high risk of developing
health problems.
- weight 20% above average.
⚫
⚫ UNDERWEIGHT – BMI less than
18.5 – 10 to 15% below average
⚫ OVERWEIGHT - BMI between 25-
29 – 10 to 20% above average
⚫ HEALTHY – BMI between 18.5 –
24.9

⚫ BMI TEND TO INCREASE WITH

AGE.
WAIST – TO – HIP RATIO
⚫ Alternatively it is called abdominal/gluteal
ratio or abdominal girth measurement
⚫ waist to hip ratio (WHR) is a valuable indicator
of body fat distribution and adiposity.
⚫ measures the ratio of your waist circumference
to your hip circumference. It determines how
much fat is stored on your waist, hips, and
buttocks.
⚫ use to see if you’re overweight - excess weight
is putting your health at risk.
⚫ It is also a valuable guide in evaluating health
risk (heart disease, diabetes, etc.)
Obtaining Correct Measurement:
⚫ Use non stretchable tape measure (in
centimetre)
⚫ Subject should stand erectly, abdominal
muscles relaxed, arms at the sides, and
feet together. The measurer faces the
subject and places the tape measure.
Measure waist at the most narrow area
below the rib case above umbilicus.
⚫ Measure hip circumference at the widest
point around the hips or buttocks with
the subject standing. Read measurement
to the nearest 0.1cm.
⚫ Formula for Assessing Body Fat
Distribution by WHR
⚫ WHR = Waist circumference (cm)
Hip circumference (cm)
A WHR of 1.0 or greater in men or 0.8
or greater in women is indicative of
android obesity and an increased risk
for obesity-related diseases. This also
appears to be true in children.
⚫ GYNOID “ pear-shaped”people,
store more fat in the buttocks, thighs
and hips.
⚫ ANDROID “apple-shaped” people,
carry their extra fat around the
abdomen/upper body.
⚫ The WHR may partially explain the
difference in high blood pressure between
men and women. Men are more likely to
be “apples” and women to be “pears”.
Men have higher rates of HTN and more
complications.
⚫ People who carry more weight around
their midsection (an apple-shaped body)
are at higher risk for heart disease, type 2
diabetes, and premature death than those
who carry more of their weight in their
hips and thighs (a pear-shaped body). Even
if your BMI is within a normal range, your
risk for disease may be increased.
⚫ According to the World Health
Organization (WHO), a healthy WHR is:
⚫ • 0.9 or less in men
⚫ • 0.85 or less for women
⚫ Waist Circumference
- serves as a marker of abdominal
fatness. Waist circumference alone
has been considered a valid indicator
for both men and women.
⚫ Interpretation : women with a waist
circumference greater than 35
inches and men with waist
circumference greater than 40
inches have high risk of central
obesity-related health problems.
SKINFOLD THICKNESS
⚫ Assess body composition, fat
distribution and reserve calories
by using a calliper .
⚫ The most accurate way to
measure body fat.
⚫ If it is more than 1 ½ inches –
over wt.
⚫ If less than ½ inch – under wt.
Harpenden
Lange Caliper
 Different
Sites For Skin fold
Measurement
Triceps- commonly used
Below the scapula
Biceps

