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HBV Protein
Recommendation: 60-80% of protein from HBV
60% - .6x76=46 g
80%- .8x76= 61 g
HBV: 46-61 g/day (of the 76 gm total protein)
PUFA=IOM recommendation 5-10% of daily kcal for diabetics
10% PUFA
.1x21900=190 kcal from PUFA
190/9 kcal per g=21 g PUFA/day (included as part of the 68 gm fat)
SFA=recommendation is same for diabetics as general population, so >10% of total kcal
>10% SFA
.1x1900=190 kcal from SFA
190/9 kcal per g=21 g SFA/day maximum (included as part of the 68 gm fat)
MUFA= recommended b/c MUFA-rich eating pattern may benefit diabetics
Remaining fat kcal that arent considered PUFA or SFA would be MUFA
So: 32%-10%-10%= 12% MUFA
12% MUFA
.12x1900= 228 kcal from MUFA
228/9kcal per g= 26 g MUFA/day (included as part of the 68 gm fat, rounded up so that
SFA+PUFA+MUFA=total fat)
Micronutrients:
Sodium recommendation for diabetics: limit to 2300 mg/day
Rx: 1900 kcal diet, 32% fat (68 g) with 10% from PUFA (21 g), no more than 10% from SFA
(21 g), and 12% from MUFA (26 g), 52% CHO (247 g), 16% protein (76 g) with 60-80% (4661 g) of protein from HBV, and a sodium restriction of 2300 mg.
2) Plan a diet and 1-day menu for Debbie using the 12 Step process (you will not do Step 11
in this assignment) in the Diet planning using exchanges slides that were covered in
lecture.
a. Be sure to distribute the exchanges throughout the day according to her prescribed
CHO distribution needs (Step 8).
b. Use the diabetic exchanges to evaluate the macronutrient composition of your sample
menu (Steps 9, 10).
c. Dont forget to perform Step 12. Be sure to compare your diet to your diet Rx.
STEP 1: See Rx above
Fat
Protein
CHO
Total
Macronutrients
% total kcal total g total kcal
32%
68
608
16%
76*
988
52%
247
304
100%
391
1900
Fat Breakdown
% of total kcal total kcal
total g
SFA
10%
190
21
MUFA
12%
228
26
PUFA
10%
190
21
Total
32%
608
68
Non-starch CHO
Breakfast: 2 fruit, 1 veg=35g
Snack: 2 veg, 1 milk (skim) =22g
Lunch: 2 fruit= 30 g
Dinner= 1 veg, 1 milk (skim), 1 other= 32 g
HS snack= 1 milk (low-fat), 1 fruit=27 g
5 fruit
3 milk (2 skim, 1 low fat)
4 veggies
1 other
TOTAL (g)
CHO g
PRO g FAT g
75
0
36
24
20
8
15
0
146
32
0
5
0
0
5
STEP 3: Starch
247g CHO (allowed) - 146 g CHO (above)= 101g CHO remaining
101/15=6.7= 7 starch exchanges
from step 2
from starch (7 exc.)
TOTAL (g)
CHO g PRO g
FAT g
146
32
5
105
14
7
251
46
12
STEP 4: Meat
76 g pro (allowed) 46 g (from above)= 30 g left
30 g/7g per meat= 4.3= 4 meat exchanges
From prev. steps
From meat exch (4 lean)
TOTAL (g)
CHO g
PRO g
FAT g
251
46
12
0
28
12
251
74
24
STEP 5: Fat
68 g (allowed) 24 g (from previous exchanges)=44 g left
44/5 g per exchange= 8.8= 9 exchanges
CHO g
PRO g
FAT g
251
74
24
0
0
45
251
74
69
Previous
Fat exchanges
TOTAL (g)
STEP 6: Totals
CHO
TOTAL g
Multiply by
TOTAL kcal
PRO
251
x4
FAT
TOTAL
74
x4
1004
69
x9
296
621
CHO
PRO
FAT
TOTAL
Rx goal Actual %
52%
52.3%
16%
15.4%
32%
32.3%
100%
Within Rx?
