Republic of the Philippines

Commission on Higher Education

Region V (Bicol)
Polangui Community College
Polangui, Albay

Subject: Food and Nutrition

Module: 1 (Diet and Health)
Lesson: 1-5 (12 Hours Credit/Weeks 1-4)

LEARNING OUTCOMES
At the end of this module, you are expected to:
a. Differentiate food fads and food frauds in food and nutrition,
b. Explain how drugs interfere with nutrient absorption, digestion, metabolism, utilization
and, or excretion,
c. Identify the result of following dietary guidelines for a healthy diet,
d. Give examples of food that an individual should consume per day based on food groups
as defined by the US Department of Agriculture,
e. Explain the importance of diet to health of an individual and family,
f. Enumerate and reflect to the 14 ways to stick to a healthy diet.

INTRODUCTION
In this module you will learn the importance of diet to health, especially in the prevention
and cure of illness. You will also inform about the guidelines for a healthy diet and how to eat a
balance diet. It is also important to plan your diet to ensure the result of a healthy habit. Please be
sure to read the materials in this module and follow the instruction on each activity so that you
will achieve your learning goals.

ELICITING CONCEPTS
Before you proceed into the learning content of this module, be familiarize yourself first
with the necessary words that you will encounter on entire lessons by answering the cross word
puzzle below.

3 4
2 5

6 8 9

CROSS
 1. It is intentional deception to secure unfair or unlawful gain, or to deprive a victim of a
legal right.
2. It is an inclination for adopting fads.
3. It is a substance which neutralizes stomach acidity and is used to relieve heartburn,
indigestion or an upset stomach. 
6.  This is a term that is used to describe all chemical reactions involved in maintaining the
living state of the cells and the organism.
7. This is a waxy type of fat, or lipid, which moves throughout your body in your blood.

DOWN
1. A trend, or craze is any form of collective behavior that develops within a culture, a
generation or social group in which a group of people enthusiastically.
5. The science that interprets the nutrients and other substances in food in relation to
maintenance, growth, reproduction, health and disease of an organism.
8. Also known as roughage, is the part of plant-based foods (grains, fruits, vegetables, nuts,
and beans) that the body can't break down.
9. It is a state of physical, mental and social well-being in which disease and infirmity are
absent.

Source:
Wikipedia. https://en.wikipedia.org/wiki/Main_Page
Google search

LEARNING ACTIVITIES
Learning Modality
Asynchronous
Content Synchronous (Google
(via Google Meet) Classroom/messenger group
chat/Printed Module)
Lesson 1. Activity 1. Discussion of the Activity 1. Read Appendix
Nutrition fads and frauds definition of Nutrition Fads and 1.1 (Nutrition Fads and
Nutrition Frauds. Frauds)
- Differentiate food fads Activity 2. Answer worksheet
and food frauds in food 1.1. Refer to the Essay
and nutrition. Rubric In Appendix 1.2.
Lesson 2. Activity 1. Watch “What Activity 1. Read appendix 2.1
Drugs effecting Health doctors don't know about the (Drugs effecting Health)
drugs they prescribe by Ben
- Explain how drugs Goldacre” Activity 2. Make a
interfere with nutrient https://www.youtube.com/ reaction/reflection paper from
absorption, digestion, watch?v=RKmxL8VYy0M the given video. Refer to
metabolism, utilization Rubric in Appendix 2.2 for
and, or excretion. writing your
reaction/reflection paper.
Lesson 3. Activity 1. Lecture-Discussion Activity 1. Read and study
Guidelines for a healthy Diet on Guidelines for a healthy the learning materials in
diet. Appendix 3.1.
- Identify the result of Activity 2. Identify the
following dietary result/effect of following Activity 2. Answer worksheet
guidelines for a healthy Dietary Guidelines by the US 3.1.
diet. Department of Agriculture.
Answer worksheet 3.1.
Lesson 4. Activity 1. Watch “Balance Activity 1. Read and study
Eating a Balance Diet Diet” by Barnabas. Appendix 4.1 (Eating Balance
https://www.youtube. Diet).
- Give examples of food com/watch?
that an individual should v=FV8mGvC2CLU
consume per day based on Activity 2. Answer worksheet
food groups as defined by 4.1.
the US Department of Activity 2. Make a reflection
Agriculture, paper/reaction paper from this
- Explain the importance of video. Refer to the Rubric in
diet to health of an Appendix 2.2.
individual and family.
Lesson 5. Activity 1. Discussion/Lecture Activity 1. Read and study
Planning Your Diet in the 14 ways to stick to a Appendix 5.1 (Planning Your
healthy diet. Diet).
- Enumerate and reflect to
the 14 ways to stick to a Activity 2. Research and write
healthy diet. a Discussion Paper on the
different kinds of diet and to
whom it is intended for. Refer
to the Appendix 5.2 for the
Rubric in Discussion Paper.

Module 1
 Appendix 1.1

Nutrition Fads and Frauds

Nutrition fraud is a comprehensive term used by the Food and Drug Administration (FDA) to
describe the abuses that occur as a result of the misleading claims for traditional foods, dietary
supplements, and dietary products and of the deceptive promotion of other food substances,
processes, and devices.

Food faddism is a dietary practice based upon an exaggerated belief in the effects of food or
nutrition on health and disease.
Food fads derive from three beliefs:
• That special attributes of a particular food may cure disease.
• That certain foods should be eliminated from the diet because
they are harmful.
• That certain foods convey special health benefits.

Food faddists are those who follow a particular nutritional practicewith zeal and whose claims for
its benefits are substantially more than science has substantiated.

Until Einstein's equation, E = mc, which may also be written Calories = me is invalidated the
only way to reduce weight (m) is to reduce the amount of calories consumed (E). In other words, to lose
weight it is necessary to eat less calories each day than you burn up, and the only way to gain weight is to
eat each day more calories than you use.

Food quackery, which involves the exploitive, entrepreneurial aspects of food faddism, is the
promotion for profit of special foods, products, processes, or appliances with false or misleading health or
therapeutic claims. A food quack is one who pretends to have medical or nutritional knowledge and who
promotes special foods, products, or appliances with false or misleading claims, usually for personal
financial gain.

Nutrition fraud flourishes today because of the diversity of cultures, the historical tradition of
concern for health and the use of natural remedies, and the introduction of advanced communication
technologies.

Food faddism has its roots in Great Britain, where patent medicines were advertised and sold by
everyone from hawkers to goldsmiths. In the colonies, legal protection of consumers against fraudulent
claims was first recorded in Massachusetts Bayin 1630. Nicholas Knopp, was whipped and fined five
pounds for selling a cure for scurvy that had "no worth nor value" and was "solde att a very deare rate".

One of the earliest nutrition faddists was Sylvester Graham, a "back to nature" reformer who was
suspicious of any food altered from its "natural" condition, such as white flour. His legacy continues
among those who question whether processed food of any type can provide adequate nutrition.

Although, it must be noted that processed foods should not necessarily be eliminated from a
person’s diet because of this belief, it is true that without fortification the more a food is processed and
thus differs from its natural form the less nutrient dense it will be.

Some groups such as fruitarians actually go a step further, they don't eat processed or cooked
foods. The reason being that when a food is cooked it is not able to be digested and becomes toxic. There
is no scientific evidence to back this argument to its fullest extent.

Popular interest in nutrition, coupled with concern about food shortages during World War I, was
fostered by the increasing promotion of the health properties of foods in the early 20th century. Vitamins,
by the very nature of their discovery, became associated with the prevention or cure of disease and were
soon promoted as curative agents.

Today the travelling patent medical man has been largely replaced by the highly skilled and
organized use of electronic means to promote fraudulent marketing - computers, customized mailing lists,
national advertisements, and other mass media. The medium and the details have changed, but the
message and the goals remain. It is difficult for consumers to evaluate the validity of the health claims
perpetrated by quacks and faddists.