Biceps
Above the iliac crest/
Suprailiac
Upper thigh
ASSESSMENT BY CLINICAL
METHOD
⚫ Clinical assessment of nutritional status
deals basically with the examination of
changes that can be seen or felt in
superficial tissues such as the skin, hair
and eyes.
⚫ In other words, its the physical
observation or assessment.
⚫ In here, signs of nutrient deficiency are
noted and some nutrient deficiency
diseases are observed such as;
 Gingival swelling
S
C
U
R
V
Y Blue spots on the skin
⚫ Rickets = lack of Ca and vit D
s/s- poorly shaped bones and
teeth
⚫ Iron deficiency anemia
(children beyond 6 mons.) = lack
in iron s/s- pallor.
⚫ Dehydration = loss of water &
electrolytes.
s/s- sunken eyeballs, dry mucous
membranes, thirst, etc.
 ASSESSMENT BY BIOCHEMICAL
TEST
⚫ includes various blood, urine , saliva and stool
test.
⚫ According to Dellova, it provides information
on protein balance, vit, mineral, and fluid status,
body composition, organ function and metabolic
status.
⚫ According to Roth a deficiency/ toxicity can be
determined by laboratory analysis of the
samples.
⚫ these test allow detection of malnutrition
before signs appear.
 MOST COMMONLY USED TEST FOR
NUTRITIONAL EVALUATION
BLOOD TEST
⚫ Serum Albumin Level measures the main protein in
the blood and is used to determine protein status..3. 5 –
5.0 g/dl or 35-50g/L
⚫ Albumin is a protein found in plants and animals.
⚫ Low levels – with malnutrition, burns, infections,
cancer and those taking birth pills, chronic disease of
liver, kidney and heart.
⚫ Serum Transferrin Level - -indicates
iron-carrying protein in the blood
⚫ transferrin is a glycoprotein that binds and transport
iron. Most is produced in the liver.
⚫ - if result is below normal there would be hepatic
failure, nephrosis, cachexia
⚫ Blood Urea Nitrogen (BUN) -Increased
level may indicate renal failure, insufficient
renal blood supply or blockage in the urinary
tract, dehydration and GI bleeding.
⚫ NV - 2.9 – 8.9 mmol/L
⚫ Creatinine Excretion – indicates the
amount of ceatinine excreted in the urine
over a 24 hour period and can be used in
estimating body muscle mass.
⚫ low creatinine excretion – indicative of
muscle mass depletion, as in malnutrition.
⚫ Serum Creatinine – indicates the amount
of creatinine in the blood and is used for
evaluating renal functions.
⚫ -N.V. 60-132 mmol/L
⚫ -↑= acute/chronic renal insufficiency,
urinary tract obstruction.
⚫ Hgb- women-12-16g/dl,men-14-18g/dl
⚫ Hct – women – 42-52%,men- 37-48%
⚫ = decreased level would mean anemia
⚫ Lipid Profile – for clients w/ heart
abnormalities/ CAD (coronary artery dse.)
⚫ Total Serum Cholesterol – less than 200
mg/dl
⚫ HDL – more than 35mg/dl
⚫ LDL – less than 130mg/dl
⚫ Serum Triglycerides – 2.9 – 8.9 mmol/L or
less than 200mg/dl
⚫ Uric Acid, serum or plasma
⚫ men – 3-99mg/dl, women – 2.5-7.7mg/dl
⚫ High level - gout, toxemia of pregnancy,
leukemia, polycythemia,renal insufficiency,
down’s syndrome, glycogen storage disease
⚫ Low levels occasionally in acute
hepatitis.
all vitamins and minerals would cause a
certain disease if there would be
abnormalities on the intake, either low or
high..but in water soluble vitamins, no
over dosage.
STOOL EXAM
Direct Stool Exam - checked for oily
materials . Excess fat in stool suggest
steatorrhea.
⚫ Chemical analysis of fecal fat- fecal
fat greater than 7g/day when the diet
includes 100 g of fat/day indicates
malabsorption.
⚫ Serum Calcium – low levels seen in
calcium and vit. D malabsorption, (recall
that steatorrhea can lead to calcium and
vit D.malabsorption.
⚫ D-xylose test – test of CHO
absorption.
⚫ Schilling test – identifies vit B₁₂
malabsorption.
⚫ URINE TEST
Creatinine - ↑ - muscle wasting,
starvation and cachectic status,
hyperthyroidism and febrile status.
↓- hypothyroidism, renal insufficiency
Men – 0-50 mg/24 hour
Women – 0-100 mg/24hour
⚫ Calcium - ↑- hyperparathyroidism,
elevated serum calcium
⚫ 50-150mg/24 hr. Or 1.05 – 1.3 mmol/L
⚫ Urinalysis – can detect protein and sugar in
urine(indicative of kidney disease and
diabetes)
⚫ Color = normal is clear, straw-colored/light
yellow.Lighter than normal may result from
excessive fld. Intake,diuretic.
⚫ = darker than normal – caused by liver disease
and certain drugs.

