NUTRITION

The study of nutrition of prime importance thru out life cycle. It is interrelated with other basic needs such as physical and economic factor. The application of thorough knowledge of nutrition from birth to death will result to effective nutrition education.

Terms associated with nutrition:

Nutrition- study of food in relation to health

-combination of process by which the living organisms ingest, digest, absorb, transport, utilizes, excretes food substances

1 Ingestion- the process of taking in of food substances

2 Digestion- process of turning large particles of food into smaller particles of food into smaller particles

3 Absorption- process of taking up fluids, nutrients by skin and blood vessels

4 Transport- carrying of nutrients to different parts of the body

5 Excretion- discharge of waste materials from body.

6 Food- any edible substances when ingested or eaten has 3 functions:

1. builds and repairs body tissue

2. supplies heat or energy

3. regulate body process

Qualities of an ideal food

1. Builds or repairs body tissue

2. Supplies heat or energy

3. Regulate body process

Qualities of an ideal food

1. Is it nourishing or nutritious

2. Is it prepared under sanitary

3. Is it free from toxic agents or does not maintain harmful substance

4. It is palatability factor satisfy a customer(color, flavor and texture)

5. It offers variety and planned with in bud get and subtask to occasion

NUTRIENT- any chemical component needed by body for one or more functions.

Classification of nutrients

1. According to function

2. According to chemical properties

3. According to concentration

According to function

1. Body building nutrient- they form tissue. Example h2O-2/3 of body weight, CHON-1/5 of body weight.

2. Nutrients that furnish energy- CHON, CHO, fats

3. Nutrients that regulate body

According to chemical nature

1. Organic substance- those containing C compounds(CHO,CHON,Fats)

2. Inorganic substance- mineral and h2O

According to essentiality (usefulness in diet)

1. Dietary essential- must be supplied in diet because body has no storage of these nutrient(vitamin c)

2. Dietary non-essential- nutrients that perform one function.

According to concentration

1. Macronutrients- present in body in large amount( water, CHON, fat, CHO)

2. Micronutrients- nutrients that are present in body in small amount(vitamin and trace minerals)

Nutritional Status or Nutriture- condition of body resulting from utilization of essential nutrient

Classifications:

a. Optimum or good nutrients- body has adequate supply of essential nutrients for growth and good health.

b. Malnutrition- condition of body resulting from lack of one or more nutrient.

-excessive supply of nutrient causing toxic effect or nutrients deficiencies.

NUTRITIONAL DEFICIENCES ARE CLASSIFIED INTO TWO
a. Primary Factor- refers to faulty diet nutrient lacking in quality. Faulty diet that bring faulty diet

1. Poverty- ignorance, poor food habits, limited food supply

b. Secondary factor – includes all condition in body after food is digest

EVALUATION OF NUTRITURE

How does a person know if he/she is well, nourished or not. There are so many ways in evaluation well status, some ECO, Data, health; statistics are useful in evaluating nutriture.

a. Dietary survey- evaluates primary factor of nutritional inadequacy

b. Physical or instrumental method- taking of HT and WT

c. Medical history- record of persons past illness and complaint

d. Medical exam- of head to foot(mouth, tongue, eye, and skin) well detect physical sins associated with malnutrition

OTHER FIELDS OF NUTRITION

1. Basic or fundamental nutrition- study of physiological needs In terms of specific nutrients

2. Child or maternal nutrition- study of nutritional principles thru out life cycle, condition in infancy, childhood, pregnancy and lactation

3. Normal therapeutic- deals with the study of nutrient intake and diet to meet ind. Needs

4. Clinical- study of the effect of food if there is excessive intake

NUTRIENTS FROM FOODS

· Fats- insoluble with h2O

-soluble in fat solvent either chloroform

Functions:

1. Conclude source of energy

2. Storage form of energy

3. Carrier of fat soluble solvent

Classification:

1. Physical appearance:

a. Visible fats- cooking oil

b. Invisible fats- egg yolk, avocado

· Protein- originated from Greek word “holding place”

-compose of element CHON

-large organic component

Functions:

1. Body building or structural role -20% or 1/5 body adult is protein, 1/3 muscle, 1/5 in bones or cartilages, 1/10, in skin

2. Expensive source of energy

3. Support growth of new tissue

Classification:

1. According to chemical component

a. Essential AA- body cannot synthesized: must have already available

b. Non essential AA-

2. According to CHON quality-

a. Complete CHON- contains all EAA

For growth or maintenance of life Example:

Casein milk

b. Partially complete CHON- can maintains life but does not support growth. Example gliadin in wheat, legumin in legumes

c. Incomplete CHON- cannot support life and growth. Example ZEIN(corn)

· Carbohydrates

Functions:

1. Big group of organic compounds prominent in plant kingdom

2. Chief source of energy or main energy food

3. Protein sparer

4. Provider of build (cellulose and fiber)

CLASSIFICATION:

According to number of sugar untis

a. Monasaccharide- one sugar unit

1. Glucose- dextrose, grape sugar, honey, corn syrup

2. Fructose- ripe fruit

3. Galactose-milk sugar

b. Dissacharide- two sugar units

1. Sucrose- cane sugar

2. maltose- malt sugar found in grain

3. Lactose- milk sugar, milk and milk product

c. Polysaccharide

1. Starch- storage form of CHO in body

2. Dextrin- action of dry heat

3. Glycogen- animal starch; storage form of CHO in body

According to digestibility

1. Digestible- sugars, starches and dextrin

2. Partially digestible

3. Indigestible CHO- dietary fiber

Religion : Judaism

Dietary Practices:

Kashrut: Jewish dietary law of keeping kosher.

1. Meat and poultry (includes cattle, sheep, goats, deer); a specific list of birds (includes chicken, turkey, goose,pheasant, duck). Not permitted: Pig and pork products

2. Fish. Permitted: Fish with fins and scales. Not permitted: Shellfish (scallops, oysters,clams), crustaceans (crab, shrimp, lobster), fishlike mammals (dolphin, whale), frog, shark,eel.

3. Meat and dairy are not eaten or prepared together. Meals are dairy or meat, not both.

4. All fruits, vegetables, grains, and eggs can be served with dairy or meat meals.

Religion : Roman Catholicism

Dietary Practices:

1. Abstain from eating meat on Fridays during Lent (the 40 days before Easter).

2. Fast (one meal is allowed) and abstain from meat on Ash Wednesday (beginning of Lent) and Good Friday (the Friday before Easter).

Religion : Eastern Orthodox Christianity

Dietary Practices:

1. Numerous feast days and fast days. On fast days, no fish, meat, or other animal products (including dairy products) are allowed. Shellfish are allowed.

Religion : Protestantism

Dietary Practices:

1. Food on religious holidays is largely determined by a family’s cultural background andpreferences.

2. Fasting is uncommon.

Religion: Mormonism

Dietary Practices:

1. Prohibit tea, coffee, and alcohol. Some Mormons abstain from anything containing caffeine.

2. Eat only small amounts of meat and base diet on grains.

3. Some Mormons fast once a month.

Religion: Seventh-Day Adventist Church

Dietary Practices:

1. Many members are lacto-ovo vegetarians (eat dairy products and eggs but no meat or poultry).

2. Avoid pork and shellfish.

3. Prohibit coffee, tea, and alcohol.

4. Drink water before and after meals, not during.

5. Avoid highly seasoned foods and eating between meals.

Religion: Islam

Dietary Practices:

1. All foods are permitted (halal) except for swine (pigs), four-legged animals that catch prey with the mouth, birds of prey that grab prey with their claws, animals (except fish and seafood) that have not been slaughtered according to ritual, and alcoholic beverages.