Purveyors of nutrition fraud capitalize on people's desire to be healthy and on the lack of certainty
in many areas of nutrition and health. No writer for a lay audience has any special insights into nutrition
which are not known by a substantial part of the scientific community. Magic and sensational diets are
nothing more than exaggerations of one facet of nutrition at the expense of another, often to the detriment
of the willing victims.

Regulation of Nutrition Fraud

The first Federal legislation, the Pure Food and Drug act of 1906, made it unlawful to
manufacture or introduce into interstate commerce adulterated or misbranded food or drug products.

Currently, numerous Government, medical and consumer-oriented organizations are responsible

for preventing and controlling fraud. These agencies work cooperatively, and their antifraud activities
have become more visible in recent years. Private agencies and organizations such as the American
Dietetic Association, the American Cancer Society, the American Medical Association, the National
Council Against Health Fraud, and other health professional groups are also active against food
fraud.

The Federal Food, Drug and Cosmetic Act empowers the FDA to prohibit the introduction of any
food, drug, device or cosmetic that is adulterated or misbranded. Only factual and nonmisleading
information is allowed on food labels. Most false promotional claims, therefore, are not made on labels.
Instead, they appear in books, lectures, .and mass media that are protected by constitutional rights. The
FDA has the authority to use its food additive and drug approval processes to control food products
allowed on the market and to remove fraudulent products.

Most fraudulent food products are classified as foods, but when therapeutic claims are made for
them, they are also considered to be drugs. If a food product is also classified as a drug and is considered
by the FDA to b~ ineffective for its claimed use, it will not have an approved New Drug Application. For
example, if it is promoted for treating a disease that is not amenable to lay diagnosis, it cannot have
adequate directions for use and will not be approved. .

Health Consequences of Fraud

Nutrition fraud may lead to deleterious health consequences, caused by the failure to seek
legitimate medical care, by potentially toxiccomponents of foods and products, by nutrient toxicities and
deficiencies, by diversion of monies from essential treatments, and by interference with sound nutrition
education.

Public health and safety can be jeopardized by false promises that divert or deter individuals from
pursuing sound forms of medical treatment or that encourage them to abandon beneficial therapy for a
disease. Fraud may encourage people to reject legitimate medical advice and to practice inappropriate
self-medication that is less likely to be helpful, and more likely to be directly harmful, than the medical
technology based on a sound understanding of human biology and nutrition.

The FDAs annual reports document numerous instances of fraudinduced failure to obtain
appropriate health care. Because early detection and treatment improve prognosis for many illnesses,
unproven "nutritional" therapies may unnecessarily delay beneficial intervention. Some diet regimens
recommended by health faddists to treat cancer, for example, are so nutritionally deficient or toxic that
adherence to them has caused death or serious illness.

Public injury can occur when foods and unproven remedies are toxic. Just because a substance
occurs naturally in food does not mean that it is necessarily safe. Many of the chemicals known to be
present in herbs have never been tested for safety. Some plant foods contain potentially unsafe
pharmacologically active ingredients such as aflatoxin, one of the most potent carcinogens known.

There has been a substantial increase in the use of herbal products that contain
pharmacologically active ingredients that can possibly produce undesirable effects such as an increase in
blood pressure. Occasional poisoniDgs and clinical intoxications are reported after the use of herbal tea
products. Ginseng, one of the most popular herbs, has been reported to produce oestro-like effects in
some people. From present evidence, it cannot be concluded that all herbal products can be consumed
safely over extended periods of time.

Potentially harmful ingredients have been identified in samples of other food supplements, such
as an oestroic hormone in commercial alfalfa tablets, arsenic in kelp tablets, and cadmium in dolomite
have caused the FDA to caution against use of these products, particularly by pregnant women and
children.

Frauds and fads may induce nutrienttoxicities or deficiencies. Many people take vitamins as self-
medication for the prevention or treatment of health problems. The use of these products varies with such
demographic factors as geographic region, education, income, and race. Women are more frequent
consumers than men. Intakes range widely, extending up to 50 times the Recommended Dietary
Allowance (RDA) for individual nutrients.
Nutrient supplements are usually safe in amounts corresponding to the RDA, but the RDA's are
already set to provide maximum benefit consistent with safety. Thus, there is no reason to think that
larger doses will improve health in already healthy people, and excess intake can be harmful. Mega-dose
intakes can have seriously harmful effects. The toxicity of high dosages of vitamin A and D is well
established. Because the margin is narrow between a safe and a toxic dose of most trace elements,
excessive supplementation with these substances may be particularly hazardous.

Excessively restrictive dietary practices can also induce serious medical problems or even death.
Popular weight reduction products often provide very low calorie intakes. Because such products have
been associated with the deaths of some young women, the FDA now requires warnings on labels to alert
consumers of such products.

Many popular diets are potentially harmful because they eliminate food groups or severely limit
food variety. Examples include those that drastically reduce carbohydrate intake, or advocate excessive
fruit consumption, and those that claim that a person cannot digest protein and carbohydrates at the same
time. This is not true, as can be seen in the Chapter - The Digestive System, g.ifferent parts of the
digestive tract deal with different nutrients and will absorb those nutrients, besides most foods usually
contain both protein and carbohydrates (eg. legumes which are often 50% protein and 50% carbohydrate).

Fad diets seldom produce long-lasting weight control. Highly restricted diets, such as the more
extreme forms of Zen macrobiotics, have led to nutritional deficiencies, starvation, and even death in a
few individuals. Such diets have also been associated with retarded fetal development and childhood
growth or other nutritional problems in young children.

Commercial interests have capitalized on a heightened public awareness of nutrition and health
issues, but much of the public cannot evaluate the validity of available weight reduction schemes,
supplements, and services. Self-appointed health and nutrition advisors have expressed distrust of proven
public health measures such as fluoridation and pasteurization and, instead, have promoted treatment
alternatives that are not supported by accepted medical practice. The public also may be misled by
extravagant claims of health benefits from the use of certain foods or nutrient supplements.

Economic Consequences of Fraud

People experience economic injury when purported remedies and cures do not work, are untrue,
or are greatly exaggerated or when purchased products are not needed. Fraudulent products are known to
be extremely profitable to those who sell them. Quackery has become big business and costs the deluded
consumers in excess of $10 billion a year!

Most fraudulent products and services can be very costly yet are promoted as having nutritional
or health benefits that have not been substantiated in scientific literature.

A vast array of substances are available for a variety of different purposes. some of them may
even appear to work owing to the power of the placebo effect - if you expect product X will make you
feel better, then it probably will. But these supplements must not be dismissed as placebos in the sense of
being inert pieces of chalk. These substances are what they say they are, and many of them have powerful
pharmacological effects (though not necessarily those claimed for them). The dangers of
hypervitaminosis is an obvious example. The effects of excess quantities of isolated amino acid
supplements, minerals such asselenium and substances such as ginseng have never been fully explored
and may be no less hazardous. Even if consumed at a level which is not harmful, their use is still
undesirable:

In most instances they are unnecessary; either providing nutrients which are surplus to
requirements or supposed nutrients which are probably not needed at all. Furthermore, those who are
most susceptible to health food claims are perhaps those who can least afford to be.

Table. Health Food Supplements and Remedies

 The public incurs other costs because many products labelled as "natural" or "organic" sell for
higher prices than their "regular" counterparts, although their special benefits are not generally
demonstrable. "Natural" vitamins often sell at double the price of synthetic products even though they are
chemically identical. In some products labelled as "natural," only a minor fraction of the vitamin is
actually derived from natural sources.

What is also very difficult to understand is why more natural foods, like whole wheat bread or
unpolished rice, often cost more than their refined counterparts, white bread or par-boiled white rice, that
have undergone costly processing and packaging which should make them more, not less expensive.