⚫ ODOR = depends on the food intake/with

concentration of urine (asparagus/onions), this
depends with how much fld.You drink.
⚫ Protein = presence of this is found on
kidney disease, multiple myeloma, heart
failure, stress or surgery
⚫ pH = this varies with diet, but usually acidic
w/ a range of pH 5-6.
⚫ = Alklaline urine is associated w/ a
vegetarian diet or fruit diet esp citrus,
vomiting, diuretics and excess taking in
antacids
⚫ Specific gravity = it is high (concentrated) in
Dhn, DM or in condition w/c it has an
excess protein in the urine.
Other Sources of Data
⚫ Subjective global assessment (SGA)
- is the gold standard for diagnosing
malnutrition. SGA is a simple bedside
method used to diagnose malnutrition
and identify those who would benefit
from nutrition care. The assessment
includes taking a history of recent
intake, weight change, gastrointestinal
symptoms and a clinical evaluation.
 What Is the Mini Nutritional
Assessment?
⚫ The MNA is a screening and assessment
tool validated for use in older adults age 65
and above who are malnourished or at risk
of malnutrition.
⚫ It’s able to classify older people as well
nourished, at risk of malnutrition or
malnourished.
⚫ The MNA was developed in 1989 by two
researchers, and was initially validated in a
group of more than 150 healthy, frail and
acutely ill older adults in France between
1990 and 1991.
 ‘Malnutrition Universal Screening Tool’
⚫ ‘MUST’ is a five-step screening tool to
identify adults, who are malnourished, at risk
of malnutrition (undernutrition), or obese.
⚫ It also includes management guidelines
which can be used to develop a care plan.
⚫ It is for use in hospitals, community and
other care settings and can be used by all
care workers.
 ‘Malnutrition Universal Screening Tool’
⚫ ‘This guide contains:
⚫ A flow chart showing the 5 steps to use for
screening and management
⚫ BMI chart
⚫ Weight loss tables
⚫ Alternative measurements when BMI cannot
be obtained by measuring weight and height.
Nutritional Risk Index (NRI)
⚫ (NRI) is a nutritional screening method
that was primarily developed for elderly
people.
⚫ It consists of real, usual body weight and
serum albumin levels.
⚫ In difficulty in identifying the usual body
weight of elderly patients, geriatric
nutritional risk index (GNRI) using the
ideal body weight was made to predict
the risk of mortality in hospitalized
elderly patients.
CALCULATING DIETS AND MEAL PLANNING

Presented by : DAISY A. DULAY, RN

N U T R I L A B
CALCULATING
DIETS AND
MEAL PLANNING
MEAL PLANNING

Planning meals that contain all the essential nutrients is the first
step toward a nutritionally adequate dietary intake.Nutrient
losses occur in food handling, cooking and service. Deciding in
advance what you will eat for a period of time, generally about 1-2
weeks. It helps you plan a healthy menu selecting and combining
of foods that would deliver a full array of nutrients. Meals should
be look good, smells good and tastes good.
IMPORTANCE OF MEAL PLANNING
1. Have a healthy foods on hand
2. Make a fewer trips to the grocery store
3. Increase the variety of foods you eat at each week
4. Saves time, money and stress
5. Improve the quality of your diet.
MEAL PLANNING PRINCIPLES:
1. Adequacy
Means that the diet provides sufficient energy and enough of all the nutrients to meet
the needs of healthy people. The

2. Balance
The art of balancing the diet involves consuming enough but not too much of each type
of food or providing foods in proportion to each other and in proportion
to the body’s need.
Balance ensures adequacy.

3. Kcalorie (energy) Control

Management of food energy intake or the amount of energy coming into the body from
foods should balance w/ the amount of energy being used by the body to sustain its
metabolic
and physical activities.
The key kcalorie control is to select foods of high nutrient density.

4.Nutrient Density
Select foods that provide the most nutrients for the least number of calories. A measure
of the nutrients a food provides relative to the energy it provides, the
more nutrients and the
fewer kcalories, the higher the nutrient density.
Nutrient density promotes adequacy and kcalorie control.
5. Moderation
Foods rich in fat and sugar provide enjoyment and energy but relatively few nutrients. In
addition, they promote weight gain when eaten in excess. A person
practicing moderation,
would eat such foods only on occasion and would regularly select foods low
in fat and sugar.
Moderation contributes to adequacy, balance and kcalorie control.
6.Variety
People should select foods from each of the food groups daily and vary their choices
w/in each food group from day to day for several reasons:
A. first, diff foods w/in the same group contain diff arrays of nutrients. Among the fruits
for
example, strawberries are esp rich in vit C, while apricots are rich in vit A
B. Second, no food is guaranteed entirely free of substances that, in excess, could be
harmful.
The strawberries may contain trace amounts of one contaminant, the cantaloupes another.
By alternating fruit choices, a person will ingest very little of either contaminant.
C. Third, as the adage goes, variety is the spice of life.
Even if a person eats string beans frequently, the person can still enjoy string beans
with
Diffrent kind of recipes use for cooking.
Eating nutritious meal need not be boring.
FACTORS TO SUCCESSFUL MEAL PLANNING

