Human Nutrition Calculations PDF

There are four ways to estimate energy (Calories):-  The number of calories per kilogram of body weight  Harris and Benedict’s equations  Aon’s equations  Excess resting energy expenditure (REE) and basal Metabolic rate (BMR) What’s th...

There are four ways to estimate energy (Calories):-  The number of calories per kilogram of body weight  Harris and Benedict’s equations  Aon’s equations  Excess resting energy expenditure (REE) and basal Metabolic rate (BMR) What’s the meaning of BMR? It is the thermal effect for food or energy that the body consumed per day  The increase in both REE and BMR is based on the body’s degree of stress, and this degree of stress is divided into three categories:- Light stress Moderate stress High stress it needs for 20% REE or Someone who has 30 Kcal / 1 kg of body it needs for 20 - 50 % suffered severe burns weight REE or 30-37 Kcal / 1 or complex surgeries kg of body weight. needs 50-100% REE or 37-50 Kcal / kg of A person undergoing body weight minor surgery Loses about 10-15 gm nitrogen in the urine. Loses about 5-10 gm A person undergoing less comBlex Loses more than 15 g procedures such as fractures and nitrogen in the urine nerve damage surgery nitrogen in urine Harris and Benedict’s equations as follows:- BMR for men = 665 + (13.8 × W (kg) + (5 × Height (cm) – (6.76 × age) BMR for women = 665 + (9.65 × W (kg) + (1.85× Height (cm) – (4.68 × age) Aon’s equations as follows;- BMR for men= 879 + 10.2 × W (kg) BMR for women = 795 + 7.18 × W (kg) i. REE, the energy expended at rest ii. SDA, the dynamic effect of food iii. EEA, the energy expended on activities 1 Example no.1 :- A patient suffering from hyperglycemia, blood acidity and low weight , 35 years old, 179 cm high and her ideal weight is 66 kg. what is her daily energy need, then calculate the amount of protein, fat and carbohydrates that the patient needs, knowing that the amount of energy from fat represents 30% of the total calories and REE represents 25% Kcal / kg of ideal body weight and the percentage of energy in excess of the energy expended represents 50% of REE knowing that the average calorie / kg of body weight is 37.5 Kcal / kg of body weight. 1 – Calculating the patient’s energy needs:- A – For average calories per kg of ideal body weight = ideal patient weight × average calories = 66 × 37.5 = 2475 Kcal /Kg of body weight B- Calculate the patient’s energy requirement based on the excess of energy expended at rest:- 1 – REE = patient’s ideal weight × resting energy expenditure = 66 × 25 =1650 Kcal / day 2- Energy in excess of resting energy expenditure = REE × energy in excess ratio = 1650 × 0.5 = 825 Kcal/ day So the patient’s total energy = 1650 + 825 = 2475 Kcal / day Secondly: - calculating the amount of protein needed by the patient: The need for an adult or mildly ill person is 0.8 gm. protein / 1 kg of ideal body weight. 0.8 gm. Protein------------------ 1 kg of body weight A gm. Protein -------------------- 66 kg A = 66 × 0.8 = 52.8 gm. Protein / day The amount of energy provided by protein 1 gm. Protein --------------- 4 Kcal 52.8 gm. Protein ------------ B Kcal B = 52.8 × 4 = 211.2 Kcal % energy that provided by protein = × 100 = 8.5% Thirdly: - Calculating the amount of fat. The amount of energy provided by fats = 2475 × 0.3 = 742.5 Kcal The amount of fats in this meal: 1 gm. Fat ----------- 9 Kcal C gm. Fat ----------- 742.5 Kcal C = 742.5 ÷ 9 = 82.5 gm. % energy that provided by carbohydrates = 100 – (% fat + % protein) = 100 – (30 + 8.5) = 61.5 % The amount of energy provided by carbohydrates = Total Kcal × % carbohydrates = 2475 × 0.615 = 1522.1 Kcal The amount of Carbohydrates in this meal =: 1 gm. Carbohydrates ---------------- 4 Kcal D gm. Carbohydrates -------------- 1522.1 Kcal D = 1522.1 ÷ 4 = 380.5 gm. Carbohydrates This patient needs to 52.8 gm. Protein + 82.5 gm. Fat + 380.5 gm. Carbohydrates. 2 Example no.2:- A patient suffering from hypertension and diabetes with an ideal weight of 62 kg and a height of 168cm. Calculate his daily energy need, then calculate the amount of protein, fat and carbohydrates that the patient needs, knowing that the amount of energy from fat represents 30% of the total calories and REE represents 25% Kcal / kg of ideal body weight and the percentage of energy in excess of the energy expended represents 50% of REE. Solution 1- Calculate the patient’s energy requirement based on the excess of energy expended at rest:- 1 – REE = patient’s ideal weight × resting energy expenditure = 62 × 25 =1550 Kcal / day 2- Energy in excess of resting energy expenditure = REE × energy in excess ratio = 1550 × 0.5 = 775 Kcal/ day So the patient’s total energy = 1550 + 775 = 2325 Kcal / day Secondly: - calculating the amount of protein needed by the patient: The need for an adult or mildly ill person is 0.8 gm. protein / 1 kg of ideal body weight. 