References:

World Food Programme. Via Cesare Giulio Viola 68/70 00148 Rome, Italy. Food and Nutrition
Handbook.

Don Ross; Regd. Off. 267-B, IO-B, Scheme, Opp. Narayan Niwas,
Gopalpura By Pass Road, Jaipur - 302018 Rajasthan (India) Ph: 0141 - 2594705, Telefax: 2597527; Food
and Nutrition. Pgs. 7-13

Appendix 1.2

Rubric for Essay Question

Score Content Organization Development

Answer is appropriate to Clear sense of order. Begins Develops each point with may
the question. Content is with a topic sentence. specific details.
9-10 factually correct. Supporting points are Answers question completely.
presented in a logical
progression.

Answer is appropriate to May lack a topic sentence, but Each point supported with some
the question. Content points are presented in a details and evidence. All important
6-8 may have one or two logical progression. points included.
factual errors.
 Content relates Logic of argument is Sparse details or evidence. Question
peripherally to the minimally perceivable. only partially answered.
4-5 question; contains Points presented in a
significant factual errors. seemingly random fashion, but
all support argument.

Content unrelated to Lacks clear organizational Statements are unsupported by any

question. plan. Reader is confused. detail or explanation.
0-3 Repetitious, incoherent, illogical
development.

Module 1

Appendix 2.1

Drugs Effecting Health

Prescription drugs may interfere with nutrient absorption, digestion, metabolism, utilization, or
excretion. Similarly, both nutritional status and diet can affect the action of drugs by altering their
metabolism and function, and various dietary components can have pharmacologic activity under certain
circumstances.
Drugs may act centrally or peripherally to decrease appetite or may reduce appetite as a result of
side effects. Drugs that act centrally include catecholaminergics, dopaminergics such as levodopa for
Parkinson's disease, serotoninergics, and endorphin modulators such as naloxone. Peripherally acting
agents include those that inhibit gastric emptying, and bulking agents.
The emetic centre, located in the brain stem, is easily stimulated by the action of many drugs.
Almost all drugs have the potential to alter gastrointestinal function, causing nausea, vomiting, diarrhoea,
and constipation. Any drug causing nausea, especially alcohol, can decrease appetite. For instance, it has
been well documented that -digitalis toxicity leads to anorexia, nausea, weight loss, and wasting.
Narcotics, analgesics, and clofibrate are also commonly associated with nausea and vomiting. Cancer
chemotherapeutic drugs such as methotrexate have a strong anoretic effect and can cause.
gastroenterological toxicity.
 In additj.on, drugs may alter nutritional status, which in turn can result in anorexia and weight
loss. High doses of aluminum or magnesium hydroxide antacids can cause phosphate depletion, leading
to muscle weakness, anorexia, and even congestive heart failure. Thiazide and furosemide diuretics can
cause sodium, potassium, and magnesium depletion, resulting in anorexia and muscle weakness.
Commonly used folate antagonists include methotrexate, a cancer chemotherapeutic agent; triamterene, a
diuretic; trimethoprim, an antibacterial agent; phenytoin, an anticonvulsant; and sulphasalazine, an anti-
inflammatory agent. Sulphasalazine and phenytoin are competitive inhibitors of folate transport in
addition to being folate antagonists. Folate deficiency can lead to weight loss and anorexia. Penicillamine
induces zinc depletion, which may cause a loss of taste acuity and possibly decreased food intake.
Alcohol abuse also commonly results in deficiencies of thiamin, folate, vitamin B6' vitamin A, and zinc.
Antacids
About a billion dollars is spent each year in the United States on antacids, making these products
among the most popular over-the-counter (OTC) drugs. These tablets and liquids are gulped down for the
relief of heartburn, sour stomach, and indigestion. Antacids may also be prescribed to treat stomach
ulcers.
Although many consumers take antacids almost casually, these drugs are not as harmless as they
may seem. Antacids can effect the way other drugs behave in the body. They can speed the absorption of
some prescription drugs, possibly causing an overdose, or slow it for others, thus reducing their
effectiveness. .
Because of concerns about known interactions between antacids and other prescription drugs,
FDA is proposing to change that label warnings read:
"Antacids may interact with certain prescription drugs. If you are presently taking a prescription
drug, do not take this product without checking with your physician."
Effects of Diet on Drug Metabolism
Dietary factors can decrease, delay or enhance the absorption of drugs, primarily by altering their
availability, their solubility, or the amount of time they spend in the stomach or intestine. Calcium, for
example, can bind tetracycline antibiotics and form a complex that renders both the drug and nutrient
unavailable. The acidity of the gastrointestinal tract also affects drug disposition. A more acidic
environment reduces the bioavailability of penicillin and isoniazid but increases the absorption of
tetracyclines. Food decreases, delays, or enhances the absorption of certain antibiotics.
Instructions to take drugs with or between meals, or the coating of drugs to prevent dissolution,
attempt to take advantage of these gastric properties, but it is uncertain how well patients adhere to such
instructions.
The effects of drugs are modulated by their rates of metabolism by the liver and other tissues.
Drugs are metabolized by two basic processes. The first (Phase I) metabolic step is usually an oxidation
reaction that alters a functional group in the drug. This alteration may either activate the drug or
deactivate it. The second step (Phase II) conjugates the oxidized drug to an inactive, water-soluble form
that can be readily excreted.
The rate of drug metabolism by mixed-function oxidase systems can be accelerated by the drugs
themselves as well as by a variety of dietary factors. Such factors include protein, cruciferous vegetables
(broccoli or cabbage), and charcoal-broiled meats.
On the other hand, low-protein, high-carbohydrate diets and deficiencies of several vitamins and
minerals reduce levels of drugmetabolizin~enzymes and consequently the rate of drug metabolism, so that
the drug concentrations may decline slowly. thus, in many cases the net effect of nutritional deficiency is
to increase drug potency.
Certain drugs can interfere with specific nutrients or non-nutrient components in foods to cause
acute adverse reactions. Such reactions can be prevented by avoiding the foods when taking the
medication. Examples include interactions between monoamineoxidase inhibitors and foods containing
tyramine, and between alcohol and disulphiram, hypoglycaemic agents, and many other drugs.
Effects of Pharmacologic Doses of Nutrients
Nutrients are sometimes used in unusually high doses for their pharmacologic effect. Niacin, for
example is used pharmacologically to reduce blood cholesterol levels. Retinoid derivatives of vitamin A
have been used successfully to treat severe acne and other conditions.
All pharmacologic therapies induce side effects, and high-dose nutritional therapies are no
exception. Although excess water-soluble vitamins are excreted and usually cause little difficulty, side
effects have been reported in cases of excessively high doses.
High dose niacin induces flushing, and neurologic symptoms have been reported from excessive
intake of vitamin B6. Excessive intake of fat soluble vitamins or their derivatives is well known to induce
toxic symptoms. Excess vitamin A, for example, causes birth defects in animals, and possibly, in humans.
Caution has been urged in its use for women who are pregnant or likely to become pregnant.
Individuals who are born without the genes to produce key functional enzymes may require
amounts of certain nutrients greatly in excess of those required by most people. Such inborn metabolic
errors have been identified for enzymes necessary for absorption, metabolism, or storage of nearly all of
the vitamins.
In some cases, higher than normal intake of the vitamin will restore activity. A classic example of
such a vitamin-responsive syndrome is pernicious anaemia, a condition of impaired absorption of vitamin
B12. Patients with this condition must have exceedingly high doses of the vitamin from food
supplements, or lower doses by injection. In other conditions, certain metabolic products cannot be
degraded and, therefore, accumulate to toxic levels. In some cases, such disorders can be treated with
carefully designed dietary preparations having a very low content of the poorly metabolized nutrient. An
example of this type of condition is phenylketonuria, a genetic lack of the enzyme that converts
the amino acid phenylalanine to tyrosine. Patients with phenylketonuria accumulate phenylalanine and
other metabolites that at high levels, are toxic and cause mental retardation and other neurologic damage.
Dietary treatment is designed to reduce the phenylalanine content of the diet to levels below those that
cause symptoms.
Treatment and Recovery from Chemical Dependency
It is the position of the American Dietetic Association that nutrition intervention, planned and
provided by a qualifiednutrition professional, is an essential component of the treatment and recovery
from chemical dependency.
It is the position of the American Dietetic Association that nutrition intervention, planned and
provided by a qualifiednutrition professional, is an essential component of the treatment and recovery
from chemical . dependency.
American consumers tend to be surprisingly conservative in their responses to common illnesses.
More than a third do not treat their ailments at all, but they are becoming more knowledgeable about the
effects of Over-the Counter remedies.
The severity of malnutrition and the need for nutrition therapy in addiction vary. Mind altering
substances (eg. alcohol) are toxic to the body, causing physical adaption, damage, and malnutrition.
Abuse of drugs accelerates nutrition needs beyond normal, so that even a well-balanced diet may
be inadequate. Nutritional problems are also caused by an increased nutrient requirement to detoxify and
metabolize drugs, inactivation of vitamins and coenzymes needed to metabolize energy, inadequate
nutrient storage in the liver, malabsorption, poor utilization of nutrients, breakdown of organs, and
increased loss of nutrients through diuresis and diarrhoea.

