EXERCISE NO.
This exercise helps you develop an appreciation of the special need for nutrients throughout
the life cycle: (1) in pregnancy and lactation, to meet the additional requirements of the
mother and the baby; (2) in infancy and early childhood, to lay the foundation for future
health; (3) in later childhood and adolescence, to strengthen this foundation for physical,
mental, and emotional health; and (4) in later adult life, to conserve health and postpone
degenerative diseases characteristic of this period.
I. Objectives
At the end of the 3-hour laboratory session, you should be able to:
1. Plan a diet for a pregnant mother requiring intake modifications of certain
nutrients.
2. Identify food items essential in the diet of a lactating mother;
3. Recognize the importance of preparing a feeding plan for children;
4. Recognize the nutritional requirements of an adolescent and;
5. Develop and prepare a diet for an adult requiring nutrient intake modifications.
II. Procedure: Case Analysis
Group 2: Lactation
A 38-year-old lactating mother, who stands 4'9" tall and weighs 52 kg, just gave birth a
month ago.
III. Evaluation
1. Compute for the desirable body weight and total energy requirement.
2. Calculate and plan the diet providing 3 meals and 2 snacks. Indicate your
answers in Table 4-1
Patient Information:
Height: 4”9 = 144.78 cm
Physical activity: Light 50%, 35 for PAL
Weight = 52kg
To get the total energy requirement, we have to:
a. DBW: Desirable Body Weight (Tanhausser’s Method)
DBW = Height (cm) - 100 (Convert height to centimeters)
DBW = [Height (cm) - 100] - 10%
DBW = (kg) = [(144.78 cm - 100) - 10%]
DBW = (kg) = (44.78 - 4.478) = 40.302
DBW = 40.302 = 40kg
b. BMR: Basal Metabolic Rate
BMR = 0.9 x DBW x 24hr/day
BMR = 0.9 x 40 x 24
BMR = 864 kcal
c. PAL: Physical Activity Level
PAL = PA x BMR
PAL = (50% Light Activity) = 0.50 x 864 kcal
PAL = 216
d. SDA: Specific Dynamic Action
SDA = 10% of (BMR +PAL)
SDA = (864 + 216) x 10%
SDA = 1080 x 10%
SDA = 108
e. TER: Total Energy Requirement
TER = (BMR + PAL + SDA)
TER = 864 + 216 + 108 + 400 (for lactating mothers)
TER = 1188kcal
According to Centers for Disease Control and Prevention (CDC, 2022), the recommended
diet considerations for maternal breastfeeding mothers should add an additional 330 to 400
kilocalories (kcal) per day. As a result, we will add 400 to the total energy requirement, which
is now 1588. (1188 + 400).
Distribution:
Carbohydrates = kcal x 0.65 1588 kcal x 0.65 = 1032.2 kcal
Protein = kcal x 0.15 1588 kcal x 0.15 = 238.2 kcal
Fats = kcal x 0.20 1588 kcal x 0.20 = 317.6 kcal
Calculate for CHO, Protein, Fat:
Carbohydrates 1032.2 kcal / 4 = 258.05 = 260 g
Protein 238.2 kcal / 4 = 59.55 = 60 g
Fats 317.6 kcal / 9 = 35.28 = 40 g
Diet Prescription:
Diet Rx: Calories Carbohydrates Protein Fats
1588 kcal 260g 60 g 40 g
● Determine the number of exchanges for all food furnishing carbohydrates from
vegetables to sugar then compute.
Food No. of CHO PRO FAT Energy Meal Distributions
Exchang Excha kcal
es nges g g g B L D Sn
I. Veg A 1 3 1 0 16 kcal 1
Veg B 2 6 2 0 32 kcal 1 1
II. Fruits 3 30 0 0 90 kcal 2 1 1
III. Milk
Whole 1 12 8 10 170 kcal 1
Milk (LF) 0 0 0
Milk (NF) 1 12 8 0 80 kcal 1
VI. Sugar 2 10 0 0 40 kcal 1 1
● Determine the rice exchanges (Prescribed Carbohydrates - Partial sum of
Carbohydrates /Rice Carbs per each exchange)
Partial sum of Carbohydrates = ?