2.Use of coffee and tea is discouraged.

Religion: Hinduism

Dietary Practices:

1. Encourages eating in moderation.

2. Meat is allowed, but the cow is sacred and is not eaten. Also avoided are pork and certain fish. Many Hindus are vegetarian.

3. Many Hindus avoid garlic, onions, mushrooms, and red foods such as tomatoes.

4. Water is taken with meals.

5. Some Hindus abstain from alcohol.

6. Hindus have a number of feast and fast days.

Religion: Buddhism

Dietary Practices:

1. Dietary laws vary depending on the country and the sect. Many Buddhists do not believe in taking life, and so they are lacto-ovo vegetarians (eat dairy products and eggs but no meat or poultry).

2. Celebrate feast and fast days.

A nutritious diet has four characteristics. It is:

1. Adequate- A diet that provides enough kcalories, essential nutrients, and fiber to keep a person healthy.

2. Balanced- A diet in which foods are chosen to provide kcalories, essential nutrients, and fiber in the right proportions.

3. Moderate- A diet that avoids excessive amounts of kcalories or any particular food or nutrient.

4. Varied- A diet in which you eat a wide selection of foods to get necessary nutrients.

How to assist someone to eat:

1.Ensure that food is neither hot or cold

2.Feed attractive, tasty, pleasant smelling food to enhance appetite

3.Make sure he is ready to eat (dentures, eyeglasses, hearing aid in place)

4.Try to make environment quiet and inviting

5.Make sure that he is seated correctly

6.Sit at eye level as you assist the person while eating

7.Use teaspoon to avoid putting too much food in mouth

8.Remind the person to check each food in mouth

9.Try to touch lower jaw lips to stimulate mouth

10.Massage throat to stimulate seed low reflexes

11.Take as much time as necessary to help person enjoy meal

12.Clean out mouth after each meal

13.Feed in small amount and gradually increases

14.If person is not swallow between spoonful put an empty spoon into mouth to trigger swallowing mechanism

15.Use swallow wide glass instead of tall narrow ones

16.Never fed person lying down

17.Do not wash down food with liquid

18.Do not straw for swallowing problems straw increase air swallowing

Basic Food Group

1. Go

2. Gro

3. Glow

Vitamins- potent organism’s compounds of unrelated chemical compound which occur in minute quantity needed in small amount for specific regulatory functions maintenance of life and growth

Classifications:

1. According to solubility

Fat soluble (vitamin A,D,E,K)

Characteristics of fat soluble:

1. Have precursor or pro vitamin compounds that can changed to active vitamin

2. Can be stored in body

3. Deficiencies slow to develop

4. Not absolutely needed daily from food sources

5. Stable especially ordinary cooking

Water Soluble (vitamin C,B1,B2, niacin, B6, B12)

Characteristics of water soluble:

1. Must supplied in diet

2. Not stored in body excess excrete in urine

3. Deficiency symptoms develop Fast

4. Destroyed at over cooking

Fat soluble vitamin

Vitamin A- Antixropthalmic Vitamin

Function:

1. Normal bone and teeth growth development

2. Normal vision

Deficiency diseases:

1. Impaired bone and teeth development

2. Difficulty in chewing and swallowing

Sources:

1. Dark green vegetable

2. Yellow fruits and vegestable

Vitamin D-anti-rachitic

-sunshine vitamin

Functions:

1. Promotes normal bone and teeth development

2. Normal vision

Deficiency Diseases

1. Muscle twitching and cramps

2. Rickets retarded growth

3. One deformity (pigeon, breast and low legged)

Sources:

1. Sunlight

2. Fortified foods

Vitamin E- Tocopherol

Function

1. Help maintain cell membrane

Deficiency Diseases:

1. Decreased RC

2. Anemia in children

Sources

1. Vegetable oil

2. Whole grain products

Vitamin K- Anti hemorrhagic

Function:

1. Coagulation of blood

Deficiency Diseases signs and symptoms:

1. Hemorrhagic diseases in new born baby

2. Delayed clotting time in adult

Water Soluble vitamin

Vitamin C

Functions:

1. Formation or maintenance of inter cellular cementing substances

2. Bulding body resistance against infection

Deficiencies Diseases:

1. Weakness

2. Lack of appetite, lowered resistance to infection, bleeding gum

3. Loose teeth

4. Delayed skeletal growth develop

Vitamin B1 Thiamin

Functions:

1. Maintenance of good appetite

2. Prevent beriberi

Deficiencies diseases:

1. Loss of appetite

2. Retarded growth

3. Numbness of extremities

4. Painful calf

5. Anorexia

Vitamin B2- Riboflavin

Functions:

1. Healthy skin, tongue, mouth

2. Normal vision

3. Normal growth and development

Deficiencies diseases:

1. Dermatitis

2. Burning sensation of eye

3. Swollen tongue

4. Cheilosis- lips swollen

5. Corners of mouth cracked

Sources

1. Milk, dairy product

2. Organ and meat

3. Enriched rice

4. Green leafy vegetable

Niacin(nicotinic acid)

Functions:

1. Energy metabolism

2. CHO, fat metabolism

Deficiencies diseases:

1. Pellagra

2. Dermatitis

3. Diarrhea

4. Dementia or death

Sources:

1. Lean meat

2. Enriched Whole Grain cereal

Vitamin B6(pyridoxine)

Functions:

1. A.A metabolism

2. Blood Formation

Deficiencies Diseases

1. Anemia, dermatitis

2. Glossitis, cheilosis

Sources:

1. Yeast and organ meat

2. Wheat germ

Vitaminb12-Cyanocobalamin

Functions:

1. Prevents certain form of anemia

2. Assist in formation of RBO

Deficiencies Diseases:

1. Yellowish skin

2. Difficulty in walking

Sources:

1. Animal CHON

Minerals- non calorific and remain as ash when food is burned

Classification

1. Macro minerals- Ca, P, S, Na, C

2.Micro minerals- Fe, Zn, Mn, Cu, I, Co, F

Function

1. Regulatory

a. Regulation of contractility of muscle

-muscle relaxation (Na, K, Mg)

-muscle contraction (Ca)

b. Maintenance of acid base balance

-acid forming (Ch, S, P)

-base forming (Ca, Na, K, Mg)

2. Structural Function

a. Growth of bones and teeth (Ca, P, Mg, F, Na)

b. Components of essential compounds

1. Iodine -Thyroxine

2. Zinc- Insulin

3. Fe- Hemoglobin

4. Chlorine- Gastric

Iodine

Function:

1. Prevent the development of simple goiter

2. Development of fingernails, skin, teeth, and hair

Food sources:

1. Seaweed

2. Shellfish

3. Seafood

Deficiency diseases:

1. Enlargement of thyroid gland

Cobalt

Function:

1. Production of RBC

2. Health of nervous system

Food sources:

1. Oyster and clam

2. Green leafy vegetable

Deficiency diseases:

1. Anemia and low production of oxygen to the different parts of the body

Chlorine

Function:

1. Maintain proper balance of body fluid

2. Essential part of digestive system

Food sources:

1. Iodized Salt

2. Seaweed

Deficiency diseases:

1. Heat cramps

2. Hair loss

Phosphorus

Function:

1. Utilization of carbohydrates and fats

2. Formation of teeth

3. Relieve fracture of bone, due to injury

Food sources:

1. Milk

2. Grain products

Deficiency diseases:

1. Anorexia

2. Stunted growth

Copper

Function:

1. Helps release energy

2. Melanin production

3. Bone formation

Food sources:

1. Cauliflower

2. Molasses

3. Wheat germ

Deficiency diseases:

1. Nephrosis

2. Skin sore

3. Loss of hair and taste

Magnesium

Function:

1. Bone and teeth formation

2. Smooth muscle

Food sources:

1. Green leafy vegetable

2. Nuts

3. Dried peas

4. Seafood

Deficiency diseases:

1. Tremors/ disorientation

2. Loss of muscle control

3. Convulsion

Iron

Function:

1. Constituent of hemoglobin

2. For hemoglobin formation

Food sources:

1. Liver

2. Malunggay

3. Ampalaya

Deficiency diseases:

1. Anemia- reduced RBC to carry oxygen

a. Nutritional anemia- inadequate intake of Iron caused by poor quality sources of food

b. Hemorrhagic anemia- excessive excretion of Iron caused by blood loss during pregnancy

c. Pernicious anemia- inadequate formation of RBC due to b12 deficiency

Zinc

Function:

1. Is component of insulin and male reproductive fluid

2. Aids in digestion and metabolism of phosphorus

3. Aids in healing process

Food sources:

1. Meat

2. Fish

3. Poultry

4. Whole grain cereals

Deficiency diseases:

1. Retarded growth

2. Delayed sexual maturity

3. Prolonged healing of wounds

4. Stretch marks

5. Loss of taste and appetite

Sodium

Function:

1. Maintains normal fluid levels in cells.

2. Maintains health of the nervous, muscular, blood and lymph systems

Food sources:

1. Table salt

2. Soy sauce

3. Cured meats

Deficiency diseases:

1. Muscle weakness

2. Nausea

3. Loss of appetite

Potassium

Function:

1. Works to control activity of heart muscles, nervous system and kidneys

Food sources:

1. Vegetables

2. Fruits

3. Meats

4. Milk

5. Prunes

6. Beans

Deficiency diseases:

1. Poor reflexes.

2. Respiratory failure

3. Cardiac arrest

4. Nervous disorders

5. Irregular pulse

Selenium

Function:

1. Works with Vitamin E

2. Preserves tissue elasticity

Food sources:

1. Corn

2. Wheat

3. Rice

Deficiency diseases:

1. Premature aging

Sulfur

Function:

1. Is part of amino acids

2. Is essential for formation of body tissues

3. Is part of the B vitamins

4. Play a part in tissue respiration

5. Is necessary for collagen synthesis

Food sources:

1. Meat

2. Poultry

3. Fish

Deficiency diseases:

1. Possibly sluggishness and fatigue

Manganese

Function:

1. Is enzyme activator

2. Plays a part in carbohydrate and fat production

3. Is necessary for normal skeletal development

4. Maintains sex-hormones production

Food sources:

1. Whole grains Nuts

2. Leafy vegetables

Deficiency diseases:

1. Paralysis

2. Convulsions

3. Dizziness

4. Ataxia

5. Loss of hearing

Calcium

Function:

1. Sustains development and maintenance of strong bones and teeth.

2. Assist normal blood clotting, muscle action, nerve function and heart function

Food sources:

1. Milk products

2. Dark green leafy vegetables

3. Shrimp

Deficiency diseases:

1. Stunted growth (in children)

2. Osteoporosis (in adults)

3. Tetany

4. Back and leg pains

5. Brittle bones

6. Insomnia

7. Irritability

Chromium

Function:

1. Stimulates enzymes in metabolism of energy and synthesis of fatty acids, cholesterol and protein

2. Increase effectiveness of insulin

Food sources:

1. Meat

2. Clams

3. Corn oil

4. Whole grain cereals

5. Brewer’s yeast

Deficiency diseases:

1. Depressed growth rate

2. Glucose intolerance in diabetics

3. Atherosclerosis

Box nutritional recommendation for persons with arthritis.

Gout

Ø Increase fluid intake to promote excretion of uric acid in the urine.

Ø A high-carbohydrate, low fat diet favors excretion of uric acid.

Ø Avoid excessive intake of purines by limiting ingestion of sardines, ripened cheese, fermented foods, internal organs, smoked meat, gravies, etc. refer to table 11 for guide on the purine content of foods found in page 25.

Ø Exclusion of alcoholic beverages

Ø Use calorie-controlled diet if weight loss necessary.

Osteoarthritis

Ø Use a calorie-controlled diet if client is obese.

Ø Increase use of fish and fish oil. These act as precursors of eicosanoids which decreases inflammations.

Ø Increase vitamin D intake as this may protect against advancement of osteoarthritis. Good sources of vitamin D include; milk fatty fish such as salmon, eggs, and some fortified cereals. Sunlight exposure also increases vitamin D synthesis in the skin

Ø Increase intake of calcium rich foods such as milk and dairy products, green leafy vegetables and sardines.

Box nutritional Recommendation for persons with osteoporosis.

Ø The diet should e adequate in calcium, at least 800-100 mg daily before menopause, 1.5 g daily after menopause unless on estrogens.

Ø Dry skim milk can be added to many foods

Ø If the patient is obese, use a calorie-controlled diet provides adequate vitamins, minerals, and calcium.

Ø Manage protein intake and maintain recommended levels without excesses

Ø Beware excess intake of fiber (especially wheat brain) because it increases calcium excretion.

Box 6. Nutritional Recommendation for persons with common gastrointestinal problems.

Diarrhea(acute enteritis)

Ø Oral rehydration therapy should be used to prevent dehydration

Ø Determine causation of diarrhea.

Ø Use TPN only for intractable diarrhea, osmotic diarrhea abates

Ø Some fiber or pectin may help like banana, apples, etc. potassium should also e replenished.

Constipation

Ø In general: increase fiber intake by including five servings of fruit and vegetables and six or more serving of bread/cereal group each day. Also increase fluid consumption.

Ø Atonic constipation (lazy bowel): diet should be high in fiber with liberal use of whole grains, fruits and vegetables. Drink 8-10 glasses of fluids daily.

Ø Spastic constipation (small tools): diet should be decreased in fiber during painful episodes. Then, increase use of prune juice, dried fruits, raw fruits and vegetables, nuts and whole grains.

Hyperacidity

Ø Omit foods that are poorly tolerated by the patient

Ø Use small feedings, frequently if preferred.

Ø Provide adequate hydration

Peptic Ulcer

Ø Provide bland diet. Limit gastric stimulants if not tolerated like alcohol, caffeine, black pepper, garlic, cloves, and chili powder. Refrain giving foods of extreme temperature.

Ø Small frequent meals. Includes some protein foods and vitamin C to speed healing.

Ø Limit saturated fats and use more PUFA when increased blood lipid levels are found.

