Cont.

Fundamentals of
Nutrition
LOURDES L. BALCUEVA,M.D.

Current Issues in Nutrition

Vegetarism a practice which has arisen
as a result of religious belief, health,
economic, ethnic or ecological reasons.
Diet includes:
vegetables yeast
seeds
fruits
dry beans sugars
cereals
peas
seaweeds
bread
nuts
bean curd

Issues
Lacto-ovo include eggs and dairy
products
Lacto vegetarians- include dairy products
Pesco vegetarian- include fish
Pollo vegetarian- include poultry
Some vegetarians exclude all animal
products; present risk of inadequate
nutrition

Nutrients low in vegetarian diet:

Iron
B12
Calcium
Essential amino acids lysine,
methionine,threonine, tryptophan
Zinc

Types of Diet in Different Regions

French- small portion, slow
paced,emphasis on vegetables
Mediterranean- emphasis on beans and
green with olive oil, low intake of meat,
sweets limited to special occasions;
salads are served after main meal
Asian- soybean products or tofu; high intake
of rice, vegetables and fish, low intake
of dessert; sesame oil and peanut oil
emphasized

Food Safety Issues

1. Use of pesticides
2. Use of additives in food to enhance
quality, flavor, texture, nutritive
value and palatability
3. Microbial contaminations
4. Natural toxicants in food
solamine- narcotic like substance in potatoes
nitrates,nitrites- green leafy vegetables
aflatoxin- peanuts,cereal grains
protease inhibitors- legumes
hemagglutinins- peanuts, red kidney beans, soybeans
cyanide- cassava, apple seeds

 5. environmental pollution- affect air, soil

and water
mercury- causes GIT, hepatic and renal
disorders
lead- anemia,GIT disorders, CNS
Cadmium- renal
polychlorinated biphenyls
radioactive materials

 6. GMO- to improve functional properties,

increase resistance to diseases,
decrease perishability.
7. Microwave- inadequate heating may
lead to food-borne illness
8. Use of food substitutes- still being
studied

Nutrient Supplementation
- FNRI survey, Filipinos deficient in iron,
Vit. A and iodine
- pregnant women and lactating women
- elderly
- lifestyle of some individuals:
smokers
alcohol drinkers
dieters
heavy exercisers
heavy caffeine drinkers
children
vegetarians

Megavitamin therapy
- 10-1000 times the RDA
- may alleviate symptoms in certain
disorders;
Antioxidants - block free radical effects
beta carotene
Vitamin C
Vitamin E
Selenium

Food Exchange List

A grouping of common foods with
practically the same amount of CHO,
CHON and FATs.
Within a group, one food item can be
exchanged with another
Foods included are simple

Summary of the 7 Exchange List

Food Group
Cal/grp
1
veg. A
veg. B
16
2
Fruit
40
3
Milk
170
4
Rice
100
5
Meat
A. Low Fat
50
B. Medium fat
95
C. High fat
122
6.
Fat
45
7
Sugar
20

CHO
3
10
12
23

CHON
1
8
2

8
8
8
-

Fats
10
2
7
10
5
-

List 1: vegetables
Leafy vegtables- 1 exvhange =1 cup raw
(25 g) or
1 cup cooked (45g)
Non-leafy vegetables- 1 exchange = cup
raw (40 g) or cup cooked (45 g)

List 2 Fruit Exchanges

per exchange- 40 cal, 10 gms CHO

Atis small 5x4 cm

Bayabas 2 medium, 4 cm.
Strawberry 1/3 cup
Papaya 1 slice 5 x 2 x 1cm
Mangga 1 small 11x 6 cm
Pakwan 1 slice 5x 3 cm
Pinya 1 slice 5x 3 x 2 cm
Saging lakatan 1 small 10 x 3 cm

List 3: Milk exchanges

1 exchange = 140 cal, 12 gms
CHO,8gms CHON,10 gms fat

Evap milk- 1/4 glass (undiluted)

Yoghurt cup
Powdered whole milk 4 level tbsp.
Powdered non-fat milk 4 level tbsp

List 4: Rice exchanges

1 exchange = 100 cal,23 gms
CHO, 2 gms CHON

Rice 1/2 cup

Bread 1 slice
Pan de sal 1 big
mamon - 1 pc 6 x 3 cm
Hot cake 1 pc. 8 cm diameter
Pretzels 8 pcs
Doughnut pc 9 x 5 cm
Noodles - cup
Camote 1 small piece

List 5: Meat exchanges

Low fat: 1 exchange = 50 cal, 8 gms
CHON, 2 gms fat
Pork
liver 1 slice 5 x 4 x 1cm
Beef
lean meat 1 pc. 5 cm cube
tenderloin - same

 Fish
lapu-lapu 1 slice, 10 x 5 x 3cm
galunggong pc 25 x 8 cm
dilis 1/3 cup

Medium Fat exchanges

1 exchange = 95 cal,8 gms CHON,
7 gms fat
Pork pata 1 pcs 2 cm cube
Goto beef cup
Chicken wings 1 small

High Fat:1 exchange = 8 gms

CHON, 10 gms Fat, 122 cal
Pork pigi pc 3 cm cube
Ox tongue cup
Balut 1 egg = 65 gms

List 6: Fat exchanges

5 gms fat, 45 cal

Butter 1 tsp
Coconut milk 1 tsp
Bacon strip
Mayonnaise 1 tsp
Sitsaron 1 pc. 3 x 4 cm
Pili nut 5 pcs

List 7: Sugar exchanges

5 gms sugar, 20 cal

Caramel 1pc 2 x 2 cm
Hard candy 1 pc
Chocolate candy 1 pc round
Sugars 1 tsp
Ube halaya 1 tsp
Yema 1 pc 5 x 1 cm

Free foods
Bouillon (fat free syrup)
Clear broth
Other spices
Coffee
Pickle dill or sour

Garlic
Gelatin (unsweetened)
Kamyas
Lemon vinegar
Mustard

Tomato paste
Tomato sauce
Tea

Assignment:
- Using your computation of your TER, make a
menu for your breakfast, lunch,and dinner
(include snacks, if needed)
- Distribute them into appropriate amount
of calories as CHO, CHON and Fats
- Use the list of food exchange for your guide
- Use the Food Composition table if a particular

food is not found in the exchange list.

NUTRITIONAL DISORDERS
A.

Protein Energy Malnutrition (PEM)

? intake of energy and protein
? nutritional losses
? nutrient requirement (underlying
illness, fever, surgery, CA)

Clinical correlation: KWASHIORKOR

Deficiency of proteins in
the diet but adequate in
calories
Signs/symptoms:
Muscle wasting
? plasma proteins (albumin)
? interstitial fluid:
Edema/ascites/anasarca

? ability to synthesize new

proteins (- N balance)
Digestive enzymes
New epithelial cells

Clinical correlation:
MARASMUS
Calorie and
protein deficiency
Emaciation and
failure to thrive
? Susceptibility TO
infection

Nutritional disorders (cont)

B. OVERWEIGHT: BMI between 25 29.9
C. OBESITY: Excess body adipose tissue
Class 1: BMI 30 34.9
Class 2: BMI greater than 35

THANK YOU