1. Begin w/ a good breakfast

A great number of adults: children eat an inadequate
breakfast or skip it. A change to a
better breakfast habit means: planning
simple and easy to prepare, but varied meals

2. Lunch is often neglected.

This can be improve by including pieces of fruit at hand
rather that drinking soft drinks.

3. Dinner patterns
Members of the family should be together and make up for any
deficiencies that might
occurred earlier in the day.
FACTORS TO CONSIDER IN MEAL PLANNING

1. Family composition
Adjust amounts for children, teenagers, pregnant and lactating women. For persons w/
less energy requirement ( elderly & women), select food high in nutritive
value.

2. Meal patterns
It is helpful in planning menu but consider the family’s habit and needs.

3. Food costs and budgeting food selection for economy

4. Variety of meals
a. Include daily food guide. Establish a menu pattern that includes recommended
amounts of nutrients of each food group for each member of the family.
b. Variety of choice. Do not use the same meats, vegs and fruit everyday.
c. Color be sensitive to color combination.Avoid meals that have the same color.
Use garnishes for a touch of color.
d. Flavour. Do not prepare spicy or bland foods all at one meal. Combine or alternate
them.
e. Preparation. Use a variety preparation method.
5. Satiety
Provide some protein and fat in each meal to allay sense of
hunger.

6. Season
Hearty foods such as stews and soups favoured in cold weather.
Lighter foods in hot
weather, with the same amount of nutrients
should be provided.

7. Time for food preparation

Budget time for best use by planning menus for several days or
a weekly menu plan.
CALCULATING DIETS

It is not always feasible to calculate nutrition information for all

of your recipes, but having information for some of your meals is
better than having nothing at all. Calculating nutrition information
for more standard recipes is a great place to start to a healthier you.
Calorie and nutrient values for meals can be calculated by knowing the
Desirable Body Weight, Basal need, Physical activities of an
individual and with the use of Exhange Lists for the making of a menu.
In preparation for computation of different therapeutic diets, it is
imperative that nursing students first acquire knowledge in
calculating diets for normal individuals, those having some illnesses,
those pregnants and lactating, children and elderly to achieve and
maintain an optimal health. and planning regular menu using the Food
Exchange List. The Food Exchange List is one of the basic tools in
nutrition and diet therapy. It is used in meal planning and estimating
the energy and macronutrients of normal and therapeutic diets.
 COMPUTATION OF DESIRABLE BODY WEIGHT (DBW)

Tannhauser’s Method

Height in cm – 100 cm

COMPUTATION OF Take 10% of remainder and subtract answer from

remainder.
DESIRABLE BODY
WEIGHT (DBW) Ex: DBW of 45 years old, male, 5’4” tall

Height = 5’4” = 64 inches = 162.56 cm

162.56 cm – 100 cm = 62.56 cm
10% of 62.56 = 6.256
62.56 kg – 6.256 = DBW (kg)
56.30 kg = DBW
 COMPUTATION OF TOTAL ENERGY ALLOWANCE (TEA)

Given:
1.Calculate your basal needs = .9 x 52kg (DBW) x 24hrs =
1123.2
Basal Need
Male = 1 kcal per kg DBW/hour Female = 0.9 kcal per kg DBW/hour
COMPUTATION OF
2.Estimate physical activities = 1123.2 x .60= 673.92
TOTAL ENERGY Physical Needs – approximate percentage increase above basal needs (use lower
factor for women)
ALLOWANCE Bed rest 10 – 20 percent
Sedentary 30 percent
Light activity 50 – 60 percent
(TEA) Moderately active 60 – 70 percent
Severely active 90 – 110 percent

3.Add values from 1 and 2 to get TEA = 1,797.12

Basal needs + Estimated Physical Activity = TEA
 4.Distribute Total Energy Allowance among Carbohydrate,
Protein, Fat as follows: CHO: 65% CHON: 15% FATS: 20%