THERAPEUTIC DIET RECOMMENDATION

Low fat diet

Indications for use

Atherosclerosisi

Weight reduction

Cholecystitis

Portal cirrhosis, hepatitis

Pancreatitis sprue

Fat malabsortion

Table 12. common foods allowed and avoided in low fat diet. NDAP, 1994

Food Group	Allowed	Avoided
Vegetable Fruit	All, cooked without added fat for with fat allowance only all	Fried, buttered, creamed or cooked with fat in excess of fat allowance
Milk Rice or substitute	Whole or evaporated cow’s milk in allowed amounts only or nonfat as desires All cereals, roots and tubers; pan de sal noodles except those avoided; macaroni, spaghetti	Carabao’s milk, condensed milk Mami, miqui, read with added fat such as croissants, sweet rolts, muffins, biscuits, pancake, waffles
Meat, fish or substitute fat	Fish, lean meat, chicken w/out skin and fat, boiled, broiled or baked; egg cooked anyway except fried; mature beans and bean products like tokwa, tofu, taho, skim milk, cheese; liver; heart, kidney tripe sweet breads In allowed amounts only	Meat and poultry with visible fat, fried or cooked with fat; fish canned in oil; processed and canned meats; fried eggs; nut, peanuts; whole milk or cream cheese Cream, butter, oil, mayonnaise and other salad dressings, bacon except as allowed in food plan; chicharon and fried foods.
Sugars and sweet desserts	All except those under avoided Gelatin, fruit juices, dietary sherbets, puddings made with skim milk, meringue, angel cake, sponge cake	Chocolate bards; cream filled sweets Pies and pastries, cookies, butter and chiffon cakes; butter and cream icings, doughnuts, yema, leche plan, desserts woth coconut milk
Beverage Soup	Coffee, tea Clear, fat-free or made with skim milk	Soda fountain beverages as milk shakes, malted milk, chocolate drinks cream soup; fatty broths

LOW CHOLESTEROL DIET
indications by use

Coronary artery disease

Hypercholesterolemia

Adults with family history of heart disease

Food Group	Allowed	Avoided
Vegetable	All, cooked without added fat for with fat allowance only	Fried, uttered, creamed in restricted fat or cooked with fatty meat
Fruit	All. When using avocado adjust fat allowance
Milk	Skim or non-fat only	All others
Rice or substitute	All cereals, roots and tubers; pan de sal noodles except those avoided;.	Croissants, muffins, crackers, biscuits, waffles, pancakes, rolls made with whole egg, butter, margarine or fat of unknown composition; mami, miki
Meat, fish or substitute	Use often: lean fish, fresh or frozen or canned in water, tomato or mustard; chicken without skin and fat Use occasionally: very lean, well trimmed cuts of beef, veal, pork; Crab meat, shrimps without head Eggs, whole, up to 3-4 per week, may be cooked in allowed fat; whites as desired Skim milk or low fat cheese, dried peas, beans, lentils; “vegemeat” tokwa, tahu and other bean products	Fatty meats, fish roe and caviar, internal organs; sausages, cold cuts; canned or frozen meats; fatty poultry with skin, tripe, sweetbreads’ lobsters, crab roe(aligui), shrimps head, oyster, clam Whole milk cheese
Fat	In prescribed amounts; corn, soybean, olive, sesame, peanut, and cottonseed oils. Coconut oil, in amount to yield a P/S ratio of 1:1	Butter; coconut meat, milk and oil in excess of allowance; hydrogenated vegetable oils like margarines and “mantika”, animal fat like lard, salted pork, bacon, meat and chicken drippings
Beverages	Coffee( not more than 5 cups black), tea, carbonated drinks	Soda fountain beverages like milk shake, malted milk and chocolate drinks
Soups	Soups made with skim milk; fat-free broths made from meat or chicken stocks or concentrates	Cream soups, fatty broth
Miscellaneous	Non-dairy cream substitutes, seasonings and spices in moderation; sauce made with allowed fats and skim milk; vinegar, pickles, mustard, catsup, banana sauce	Sauces and gravies with restricted fats or milk; popcorn, french-fries or potato chips; butter dipped foods, packed dinners or “instant foods” at unknown content.

Los Sodium Diet

Indications for Use:

Congestive Heart Failure with edema or hypertension

Liver disease with oscites

Glomerulonephritis

Nephrotic Syndrome

Acute and Chronic Renal Failure

Type of Food	Allowed	Avoided
Soups	Plain broths and soups prepared from allowed foods with no added salt	Canned soups, bouillon cubes and meat extracts
Protein-rich foods	Egg limited to one daily; unsalted meat, fish and poultry Low sodium peanut butter and cheese	Canned, frozen, salted, cured, smoked or processes meats, meats, fish, and poultry and those containing sodium Regular cheese, peanut butter and salted pickled egg
Vegetables	Fresh vegetables and those and those canned without salt; carrots and celery when used sparingly	Canned and frozen vegetable processed with salt except “dietetic” packs or those frozen without salt.
Fruits	Fresh, canned, dried or frozen or juices if no sodium benzoate or sulfate has been added	Artificially colored juices and glazed or candied fruits; maraschino cherries Dried or frozen fruits to which salt, sulfites and other additives containing sodium has been added
Fats	Unsalted fats, oil spreads and nuts or margarine in allowed amounts	Drippings from bacon, ham, salted pork and other salted meats; chicharon, margarine and butter in excessive amounts. Commercial salad dressing, salted nuts and olives
Cereals	Pan de sal and sliced bread in allowed amounts breads and rolls made with potassium bicarbonate. Cooked and unsalted cereals like farina, oatmeal, shredded and puffed wheat and rice; other unsalted noodles as sotanghon and bihon	Bread or rolls with baking soda, baking powder, salt and sodium containing additives; commercial mixes, quick cooking and dry cereals. Miki, misua, mami, canton, suamn sa lihia, cuchinta; puto. Self rising flours, potato chips, pretzels, popcorn, crackers, cookies, cakes, etc., unless especially prepared to be low in sodium Commercial candies and pudding

Nutritional recommendation for common illnesses

Nutritional recommendation for people with cardiovascular disease.

Hyper tension

Ø Reduce intake sodium especially for sodium sensitive individuals. Salt substitute may e given..

Ø Use a calorie-controlled diet. If overweight and obese. It is important to individualize the diet.

Ø Use high biologic value proteins( beef, pork, chicken and egg), but not excess

Ø Limit caffeine-containing beverages to 2-3 cups day or according to your tolerance.

Ø Increase low fat dairy foods,

Ø Carbohydrates should be preferably complex carbohydrates such as beans, oat bran, and apples (soluble fiber). Increase fruit and vegetable consumption

Ø Restrict alcohol beverages.

Ø Exercise (aerobic) regularly.

Ø Stops smoking and reduce intake of saturated fat and cholesterol for overall cardiovascular health.

Atherosclerosis

Ø Restrict saturated fat to 10% of the total fat and increase MUFAs and PUFAs.

Ø Limit cholesterol to 250mg or less per day.

Ø Refer to US national Cholesterol Education Program (NCERP) for guideline to lower blood cholesterol.

Ø Limit trans-fatty acids.

Ø Use a calorie- controlled diet with increased content of complex carbohydrates rather than concentrated sweets and simple sugars.