3 + 6 + 30 + 12 + 12+ 10 = 73 g
No. of Rice Exchanges:
(Prescribed Carbohydrates - Partial sum of Carbohydrates)
260 - 73 = 187 g
182g / 23 = 8.1 or 8 servings of rice
Food No. of CHO PRO FAT Energy Meal Distributions
Exchang Excha kcal
es nges g g g B L D Sn
IV. Rice
Rice (LP) 4 92 0 0 400 kcal 2 2
Rice (HP) 4 92 16 0 432 kcal 2 2
● Determine the meat exchange (Prescribed protein - Partial sum of Protein / Meat
protein per exchange )
Protein partial sum = ?
1+2+8+8+16 = 35 g
No. of Meat Exchanges:
(Prescribed Protein - Partial sum of Protein)
60g - 35g = 25g
25g / 8 = 3.1 or 3 Meat Exchanges
Food No. of CHO PRO FAT Energy Meal Distributions
Exchang Excha kcal
es nges g g g B L D Sn
V. Meat
Meat (LF) 2 0 16 2 82 kcal 1 1
Meat (MF) 1 0 8 6 86 kcal 1
● Determine the fat exchange (Prescribed Fat- Partial sum of Fat / per Fat exchange)
Fat partial sum
10+2+6 = 18 g
No. of Fat Exchanges:
(Prescribed Fat - Partial sum of Fat)
40 - 18 = 22
22g / 8 = 2.75 or 3 Fat Exchanges
Food No. of CHO PRO FAT Energy Meal Distributions
Exchang Excha kcal
es nges g g g B L D Sn
VII. Fat 3 15 135 kcal 1 1 1
TOTAL 312 g 79 g 42 g 1,942 kcal
Table Meal Plan: 4-1
Food No. of CHO PRO FAT Energy Meal Distributions
Exchanges Excha kcal
nges g g g B L D Sn
I. Veg A 1 3 1 0 16 kcal 1
Veg B 2 6 2 0 32 kcal 1 1
II. Fruits 3 30 0 0 90 kcal 2 1 1
III. Milk
Whole 1 12 8 10 170 kcal 1
Milk (LF) 0 0 0
Milk (NF) 1 12 8 0 80 kcal 1
IV. Rice
Rice (LP) 4 92 0 0 400 kcal 2 2
Rice (HP) 4 92 16 0 432 kcal 2 2
V. Meat
Meat (LF) 2 0 16 2 82 kcal 1 1
Meat (MF) 1 0 8 6 86 kcal 1
VI. Sugar 2 10 0 0 40 kcal 1 1
VII. Fat 3 15 135 kcal 1 1 1
Total 257g 59g 33g 1,563 kcal
3. Prepare the assigned sample menu plan for class presentation:
Table 4-2. Sample Lunch Menu for Lactating Mother
Menu Household Measure
Brown Rice 1 cup
Baked Salmon 2 slices
Water 250 mL
Banana Smoothie 325 mL
Vegetables 2 ½ cup
Low fat greek yogurt 1 cup
Strawberries 1 cup
4. Discuss the case assessment and tray presentation in class emphasizing the rationale of
the diet given, nutrient modification, and intervention.
Table 4-3 Case Assessment for Lactating Mother
Meal Prepared Nutrient Modification Rationale Nutrient Intervention
Brown Rice ● 1 cup Brown rice is highly Research indicates
● Soak brown nutritious, giving the that brown rice
rice for half body a wide variety of increases breast milk
an hour then vitamins, minerals, and production. However,
cook in rice antioxidants, which a breastfeeding
cooker breastfeeding mother mothers can ingest
requires to provide the white rice if brown
infant with the rice is not available.
necessary nutrition. It
also gives the mother Today, brown rice is
tremendous energy and increasingly popular
contributes to a healthy and readily available.
direction. Additionally, it is
unprocessed and
whole grain with
ideal fiber and
vitamin content than
white rice.
