University of St.

La Salle
College of Nursing
NCM 105: Nutrition and Diet Therapy (LAB)

Module 3
Calculating Diet, Meal Planning, and Meal Distribution 
 
Disease condition Chronic Renal Failure Group:____ Section:______ Score:
_________
  85pts
Instruction:
I. Create a Normal Filipino Meal Plan.

II .   Procedures
A.  Following the steps in estimating the desirable body weight (DBW), calculate for
the total energy allowance (TEA). 

1. Height = 157 _cm  and body weight =  60 kg.

Convert lbs into kg weight. (2pts)

2. Using Tannhauser’s method determine the desirable body weight (DBW) 4pts

Measure hgt. in cm and deduct 100. From the difference take off its 10%

Height in cm_157____
A (Hgt in cm-100) = __57___(difference)
B (10% of the diference) =_5.7____

A - B = _51.3_____ DBW kg

2. Calculate basal needs (3pts)

  = . 1 _kcal per kg DBW/hour  x  51.3_ kg  (DBW)  x  24  =  _1231.2____ kcal (do
not round off yet if there is decimal points)

Basal Need
Male = 1kcal per kg DBW/hour Female = 0.9 kcal per kg DBW/hour

3. Estimate physical activities = 1231.2______ x .60_____ = _738.72___ kcal (2pts)

 Physical needs - approximate percentage increase above basal needs
(use lower factor for women)

Bed rest
10 - 20 %
• mostly resting with little or no activity

Sedentary
30%
• reading, writing, eating, watching TV , office work, sitting at work

Light Activity
• cooking, washing dishes, ironing, welding, standing at work, rapid 50 - 60 %
typing
Moderately Active
• mopping, scrubbing, sweeping, gardening, carpentry, walking fast,
60 - 70 %
standing at work, with moderate arm movement, sitting at work with
vigorous arm movement
Heavy/Severely Active
• heavy scrubbing, hand washing, walking fast, bowling, golfing, heavy 90 - 110 %
gardening

4 .  Add values from 2 and 3 to get TEA (3pts)

TEA = 1231.2 kcal  +  738.72 kcal = _1969.92_ kcal (do not round off yet)

5.  Distribute the total energy allowance among carbohydrates, proteins and fats
according to the NEEDED REQUIREMENT OF THE DISEASE CONDITION .
Carbohydrates 55 - 75 % 
Protein 10 - 15 %
Fats 15 - 30 %

              
6.   (6pts). Use the TEA (final answer) from #4. Do not round off yet your answers)

Carbohydrates  = 1969.92 kcal   x  _.75_____  = _1477.44___ kcal

Proteins  = 1969.92 kcal   x  _.10_____  =  _196.99___   kcal
Fats  = 1969.92 kcal   x   _.15____=   __295.48__ kcal

7.  Calculate the number of grams  of carbohydrates, proteins, and fats by dividing the
calories for each nutrient by corresponding physiologic fuel values (4 kcal/g CHO, 
4 kcal/g protein, 9 kcal/g fat. ( 6pts). Show the answer with decimal point and opposite
of it will be the rounded off ( nearest 5g.)

Carbohydrates  = 1477.44 kcal  4 kcal  = 369.36 g

Proteins  = 196.99 kcal   4 kcal =  49.24   g
Fats  = 295.48 kcal  9 kcal =  32.83    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 : (4pts)
Diet Prescription  : 2000 kcal, 370 grams carbohydrates, 50 grams protein, and 35
grams fat

B. Using 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. Fill up the table with your answers.

Energy and macronutrient composition of exchanges

Table 1
Food Exchanges No. CHO CHON Fats Energy Meal Distribution
Of kcal
Exch g g g B AM L PM D
ange Sna Snacks
s cks

I. Vegetables 5 3 15 1 5 16 80

II. Fruits 5 10 50 40
200
III. Milk Whole 1 12 12 8 8 10 10 170
170
Low fat 12 8 5 125

Non-fat/skim/fat-free 12 8 80

IV. Rice A: Low CHON 5 23 92 460

115
Rice B: Med. 4 23 92 2 8 100
CHON 400
Rice C: High CHON 3 23 69 4 12 108
324
V. Meat low fat 1 8 8 1 1 41 41

Medium fat 1 8 8 6 6 86 86

High fat 8 10 122

VI. Fat 4 5 20 45 180

VII. Sugar 3 5 15 20 60

Total ( 5 pts) 32 368 49 37 2001

2. Determine the amount of vegetable exchanges(Allow 3-5 exchanges). Write your
answer in Table 1 (1pt.)

3.Determine the amount of fruit exchanges. (A reasonable allowance of 3-5 exchanges

can be given, unless there is drastic restriction of simple carbohydrates). Write your
answer in Table 1. (1pt.)