YES
YES
YES
# of exchanges
2
1
4
5
1
7
4
9
1921
STEP 8: Distribution
This chart contains data on Debbies recommended CHO distribution:
% CHO
CHO
Meal
kcal
kcal
CHO g
Breakfast
20%
198
50
Snack
15%
148
37
Lunch
30%
296
74
Dinner
25%
247
62
HS Snack
10%
99
25
Breakfast Snack
Lunch Dinner Snack Total
50
37
75
62
27
251
50/251 37/251 75/251 62/251 27/251
19.92% 14.74% 29.88% 24.70% 10.75%
20%
15%
30%
25%
10%
YES
YES
YES
YES
YES
Exchange
1 fruit
1 fruit
1 veg
1 starch
1 fat
CHO
PRO
Fat
(g)
(g)
(g)
15
0
0
15
0
0
5
2
0
15
2
1
0
0
5
50
4
6
Snack
Food
Baby carrots, 1 cup
Skim Milk, 1 cup
Celery sticks, 1 cup
Saltine Crackers, 6
Tahini, 4 tsp
TOTALS
Exchange
1 veg
1 milk
1 veg
1 starch
2 fat
CHO
(g)
5
12
5
15
0
37
PRO
(g)
Fat
(g)
2
8
2
2
0
14
0
0
0
1
10
11
Lunch
Food
Bread, 2 slices
Lettuce
Mayonnaise, 1 tsp
2 eggs, whites only, hard boiled
orange juice, 1/2 cup
Med. Apple
Green peas, 1/2 cup
TOTALS
Exchange
2 starch
free
1 fat
1 lean meat
1 fruit
1 fruit
1 starch
CHO
PRO
Fat
(g)
(g)
(g)
30
4
2
0
0
15
15
15
75
0
7
0
0
2
13
5
3
0
0
1
11
Dinner
Food
salad greens, 5 oz
sliced bell peppers, 1 cup
fat free salad dressing, 3 Tbsp.
Skim milk, 1 cup
mashed potatoes, 1 cup
chicken breast, 3 oz
margarine, 1 tsp
TOTALS
Exchange
free
1 veg
1 other
1 milk
2 starch +2
fat
3 lean meats
1 fat
CHO
(g)
PRO
(g)
Fat
(g)
5
15
12
2
0
8
0
0
0
30
0
0
62
4
21
0
35
12
9
5
26
HS Snack
Food
yogurt, plain, 6 oz
Banana, extra small
Almonds, 12
TOTALS
Exchange
1 low fat milk
1 fruit
2 fats
CHO
PRO
Fat
(g)
(g)
(g)
12
8
5
15
0
0
0
0
10
27
8
15
251
74
69
PRO
251
x4
FAT
74
x4
1004
TOTAL
69
x9
296
621
1921
The total grams in Daily Totals in Meal Plan from step 9 (above) match the grams in this
chart (251 for CHO, 74 for pro, 69 for fat) so the measures from the example diet and the
exchange calculations are exactly the same:
CHO: 1004/1921= .523= 52.3% (Within 1% of Rx)
PRO: 296/1921=.154 = 15.4% (Within 1% of Rx)
FAT: 621/1921= .323= 32.3% (Within 1% of Rx)
52.3%+15.4%+32.3%=100%
STEP 12: Summary Table
Nutrient
Kcal
CHO
PRO
HBV
FAT
SFA
MUFA
PUFA
Na
CHO Dist:
Breakfast
CHO Dist: Snack
CHO Dist: Lunch
CHO Dist: Dinner
CHO Dist: HS
Snack
Goal
1900
52%
16%
60-80% of
protein
32%
>10%
12%
10%
2300 mg max
Summary Table
Meal Plan
Evaluation
Within 50 Kcal,
1921 ok
52.30% OK
15.40% OK
70.3% of
protein
OK
32.30% OK
13.59% Too high
7.50% Too low
1.24% OK
20%
15%
30%
25%
19.92%
14.74%
29.88%
24.70%
OK
OK
OK
OK
None
None
None
None
10%
10.75% OK
None
I found the totals for the different types of fat by writing out the exchanges on the chart
below and adding up the totals for each type:
From Meats
From Milk
Saltine Crackers
Tahini
Mayonnaise
Bread
Mashed Potatoes
Green Peas
Peanut Butter
Margarine
Almonds
Fat
SFA
MUFA
PUFA
Kcal