Baked Salmon ● 2 to ¾ -ounce Salmon is an excellent Since mercury
● Salmon fillet source of vital fatty exposure might
● Combine acids and Omega-3, impair fetal and
olive oil, considered superfoods. neonatal brain and
garlic, herbs, Including salmon in a nervous system
and lemon meal plan for development,
juice. Rub breastfeeding increases breastfeeding
this sauce the nutritional value of mothers should
thoroughly breast milk avoid mercury-rich
over salmon foods.
fillets to avoid
dry patches. That is why
● Bake the breastfeeding
salmon in the mothers can utilize
oven for the safe choice of
15-18 fish like salmon; if
minutes salmon is
unavailable, tilapia,
codfish, and pollack
can be a safe
choice.
Water ● 250 mL Water is the primary A mother should
● Can be warm and most important drink an 8-ounce
or cold constituent of the glass of water each
human body. It is meal and every time
recommended to she breastfeeds.
consume at least ten Nonetheless, juice or
glasses of water every milk can be
day. During substituted if water is
breastfeeding, a mother not preferred.
produces between 700 According to
and 850 ml of milk research, drinking
daily. In the meanwhile, something warm
increased water intake helps mothers calm
is needed. down and sets off
the letdown reflex.
Banana ● 325 mL The banana is a Bananas include
Smoothie ● Bananas tropical fruit that is several
● Greek yogurt commonly consumed phytochemicals that
● Almond milk worldwide. It might be can promote
● Blend the made into a smoothie long-term health.
banana with that is appropriate for However, since
the other breastfeeding mothers. bananas are also
ingredients Bananas are an heavy in
into the excellent source of carbohydrates, some
blender. numerous nutrients, breastfeeding
including potassium, mothers may wish to
calcium, vitamin C, avoid them to reduce
vitamin B6, iron, and calories and lose
dietary fiber. It gives weight.
various benefits that Overconsumption of
are safe for the mother banana smoothies
and infant when may exacerbate
breastfeeding. It cough and cold
provides energy, aids in symptoms and raise
maintaining blood blood sugar levels.
pressure and
hemoglobin levels,
strengthens bones, and
aids in reducing
postpartum depression.
Vegetables ● 2 ½ cup of Vegetables include an Vegetables are
green leafy abundance of vitamins beneficial for the
vegetables and antioxidants. A mother since they
particularly significant amount will include many
spinach, assist the body in nutrients that can aid
broccoli, replenishing the in nursing. However,
kale,asparag nutrients required to the infant may get
us, produce milk. Green food allergies from
fenugreek vegetables are the mother's diet. Of
leaves, and nutrient-dense, course, just like any
mustard particularly in calcium. other food, even
greens In addition, they contain though it is safe for
● It can be phytoestrogens, which lactation, it should be
cooked with may have a favorable overdone. Nothing in
butter influence on breast milk excess is ever a
production. good idea.
Low fat greek ● 1 cup Greek yogurt is an Since Greek yogurt
yogurt excellent source of has less lactose than
protein. Eating greek conventional yogurt,
yogurt when you're on it can prevent an
the go or busy taking upset stomach that
care of the baby is also certain infants may
easy. Many dairy experience due to a
products, including dairy allergy. If the
cheese, yogurt, and infant has been
milk, have additional diagnosed with milk
vitamin D and are a protein intolerance,
good source of calcium. yogurt and other
As the baby's bones dairy products
develop, more calcium should be excluded
may be beneficial. from the diet.