4. Determine the amount of milk exchanges. (Allow at least 1 milk exchange). The type
and amount of milk depend on needs, food habits, and economic considerations. Write
your answer in Table 1. (1pt.)

5. Determine the amount of sugar desired. (Allow 3-6 exchanges or 5-9 teaspoons of
sugar per day unless contraindicated.) Write your answer in Table 1. (1pt. )

6. Sub-total the amounts of carbohydrates, proteins, and 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. Fill up the table with your answers

Get the partial sum of CHO ( 5pts)

Vegetables- + 15
Fruits- + 50
Milk- + 12
Sugar - + __15___
Total- = 92 grams

(6pts)
Deduct partial sum of CHO from prescribed CHO
Prescribed CHO 370 grams
Partial sum of CHO - 92 grams
= 278 grams

CHO – 268 grams =_12.08_ rice exchange or _12_ (round of the whole number)
23

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 exchanges required.

Get the partial sum of CHON

Vegetables- + 5 (10 pts)

Milk - + 8
Rice- + 20______
Total- = 33 grams

Deduct partial sum of CHON from prescribed CHON

Prescribed CHON 50 grams
Partial sum of CHON - 33 grams
= 17 grams

CHON - 17 grams = 2.12 meat exchange or __2__(round off to whole number)

8
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.

Get the partial sum of Fats

(9pts)
Milk- + 10
Meat- +___7______
Total = 17 grams

Deduct partial sum of Fats from prescribed Fats

Prescribed Fats 35 grams
Partial sum of Fats - 17 grams
= 18 grams

Fats 18 grams = 3.6 fat exchange or __4__(round off to whole number)

5

10. The total number of exchanges obtained will be used for planning your menu.

C. Provide a one-day sample menu.

1. Distribute the exchanges into breakfast, lunch, dinner, and snacks and provide a one-
day sample menu.

Breakfast 40%
Lunch 30%
Dinner 20%
Snacks 10% (5% for am snacks and 5% for pm snacks)

2. Multiply the TEA (Total Energy Requirement - kcal) to the percentage allowed per
meal. (4pts)
 
Breakfast 40% 1969.92 kcal x .40 = 788 kcal
Lunch 30% 1969.92 kcal x .30 = 591
kcal
Dinner 20% 1969.92 kcal x .20 = 394
kcal
Snacks 10% (5% for am snacks and 5% for pm 1969.92 kcal x .10 = 197
snacks) kcal
Total 1970 kcal
3.  Multiply the total number of servings/exchange to each meal including snacks to
determine the number of servings/meal in a given day. (4pts)

Breakfast 32 x .40 = _13_ servings

Lunch 32 x .30 = _10__ servings
Dinner 32 x .20 = _6__ servings
Snacks 32 x .10 = _3__ servings

Complete the table below. Distribute the number of exchanges/servings per meal.
Food Exchanges No. Of CHO CHON Fats Energy Meal Distribution
Excha kcal
nges g g g B AM L PM D
Snac Snac
ks ks

I. Vegetables 5 3 15 1 5 16 80

II. Fruits 5 10 50 40 200

III. Milk Whole 1 12 12 8 8 10 10 170 170

Low fat 12 8 5 125

Non-fat/skim/fat-free 12 8 80

IV. Rice A: Low CHON 5 23 115 92 460

Rice B: Med CHON 4 23 92 2 8 100 400

Rice C: High CHON 3 23 69 4 12 108 324

V. Meat low fat 1 8 8 1 1 41 41

Medium fat 1 8 8 6 6 86 86

High fat 8 10 122

VI. Fat 4 5 20 45 180

VII. Sugar 3 5 15 20 60

Total 32 368 49 37 2001

4. Decide on the food to prepare according to serving size, basing from the food group
in the food exchange list.

Food Exchanges No. Of Meal Distribution

Excha
nges Breakfast AM Snacks Lunch PM Snacks Dinner

I. Vegetables

II. Fruits

III. Milk Whole

Low fat

Non-fat/skim/fat-free

IV. Rice A: Low CHON

Rice B: Med CHON

Rice C: High CHON

V. Meat low fat

Medium fat

High fat

VI. Fat

VII. Sugar

Total

5. Write down your menu for cooking demonstration below: (8pts) Copy what you have
written in #4. Specify what specific meal of the day either breakfast, lunch or dinner and
2 snacks will you prepare.