Table. Estimated Sales of Over-the-Counter

Internal Medications (Millions of dollars)

Category of Medications 1982 1985 1990

Analgesics 1484 1844 2490
Cough, cold, allergy, sinus 1269 1659 2241
Digestive aids 1228 1393 1654
Motion sickness 25 33 43
Sleep aids/sedatives 41 50 66
Appetite suppressants" 229 280 350
Vitamins and minerals" 1031 1509 2176
$5307 $6768 $9020
Figures are for estimated retail sales through retail outlets.

Nutrition care is defined to include an elevation of the addict's nutritional status at detoxification,
supervision of nutritional rehabilitation through delivery of palatable, nourishing meals and supplements
that encourage normal eating patterns, and provision of nutritional counseling to help the addict develop
an eating plan supportive of stable recovery.
Chemical dependence is a bio-psychosocial disease. Patients with a compromised liver function
have a narrow therapeutic window for iron or fat-soluble vitamin supplements and may even be in a
condition of iron overload. Therefore the use of high-potency vitamin or mineral
supplements should be discouraged unless clinical evidence of nutritional deficiency is present.
The majority of abusers have suppressed immune status, which is compounded by an inadequate
diet. Abusers exposed to the human immunodeficiency virus (HIV) are thus at greater risk for contracting
HIV infection. Unless rectified, a poor diet may be one factor in stimulating propagation of the virus
toward more severe stages of HIV infection.
If AIDS is diagnosed in the patient in treatment, nutrition monitoring is essential. Adequate-
calorie, nutrient-dense diets, with supportive or aggressive supplementation if indicated, are essential.
Nutritional recovery is a component of the physical foundation for rehabilitation that precedes
healthy mental, emotional, and spiritual and conservative quantities of dietary fats and emphasizes
balance, variety, caloric appropriateness, and regularity will be conducive to progress in recovery. A
high-protein, high-fat diet has been reported to increase the incidence of drinking.
The menu planner should recognize that the stay of the average addict in treatment is lengthy.
Food offerings should be designed to maximize attractive appearance and palatability to stimulate
appetite and willingness to eat regular meals as well as to support general morale. The patient should be
encouraged to choose foods freely in a cafeteria or family-style setting. Social interaction during
mealtime facilitates treatment goals of resocialization without drugs.
Substance substitution, such as the replacement of sugar, caffeine, or nicotine for the drug of
choice, often occurs during recovery.
Substance substitution compromises the quality of nutritional rehabilitation and perpetuates the
behavioural aspect of addiction. The recovering addict needs to learn how to cope with substitution
patterns.
Irregular meals, snacking, and consequent blood sugar fluctuations, along with a stressful
environment, may stimulate cravings that make the reco';'e'ring addict susceptible to relapsing.
Addicts have been reported to believe that consumption of sweets helped them maintain sobriety.
Eating disorders are common in chemically dependant women. Current theories of addiction suggest that
compulsive eating, like alcoholism, is rooted in similar issues of codependency that form the addictive
personality. Eating disorders may Involve an addiction that occurred long before alcohol or other drugs
were abused. However, as chemical dependency develops, the eating disorder may go into remission,
only to reappear during abstinent recovery. In other patients the abuse of alcohol and drugs suchas
amphetamine and cocaine alters normal appetite, digestion, and metabolic regulatory systems,
stimulatingthe development of an eating disorder.
Nutrition counselling should include specific food-related emotional issues. Self-esteem,
responsibility, and socialization skills should be addressed to change eating habits. Because the family is
intimately involved in the success of recovery, the family member involved with meal preparation should
also receive counselling to prevent the use of food as a weapon of sabotage.
 Besides the usual presentation of nutritional consequences of drug abuse and food sources for
nutrient needs, the dietitian should discuss practical ways to handle stress and cravings, how to integrate
healthy lifestyle choices into daily recovery principals, weight management and eating disorder risks, and
avoidance of substance substitutions such as, sugar, caffeine, and nicotine. The dietitian should also
counter nutrition myths touted in the popular literature and circulated among people.
Many debilitating nutritional consequences result from drug and alcohol abuse. Chronic nutrition
impairment causes serious damage to the liver and the brain, which reinforces th\:! craving for more drugs
and alcohol, and perpetuates the phycological aspect of addiction. During treatment efforts are
concentrated on physical recovery, which prepares individuals to function at a higher level in treatment -
cognitivaly, mentally, and socially.
Improved nutritional status can make treatment more effective, while reducing drug and alcohol
craving, thereby preventing relapse. Nutrition professionals should take aggressive action to ensure
involvement in treatment and recovery programs. In addition they are encouraged to participate in
nutrition research activities to strengthen the knowledge base in this area.

Table. Biological, Psychological, and Social Factors

of Chemical Dependence Disease.

Appendix 2.2

Reaction Paper Rubric

Trait Exceeds 9-10pts Meets 5-8pts Below 0-4pts Score

Introduces theme of Fails to present the
Introduces theme of
paper, and articles theme, or fails to
Introduction paper and articles
using rich and provide introduction to
effectively
descriptive language. articles
Provides accurate and Fails to summarize
Summarizes main
descriptive, concise articles effectively due
points of the
Information summary of article to omission of key
articles
summary information, effectively points or inaccurate
competently and
summarizing main characterization of
accurately.
points of articles. information.
Critique Thoughtfully critiques Critiques author(s)’ Fails to effectively
author(s)’ main points, main points, using present critique; and/or
using evidence to back evidence to back up fails to use evidence to
up arguments. Critique arguments. back up arguments;
is insightful and and/or uses flawed
thorough. logic to support
 statements.
Conclusion presents Effective
particularly strong or conclusion is
Missing or inconsistent
Conclusion compelling closing presented that
conclusion.
statement that ties corresponds with
closely to introduction. introduction.
Information is Information is
organized in a fully organized
effective manner; competently,
Missing or ineffective
Organization presents strong with thesis,
elements.
introduction, expressive supporting
body, and purposeful information and
conclusion conclusion.
Sentences
effectively
Sentences effectively Repeated errors in
Sentence constructed with 1‐
constructed with no sentence structure or
Structure 2 minor
grammatical errors grammar
grammatical
errors
1‐2 minor errors in
Spelling, capitalization
spelling,
Mechanics and punctuation error‐ More than 2 errors
punctuation or
free
capitalization
Total Score 70 pts

11- 13- 15- 17- 20- 22- 24- 27- 29- 31- 33- 35-
Score 0,4 5-7 8 9-10
12 14 16 19 21 23 26 28 30 32 34 37
Eqvlnt 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
Score 38- 40- 42- 44- 47- 49- 51- 53- 56- 58- 60- 63- 65- 67-
70
39 41 43 46 48 50 52 55 57 59 62 64 66 69
Eqvlnt 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95

Module 1

Appendix 3.1

Guidelines for a Healthy Diet

The Nutritional Guidelines for Filipinos (NGF) is a set of dietary guidelines based on the eating
pattern, lifestyle, and health status of Filipinos.