Strawberries ● 1 cup Strawberries are loaded Strawberry is safe
● Freshly with many of the for breastfeeding
washed vitamins and minerals mothers when
necessary for the consumed in
wellness of the mother proportions found in
and infant. Additionally, meals. Strawberries
strawberries contain contain 8.12 mg of
trace amounts of sugar per cup
calcium, magnesium, despite their
and potassium. With nutritional benefits.
97.6 milligrams per Strawberries may
1-cup serving, have pesticide
strawberries are an residue. Consuming
excellent source of an excessive amount
vitamin C. of berries may result
in stomach
discomfort,
heartburn, diarrhea,
reflux, bloating, and
allergic reactions.
5. Submit the individual worksheets at the end of the laboratory activity.
6. In planning meals for adults, you can refer to the suggested menu for adults in Appendix
IV. Questions for Discussion
1. What nutritional advice is recommended for a healthy pregnancy? Lactation?
Physically and nutritionally, pregnancy is a challenging period. To satisfy the needs of the
fetus, other food is required. Pregnancy increases a woman's body fat reserves to meet
nutritional demands. In the meantime, a breastfeeding woman must consume enough food
to safeguard her health and produce adequate quantities/quality milk. A pregnant woman's
daily diet should consist of 350 calories, 0.5 g of protein during the first trimester, 6.9 g
during the second trimester, and 22.7 g of protein during the third trimester. During specific
physiological periods, certain micronutrients are required in more significant quantities. Folic
acid supplementation during pregnancy reduces the incidence of congenital disabilities and
increases birth weight. Iron is necessary for the mother and the developing fetus to meet the
high demands of erythropoiesis (RBC formation). Calcium is required during pregnancy and
lactation to develop healthy bones and teeth in the offspring, produce calcium-rich breast
milk, and prevent osteoporosis in the mother.
Similarly, consuming iodine enhances the mental health of the developing fetus. During
nursing, vitamin A is essential for child mortality. In addition, a breastfeeding mother must
ingest minerals such as vitamins B12 and C.
2. What are the different factors to consider in planning a menu for growing children?
When creating a meal for growing children, there are many factors to consider, as they
demand more energy and nutrients necessary for their development. MedlinePlus
recommends that meal preparers fill half of a child's plate with fruits and vegetables, slightly
more than a quarter with whole grains, and less with lean meat, nuts, or eggs. Their meals
should be colorful and appealing to encourage them to consume their food and prevent them
from becoming bored. Children have a limited appetite, so meals should be presented in
small servings. Long-term consumption of high-fat, high-sugar, and high-salt foods should be
avoided because it can harm one's health. Before creating a menu for a child, it is advisable
to determine their food preferences and allergies. The food's importance to a child's culture,
since some foods are essential in the family due to tradition.
Children who are growing up must consume more food than usual to maintain weight. They
are less hungry between growth phases. Children older than six months require foods from
the five dietary groups to sustain their health and growth. These young children cannot
receive all the nutrients they need from a single diet. Serve various foods to ensure that
children acquire all the necessary nutrients. At least one serving of vitamin C-rich fruit,
vegetable, or juice is consumed daily by all children older than six months. Serve vitamin
A-rich food at least three times per week.
https://healthyeating.sfgate.com/can-nursing-mothers-eat-strawberries-2888.html
https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-and-diet
https://www.verywellfamily.com/foods-that-increase-breast-milk-supply-431598
https://www.chop.edu/pages/diet-breastfeeding-mothers#:~:text=Include%20protein%20food
s%202%2D3,oatmeal%20in%20your%20daily%20diet.
https://thenaturalnipple.com/blogs/news/10-best-foods-to-increase-breast-milk-1#:~:text=Bro
wn%20Rice,Eat%20it%20with%20vegetables.
https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-8-19/tables/2
https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrie
nts/maternal-diet.html#:~:text=An%20additional%20330%20to%20400,active%2C%20non%
2Dpregnant%20women%20who