TEA 5.For a normal diet, allot 65% of the total energy

allowance for carbohydrates, 15 % protein and 20% fat.
DISTRIBUTION Thus, the corresponding energy contributions of the
three nutrients in your diet are as follows:

Carbohydrate = 1797 kcal X 65% = 1168.05 kcal= 1150 kcal

Protein = 1797 kcal X 15% = 269.55 kcal = 250 kcal
Fats = 1797 kcal X 20% = 359.4 kcal = 350 kcal
 6.Calculate the number of grams of CHO, CHON and
Fats by dividing the calories for each nutrient by
the corresponding physiologic fuel values
FUEL FACTOR
Carbohydrate = 1150 kcal / 4 = 287.5 gms= 285
Protein = 250 kcal /4 = 62.5 gms= 60
Fats = 350 kcal / 9 = 38.88 gms= 40

7. For simplicity and practicality of the diet prescription (Rx),

round off calories to the nearest 50, and carbohydrates,
proteins and fats to the nearest 5 gms.
Diet Rx:
Carbohydrates = 285gms
Protein = 60 gms
Fats = 40 gms
 Steps in Meal Planning Using The
Food Exchange List
1. Use the table provided for the meal plans.
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges).
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given, unless there is drastic
restriction of simple carbohydrates).
4. Determine the amount of milk exchanges. Type and amount of milk depends upon needs, food habits and economic
considerations.
5. Determine the amount of sugar desired. (Allow 5 to 9 teaspoons of sugar per day unless contraindicated.)
6. Sub-total the amounts of CHO, CHON and Fats and calories provided.
7. Subtract the amount of CHO so far provided by the vegetable, fruit, milk exchanges and the sugar allowed from the prescribed
amount. Divide the result by 23, which is the amount of carbohydrate in one rice exchange necessary to fill up the prescribed
amount.
8. Sub-total the amount of protein; subtract from the total protein prescribed and divide the result by 8 to get the number of meat
meal exchanges required.
9. Sub-total the amount of fat; subtract from the total fat prescribed and divide the result by 5 to get the number of fat exchanges
required.
10. The total number of exchanges obtained will be used for planning your menu. Distribute these exchanges into breakfast, lunch,
supper and snacks and provide a one-day sample menu.
RECOMMENDED gram OF
NUTRIENTS PER EXCHANGE
Food Exchange CHO CHON FATS
Veg. A & B 3 1 0
Fruits 10 0 0
Milk 12 8 Skim: 0, Low-fat: 5, Whole: 8
Rice 23 2 0

Meat 0 8 Very lean: 0-1, Lean: 3; Med-

fat: 5; High-fat:8
Sugar 5 0 0
Fats 0 0 5
 Steps in Meal Planning Using The
Food Exchange List
1. Use the table provided for the meal plans.

Food No. of CHO CHON FAT ENERGY kcal Meal Distribution

Exchanges Exchanges Breakfast Lunch Dinner Snack
I. Veg AVeg B

II. Fruits
III. Milk (LF)

IV. Rice

V. Meat (mf)

VI. Sugar
VII. Fat
TOTAL
 Steps in Meal Planning Using The
Food Exchange List
1. Use the table provided for the meal plans.

Food No. of CHO CHON FAT ENERGY kcal Meal Distribution

Exchanges Exchanges 285 g 60 g 40 g Breakfast Lunch Dinner Snack
I. Veg AVeg B

II. Fruits
III. Milk (LF)

IV. Rice

V. Meat (mf)

VI. Sugar
VII. Fat
TOTAL
 Food Exchange CHO CHON FATS
Veg. A & B 3 1 0

Steps in Meal Planning Using The Fruits

Milk
10
12
0
8
0
Skim: 0, Low-
fat: 5, Whole: 8

Food Exchange List

Rice 23 2 0
Meat 0 8 Very lean: 0-1,
Lean: 3; Med-
fat: 5; High-
fat:8
Sugar 5 0 0
1. Use the table provided for the meal plans. Fats 0 0 5
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges).
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits
III. Milk (LF)

