FN 110 Meal Plan using FEL

Name: _________________________________________________ Signature: ______________________________

Part I. Diet Prescription. Compute the following based on the data below.
Subject: Adult female
Height: 5’3”
Physical Activity Level: Moderate
Answer Computation
1. DBW _____ kg Express height of 5’3” in cm:
5’3” = (5’ x _____ inches/ft) + 3”
= ______ inches x _____ cm/inches
= ______ cm
Subtract the factor 100 from height (cm):
=______ cm – 100
= ______ kg
Adjust DBW (kg) to Filipino stature by deducting 10% from DBW (kg):
= ______ – 10%
DBW = ______ kg
2. TEA ________ kcal TEA = DBW x Physical Activity Factor
= ______ kg x ______ kcal/kg DBW/day
TEA = ________ kcal
(Round off to nearest 50)
3. CPF ______ g CHO CHO = (TEA x ____% of TEA for CHO) ÷ ____ kcal/g Physiologic fuel value
______ g CHON = (________ kcal x ____) ÷ ____ kcal/g
______ g Fat CHO = _______ g

CHON = (TEA x ____% TEA for CHON) ÷ ____ kcal/g Physiologic fuel value
= (________ kcal x ____) ÷ ____ kcal/g
CHON = _______g

Fat = (TEA x ____% TEA for Fat) ÷ ____ kcal/g Physiologic fuel value
= (________ kcal x ____) ÷ ____ kcal/g
Fat = _______ g
(Round off to nearest 5)
4. Diet Rx: Energy __________ kcal; CHO ______ g; CHON ______ g; Fat ______ g

Part II. Translating Diet Rx to Food Exchanges.

Composition of Food Exchanges:
Measure CHO CHON Fat Energy
Food
(1 exchange) grams grams grams kcal
Veg A 2 cups raw
3 1 - 16
1 cup cooked
Veg B ½ cup raw or cooked 3 1 - 16
Fruit Varies 10 - - 40
Milk
Whole Varies 12 8 10 170
Low Fat Varies 12 8 5 125
Skimmed Varies 12 8 tr 80
Sugar 1 tsp 5 - - 20
Rice Varies 23 2 - 100
Meat
Lean Varies - 8 1 41
Medium Fat Varies - 8 6 86
High Fat Varies - 8 10 122
Fat 1 tsp - - 5 45
Name: _________________________________________________ Signature: ______________________________

Compute for the following based on the Table of Composition of Food Exchanges:
No. of CHO CHON Fat Energy
Food
Exchanges grams grams grams kcal
Veg A 2 ______ ______ ______
Veg B 3 ______ ______ ______
Fruit 3 ______ ______
Milk
Whole 1 ______ ______ ______ ______
Sugar 4 ______ ______
Partial Sum = ______
Rice ______ ______ ______ ______
Partial Sum = ______
Meat
Lean 3 ______ ______ ______
Medium Fat 2 ______ ______ ______
Fat ______ ______ ______
TOTAL ______ ______ ______ ______

Distribute the number of exchanges per food group and make a sample menu:
Food No. of
Breakfast AM Snack Lunch PM Snack Dinner
Exchanges
Veg A 2 1 1
Veg B 3 1 2
Fruit 3 1 1 1
Milk, Whole 1 1
Sugar 4 2 2
Rice ______ ______ ______ ______ ______ ______
Meat, Lean 3 1 1 1
Meat, Medium Fat 2 1 1
Fat ______ ______ ______ ______ ______

Sample Menu