0.8 gm. Protein------------------ 1 kg of body weight A gm. Protein -------------------- 62 kg A = 62 × 0.8 = 49.6 gm. Protein / day The amount of energy provided by protein 1 gm. Protein --------------- 4 Kcal 49.6 gm. Protein ------------ B Kcal B = 49.6 × 4 = 198.4 Kcal % energy that provided by protein = × 100 = 8.5% Thirdly: - Calculating the amount of fat. The amount of energy provided by fats = 2325 × 0.3 = 297.5 Kcal The amount of fats in this meal: 1 gm. Fat ----------- 9 Kcal C gm. Fat ----------- 297.5 Kcal C = 297.5 ÷ 9 = 33 gm. % energy that provided by carbohydrates = 100 – (% fat + % protein) = 100 – (30 + 8.5) = 61.5 % The amount of energy provided by carbohydrates = Total Kcal × % carbohydrates = 2325 × 0.615 = 1429.8 Kcal The amount of Carbohydrates in this meal =: 1 gm. Carbohydrates ---------------- 4 Kcal D gm. Carbohydrates -------------- 1429.8 Kcal D = 1429.8 ÷ 4 = 357.45 gm. Carbohydrates This patient needs to 49.6 gm. Protein + 33 gm. Fat + 357.45 gm. Carbohydrates. 3  A woman patient suffers from blood acidity that underwent a complicated operation with an ideal weight of 59 kg and a height of 168 cm. Calculate his daily energy need, the total calories intake is 3705 Kcal and if she needs 200 Kcal/ 1 g nitrogen and the percentage of energy from fat represents 30% of the total calories so calculate the amount of protein, fat and carbohydrates that the patient needs. Total need of energy = ideal weight × Total calories = 59 × 3705 = 2212.5 Kcal / kg of body weight calculating the amount of protein needed by the patient: 1 gm. nitrogen ------------------------- 200 Kcal A g. nitrogen -------------------------- 2212.5 Kcal A= 2212.5 ÷200 = 11.06 g nitrogen Amount of protein = Amount of nitrogen × 6.25 = 11.06 × 6.25 = 69.13 g protein 1 gm. Protein --------------- 4 Kcal 69.13 gm. Protein ------------ B Kcal B = 69.13 × 4 = 276.5 Kcal % energy that provided by protein = × 100 = 12.49% 2- Calculating the amount of fat. The amount of energy provided by fats = 2212.5 × 0.3 = 663.75 Kcal The amount of fats in this meal: 1 gm. Fat ----------- 9 Kcal C gm. Fat ----------- 663.75 Kcal C = 663.75 ÷ 9 = 73.75 gm. % energy that provided by carbohydrates = 100 – (% fat + % protein) = 100 – (30 + 12.49) = 57.5 % The amount of energy provided by carbohydrates = Total Kcal × % carbohydrates = 2212.5 × 0.575 = 1272.18 Kcal The amount of Carbohydrates in this meal =: 1 gm. Carbohydrates ---------------- 4 Kcal D gm. Carbohydrates -------------- 1272.18 Kcal D = 1272.18 ÷ 4 = 318.045 gm. Carbohydrates This patient needs to 69.13 gm. Protein + 73.75 gm. Fat + 318.045 gm. Carbohydrates. 4 Example no.4:- A patient suffers from Colonic pain and Stomach ulcer with an ideal weight of 75.5 kg. Calculate his daily energy need, then calculate the amount of protein, fat and carbohydrates that the patient needs, knowing that the amount of energy from fat represents 25% of the total calories and REE represents 30 Kcal / kg of ideal body weight and the percentage of energy in excess of the energy expended represents 50% of REE. Patient needs 150 Kcal / 1 g nitrogen. 1- Calculate the patient’s energy requirement based on the excess of energy expended at rest:- 1 – REE = patient’s ideal weight × resting energy expenditure = 75.5 × 30 =2265 Kcal / day 2- Energy in excess of resting energy expenditure = REE × energy in excess ratio = 2265 × 0.5 = 1132.5 Kcal/ day So the patient’s total energy = 2265 + 1132.5 = 3397.5 Kcal / day 1 gm. nitrogen ------------------------- 150 Kcal A g. nitrogen -------------------------- 3397.5 Kcal A= 3397.5 ÷150 = 22.65 g nitrogen Amount of protein = Amount of nitrogen × 6.25 = 22.65 × 6.25 = 141.5 g protein 1 gm. Protein --------------- 4 Kcal 141.5 gm. Protein ------------ B Kcal B = 141.5 × 4 = 566 Kcal % energy that provided by protein = × 100 = 16.65% 3- Calculating the amount of fat. The amount of energy provided by fats = 3397.5 × 0.25 = 849.3 Kcal The amount of fats in this meal: 1 gm. Fat ----------- 9 Kcal C gm. Fat ----------- 849.3 Kcal C = 849.3 ÷ 9 = 94.3 gm. % energy that provided by carbohydrates = 100 – (% fat + % protein) = 100 – (25 + 16.65) = 58.35 % The amount of energy provided by carbohydrates = Total Kcal × % carbohydrates = 3397.5 × 0.5835 = 1982.4 Kcal The amount of Carbohydrates in this meal =: 1 gm. Carbohydrates ---------------- 4 Kcal D gm. Carbohydrates -------------- 1982.4 Kcal D = 1982.4 ÷ 4 = 495.6 gm. Carbohydrates This patient needs to 141.5 gm. Protein + 94.3 gm. Fat + 495.6 gm. Carbohydrates. 5