Medical Nutrition Therapy Manual

MEDICAL NUTRITION THERAPY MANUAL

HDFN 401

IMPORTANT CONVERSIONS:

*WEIGHT:

1 kg = 1000 g = 2.2 lbs

454g = 1 lb= 16 oz

28.4 g = 1 oz

1 g = 1000 mg

1 mg = 1000 µg

*VOLUME:

1 L = 1000mL = 1 qt = 4c

240 mL = 1 c = 8 oz

5 mL = 1 tsp

15 mL = 1 T = 3 tsp

16 T = 1 c

30 mL = 1 fl oz

*LENGTH:

2.54 cm = 1 in

*NUTRITION:

1 lb = 3500 kcal

1 g CHO = 4 kcal

1 g Protein = 4 kcal

1 g Fat = 9 kcal

*BIOCHEMICAL:

Glucose: .0555 x mg/dL = mmol/L

Lipids (TC, LDL, HDL): .0259 x mg/dL = mmol/L

Lipids (TG): .011 x mg/dL = mmol/L

ESTIMATING CALORIE NEEDS:

*RESTING METABOLIC RATE (RMR):

MIFFLIN-ST. JEOR

MEN (10 x wt. in kg) + (6.25 x ht. in cm) - (5 x age) + 5

WOMEN (10 x wt. in kg) + (6.25 x ht. in cm) - (5 x age) - 161

* Multiply RMR by AF of 1.3 for sedentary people or higher AF for active individuals

*EMPERICAL FORMULAS:

OBESES/VERY INACTIVE 10 - 12 kcal/lb

> 55 YO, ACTIVE WOMEN, SEDENTARY MEN 13 kcal/lb

ACTIVE MEN, VERY ACTIVE WOMEN 15 kcal/lb

THIN OR VERY ACTIVE MEN 20 kcal/lb

*HARRIS-BENEDICT:

*Classic formula for basal needs but over and underestimates needs

NORMAL - OVERWEIGHT INDIVIDUALS

MEN 66.47 + (13.75 x wt in kg) + (5.0 x ht in cm) - (6.76 x age)

WOMEN 655.10 + (9.56 x wt in kg) + (1.85 x ht in cm) - (4.68 x age)

OBESE INDIVIDUALS (>130% IBW)

MEN Adjusted body weight = (CBW - IBW) x .38 + IBW

WOMEN Adjusted body weight = (CBW - IBW) x .32 + IBW

* Now multiply Basal Energy Needs by the suitable activity or stress factor

ACTIVITY DESCRIPTION (if healthy) ACTIVITY FACTOR (AF)

Chair or bed bound 1.2 * BEE

Seated work and little or no leisure activity 1.4 - 1.5 * BEE

Seated work with little strenuous activity 1.6 - 1.7 * BEE

Standing work 1.8 - 1.9 * BEE

Strenuous work or highly active activities 2.0 - 2.4 * BEE

30 - 60 min strenuous activity (4-5 x's/wk) AF + .3

CLINICAL STATUS (use if sick) STRESS FACTOR * BEE

Elective Surgery 1.0 - 1.1

Multiple trauma 1.4

Severe Infection 1.2 - 1.6

Peritonitis 1.05 - 1.25

Multiple/long bone fractures 1.1 - 1.3

Infection with trauma 1.3 - 1.55

Sepsis 1.2 - 1.4

Closed head Injury 1.3

Cancer 1.1 - 1.45

Burns 1.5 - 2.1

*ESTIMATED ENERGY NEEDS DEPENDING ON AGE AND ACTIVITY LEVELS

EER FOR INFANTS AND CHILDREN 0 - 2 YO

0 - 3 mos. (89 x wt. in kg - 100) + 175

4 - 6 mos. (89 x wt. in kg - 100) + 56

7 - 12 mos. (89 x wt. in kg - 100) + 22

13 - 35 mos. (89 x wt. in kg - 100) + 20

EER FOR BOYS 3 - 8 YO

88.5 - 61.9 x age + PA x (26.7 x wt in kg + 903 x ht in m + 20)

EER FOR BOYS 9 - 18

88.5 - 61.9 x age + PA x (26.7 x wt in kg + 903 x ht in m + 25)

PA FOR BOYS 3 - 18

Sedentary 1.0

Low active 1.13

Active 1.26

Very active 1.42

EER FOR GIRLS 3 - 8 YO

135.3 - 30.8 X AGE + PA X (10 X wt in kg = 934 x ht in m + 20)

EER FOR GIRLS 9 - 18 YO

135.3 - 30.8 X AGE + PA X (10 X wt in kg = 934 x ht in m + 25)

PA FOR GIRLS 3 - 18 YO

Sedentary 1.0

Low active 1.16

Active 1.31

Very active 1.56

EER FOR MEN 19 YO & OLDER

BMI: 18.5 - 25 kg/m2 662 - 9.53 x age + PA(15.91 x wt in kg + 539.6 x ht in m)