The NGF contains all the nutrition messages to healthy living for all age groups from infants to
adults, pregnant and lactating women, and the elderly.

Below are the new messages of the 2012 NGF:

- Eat a variety of foods everyday to get the nutrients needed by the body.
- Breastfeed infants exclusively from birth up to six months and then give appropriate
complementary foods while continuing breastfeeding for two years and beyond for optimum
growth and development.
- Eat more vegetables and fruits to get the essential vitamins, minerals, and fiber for regulation of
body processes.
- Consume fish, lean meat, poultry, egg, dried beans or nuts daily for growth and repair of body
tissues.
- Consume milk, milk products, and other calcium-rich food such as small fish and shellfish,
 everyday for healthy bones and teeth.
- Consume safe foods and water to prevent diarrhea and other food-and water-borne diseases.
- Use iodized salt to prevent Iodine Deficiency Disorders.
- Limit intake of salty, fried, fatty, and sugar-rich foods to prevent cardiovascular diseases.
- Attain normal body weight through proper diet and moderate physical activity to maintain good
health and help prevent obesity.
- Be physically active, make healthy food choices, manage stress, avoid alcoholic beverage, and
do not smoke to help prevent lifestyle-related non-communicable disease.
The revisions were made based on the results of the 2008 National Nutrition Survey (NNS)
conducted by FNRI-DOST.

Based on the said survey, the Filipino household diet fell below the recommended levels except
for niacin, which is above the recommended.

Low urinary iodine excretion is still a prevalent problem among pregnant and lactating mothers,
indicating to low iodine intake. Iodine is important during pregnancy because it is needed for the brain
development of the infant while lactating mothers must have adequate supply of iodine in their
breastmilk. 

High cholesterol level may be attributed to the high consumption of sodium rich foods by
Filipinos.

Dietary Guidelines
The Dietary Guidelines published by the USDA and Human Services recommend that people
maintain desirable weight, limit intake of fat and cholesterol, and consume adequate amounts of starch
and fibre.

Although these guidelines are developed by the US Department of Agriculture and the
Department of Health and Human Services for healthy Americans, they have received the consensus by
most authorities, and can be used by *healthy people throughout the world.

*Healthy refers to people who do not suffer from malnutrition or any other condition that requires
a change in dietary guidelines or nutrient allowances

People should focus on their total diet in a more positive way, especially with respect to fat and
cholesterol. Most people following a Western type diet are consuming far too much fat and cholesterol,
and not enough carbohydrate and fibre.

The easy way to overcome this problem is to eat moderate amounts of foods from all the different
food groups, and avoid dietary extremes that include an excess of fatty foods, cholesterol, or sugars.

Eat a Variety of Foods

All foods that supply calories and essential nutrients, potentially, can be included in an adequate
diet. In some cases, certain groups of people (eg. pregnant women, vegetarians) should eat foods to obtain
a greater amount of a particular nutrient (eg. calcium-rich foods, iron-rich foods).

But, when choosing a greater variety of foods from the different food groups, choose low-calorie
foods, especially for elderly persons and persons who are sedentary or trying to loose weight.

No single food can supply all the nutrients in the amounts you need. To make sure you eat all the
nutrients and other substances needed for health, choose the recommended number of servings from each
of the food groups displayed in the Food Guide Pyramid.

Maintain Healthy Weight:

A healthy weight is the weight a person should be to live a healthy life, and reduce the chances of
conditions that are associated with either obesl'y or malnutrition caused from hunger and starvation.
 "Too lean" is a health problem often found in young women, too easily influenced -by the peer
pressure of modern living. They strive to loose weight even when they are under-weight.

A healthy weight can be calculated by considering body mass index

and waist-to-hip ratio.

If a person is over-weight, and this is not caused by a weight-related disease, the importance of
following one of the many weight reduction strategies and the necessity to exercise and increase the
amount of energy expended, is paramount.

To maintain weight you must balance the energy in food with the amount of energy your body
uses.

Table. Body Mass Index Used to Define Desirable Weight and

Overweight for "Ideal" Reference Populations

Physical activity is an important way to use up food enelgy. To use up dietary energy spend more
time being physically active, like walking the dog, and less time being inactive, like watching television.

Ratios of weight to height estimate total body mass rather than fat mass, but they correlate highly
with the amount of body fat. The most commonly used ratio is known as Quetelet's index, or the BMI,
and is usually defined as body weight in kilograms divided by the square of the height in meters (wt/ht2)

A reasonable weight reduction programme should have a goal of Illh to 1 pound per week.
Loosing more than 1 pound a week is not recommended, nor should drugs or other extreme means of
weight reduction be used (See chapter on Dietary Fads and Frauds).Extreme approaches to weight loss,
such as self induced vomiting or the use of laxatives; amphetamines, or diuretics, are not appropriate and
can be dangerous to health.

Table. Lists Healthy Weight Ranges for Adults.

Height Weight (in Pounds)

4' 10" 91 - 119
4' 11" 94 - 124
5' 0" 97 - 128
5' I" 101 - 132
5' 2" 104 - 137
5' 3" 107 - 141
5' 4" 111 - 146
5' 5" 114 - 150
5' 6" 118 - 155
5' 7" 121- 160
5' 8" 125 - 164
5' 9" 129 - 169
5' 10" 132 - 174
5' II" 136 - 179
5' 0" 140 - 184
6' I" 144 - 189
6' 2" 148 - 195
6' 3" 152 - 200
 6' 4" 156 - 205
6' 5" 160 - 211
6' 6" 164 – 216

The higher values in the weight r:ange apply to people with more muscle and bone. Weights
above this range are less healthy for most people.

Choose a Diet Low in Fat, Saturated Fat and Cholesterol

As already stated, there is a need for people following a Western Diet to reduce the amount of fat,
saturated fat and cholesterol that they consume. Only about 25 percent of calories should come from fats,
and no more than 10 percent from saturated fats

Risk for heart disease is increased among people with elevated blood cholesterol levels. It is
important to get your blood cholesterol checked regularly. If blood cholesterol is above 5.2 mmol/L,
follow the advice of health professionals about diet and if necessary medication.

Fat, whether from plant or animal sources, contains more than twice the number of calories as an
equal amount of carbohydrate or protein. Each gram of fat contains 9 calories. Some foods and food
groups are higher in fat than others. This guideline emphasizes the continued importance of choosing a
diet with less total fat, saturated fat, and cholesterol.

Choose a Diet·with Plenty of Vegetables, Fruits and Grain Products

Foods that provide complex carbohydrates, dietary fibre, and other components are linked to
good health, mainly by lowering the fat content in the diet. This guideline is consistent with the scientific
evidence that supports the health benefits of diets with more complex carbohydrates and a variety of
fibre-rich foods. Most of the calories in your diet should come from grain products, fruits and
vegetables.These include bread, cereals, pasta, rice and potatoes. Dry beans are included in the meat
group but can also count as servings of vegetables. Plant foods are generally low in fats, depending on
how they are prepared and what is added to them. Fibre is found only in plant foods. Eating a variety of
fibre-containing foods is important for proper bowel function and can reduce the risk of chronic
constipation, diverticular disease, heart disease and some cancers.

