ConversionLarge Unit Small Unit
1 inch 2.54 cm
1kg 2.2 lbs
1 foot 12 inches
1 kcal 4.184 kj
1 m 100 cm
NB: From a larger unit to a smaller unit multiple.From a smaller unit to a larger unit divide.
BMI calculationsWeight (kg)/Height(m2)
John weighs 5 kg and is .5 m tall. What is his BMI?
Answer= 5/ .5 * .5= 5/ 0.25= 20kg/m2
BMI calculationsWeight(lbs)/ Height (inches2) * 703Peter weighs 180 lbs and is six feet tall.
Calculate his BMI?Answer
=180/ (72 *72)* 703= 180/5184 * 703= 0.0347* 703=24.39 lbs/inches2
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
Caloric Requirements- BMRHarris Benedict FormulaWomen: BMR = 655 + ( 9.6 x weight in
kilos ) + ( 1.8 x height in cm ) - ( 4.7 x age in years )
Men: BMR = 66 + ( 13.7 x weight in kilos ) + ( 5 x height in cm ) - ( 6.8 x age in years )
Calculating BMR for Women: An Example20 year old Shuana weighs 54kg, and is 1.2 m
tall. Calculate her BMR.BMR= 655+ (9.6 * 54) + (1.8 * 120) – (4.7 *
20)655+ (518.4)+(216)- (94)= 1389.4-94=1295.4 calories
Calculating BMR for Men: An Example22 year old Shuan weighs 68kg, and is 1.6 m
tall. Calculate his BMR.BMR= 66 + (13.7 x 68) + (5 x 160) - (6.8 x
22)= 66+ (931.6)+ (800)-(149.6)=1797.6-149.6=1648 calcories
Calculating Physical Activity LevelTotal daily energy expenditure (TDEE)/ Basal Metabolic Rate (BMR)
Category PAL Description
Sedentary 1.2 (little or no exercise, desk job)
Lightly active 1.375 (light exercise/sports 1-3 days/wk)
Moderately active 1.55 (moderate exercise/sports 3-5 days/wk)
Very active 1.725 (hard exercise/sports 6-7 days/wk)
Extra Active 1.9 (hard daily exercise/sports & physical job or2 X day training, marathon, football camp,contest, etc.)
Calculating Physical Activity LevelIf Sharon total energy expenditure for the
last 24 hours is 1836.5 kcal and her BMR is 1479.8 kcal what is her PAL? Categorise her PAL.
PAL= TDEE/BMR= 1836.5/1479.8= 1.24PAL category: Low active
Calculating Total Daily Energy Requirement Caloric Requirement- BMR * PALShari has a BMR of 1524 kcal/day and is moderately active. How much calories must she take in per day to meet her caloric requirementsTER= 1524*1.55= 2362.22 kcal
Atwater factorsMacronutrients and Alcohol Energy contribution
Protein 4 kcal/g
Carbohydrate 4 kcal/g
Fat 9 kcal/g
Alcohol 7 kcal/g
Calculating energy contributions- Macronutrients
Each 2gram dumpling consists of 0.5 g of carb and 0.3 g of protein and 0.1 g of fat.
Kerry consumes 3 ½ dumplings, 2 grams of salt fish prepared in 2.25 grams of oil.
She drinks a bottle of “Sprout juice” which reads 25 grams of carbs and 30 grams of protein, and total fat is 13g per serving.
Calculating energy contributions- MacronutrientsEach bottle contains 1.5 servings.
Calculate the number of calories Kerry receives from fat, carbohydrates, and protein and the total caloric intake for that meal.
Energy from carbohydratesAnswer
Carb= 3.5 * 0.5 from dumpling= 1.75 gFrom juice= 25 * 1.5= 37.5 gAdd all carbs consumed= 1.75 + 37.5= 39.25 gEnergy from carb= 39.25g * 4kcal/ 1 g= 157 kcal/g
Energy from FatsFat from dumpling= 3.5 * 0.1= 0.35gFat from oil= 2.25 gFat from juice= 13gAdd all the fat contribution= 0.35g + 2.25g+
13g= 15.6gEnergy from fat = 15.6g * 9kcal/1 g= 140.4
kcal
Energy from ProteinProtein from dumpling = 3.5 * 0.3g= 1.05gProtein from juice = 30g* 1.5= 45gAdd all the protein contribution= 1.05g + 45
g= 46.05gEnergy from Protein= 46.05g * 4Kcal/1 g=
184.2 kcal
Total Energy consumedTotal energy consumed= sum of fat, protein
and carbohydrate energy contribution= 184.2kcal+ 140.4 kcal+ 157kcal= 481.6 kcal
Malnutrition Universal Screening Tool (MUST) for adults
Step 1. BMI Score 0= > 20 1= 18.5 -20.0 2=< 18.5Step 2. Unplanned weight loss score 0=<5% 1= 5-10% 2=>10%
MUSTIf wt or ht cannot be established, use
documented or recalled values.