Ø Among should include fewer animal proteins and more legumes and vegetables.

Ø Diet should include an adequate high-soluble fiber intake. Oat bran, corn bran, apples and legumes should be use often.

Notional Recommendation for Persons with Common Infection

Fever

Ø Increase in caloric requirement for all ages due to increased metabolic rate:

Infants: additional 200 kcal/g per 1ºF rise

Children: additional 100-150 kcal/kg per 1ºF rise

Adult: 30-40 kcal/kg or an additional 500-600 kcal per 1º Rise

Ø Adults need 1.5-2.5g protein/kg it severe: and adequate carbohydrate to spare protein and restore glycogen in the liver

Ø Adult’s need 10-15 cups fluid per day. Salty broths, fruit juices, and milk can be used.

Typhoid fever

Ø For patients with acute fever, use a diet of high protein, high calorie liquids. A low residue diet may be needed temporarily.

Ø As treatment progresses, gradually add soft, bland foods. Try small, frequent feedings. Gradually add pectin and other fiber.

Ø Include good dietary sources of Vitamin A and C

Dengue Fever

Ø Treatment is only supportive in case of dengue fever, which mean rest, plenty of fluids and acetaminophen to keep the temperature

Nutritional Recommendation for Prevention of Cancer

Ø Increase consumption of leafy green and yellow vegetables, fruits and unrefined cereals

Ø Eat fat and fatty foods in moderation

Ø Limit consumption of smoked, charcoal- broiled, salted-cured and salt pickled foods.

Ø Avoid moldy foods.

Ø Drink alcoholic beverages in moderation and stop smoking.

Therapeutic diet- normal diet adapted modified or designed to treat or to cure diseases.

Therapeutic- to cure

Diet-usual food and drink consumed

I. Regular-prescribed for ambulatory or bed patient whose condition does not require any dietary modification for any therapeutic diet.

II. Soft diet-diet consisting of foods that are soft in texture, read digestible with no harsh fibers and connective tissue, bland in flavor, not highly seasoned intermediate diet between regular and full liquid diet

Food included:

1. All liquid, tender, cooked, minced or ground meat, fish poultry

2. Low fiber cooked vegetable carrots, squash, potato, chayote

3. Fiber fruits eaten without skin and seeds like ripe banana, papaya mango sectioned orange

4. Plain desserts like plain ice cream, custard, gelatin pudding

Food avoided:

1. Long fiber and tough meat

2. Raw and gas forming fruits and vegetable

3. Thos with skin or seeds

4. Hard dried foods

5. Highly seasoned food

III. Bland diet- diet consisting of bland and mild flavor foods

- Soft or smooth in texture

- Not mechanically or chemically irritating to stomach

- Do not stimulate undue gastric secretion

Foods avoided:

1. Foods which are fibrous, hard and harsh

2. Strong flavored vegetable like cabbage, onion leek, cauliflower and turnips

3. Flavoring substance like spices, spices, herbs and condiments

Indications like spices, herbs and condiments

Indication for use:

1. Cases if indigestion

2. Diarrhea

3. Gastritis

4. Gall bladder disease

IV. Diabetic diet- dietary requirement of diabetes differs with individual severity of diseases type and extent insulin therapy received

V. Residue modified diet- certain foods white fiers free may leave high amount of residue in color such as fruits, vegetal, rich fatty foods, soft cooked egg, butter and lards

Foods which give residue:

1. Lean meat and fish

2. Liver and hard boiled egg

3. Strained fruit slices

4. Rice

Indication for use

1. Diseases involving bowel

2. Edema

VI. Tue feeding or osterized- liquid diet introduced into the stomach by means of polyvinyl tube inserted through mouth or nose

Indication for use:

1. In ability or refusal to take foods as in obstruction of esophagus

2. Anorexia Nervosa- mental state leading to complete aversion to all foods

3. Severe burns

4. Comatose

Toddler- orange juice contains vitamin C for age or young require 1/3 c apple juice

- Weaning starts

- Supplementary foods

Lunch ideas for toddlers and preschools:

Lunch- very important part of child’s daily food intake

-variety of pack lunches

Team with fruit and milk

Making vegetable to preschoolers:

1. Serve vegetable raw or crisp

2. Mix yogurt, blend cottage, cheese and seasoning, foe vegetable dipping sour cream and mayonnaise are fine for flavoring

3. Check parent food preferences

4. Tuck vegetables into casseroles, meat loves, omelet, sand- filling and baked food such as grated cheese can be onion porated into mixture

5. Add extra vegetables to child’s favorite soup

6. Plant some vegetables. Children are willing to try something that they have picked and groom

7. Blend cooked vegetables add to sauce gravy, home made soup or spaghetti sauce

STEPS IN CALCULATING DIETS

1. Estimate the Desirable Body Weight (DBW), sometimes referred to as reference, ideal or standard body weight. The following are the methods used in determining desirable body weight

a. In the absence of the FNRI standard tale, use the Tanhausse’s Method. Measure height in centimeter (cm), deduct from the measurement the factor 100 and the difference is the DBW in kilograms (kg). To apply this DBW in Filipino stature, deduct 10%

For example

An adult sedentary female who stands 5 feet 1 inch

Ht = feet 1 inch = 61.0 inches

= 61.0 inches x 2.54.

=154.94 cm.

DBW=154.94-100 = 54.94 kg.

= 54.94-5.49 (10% of 54.94)

= 49.95kg or

= 50kg

2. Determine the reasonable energy allowance of the individual by multiplying his DBW with following values, according to:

ACTIVITY kcal/kg DBW/day

Bed rest (hospital patients) 27.5

Sedentary (mostly sitting) 30.0

Light (tailor, nurse physicians, jeepney driver 35.0

Moderate (carpenter, painter, heavy house work) 40.0

Very active (swimming, lumberman)

For Example:

Total Energy Allowance (TEA) = 50 (kg) x 30= 1500 Kcal

Round the figures for practical for practical purpose = 1500 Kcal (6300 kj)

3. Determine the carbohydrate (CHO), protein (CHON) and fat by:

A. Percentage distribution

Carbohydrates -40-60% of the TEA

Proteins -10-15% of the TEA

Fat -25-35% of the TEA

Adjust percentage levels depending upon the diet prescription.

For example:

For normal diet, allot 60% of the total energy allowance for carbohydrates, 15% for protein and 25% for protein and 25% for Fat. The corresponding energy contribution of the three foodstuffs is:

CHO- 1500x0.60 = 900 kcal

PRO-1500x0.15 = 225 Kcal

Fat-1500x.0.25 = 375 kcal

B. Calculate the number of grams of CHOS, CHON and FAT by dividing the corresponding caloric distribution by the physiological fuel values (4 kcal for CHO and CHON and 9 kcal for FAT per gram).

For example:

CHON – 255 4 = 56.2g

FAT-375 9=41.7g

Round off figures for practical purposes

Diet Rx kcal 1500 CHO 55G Fat 40g

FOOD EXCAHNGE LIST FOR MEAL PLANNING

The foods have been divided into 6 groups or lists. The listed measure of each food constitution an exchange within each group contains approximately the same amounts of energy, carbohydrate, protein, and fat. They contain same or similar vitamins and minerals. Food in any group can thus he substituted or exchanged with other foods in the same group. In list 5 for example, one-medium-sized chicken egg or 1 cup mongo or 1 medium sized fish maybe exchanged for 1 slice of grams protein and 2 any 3.0 cm. cube meat included in list. Each of these exchanges would provide 8 grams of protein and 2 grams fat. To illustrate further, a patient allowed exchanges of meat per day might select as follows: 1 medium- sized fish, 1 sliced liver, 4 pcs. Sausages and 1 piece (3.0 cm. cube) of beef .