Use Sugars in Moderation

Sugars include all simple carbohydrates, such as sucrose, glucose and lactose, and foods
containing them such as candies, honey, and chocolate.

Sugars and foods containing them in large amounts supply energy but are limited in nutrients.
Furthermore, sugars and starches, which break down in the mouth, can contribute to tooth decay. The
importance of fluoride and dental hygiene in the prevention of tooth decay is also stressed.

Sugar substitutes do not provide significant calories and may be used to reduce calorie intake.
However, foods containing sugar substitutes may not always be lower in calories than similar products
that do contain sugar. Unless you reduce the total calories you eat, the use of sugar substitutes will not
cause you to lose weight.

Use Salt and Sodium in Moderation

Sodium plays an essential role in regulating fluids and blood pressure. However many studies
have shown that a high sodium intake is associated with high blood pressure. Eating foods high in
potassium helps to counter the effects of high sodium consumption on blood pressure.

Using less salt and sodium than is normally used will benefit those people whose blood pressure
goes up with salt intake. Hereditary factors as well as excessive drinking have also been shown to be
related to high blood pressure. Adults are encouraged to get their blood pressure checked and, if it is high,
to consult a physician about diet.

It is easy to reduce sodium intake by using less salt in cooking and on the table, but when eating
processed foods it is important to look on the label for sodium substances, as these are used excessively in
many types of sauces and condiments.
If You Drink Alcoholic Beverages, Do So in Moderation:
Alcohol has no net benefit to health and is not an essential nutrient in any way. If you can not
avoid drinking, do so in moderation. One or two drinks per day are not usually associated with health
risks.

Inflammation of the pancreas and damage to the heart and brain are some of the complications of
drinking. Studies have shown that alcohol is linked to risks of heart attacks, hypertension, haemorrhagic
stroke, cirrhosis of the liver, inflammation of the pancreas, violence, suicide, birth defects and overall
mortality.

Table. A Comparison of Recent Government Dietary

Recommendations for Some Nutrients

Surgeon General's Report on Nutrition

National Research Council's Diet and Health.
and Health.
Fat and cholesterol
Reduce total fat intake to 30% or less.
Reduce consumption of fat
Reduce saturated fatty acid intake to less than 10% of total
(especially saturated fat) and cholesterol.
calories, and intake of cholesterol to less than 300mg daily.
Energy and weight control
Achieve and maintain a desirable
body weight. To do so, choose a diet in
Balance food intake and physical activity to
which caloric intake is consistent with
maintain appropriate body weight.
energy expenditure. Complex carbohydrate
and fibre
Everyday eat five or more servings of a
Increase consumption of whole combination of vegetables and fruits, especially green and
grain foods and cereal products, vegetables yellow vegetables and citrus fruits. Increase intake of
(including dried beans and peas), and starches and other complex carbohydrates by eating six or
fruits. more daily servings of a combination of breads, cereals,
and legumes.
Sodium
Reduce intake of sodium by choosing
Limit total daily intake of salt ot 6gm or less. Limit salt in
foods low in sodium and limiting the
cooking and avoid adding it to foods at the table.
amount of salt added in food preparation
and at the table.
Calcium
Adolescent girls and adult women should
increase consumption of foods high in Maintain adequate calcium intake.
calcium, including low-fat dairy products.

Calorie Requirements
In additibn to requiring a certain amount of nutrients, your body also requires a certain amount of
calories daily. Total energy expenditure includes the energy expended in rest, in physical activity, and as
a result of thermogenisis. These components, in tum, are affected by several variables, including age, sex,
body size and composition, genetic factors, energy intake, physiologic state (eg. growth, pregnancy,
lactation), coexisting pathological conditions, and ambient temperature.

Table. Daily Calorie Allowance.

• Resting Metabolic Rate represents the minimum energy needs of the body, for day and night with no
exercise or exposure to cold.
• Sedentary includes occupations that involve sitting most of the day, such as office work and studying.
• Light includes activities which involve standing most of the day, such as teaching or laboratory work.
• Moderate may include walking, gardening, and housework.
• Active includes dancing, skating, and manual labour such as farm or construction work. ,

Using the chart you can determine the amount of calories you require daily, depending on your
activity level. For example a 130 pound male waiter requires 2730 calories. (Moderate activity level 21 x
130 lb = 2730 Cal.)

The following table indicates the approximate number of calories used

by the body during a half-hour of the activity.

Table. Energy Expenditure

ACTIVITY ENERGY(Kcal per 12 hours)

Badminton 220
Basketball 400
Cleaning 95
Cooking, active 110
Cycling, morderate 150
Disco 250
Driving 75
Gardening 150
Golf 170
Jogging 300
Marathon running 495
Sitting 45
Skiing (Nordic) 540
Sleeping 30
Squash 325
Studying 50
Swimming 300
Tennis 250
Walking 160
Watching Television 45

Metabolism
The person who can eat and eat and never gain a pound probably does not exist, according to a
recent US Department of Agriculture study. The study should help resolve two conflicting schools of
thought on whether a person's metabolism automatically gears up to prevent weight gain when eating
extra calories day after day. The findings show very little change in metabolism.
 For three weeks, seven men consumed 1000 kcal more each day than they would normally eat.
All of them gained weight, on average a A ¼ lb per day.

After the men stopped overeating, they dropped weight rapidly, even though they were told not to
diet. They unconsciously chose fewer calories than they would normally eat, primarily by avoiding high-
fat foods.

This supports the hypothesis that successful body weight regulation might be associated with
body fat and carbohydrate levels rather than by a single factor such as total energy level. The men had
plenty of fat reserves, so they selected less fat. While it's not uncommon for a persons' caloric intake to
vary 1000 kcal from day to day, it's not easy to eat an extra 1000 kcal day after day. The men consumed
all the extra food they were given.

A greater potential for error lies in incorrectly estimating the number of calories needed to
maintain weight. It is very difficult to make an accurate estimate. If researchers underestimate, then some
of the "extra" calories they feed the Subjects are not really extra, and the subject does not gain weight.

References:

Nutritional Guidelines for Filipinos: a prescription to good nutrition;

https://www.fnri.dost.gov.ph/index.php/publications/writers-pool-corner/57-food-and-nutrition/204-
nutritional-guidelines-for-filipinos-a-prescription-to-good-nutrition

Don Ross; Regd. Off. 267-B, IO-B, Scheme, Opp. Narayan Niwas,
Gopalpura By Pass Road, Jaipur - 302018 Rajasthan (India) Ph: 0141 - 2594705, Telefax: 2597527; Food
and Nutrition.

Module 1

Appendix 4.1

Eating a Balance Diet

Eating a balanced diet means eating a wide variety of foods. A traditional way of getting a
balanced diet has been to eat a certain number of portions from certain food groups, as defined by the US
Department of Agriculture.

The five basic groups are vegetables; fruit; bread and cereal; dairy; and meat, poultry, fish, and
legumes (dry beans, lentils and peas).

It's recommended that you have four servings from the fruit and vegetable group, and should
include one good source of vitamin C each day, such as citrus fruit, and a good source of vitamin A,
usually deepyellow or dark-green vegetables. From the bread and cereals group, it is recommended that
you get six basic servings including some whole-grain bread or cereals.
 The recommended servings from the milk and cheese group vary with age, the highest
recommendations for teens and nursing mothers (four servings). Two basic servings from the meat,
poultry, fish and bean group are recommended. Then there's the sixth group: fats, sweets, and alcohol. It's
a group you want to avoid getting too many servings from. Foods in this group have plenty of calories
and not a fair balance of other nutrients.

Eggs, as a protein source, are included in the same group as meat, poultry, fish and beans. One
egg is considered a serving in that group. So if you eat two eggs for breakfast you have obtained your
recommendations from the protein group and should have no more egg, meat, poultry or fish that day.