IV. Rice

V. Meat (mf)

VI. Sugar
VII. Fat
TOTAL
 Food Exchange CHO CHON FATS
Veg. A & B 3 1 0

Steps in Meal Planning Using The Fruits

Milk
10
12
0
8
0
Skim: 0, Low-
fat: 5, Whole: 8

Food Exchange List

Rice 23 2 0
Meat 0 8 Very lean: 0-1,
Lean: 3; Med-
fat: 5; High-
fat:8
Sugar 5 0 0
1. Use the table provided for the meal plans. Fats 0 0 5
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges).
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given, unless there is drastic
restriction of simple carbohydrates).
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF)

IV. Rice

V. Meat (mf)

VI. Sugar
VII. Fat
TOTAL
 Food Exchange CHO CHON FATS
Veg. A & B 3 1 0
Fruits 10 0 0

Steps in Meal Planning Using The Milk

Rice
12

23
8

2
Skim: 0, Low-
fat: 5, Whole: 8
0

Food Exchange List

Meat 0 8 Very lean: 0-1,
Lean: 3; Med-
fat: 5; High-
1. Use the table provided for the meal plans. fat:8
Sugar 5 0 0
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges). Fats 0 0 5
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given, unless there is drastic
restriction of simple carbohydrates).
4. Determine the amount of milk exchanges. Type and amount of milk depends upon needs, food habits and economic
considerations.
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 24 X 4 = 96
16 X 4 = 64
total = 250
IV. Rice

V. Meat (mf)

VI. Sugar
VII. Fat
TOTAL
 Food Exchange CHO CHON FATS
Veg. A & B 3 1 0
Fruits 10 0 0

Steps in Meal Planning Using The

Milk 12 8 Skim: 0, Low-
fat: 5, Whole: 8
Rice 23 2 0

Food Exchange List

Meat 0 8 Very lean: 0-1,
Lean: 3; Med-
fat: 5; High-
1. Use the table provided for the meal plans. fat:8
Sugar 5 0 0
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges).
Fats 0 0 5
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given, unless there is drastic
restriction of simple carbohydrates).
4. Determine the amount of milk exchanges. Type and amount of milk depends upon needs, food habits and economic
considerations.
5. Determine the amount of sugar desired. (Allow 5 to 9 teaspoons of sugar per day unless contraindicated.)
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 24 X 4 = 96
16 X 4 = 64
total = 250
IV. Rice

V. Meat (mf)

VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40
VII. Fat
TOTAL
 Steps in Meal Planning Using The Food Exchange List
1. Use the table provided for the meal plans.
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges).
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given, unless there is drastic
restriction of simple carbohydrates).
4. Determine the amount of milk exchanges. Type and amount of milk depends upon needs, food habits and economic
considerations.
5. Determine the amount of sugar desired. (Allow 5 to 9 teaspoons of sugar per day unless contraindicated.)
6. Sub-total the amounts of CHO, CHON and Fats and calories provided.

Food No. of CHO CHON FAT ENERGY kcal Meal Distribution

Exchanges Exchanges 250 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 0 24 X 4 = 96
16 X 4 = 64
total = 250
IV. Rice

V. Meat (mf)

VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40
VII. Fat
TOTAL 9 + 40 + 24 +10 = 3 + 16 = 19 0 48 + 160 + 250 +
83 40 = 498
 Food Exchange CHO CHON FATS
Steps in Meal Planning Using The Food Exchange List Veg. A & B 3 1 0
1. Use the table provided for the meal plans. Fruits 10 0 0
Milk 12 8
Skim: 0, Low-
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges). fat: 5, Whole: 8
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given,
Riceunless there
23 is2drastic
0
restriction of simple carbohydrates). Meat 0 8 Very lean: 0-1,
4. Determine the amount of milk exchanges. Type and amount of milk depends upon needs, food habits and economic Lean: 3; Med-
fat: 5; High-
considerations. fat:8
5. Determine the amount of sugar desired. (Allow 5 to 9 teaspoons of sugar per day unless contraindicated.)
Sugar 5 0 0
6. Sub-total the amounts of CHO, CHON and Fats and calories provided. Fats 0 0 5

7. Subtract the amount of CHO so far provided by the vegetable, fruit, milk exchanges and the sugar allowed from the prescribed
amount. Divide the result by 23, which is the amount of carbohydrate in one rice exchange necessary to fill up the prescribed
amount.
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 0 24 X 4 = 96
16 X 4 = 64
total = 250
IV. Rice 9 9 x 23 = 207 9 x 2 = 18 0 207 x 4 = 828
18 x 4 = 72 285 - 83 = 202
total = 900 202 / 23 = 8.78 or 9
V. Meat (mf)

VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40
VII. Fat
TOTAL 9 + 40 + 24 +10 = 3 + 16 = 19 0 48 + 160 + 250 +
83 40 = 498
 Food Exchange CHO CHON FATS
Steps in Meal Planning Using The Food Exchange List
1. Use the table provided for the meal plans.
Veg. A & B 3 1 0
Fruits 10 0 0
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges). Milk 12 8 Skim: 0, Low-
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given, unless there is drastic restriction of simple carbohydrates). fat: 5, Whole: 8
4. Determine the amount of milk exchanges. Type and amount of milk depends upon needs, food habits and economic considerations. Rice 23 2 0
5. Determine the amount of sugar desired. (Allow 5 to 9 teaspoons of sugar per day unless contraindicated.)
Meat 0 8 Very lean: 0-1,
6. Sub-total the amounts of CHO, CHON and Fats and calories provided.
Lean: 3; Med-
7. Subtract the amount of CHO so far provided by the vegetable, fruit, milk exchanges and the sugar allowed from the prescribed amount. Divide the result by 23, which is the
fat: 5; High-
amount of carbohydrate in one rice exchange necessary to fill up the prescribed amount.
fat:8
Sugar 5 0 0
Fats 0 0 5

8. Sub-total the amount of protein; subtract from the total protein prescribed and divide the result by 8 to get the number of meat
meal exchanges required.
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48 60 - 37 = 23
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 0 24 X 4 = 96
23 / 8 = 2. 875 or 3
16 X 4 = 64
total = 250
IV. Rice 9 9 x 23 = 207 9 x 2 = 18 0 207 x 4 = 828
18 x 4 = 72
total = 900
V. Meat (mf) 3 0 3 x 8 = 24 3 x 5= 15 24 x 4 = 96
15 x 9 = 135
total = 231
VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40
VII. Fat
TOTAL 9 + 40 + 24 +10 = 3 + 16 + 18 = 37 0 48 + 160 + 250 +
83 40 = 498
 Food Exchange CHO CHON FATS

Steps in Meal Planning Using The Food Exchange List

1. Use the table provided for the meal plans.
Veg. A & B
Fruits
3
10
1
0
0
0
2. Determine the amount of vegetable. A and B exchanges the patient can eat (Allow 2-3 exchanges). Milk 12 8 Skim: 0, Low-
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be given, unless there is drastic restriction of simple carbohydrates). fat: 5, Whole: 8
4. Determine the amount of milk exchanges. Type and amount of milk depends upon needs, food habits and economic considerations. Rice 23 2 0
5. Determine the amount of sugar desired. (Allow 5 to 9 teaspoons of sugar per day unless contraindicated.) Meat 0 8 Very lean: 0-1,
6. Sub-total the amounts of CHO, CHON and Fats and calories provided. Lean: 3; Med-
7. Subtract the amount of CHO so far provided by the vegetable, fruit, milk exchanges and the sugar allowed from the prescribed amount. Divide the result by 23, whichfat:
is the
5; High-
amount of carbohydrate in one rice exchange necessary to fill up the prescribed amount. fat:8
8. Sub-total the amount of protein; subtract from the total protein prescribed and divide the result by 8 to get the number of meat meal exchanges required.
Sugar 5 0 0
Fats 0 0 5
9. Sub-total the amount of fat; subtract from the total fat prescribed and divide the result by 5 to get the number of fat exchanges
required.
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
40 - 15 = 25
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 0 24 X 4 = 96 25 / 5 = 5
16 X 4 = 64
total = 250
IV. Rice 9 9 x 23 = 207 9 x 2 = 18 0 207 x 4 = 828
18 x 4 = 72
total = 900
V. Meat (mf) 3 0 3 x 8 = 24 3 x 5= 15 24 x 4 = 96
15 x 9 = 135
total = 231
VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40
VII. Fat 5 0 0 5 x 5 =25 25 x 9 = 225
TOTAL 9 + 40 + 24 +10 = 3 + 16 + 18 = 37 15
83
 Steps in Meal Planning Using The Food Exchange List
TEA : 1, 797
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 0 24 X 4 = 96 1854 - 1797= 57 difference
16 X 4 = 64
total = 250 Allowable difference:
IV. Rice 9 9 x 23 = 207 9 x 2 = 18 0 207 x 4 = 828 - excess of 30
18 x 4 = 72
total = 900
- deficient of 10
V. Meat (mf) 3 0 3 x 8 = 24 3 x 5= 15 24 x 4 = 96
15 x 9 = 135 there is a excess of 57; so
total = 231 there is a need to modify
VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40 the plan
VII. Fat 5 0 0 5 x 5 =25 25 x 9 = 225
TOTAL 9 + 40 + 24 + 207 3 + 16 + 18 + 24 15 + 25 = 40 48 + 160 + 250 +
+ 10 = 290 = 61 900 + 231 + 40 +
225 = 1854
 Steps in Meal Planning Using The Food Exchange List
TEA : 1, 797
Food No. of CHO CHON FAT ENERGY kcal Meal Distribution
Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 0 24 X 4 = 96
16 X 4 = 64 Find an item to modify : Fat
total = 250
IV. Rice 9 9 x 23 = 207 9 x 2 = 18 0 207 x 4 = 828
18 x 4 = 72 1809 - 1797 = 12 Excess
total = 900
V. Meat (mf) 3 0 3 x 8 = 24 3 x 5= 15 24 x 4 = 96
15 x 9 = 135
total = 231
VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40
VII. Fat 5 0 0 5 x 5 =25 25 x 9 = 225
MODIFIED 4 0 0 4 X 5 = 20 20 X 9 = 180
TOTAL 9 + 40 + 24 + 207 3 + 16 + 18 + 24 15 + 25 = 40 48 + 160 + 250
+ 10 = 290 = 61 + 900 + 231 + 40
+ 180= 1809
 Steps in Meal Planning Using The Food Exchange List
10. The total number of exchanges obtained will be used for planning your menu. Distribute these exchanges into
breakfast, lunch, supper and snacks and provide a one-day sample menu.