Food exchange list is used as a tool for quick estimation of CHO, CHON, fat values not only for diabetic diets, but for normal and other therapeutic diets as well. Serving’s portions indicate amount of food that can be consumed by one person at one time or in one meal.

COMPOSITION OF FOOD EXCHANES

LIST	FOOD MEASURE	CARBOHYDRATE	PROTEIN	FAT	ENERGY
		Gm	gm	gm	Kcal
I
A. Veg A	1 cup raw
	½ cup, cooked
B. Veg B	½ cup, cooked	3	1		16
	1.2 cup raw
II. Fruit varies		10			40
III. Milk
Evap.	½ cup
Whole	1 cup
Powder	4 tsp	12	8	10	170
Skim	4tsp	12	8		18
IV. Rice	Varies	23	2		100
V. Meat
Low Fat			8	2	50
VI. fat	1 teaspoon			5	45
VII. sugar	1 teaspoon	5			20

LIST 1 – VEGETABLE EXCHANGE

1 EXCHANGE = 3 gms. Carbohydrates

=1 gm. Protein

---à 16 KCALORIES

Vegetable are important sources of mineral and vitamins. Select at least green and yellow vegetable everyday.

Dark green and deep yellow vegetable are among the leading sources of PRO-VITAMINS A. Include at least one serving in diet daily.

LEAFY VEGETABLE: 1 EXCHANGE = 1 CUP raw (25gm)

½ cup cooked (46 gms)

NON LEAFY VEGETABLES: 1 exchange =1/2 cup raw (40gm)

½ cup cooked (45gm)

The list showed the kinds of vegetables to use for one vegetable exchange.
GROUP A contains negligible carbohydrate, protein, energy if only one exchange or less is used.

GROUP A VEGETABLES

Alagaw, dahon (fragmant premona leaves)

Alugbati, dahon (malabar night shade tree)

Amapalaya, Dahon at bunga (bitter melon leaves and fruit)

Awing, Dahon (garlic leaves)

Kalabasa, ulaklak at dahon (squash Fflowers, leaves

Kamatis (tomatoes)

Kamote, Dahon (sweet potato leaves)

Kamoteng kahoy, dahon (cassva leaves)

Kangkong (swamp cabbage)

Katuray, bulaklak or dahon (sesan flowers and leaves)

Kitsay (celery American)

Koliplawer (cauliflower)

Gai, Dahon

Himbabao

Ispinaka ( new Zealand Spinach)

Labanos (raddish)

Labong (bamboo shoots)

Letsugas (lettuce)

Malunggay, dahon ( horse raddish leaf)

Mustasa (mustard)

Pako (fern)

Papaya, hilaw (papaya green)

Patola (sponge gound)

Pepino (cucumber)

Petsay (Chinese cabbage)

Saluyot (jule)

Sayote, dahon at unga (chayote leaves and fruie)

Sigarilyas (goa or winged beans)

Sili, dahon at unga (pepper leaves and fruit)

Sitaw, dahon (yard-long bean leaves)

Talinum (Philippine spinach)

Talong (eggplant)

Unsoy (corrainder)

Upo (bottle gound)

VEGETABLE B GROUP
Abitsuelas, Bunga (Snapbeans Pad)

Ataw (hyacinth ean)

Kabuti (mushroom)

Kadyos, sariwa (pigeon pea pad)

Kalabas, bunga (squash fruit)

Kalamansi bunga

Karot(carrit)

Gamet(seaweed)

Lang ka, Hilaw(jackfruit unripe)
Malunggay, Bunga(Horse Raddish Fruit)
Niyog, Ubod (Coconut Shoot)
Okra
Paayap (Cowpea)
Remolatsa(Beets)

Rimas(breadfruit)

Sagin puso(anana heart)

Sibuyas (onion)

Sinkamas, bunga (yambean)

Sitaw bunga(stringeans pad)
Sitsaro (Sweet Pea)
Togue(Monggo Bean Sprout)

VEGETABLE PRODUCTS:

FOOD	WEIGHT IN GRMS (wtgm) EDIBLE PORTION (E.P)	MEASURE
Kamatis katas, nakalata (tomato juice, canned)	60	1/2cup undiluted
Kamatis, ketsuo (tomato ketchup)	10	2tsp

LIST 2 - FRUIT EXCHANGES

1 exchange = 10 gms. Carbohydrate—40kilo calorie

Fruits are valuable for their vitamin, mineral, fiber content. Include at least one exchange daily in diet. Mangoes and papaya main both vitamins A and c. Bananas, orange, dried fruits are sources of potassium, magnesium and vitamin B6 are found in bananas.

Fruits maybe used as fresh, dried, canned, frozen, cooked, fresh juices like kalamansi (phil. Lemon) dayap and lemon maybe rated as “free food” when sweetened by artificial sweeteners.

Kalamansi or any other sour fruit juice does not have special reducing properties. The natural sweetness of fruit is not contraindicated for diabetes.

This list shows the kind and amount of OCDS to use for one fruit exchange.

FOOD	WEIGHT (gm)/ E.P	MEASURE
Fresh
A. High Vit C
Anonas	30	½ small – 5cm
Atis(sugarapple)	40	1.2 small – 5x4 cm
Bayabas(guave)	50	2 med- 4 cm diameter
Kalamatsili (Aztec kuamatchill)	50	7pods
Kasuy(cashew)	70	1 large-7x6cm ½ diameter
Dalanghita(ladu)	135	2 med.-6cm diameter
Datiles	45	2/3
Guyabano	60	½ of 5x6x2 cm
Istrober(strawberry)	140	1cup
Mangga, hindo(mango ripe)	65	1med. Slice 11x7cm
Papaya, hinog (papaya ripe)	85	1slice 10x6x2 cm
Suha(pomelo)	40	3segments 8x4x3cm
Tiyesa(carristel Tiesa)	25	1/4med. 10cm long