Table Daily Food Choices

The Importance of Diet to Health

The importance of diet to health, especially in the prevention and cure of illness, is slowly
becoming apparent. We endeavor to provide you with more than the basic, and usually inaccurate
information on diet and nutrition. So whether you are a registered dietitian and want to brush up on the
immense amount of information, or whether you just want to find out, for the first time what you should
be eating. This topic is as arguable as religion, politics and sex. There are always many different opinions
relating to diet and nutrition.
 Module 1

Appendix 5.1

Planning Your Diet

The fact that more than 20% of the United States adult population is obese presents a major
public health concern. However, the failure to follow through and maintain weight loss on their own, after
termination of counselling, makes the long-term success of weight loss programs difficult to achieve.
Health professionals often assume that patients will dutifully comply with recommendations
simply because they are urged to do so. The magnitude of noncompliance has been well documented.
Adherence to dietary programs is thought to be poorer than to medication regimens. Dietary regimens are
often restrictive, require changes in life-style and behaviours, interfere with family habits and customs,
and are of long duration.
Weight control methods are considered a success if weight loss is maintained without expense to
overall health. A goal of any successful weight reduction programme is to promote permanent life-style
changes. The physical and psychological consequences of repeated weight fluctuations may be more
harmful than maintaining some degree of overweight.
 The ultimate goal of all weight loss programs is to reduce nutritional risk factors associated with
chronic diseases by increasing consumer awareness of healthy food choices.
In 1992 over 49 million people were dieting. The National Council Against Fraud estimates that
quackery costs consumers between $25 billion and $50 billion a year - and nutrition fraud is the most
common type.
Therefore to identify a quality weight loss programme, and not to be misled by a "fad diet", the
following indicators must be considered:
• A variety of foods. Weight control programs should be individualized to fit people's life-styles and food
preferences. Individualization diminishes feelings of deprivation, which lead to discouragement,
bingeing, and rebound weight gain – all hallmarks of the yo-yo diet syndrome.
• Enough calories to maintain good health. Consuming less than 1200 kcal a day may result in loss of
muscle instead of fat and may compromise nutritional status as a result of deficient nutrient intakes.
• Realistic weight loss goals. To lose body fat and not just water, a maximum weight loss of 2 pounds per
week is advised.
• Regular exercise. Especially as we age, exercise can be the key to weight loss and maintenance of a
desirable weight.
• Behaviour modification. Registered dietitians counsel people to keep lost weight off by helping them
alter their eating behavior and responses to foods for the rest of their lives.
Unfortunately, a current trend toward the view that a single food is either a panacea or a poison is
being gradually adopted by major health associations. This "good foodlbad food" dichotomy ignores the
consensus among nutritionists that all foods can be compatible with health when used in moderation as
part of a balanced, varied diet.
Over the past decade people have become obsessed with the nutritional value of the food they eat.
Time and again, nutrition ranks high among consumer concerns, along with food safety, convenience,
quality, and value. In the United States sales in the "healthy foods" category accounted for $65 billion in
1985, but are expected to reach $98 billion by 1995.
Consumers are asking for specific information about which foods and, in particular, which brands
of packaged foods to choose from when they eat or purchase foods. For example the broad guideline to
avoid to much fat, saturated fat and cholesterol require specific behavior implementations that include:
• Eat more fresh fruits and vegetables, whole grain breads and cereals, potatoes, rice noodles, dried beans,
peas, and lentils.
• Choose low fat dairy products, including skim, 1%, and 2% milk, low-fat cheeses, and low-fat yogurt.
• Choose lean meats, fish, chicken and turkey.
Very Low Calorie Weight Loss Diets (VLCD)
It is the position of the American Dietetic Association that while VLCD's promote rapid weight
loss and may be beneficial for certain individuals, such diets have health risks and should be undertaken
only with the supervision of a multidisciplinary health team with monitoring by a physician and nutrition
counselling by a registered dietitian. Side effects that have been associated with VLCD's are cold
intolerance, fatigue, . light-headedness, nervpusness, euphoria, constipation or diarrhoea, dry skin,
thinning of hair, anaemia, and menstrual irregularities.\

Low Body Weight and Weight Loss

Excessive concern about weight may cause or lead to such unhealthy behaviors as excessive
exercise, self-induced vomiting, and the abuse of laxatives or other medications. These practices may
only worsen the concern about weight. Excessive exercise may also affect hormone production, increase
the loss of calcium from the bones, and increase the risk of fractures.
Low body weight and rapid unintentional weight loss are highly predictive of mortality,
especially in the elderly population. Weight loss is frequently reported in elderly patients.
 Acute and chronic diseases are leading causes of involuntary weight loss. Whereas physical
disease probably accounts for a majority of cases of involuntary weight loss, psychiatric disorders such as
dementia and depression also may result in severe nutritional deficiencies.
Energy requirements decrease because of the lower basal metabolic rate and reduced physical
activity. These low energy requirements make it more difficult for the elderly to obtain adequate amounts
of required nutrients. Health care professionals must monitor body weight in elderly persons and carefully
evaluate any cases of rapid, unintentional weight loss to prevent further deterioration of health status.
Weight loss generally consists of both lean body mass and body fat.Contributions of lean body
mass and fat to total weight loss is a function of body fat content. Excessive loss of lean body mass will
result in skeletal and cardiac muscle wasting and loss of visceral protein. Because lean body mass
declines with age, elderly individuals who are at average or slightly above average weight may be better
able to tolerate weight loss that occurs with aging or disease than underweight individuals.
It has been well documented that physical disease can lead to weight loss. Disease may limit
dietary intake or may alter physiological processes, resulting in decreased nutrient digestion or
absorption, increased nutrient excretion, or increased nutrient requirements.
Cancer is the most frequently cited cause of involuntary weight loss, and weight loss may occur
during early stages of tumour growth before other symptoms emerge. The anorexia of malignancy has
been related to taste alterations; changes in gastrointestinal tract contraction and secretion; metabolic
disturbances resulting in changes of circulating glucose, amino acid, fatty acid, or lactic acid levels;
changes in hypothalamic function; and weakness leading to decreased motor activity.
In addition to cancer, gastrointestinal disease, uncontrolled diabetes, and cardiovascular disorders
such as congestive heart failure, alcohol abuse, pulmonary disease, and infection are major causes of
involuntary weight loss. Less common, but still a cause of notable weight loss, is hyperthyroidism.
Specific nutrient deficiencies and low nutrient intakes, which may contribute to weight loss, have
been documented in patients with dementia. Deficiencies of folate, thiamin, niacin, riboflavin, and
vitamin BI2 and electrolyte imbalance may impair cognitive function and mimic dementia.
Some nutrient deficiencies that alter mental status may be present in the elderly population.
Altered mental states attributable to nutrient deficiencies and weight loss can be corrected. Several studies
have shown that folate deficiency leads to confusion and signs of dementia in elderly individuals, but can
be reversed with appropriate supplementation. If confusion and dementia caused by nutrient deficiencies
are not diagnosed and corrected, they may lead to even lower nutrient intakes and more severe alterations
in mental status.

14 Simple Ways to Stick to a Healthy Diet

Eating healthy can help you lose weight and have more energy. It can also improve your mood
and reduce your risk of disease. Yet despite these benefits, maintaining a healthy diet and lifestyle can be
challenging.

Here are 14 ways to stick to a healthy diet.

1. Start with realistic expectations

Eating a nutritious diet has many benefits, including potential weight loss. However, it’s
important to set realistic expectations.
For example, if you pressure yourself to lose weight too quickly, your plan to achieve better
health may backfire.
Researchers found that obese people who expected to lose a lot of weight were more likely to
drop out of a weight loss program within 6–12 months .
Setting a more realistic and achievable goal can keep you from getting discouraged and may even
lead to greater weight loss.
 2. Think about what really motivates you
Remembering why you’re making healthy choices can help you stay on course. Making a list of
specific reasons why you want to get healthier can be helpful. Keep this list handy and refer to it when
you feel you need a reminder.

