Nutrition and Diet Therapy Exercises
Calculating Diets and Meal Planning
Prepared by: Combento Honeylette Princess A. Exercise No.1
BSN 2-B August 30, 2020
To prepare for the computation of different therapeutic diets, nursing students like you should first
acquire the knowledge in calculating diets for normal individuals and planning regular
menu using the Food Exchange List. The FEL 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.
I. Objectives
This laboratory session helps you compute your own calorie requirements and plan your meals.
At the end of the 3-hour laboratory session, you should be able to:
1. assess your nutritional status and compute for your calorie requirements and
2. plan a one-day menu based on your requirements.
II. Procedures
A. Following the steps in estimating the desirable body weight (DBW) discusses in the lecture
portion, calculate your total energy allowance (TEA).
1. Determine your height = 5ft and actual body weight = 88.18 lbs.
Convert lbs into kg weight 40kg
a. Tannhauser’s Method
Female, 20 years old, 5 ft. tall
Height = 5 ft. tall = 121.92 cm
121.92 – 100 = 21.92 cm
10% of 21.92 cm = 2.192
21.92 – 2.19 = DBW (kg)
DBW (kg) = 19.73 kg / 43.28 lbs
2. Calculate your basal needs = 0.9 kcal/kg x 19.73 kg x 24 = 426.17 kcal
Basal Need
Male = 1 kcal per kg DBW/hour Female = 0.9 kcal per kg DBW/hour
3. Estimate physical activities = 213.08 kcal
EPA = BMR x .5 (light activity)
EPA = 426.17 x .5
EPA = 213.08 kcal
Physical needs – Approximate percentage increase above basal needs
(use lower factor for human)
Bed Rest 10 – 20 percent
Sedentary 30 percent
Light Activity 50 – 60 percent
Moderate Active 60 – 70 percent
Severely active 90 – 110 percent
4. Add values from 2 and 3 to get TEA = 426.17 kcal + 213.08 kcal = 639.25 kcal
5. Distribute the total energy allowance among carbohydrates, proteins, and fats as follows:
Carbohydrates: 50% to 70%
Proteins: 10% to 15%
Fats: 20% to 30%
Allowances for proteins can also be provided based on the Recommended Energy and Nutrient
Intakes per Day for Filipinos (RENI) as shown in Appendix A-1.
6. For a normal diet, allot 65% for the total energy allowance for carbohydrates, 15%
proteins, and 20% fats. Thus, the corresponding energy contributions of the three
nutrients in your diet are as follows:
Estimated physical act
Carbohydrates = 213.08 kcal x 0.65 = 138.5 kcal
Proteins = 213.08 kcal x 0.15 = 31.96 kcal
Fats = 213.08 kcal x 0.20 = 42.61 kcal
7. Calculate the number of grams of carbohydrates, proteins, and fats by dividing the
calories for each nutrient corresponding physiologic fuel values (4 kcal/g CHO, 4 kcal/g proteins, 9
kcal/g fat)
Carbohydrates = 138.5 kcal / 4 = 34.63 g
Proteins = 31.96 kcal / 4 = 7.99 g
Fats = 42.61 kcal / 9 = 4.73 g
8. 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 g. Thus, your diet prescription is:
Diet Rx: Kcal 426; CHO 35 g, CHON 8 g, Fat 5 g
B. Using the Food Exchange List, design your meal plan taking into consideration your food
habits, food behavior, preferences, and the like. Follow the steps in meal planning.
Steps in Meal Planning using the Food Exchange List
1. Use the table provided for the meal plan.
2. Determine the amount of vegetable A and B exchanges you can eat (Allow 2-3 exchanges).
3. Determine the amount of fruit exchanges. (A reasonable allowance of 3-4 exchanges can be
give, unless there is drastic restriction of simple carbohydrates).
4. Determine the amount of milk exchanges. The type and amount of milk depend on needs,
food habits, and economic considerations.
5. Determine the amount of sugar desired. (Allow 5-9 teaspoons of sugar per day unless
contradicted).