B. OTHER FRESH FRUITS:

FOOD	WEIGHT ( gm)/E.P	MEASURE
Baliming (carambola)	130	1 ½ large 9x5 cm
Kaimito(star apple)	60	½ med. 6cm diameter
Kamyas(balimbi)	220	15 med. 6x2 cm
Duhat (black plum)	60	24 small pcs.
Langka, hinog (jackfruit Ripe)	40	2 seamants 8cm
Lanzones (lanso)	70	7med-4x2cm
Letsiyas (lychees)	50	4pcs.
Mabolo (ebony fruit)	50	½ small- 6cm diameter
Macopa (curacao apples)	130	6samll – 2cm
Mangga, manialang (mango, medium ripe)	60	1med. Slice 11x6 cm
Mangga, Indiyan	80	1 small
Mangga, Paho	60	8 small
Mangostan (mangosteen)	55	3 med. 6 cm diameter
Mansanas(apple)	65	1 small 6 cm diameter
Marang (jehove oak)	35	½ medium 12x10cm
Milon (melan)	175	1 slice-23x6cm
Pakwan (watermelon)	140	1 slice 11x6cm
Peras(pears)	80	1 med- 6cm diameter
Pinya(pineapple)	75	1 slice -10x6x2cm
Rambutan	50	3pcs
Saging, bungulan(banana)	40	42 of 1 med-15x
Saging, bakalan(banana)	35	1 small 10x3cm
Saging, latundan(banana)	40	1 small 10x4cm
Saging, saba(banana)	40	1 small 10x4cm
Sampalok, hinog	15	2 med- 7 segments
Siniguleas (Spanish plum)	50	5 small- 3cm
Tsiko(saoedilla)	40	1 small 4 cm
Ubas (grapes)	50	12 pcs
CANNED, DRAINED
Apple Sauce	45	3tbsp
Fruit Cocktail	55	¼ cup
Fruit cocktail, tropical	40	3tbps
Peaches	65	1 med.
Pineapples, crushed	60	3 tbsp
Pineapple, sliced	35	1 slice – 7cm

DRIED:
Banana Chips, salted	20	4 pcs 6x3 ½ cm
Champoy	10	2pcs- 2cm
Dates	15	3pcs
Likyam (preserved fruit)	15	2pcs- 3x3x1cm
Mangga, Chips (mango chips)	10	2pcs-2x8cm
Pasas, Walang buto(seedless raisins)	15	2 tbsp.
Prunes	15	3 pcs

FRESH JUICES: FRESH
Kalamansi (phil. Lemon)	120	½ cup
Dayap (lime)	160	Undiluted
Apple juice, sweetened	60	¾ cup
Mango juice, sweetened	85	¼ cup
Orange juice, Unsweetened	100	6tbsp
Pineapple juice,	60	¼ cup
Unsweetened
Pineapple grape fruit	75	5tbsp
Pineapple-orange, sweetened	85	6tbsp
Pineapple-pomelo, sweetened	75	5tbsp
Pineapple juice unsweetened	60	¼ cup

OTHERS:
Buko, meat (young coconut)	100	½ cup
Buko, water	180	1 cup
Sherbet	40	3tbsp

LIST 3- MILK EXCHANGES

1 exchange = 12 grms carbohydrates

8grms protein

10 grms fat

Milk is an excellent source of CA. also good source of phosphorus, protein B complex vitamins, including folacin.

The milk allowance is the meal plan can be used as a can be added in cereals or mixed with coffee, tea.

This list shows the kinds and amount of milk or milk ducts to use. For one milk exchange whole milk contains SATURATED FAT

FOOD	WEIGHT (gm)/ E.P	MEASURE
Whole milk
Milk, evap diluted	120	½ glass
Milk, Evap filled	140	½ glass
Undiluted
Milk, evap Recombined	155	½ glass
Undiluted
Milk, fresh carabao’s	240	½ glass
Milk, fresh cow’s	240	1 glass
Milk, powdered	30	4 level tbsp

NON-FAT MILK:
Buttermilk	195	¾ glass
Powdered	30	4 level tbsp.
Yoghurt	125	½ cup

LIST 4- RICE EXCHANGES

1 exchange = 23 carbohydrates

2 grms protein

-à KCALORIE

1 exchange = ½ cup rice or rice equivalent

Rice, other cereals and other rice equivalents supply the body heat and energy, whole grain or enriched rice and creals are good sources of Fe and are among the better sources of Thiamin.

This list shows the kind and amounts of rice equivalent, rice and bakery products to use for one rice exchange.

FOOD	WEIGHT (gm)/E.P.	MEASURE
RICE AND RICE PRODUCT
Rice, cooked	80	½ cup, packed
Lugaw, (rice gruel)	180	1 cup
Rice products
Amapaw, bigas (sweetened puffed rice)	25	1pc. 8x5x4 cm
Amapaw, Pinipig (sweetened puffed glutinous rice)	25	1 pc 15x6 cm
Bibingka galapong	45	1 slice ¼ of 15 cm
Bibingka, malagkit	40	½ slice 6x5x3 cm
Biko	40	¾ slice 10x5x1 cm
BUtse, kamote	45	1 piece – 7x1
Kalamay, malagkit at latik	50	1 piece4x6x2 cm
Kutsinta	60	1 piece4x6x2 cm
Espasol	35	2 pcs. 8x2x1 cm
Palitaw	55	1 piece 12x7x1 cm
Puto bumbong	40	2 pieces 11x2x1cm
Puto, pula	45	3 pieces 4x3 cm
Puto, puti	45	1/3 slice 9x8 cm
Puto seko, bilog	25	6 pcs. 4x5 cm
Puto seko, haba	25	5 pcs. 4x5
Sapin-sapin	75	1 slice 5x3x4 cm
Suman sa ibos	60	½ of 13x3 cm
Suman lihiya	55	1 pc, 9x3 cm
Suman marwero	50	2 pieces 9x3
Tamales	100	2 pieces 7x6
Tikoy (Chinese glutinous rice)	40	1 slice ¼ of 12 cm
Tupig (ilokano suman)	35	½ pc. 14x3x1

II. RICE EQUIVALENTS:
BREAD:
Pan Amerikano	40	2 pcs. 9x8x1 cm
Pan de onete	40	1 pc. 6cm
Pan de coco	40	1 pc. 7x6 cm
Pan De leche	40	1 pc. 3x8x8 cm
Pan de limon	40	¾ pc 10x9x4
Pandesal	40	2 pcs. 7x4 cm
Roll (for hotdog/hamburger)	40	¾ pc. 11x4x3

BAKERY PRODUCTS: A.) CAKES
Cake sponge	40	1 slice 5x5x5 cm
Mamon tostado (palin cake toasted)	30	3 pcs. 8x3x2 cm
Piyanono (jellyroll)	35	1 slice 5x4 cm
B.) BISCUITS:
Apas (lucena Buscuit)	25	6 pcs. 1 1x2x12cm
bIscotso (toasted bread)	30	5 pcs. 8x7x1 ½ cm
Biskuwit, GEM(gem biscuit)	30	15 pcs. 2 1/2 x11cm thick
Kababayan	35	1 pc. 6x2 cm
Galyetas, patatas	30	10 pcs. 6x2cm
Pretzels (Plain)	30	10 pcs. 4x4 cm
C.) COOKIES		10 pcs.
Brohas (lady finger)	30	5 pcs. 9x4 cm
Ensaymada	35	½ pcs. 11x6 cm
Masadpudrida	25	1 pc. 7x1 cm
Pasiensiya	25	6 pcs. 3cm diameter
D.) CORN AND COREN PRODUCTS:
Inatog (homing)	90	½ cup
Chiz Curls	25	1 ¼ cup
Corn flakes	25	1 cup
Mais, Nilaga (corn nilaga)	65	1 1/2cm
Mais Dilaw, Nakalata ( golden sweet corn, canned)	145	1 ½ cm
Maha, mais (ground corn pudding)	85	1 slice 5x4x2 cm

E.) NOODLES, COOKED
Bihon, macaroni
Mami, misua
Sotanghon, spaghetti	100	1 cup

ROOTCROPS AND PRODUCTS:
Kamote(sweet potato)	80	1 cup
Kamote, Kahoy (cassava tuber)	85	1 pc. 81/2x5cm
Gabi(taro_	85	1pc. 6x5 cm
Patatas (potatoes)	165	1 pc. 9x5 1x2 cm
Suman-Kamoteng Kahot	45	1 1x2 pcs. 8x6 cm
Tugi (spiny yam)	135	½ pcs 11x3 cm
Ubi (yam)	130	1 ¼ cups cubed

OTHERS:
Cornstarch	5	1 tsp.
Flour, all purpose	30	3 tbsp.
Oatmeal, Raw	30	3tbsp.