3. Keep unhealthy foods out of the house

It’s difficult to eat healthy if you’re surrounded by junk foods. If other family members want to have
these foods around, try keeping them hidden rather than on countertops. The saying out of sight, out of
mind definitely applies here. Having food on display in various areas of the house has been linked to
obesity and increased consumption of unhealthy foods .

4. Don’t have an ‘all or nothing’ approach

A major roadblock to achieving a healthy diet and lifestyle is black-and-white thinking. One common
scenario is that you have a few unhealthy appetizers at a party, decide that your diet is ruined for the day,
and proceed to overindulge in unhealthy foods. Instead of considering the day ruined, try putting the past
behind you and choosing healthy, unprocessed foods that contain protein for the remainder of the party.
This will help you feel full and satisfied rather than stuffed and frustrated. A few off-plan choices make
very little difference in the long run, as long as you balance them with healthy foods.

5. Carry healthy snacks

Sticking to a healthy diet can be tough when you’re away from home for extended periods. When you
get too hungry on the go, you may end up grabbing whatever is available. This is often processed food
that doesn’t really satisfy hunger and isn’t good for you in the long run. Having healthy high-protein
snacks on hand can help keep your appetite in check until you’re able to have a full meal. Some examples
of good, portable snacks are almonds, peanuts, and jerky. Also consider filling a small cooler with hard
boiled eggs, cheese, or Greek yogurt.

6. Exercise and change diet at the same time

You may have heard you shouldn’t change too many things at once when trying to improve your
health. In general, this is good advice. Still, research shows that when you make both dietary and physical
activity changes at the same time, the results tend to reinforce each other. In a study in 200 people, those
who began eating a healthy diet and exercising at the same time found it easier to maintain these
behaviors than those who started with either diet or exercise alone, then added the other later.

7. Have a game plan before eating out

Trying to maintain a healthy diet while eating out can be very challenging. Still, there are ways to
make it easier, such as checking out the menu before you go or drinking water before and during the
meal. It’s best to have a strategy in place before you get to the restaurant rather than being overwhelmed
once you get there. Here are 20 clever tips to eat healthy when eating out.

8. Don’t let traveling derail you

Whether you’re traveling for business or pleasure, being outside of your familiar territory can make it
difficult to stick to a healthy lifestyle. Here are a few tips:
 Research the restaurants and supermarkets ahead of time.
 Pack some healthy foods that don’t spoil easily.
 Challenge yourself to stay on track for most of the trip.

9. Practice mindful eating

Eating mindfully can help you maintain a healthy lifestyle. Take time to enjoy your food and
appreciate its ability to nourish you. This increases your chances of making successful, lasting behavioral
changes. In a four-month study, overweight and obese women who practiced mindful eating significantly
 improved their relationship with food . Another 6-week study in women with binge eating disorder found
that binge episodes decreased from 4 to 1.5 per week when the women practiced mindful eating. Plus, the
severity of each binge decreased.

10. Track and monitor your progress

Logging the foods you eat into a diary, online food tracker, or app can help you stick to a healthy diet
and lose weight. Measuring your exercise progress is also beneficial and provides you with motivation
that can help you keep going. In a three-month study, overweight women who were given pedometers
walked farther and lost six times more weight than those who didn’t use them.

11. Get a partner to join you

Sticking with a healthy eating and exercise plan can be tough to do on your own. Having a diet or
exercise buddy may be helpful, especially if that person is your partner or spouse. Researchers studying
data from over 3,000 couples found that when one person made a positive lifestyle change, such as
increasing physical activity, the other was more likely to follow their lead.

12. Start the day with a high-protein breakfast

If your first meal is well balanced and contains adequate protein, you’re more likely to maintain
stable blood sugar levels and not overeat for the rest of the day. In one study, overweight women who
consumed at least 30 grams of protein at breakfast felt more satisfied and ate fewer calories at lunch than
those who ate a lower-protein breakfast.

13. Realize that it takes time to change your habits

Don’t be discouraged if it takes longer than you expect to adapt to your new, healthy way of living.
Researchers have found that it takes an average of 66 days to make a new behavior a habit.
Eventually, eating healthy and exercising regularly will become automatic.

14. Figure out what works best for you

There is no perfect way that works for everyone. It’s important to find a way of eating and exercising
that you enjoy, find sustainable, and can stick to for the rest of your life. The best diet for you is the one
you can stick to in the long run.

Source:

14 Simple Ways to Stick to a Healthy Diet.

https://www.healthline.com/nutrition/14-ways-to-stick-to-a-diet

Appendix 5.2

Rubric for Discussion Paper

Excellent Good Average Needs improvement

5 pts 4 pts 3 pts 2 pts
Context and Relevant title.
structure Strong introduction with Most elements Some elements Many elements
thesis statement and context. achieved. achieved. missing.
Body has clear main points
with smooth and logical
transitions. Conclusion
emphasizes importance and
relevance of topic.
Knowledge
and Strong use of sources - Good use of sources Some use of Insufficient use of
argumentation including summary, and some sources and very sources and/or sources
 quotations, interpretation and argumentation. little or unclear misunderstood.
analysis. Argumentation. argumentation. Unclear or lacking
argumentation.
Vocabulary Wide and growing
and style vocabulary. Most elements Some elements Vocabulary in this
Variety of sentence types. achieved. achieved. paper is limited. There
are several instances
of incorrect word
choices. There is a
narrow range of
sentence variety.
Paragraphs
and Main ideas appropriately Good control. Paper has Use of paragraphs and
punctuation divided by paragraphs. examples of punctuation needs
Sentences divided by proper proper use of improvement.
punctuation. paragraphs and
punctuation.
Spelling and Good control. Paper Paper has several
grammar has some errors that errors that could Several sentences
Precise and consistent control. do not interfere with interfere with and/or ideas are
understanding. understanding or difficult to understand
affect readability. because of errors.

Score 0-1 2 3 4 5 6 7 8 9 10 11 12
Eqvln 76-77 78 79
65 66-67 68 69 70 71-72 73 74 75
t

Score 13 14 15 16 17 18 19 20 21 22 23 24 25
Eqvln
80 81-82 83 84 85 86-87 88 89 90 91 92-93 94 95
t

Module 1
Worksheet 1.1
Lesson 1
Nutrition Fads and Frauds

Name: __________________________________________ Course/Yr/Sec:______________________

Instructor: ______________________________________________

Instruction: Refer to Appendix 1.1 to answer what is ask below.

Answer the following qustions below. Refer to the rubric in Appendix 1.2.

1. Define nutrition fads in your own words.

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2. Define Nutrition Frauds in your own words.

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3. Give the Health Consequences of Frauds and state a brief description of each consequence.
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4. What are the economics consequences of Frauds and discuss each briefly.
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___________________________________________________________________________.

Module 1
Worksheet 3.1
Lesson 3
Guidelines for a Healthy Diet

Name: __________________________________________ Course/Yr/Sec:______________________

Instructor: ______________________________________________

Instruction: Refer to Appendix 3.1 to answer what is ask below.

Give the guidelines for a healthy diet and identify the result/effect of following these guidelines
to our body.

Guidelines Result/Effect
 Module 1
Worksheet 4.1
Lesson 4
Eating a Balance Diet

Name: __________________________________________ Course/Yr/Sec:______________________

Instructor: ______________________________________________

Instruction: Refer to Appendix 4.1 to answer what is ask below.

Except from the food that are given from the Appendix 4.1, give another examples of food that an
individual should eat per day based on food groups as defined by the US Department of Agriculture.
 Suggested Daily
Food Groups Food To Serve
Servings