6. Sub-total the amount of carbohydrates, proteins, fats, and calories provided.
7. Subtract the amount of carbohydrates so far provided by the vegetable, fruit, and milk
exchanges, and sugar allowed from the prescribed amount. Divide the result by 23, which is
the amount of carbohydrates in one rice exchange necessary to fill up the prescribed
amount.
8. Sub-total the amount of proteins; subtract from the total proteins prescribed and divide the
result by 8 to get the number of meat exchange required.
9. Sub-total the amount of fats; subtract from the total fats 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, dinner, and snacks and provide a one-day sample
menu.
Table 1 -1. Meal Plan for Normal Diet
Food No. CHO PRO FAT ENERGY Meal Distribution
Exch of g g g kc al B L D Sn
Ange Exch
s Ange
s
I.Veg A 2 6 2 0 32 - 1 1 -
Veg B 1 3 1 0 16 - 1 - -
II. Fruits 5 50 0 0 200 - 3 2 -
III. Milk 2 24 16 10 250 1 - - 1
(fat - free)
IV. Rice 3 69 6 0 300 1 1 1 -
V. Meat 4 0 32 4 164 1 1 1 1
and meat
VI. Sugar 5 25 0 0 100 - - - 4
VII. Fat 1 0 0 5 45 - 1 - -
Total 177g 57g 24g 1107
kcal
Carbohydrates
Total CHO− (Veg A + Veg B + Fruits + Milk + Sugar)
23g
177 g − ( 6 g + 3 g + 50 g + 24 + 69 )
23g
= 6.6
Proteins
Total proteins prescribed−Total proteins
8g
147 g – 57 g
8g
= 11.25
Fats
Total fats prescribed−Total fats
5g
90g−24g
5g
=13.2
Table 1- 2 Sample Menu for a Normal Diet
Breakfast Lunch Dinner
(indicate HH* measure) (indicate HH* measure) (indicate HH* measure)
½ cup white rice ½ cup white rice ½ cup white rice
1 fried egg 1 oz tuna canned in oil, drained ½ cup cooked carrots
1 cup raw fresh tomato 2 tbsp avocado ½ cup cooked kale
1 cup fat- free milk Glass of water Glass of water
2 glasses of water
Table 1-2 Sample Menu for a Normal Diet (cont’d)
Snacks
(indicates HH* measures)
AM Snacks PM Snacks Midnight Snacks
1 unpeeled apple ¼ cup cottage cheese
1 cup plain yogurt with 1 1 fresh pineapple slice 1 cup of frozen yogurt
tablespoon of honey 3 graham crackers
Glass of water Glass of water with lemon
* HH - household measures
C. Submit the individual worksheets at the end of the laboratory activity.
D. In planning nutritious diets, you can also use Your Guide to Good Nutrition (Appendix B)
and the Daily Nutritional Guide Pyramid for Filipino Adults (Appendix C). These nutrition
tools are daily food guides which use the recommended amounts and number of
servings of food to provide the variety of nutrients needed by the body.
III. Questions for Discussions
1. What are the bases for estimating the desirable intake of an individual? The bases for
estimating the desirable intake of an individual are age, gender, height, weight, activity, and
goal such as weight maintenance, lose weight, and gain weight.
2. What are the pointers to consider in planning a normal diet? A therapeutic diet? In
planning a normal diet, you should look at your food habits and food behavior. A healthy
meal plan for a normal diet includes a variety of healthy foods from all the food groups.
Fruits and vegetables make up about half of your plate, and grains and protein make up the
other half. The amount of calories and serving sizes you need depends on your age, gender,
weight, height, and how active you are in a daily basis.
In planning a therapeutic diet, you should know first that its purpose is to maintain normal
body functioning by controlling the intake of certain foods or nutrients. It is a combination of
sufficient calories and nutrients to regulate an amount of food needed. It is important to
consider that there are various types of therapeutic diets - regular diets, soft diet, diabetic
diet, calorie-controlled diet, low cholesterol diet, low fat, and high protein diets. Therapeutic
diets are useful for those who want to maintain their diet patterns in order to increase or
decrease weight loss.
