Week 1.1

• Dietary Reference Intakes


  A generic term for a set of nutrient reference values for planning and assessing diets of an individual
• Patient's Dietary Reference Intake

  Collective term compromising reference value for energy and nutrients levels of intake
• Estimated Average Requirement


  A daily nutrient intake level that meets the median or average requirement of a healthy individual in particular life stage and sex group, corrected for incomplete utilization of dietary nutrient bioavailability
• Recommended dietary allowance


  Derived from Estimated Average Requirement, which is an estimate of the intake at which the risk of inadequacy to an individual is 50%
• Recommended energy / Nutrient intake


  A level of intake of energy or nutrient which is considered adequate for the maintenance of health and well-being of health person in the population, also known as Recommended Daily Allowance
• Adequate intake


  Daily nutrient intake level that is based on observed or experimentally-determined approximation of the average nutrient intake by a group of apparently healthy people that are assumed to sustain a defined nutritional state
• Tolerable Upper Intake Level or Upper Limit


  Highest average daily nutrient intake level likely to pose no adverse health effect to almost all individual in the general population
• Components of Energy Expenditure

  • Basal metabolism
  • Basal metabolic rate
• Basal metabolism


  Measure of energy needed by the body at rest for its internal chemical activities like respiration, cellular metabolism, circulation, glandular activity and maintenance of body temperature
• Basal metabolic rate


  Rate of basal metabolism in a given person at a given time and situation
• Food and Fluid Intake Regulating Mechanism (Hypothalamus)

  • Thirst
  • Hunger
  • Appetite
  • Satiety
• Thirst


  Loss of body fluid more than 2% will prompt thirst
• Hunger


  Triggered by low blood glucose level (<70 mg/dl)
• Appetite


  Triggered by sight, smell and thought of foods
• Satiety


  Triggered by gastric distention
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• Body Mass Index


  A measure of body fat based on height and weight that applies to adult men and women
• Conversions


  1. Pounds (lbs) to kilos = wt. in lbs / 2.2

  2. Feet to meters = 0.3048 x feet

  3. Inches to meters = 0.0254 x inches
• So if converting feet-inches height to meters you just need to add the value from the conversions you got
• Interpretation of BMI


  • Less than 18.5 = Underweight
  • 18.5-24.9 = Healthy or Normal
  • 25-29.9 = Overweight
  • 30-34.9 = Obese 1
  • 35-39.9 = Obese 2
  • More than 40 = Extremely or Morbid Obese
• Desirable Body Weight (DBW)

  1. Infants (0-6 mos) = Birthweight (g) + (Age in mos x 600)

  2. For 7-12 mos = Birthweight (g) + (Age in mos x 500)

  3. Children = age in year x 2 + 8

  4. Adults (Tanhausser's method): Non-Asians: height in cm - 100, Asians: height in cm - 100 x .90

  5. Lowest DBW: DBW x .90

  6. Highest DBW: DBW x 1.10
• Basal Metabolic Rate (BMR)


  • Male: 1kcal x weight in kg x 24
  • Female: 0.9 x weight in kg x 24
• Total Calorie Requirement/Day


  1. Infants (0-6 mos) = DBW x 120cals

  2. For 7-12 mos = DBW x 110cals

  3. Children = 1000 + (100 x age in years)

  4. Adolescent = DBW x 45cals

  5. Adult (Krause method) = DBW x PA Value
• Physical Activity Value


  • Bed rest = 27.5
  • Sedentary: Secretary, Clerk, Administrator, Cashier, Banker, Desk jobs = 30
  • Light: Teacher, Nurse, Student, Lab technicians, Housewife with maid = 35
  • Moderate: Vendor, Mechanic, Public utility drivers and car drivers = 40
  • Heavy: Athletes, Fisherman, Farmer, Carpenters, Miner, Laborers, Heavy equipment operators = 45