LIST 5 MEAT CHANGES

Foods high in protein are included in the meat exchange list, these food include meat, dish, eggs, poultry, legumes. Protein in needby the body for growth muscle building and repair tissue.

When one meat exchange is given in the diet, any one item in the list may be substituted for another. Lean meats are to be used in planning a diet low in saturated fats.

This list shows the kind and amounts of low fat meat and other protein rich foods to use for one low fat meat exchange.

FOOD	WEIGHT(gm)	MEASURE
I. PORK: INTERNAL ORGANS:
Atay (liver) Bahay guya (uterus) Bitukang Maliit (S.I.) Dugo (blood) Lopay (spleen) -> Puso (heart) ->	35	1 slice
	->40	¾ cup
II. BEEF:
Bais(shank), laman (lean meat) Paypay (shank), pierna corta Pierna larga(round), solomilyo Tenderloin), tagiliran gitna hulihan( soloin Steak) Tagiliran unahan (centerloin)	35	1 pc. 3.0cm cut
INTERNAL ORGANS:
Atay (liver) Bhay guya (uterus) Bitukang malii(S.I) Dugo (blood) Lapay (spleen), Librilyo (omascum, Puso (heart)	35 40	1 slice 4 1.2x3x1cm ¾ cup
III. CARABAO
Bias(shank), Hita(round) Laman Bahagyang taba (meat, med. Fat), Laman Walang Taba(lean Meat) Paypay(shoulder) Pierna corta at pierna larga (round) Topadera (rump)	35	1 pc. 3.0 cm cube
INTERNAL ORGAN:
Atay (liver) Baga (lungs) Dugo (blood) Lapay (spleen), Librilyo(omascum, Puso (heart)	40	¾ cup
IV. CHICKEN:
Hita (leg)->		½ leg
Laman(meat)->		3.0cm cube meat
Paa(feet) ->		4pcs.
Pitso (breastmeat)->		¼ breast
	->20
INTERNAL ORGAN:
Atay(liver) Balumbalunan (gizzard) Dugo (blood)	30	1/2pc. Liver 2 pcs. ½ C blood
V. FISH:
LARGE VARIETY:
Baloko, bangis, dalag Labahita, lapu-lapu Tulingan except those Listed in med. Fat Meat exchange	35
MEDIUM VARIETY:
Hasa-hasa Dalagang Bukid Galunggong Hito	30	1 pc. 18x41 1/2cm 1pc. 16x31 ½ cm ½ pc 22x5 cm
SMALL VARIETY:
Sapsap Tilapya Tamban Dilis		3 pcs. 14x6cm 2pcs, 12 3/4x4 1/2cm ½ pc ¼ cup
VI. OTHER SEAFOODS:
Alamang (sm. Shrimp)	30	1 ¼ tbsp
Alimango, aligue (crabfat)	15	1tsp
Alimango, laman (crabmeat)	45	½ C flaked
Alimasag, laman (crabmeat)	40	½ C flaked/2 med
Kuhol (snail)	50	Be shelled/ or 3 cups w/ shell
Halaan(clams)	75	1/3 cup shelled / 3cups w/ sheel
Hipong puti (white shrimp)	70	½ cup
Hipon Suwane (shrimps)	45	9 pcs. Or 2/3 cup
Hipon Tgunton (shrips)	25	½ tbsp
Paros (rayed Shell)	60	1 C shelled 2 2/3 C w/ shell
Pugita(octopus)	30	½ cup
Pusit (squid)	45	2 ¼ med. Pcs
Sugpo (tiger prawn)	25	1 med. 22x3 ½ cm
Susong pilipit (fresh water snail)	65	1/3 C shelled 2 C w/ shell
Tahong (salt water mussel)	260	½ cup
Talaba(oyster)	105	½2/3 cup
Talangka(small crabs)	30	75 pcs. A.D
Tulya (clams)	90	1/3 shelled
		7 cups w/ shell
VII. BEANS AND NUTS
Kadyos (pigeon pea seed)	55	½ cup
Kastanyas binusa (chesnut, Toasteed)	160	45 pcs., 1/77 pcs. Sm
VIII. CHEESE:
Cottage cheese	60	1/3 cup
IX. PROCESSED FOODS:
a.) BEAN PRODUCTS:
Veg. franks	60	2 pcs
Veg. meat	50	1 ½ slices
Veg. Sausages	50	4 pieces
b. FISH PRODUCT
Daing (dried Fish)
SMALL: (sapsap, tamban)	20	3pcs.
MED: alakaak Alumahan Bisugo Biyang puto	20	1pc. 22x1.1 cm
LARGE: Lapu-lapu Tanigi	20	¼ pcs.
Tinapa (Baangus)	30	¼ pc 29x8 cm
Tinapa(galunggong)	30	3pcs
Tinapa(tamban)	30	½ pc
Tuyo(dried)
SMALL: ayungin, dilis Sapsap tunsoy	20	3sm/ ¼ C very
Tuyo (alamang)	15	1/3 cup
Tuyo, Pusit	15	¾ cup
X. MEAT PRODUCTS:
Tocino	45	¾ pc. 3.0cm cube

LIST 6-FAT EXCHANGES

Fat is concentrated source of energy. Each gm. Of a fat provides almost 2 ½ times as much as energy as an equal weight of CHO or CHON.

Frying one exchange of meat or sautéing one exchange of vegetable will absorb approximately one exchange of fat.

The list shows the kinds and amounts of fat to use for one fat exchange

SATURATED FATS	WT (gms)	MEASURE
Bacon	10	1 strip
Butter	5	1 tsp
Coconut. Grated	20	2 tbsp
Coconut, milk	15	1 tbsp
Cream Cheese	15	1 tsp
Kropeck	20	1 tbsp
Latik	10	4 pcs
Matgarine	5	2 tsp
Mayonnaise	5	1 tsp
Salad dressing (mayonnaise)	10	1 tsp
Sandwich spread	15	2 tsp
Shartening (lard, coconut oil)	5	1 tsp
Sitsaron	10	1 tsp
Whipping cream (heavy)	15	1 tsp
Whipping cream (light)	15	1tsp
POLY UNSATURATED FATS:
Avocado (red/green)	75	½ med
Peanut butter	10	2tsp
Butong pakwan	10	1tsp
Pili nut	5	5 pcs
Salad dressing (French)	15	1tsp
Shortening (olive oil)	5	1tsp

FREE FOODS

The following foods may e used freely unless specifically prohibited by physician. These foods may be used with other foods in diet.

Bouillon (fat free syrup)

Clear broth

Coffee

Gelatn(unsweetened)

Kamyas

Lemon

Mustard

OTHER SPICES:

Pepper

Pickle dill/ sour/ unsweetened

Tomato paste

Tomato sauce

Tea

vinegar