If none of the values can be obtained: Use clinical impression (very thin, thin,
obese) and mid-upper arm circumference (<23.5 cm- thin) & (>32 cm = obese)
MUSTWt change: clothes, jewelry loose-fitting =wt
loss, or too tight=wt gain
History of decreased food intake, loss of appetite or dysphagia over 3-6 months
MUSTUnderlying disease or psychosocial/physical
disabilities likely to cause wt change
Acute disease with negligible intake
MUSTStep 3. Acute disease score: 2 = none or negligible intake for >5 days
Step 4. Add the scores to calculate overall risk of malnutrition0 = low risk: routine clinical care1 = medium risk: observe2 or more= high risk: treat
Calculations of MUST scoreJemma is 20 years old and weighed 45kg last
month and now weighs 41 kg. He is 155 cm tall. He has had little appetite for the last month and has stage 3 cancer. Calculate his MUST score.
Step 1BMI= 45/1.55 * 1.55=45/2.402518.73kg/m2
Calculations of MUST scoreStep 2
Percentage weight loss: Current percentage of usual weight- 41/45 *100= 91.11Percentage weight loss- 100- 91.11= 8.89 %
Step 3Disease score= 2
Step 4 compute the scoresBMI score= 1Weight loss score= 1Disease score= 2Total score= 4
RecommendationHigh Risk-Treat
Calculating Waist Hip RatioWaist (unit)/hip (unit)NB units must be the sameWHR is the ratio of the circumference of the
waist to that of the hipRecommendationsWHO STEPS states that abdominal obesity is
defined as a waist–hip ratio above 0.90 for males and above 0.85 for females and increased cardiovascular risk
Calculating Waist Hip RatioFreta has a waist circumference of 32 cm and
a hip circumference of 14.96 inWhat is her WHR and your recommendations
for her?WHR = WC/HC in same unit
Convert HC- cm= 14.96 in* 2.54cm/ 1 in= 38 cm
Divide WC by HC=32/38= 0.84Low cardiovascular risk (normal)
Caloric intake from IV administrationNurse Joy is caring for critically ill Koju. Koju is ordered to receive 20% DW in 500 mls and 1L requirement.How many calories is Koju receiving daily? How many
bags of fluid are needed to meet a requirement of 1600 kcal?
Volume of Dextrose in 500ml bag- 20/100 * 500= 100mls
1ml = 1g Thus 100mls dextrose = 100g dextroseNumber of calories provided by each bag of DW=
volume of dextrose per * 4kcal= 100 * 4kcal= 400kcalNumber of calories in 1L= conversion of L= mls1L = 1000mls
Caloric intake from IV administrationNumber of 500ml bag in 1L= 1000/500= 2Multiply number of bags by kcals per bag= 2*
400kcal= 800 kcalsAnswer to number of calories that Koju is
receiving daily= 800 kcals
Ques 2.- Bags of fluid needed to meet 1600 kcal requirement
Divide TEE by calories per bag= 1600kcal/ 400kcal *1 bag= 4 bags
Convert bags to mls= 1 bag = 500mlsThus 4 bags = 500 mls* 4bags/ 1 ml= 2000mls Convert to L= 2000ml/ 1000ml * 1L= 2L
Caloric Intake_ MacronutrientsSquare has a TEE of 1850 kcal per day?
What is the expected contribution of the three macronutrients; using the ratio of carbs – 55%, protein- 30%, fats- 15%.
Carb= 1850* 55/100= 1017.5 kcalProtein= 1850 * 30/100= 555 kcalFats= 1850 * 15/100= 277.5 kcalTotal= ( 1017.5 + 555 + 277.5) kcal= 1850
Kcal
Caloric Intake_ MacronutrientsPaige has a TEE of 1920 Kcal/d? What mass of
macronutrients should she consume to meet RDA; using RDA values of 55% carb, 30% protein & 15% fats.
Mass of Carbs required for 1 dayCarb= 1920 kcal * 55/100= 1056 kcalKcal to gram= 1056/ 4 kcal * 1 g= 264 g
Mass of Protein required for 1 dayProtein= 1920* 30/100= 576 kcalKcal to gram= 576/ 4kcal * 1g= 144 g
Mass of Fats required for 1 dayFat= 1920 * 15/100= 288 kcalKcal to gram= 288/9 kcal * 1g= 32 g
Calculating Ideal weightUsual
Frame size can be estimated using wrist circumference, or elbow breadth measurement.
Growth charts and assessment of childrenJames is 6 months old and weighs 6.5 kg and
is 22 cm tall. Using the growth chart for boys identify his percentile:Weight for ageWeight for lengthLength for ageBMI for age – weight for length for ageGrowth Charts\L_A and W_A growth charts (Bo
ys).pdfGrowth Charts\W_L growth charts.pdf
ReferencesRetrieved from
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
Xuereb, G. C. (2004). Healthy eating for better living: A manual on nutrition and HIV/AIDS for healthcare workers in the Caribbean. Cajanus, 37(4): 171-224. Retrieved from www.paho.org/cfni
Retrieved from http://www.who.int/childgrowth/en