Food No. of CHO CHON FAT ENERGY kcal Meal Distribution

Exchanges Exchanges 285 g 60 g 40 g CHO : 4, CHON: Breakfast Lunch Dinner Snack
4, FATS: 9
I. Veg AVeg B 2 2 x3 = 6 2x1=2 2x0=0 9 x 4 =36 1 1 1
1 1x3=3 1x1=1 1x0=0 3x 4 = 12
6+3=9 2+1=3 0 0X9=0
total = 48
II. Fruits 4 4 X 10 = 40 0 0 40 X 4 = 160 1 1 1 1
III. Milk (LF) 2 2 X 12 = 24 2 X 8 = 16 0 24 X 4 = 96 1 1
16 X 4 = 64
total = 250
IV. Rice 9 9 x 23 = 207 9 x 2 = 18 0 207 x 4 = 828 2 2.5 2.5 2
18 x 4 = 72
total = 900
V. Meat (mf) 3 0 3 x 8 = 24 3 x 5= 15 24 x 4 = 96 1 1 1
15 x 9 = 135
total = 231
VI. Sugar 2 2 X 5 = 10 0 0 10 x 4 = 40 1 1
VII. Fat 4 0 0 4 X 5 = 20 20 X 9 = 180 1 1 1 1

TOTAL 9 + 40 + 24 + 207 3 + 16 + 18 + 24 15 + 25 = 40 48 + 160 + 250

+ 10 = 290 = 61 + 900 + 231 + 40
+ 180= 1809
SAMPLE MENU FOR A NORMAL DIET
Breakfast(Indicate HH* Measures) Lunch(Indicate HH* Measures) Supper(Indicate HH* Measures)

1 ½ Cups cooked rice 1 cup cooked rice1 slice lean pork 1 cup cooked rice
1 fried bacon strip (matchbox size) adobo or 1 slice bulalo
1 small fried chicken leg 1 medium fried tilapia ½ cup cabbage (added to bulalo)
1 small ripe banana1 1 small apple 1 slice ripe melon
1 tbsp sauteed green peas 1 cup steamed kangkong or 1 glass of water
1 glass of milk w/ 2 tsp. Sugar steamed ½ cup of broccoli
1 glass water 1 glass of water

Snacks(Indicate HH* Measures)

AM Snack PM Snack 1 slice cassava cake1 glass Midnight Snack
buko jiuce(coconut water)
 EN
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.