INTRODUCTION TO

NUTRITION
At the end of the lesson, the students
should be able to:
1. Explain what constitutes a balanced
diet
2. Discuss on the Malaysian Dietary
Guidelines
3. Describe energy expenditure, its
components and the recommended
calorie intake
4. Understand macro- & micronutrients
and their differences
 Balanced Diet
The Malaysian Dietary Guidelines
(2010)
Energy Expenditure
Recommended Calorie Intake
Macronutrients
Micronutrients
 A diet that
contains
adequate
amounts of all
the necessary
nutrients
required for
healthy growth
and activity
 The Malaysian Dietary Guidelines (2010) is
a compilation of the latest science-based
nutrition and physical activity
recommendations prepared by the
Technical Working Group on Nutritional
Guidelines under the auspices of National
Coordinating Committee on Food and
Nutrition (NCCFN)
It contains 14 key messages, aiming at
providing advice on how to promote healthy
eating and practice an active lifestyle
14 KEY MESSAGES (Malaysian Dietary Guidelines 2010)
Key Message 1 : Eat a variety of foods within your recommended
intake

Key Message 2 : Maintain body weight in a healthy range

Key Message 3 : Be physically active everyday

Key Message 4 : Eat adequate amount of rice, other cereal products

(preferably whole grain) and tubers

Key Message 5 : Eat plenty of fruits and vegetables everyday

Key Message 6 : Consume moderate amounts of fish, meat, poultry,

egg, legumes and nuts
Key Message 7 : Consume adequate amounts of milk and milk
products
14 KEY MESSAGES (Malaysian Dietary Guidelines
2010)
Key Message 8 : Limit intake of foods high in fats and minimise fats
and oils in food preparation

Key Message 9 : Choose and prepare foods with less salt and sauces

Key Message 10 : Consume foods and beverages low in sugar

Key Message 11 : Drink plenty of water daily

Key Message 12 : Practice exclusive breastfeeding from birth until six

months and continue to breastfeed until two years of age

Key Message 13 : Consume safe and clean foods and beverages

Key Message 14 : Make effective use of nutrition information on food

labels
 1. Eat a variety of foods within your
recommended intake
Choose your daily food intake
from a combination of foods based on the
Malaysian Food Pyramid
according to the serving size recommended
Additional Recommendation:
Supplements are not necessary for most
individuals
May be needed to meet specific nutrient
requirements, eg in pregnant & lactating
mothers & for the elderly, on the advice of
nutritionists, dietitians or medical doctors
Malaysian Food Pyramid
Balanced Diet Guide
2. Maintain body weight in a healthy
range
Maintain body weight in the healthy range
by balancing calorie intake with physical
activity
Weigh yourself regularly, at least once a
week
If you are an adult, prevent gradual weight
gain over time
If overweight, aim for a slow & steady
weight loss
If underweight, increase energy intake as
recommended
 3. Be physically active everyday

Be active everyday in as many ways as you

can
Accumulate at least 30 minutes of moderate
intensity physical activity on at least 5-6
days/week, preferably daily
Participate in activities that increase
flexibility, strength & endurance of the
muscles, as frequent as 2-3 times/weeks
Limit physical inactivity & sedentary habits
 Additional Recommendations:
Special Groups (Part1)
Children & Adolescents
Toddlers should accumulate at least 30
min/day
Preschoolers should accumulate 60
min/day of structured physical activity
Additional 60 min to several hours/day of
unstructured physical activity
 Additional Recommendations:
Special Groups (Part II)
Pregnant Women
Healthy pregnant women who are not previously
active should engage in moderate intensity activity
for up to 30 min/day during pregnancy & during
postpartum period
For the habitually active, do stay active at
appropriate level
Muscle training especially for back, stomach &
pelvic floor strengthening is important for bearing
the weight of the baby
Activities at high risk of falling (eg riding) & contact
(basketball) should be avoided
 Additional Recommendations:
Special Groups (Part1II)
Overweight/Obese
To lose weight, it is recommended to:
a total of more than 30 min/day of moderate
intensity physical activity
40-60 min/day of moderate intensity activity to
prevent the transition from overweight to obesity
60-90 min/day of moderate intensity or lesser
amount of vigorous activity to control weight,
prevent weight gain or regain among formerly
obese individuals
 4. Eat adequate amount of rice, other
cereal products (preferably whole grain)
& tubers
Consume at least 4 servings of cereal foods
daily
Choose at least half of your grain products
from whole grains
Choose cereal products that are high in
fibre, low in fat, sugar & salt
 5. Eat plenty of fruits & vegetables
everyday
Eat a variety of fruits everyday
Eat a variety of vegetables everyday
Eat at least 5 servings of fruits & vegetables
everyday
 6. Consume moderate amounts of
fish, meat, poultry, eggs, legumes &
nuts
Consume fish more frequently, if possible
daily
Consume meat, poultry & egg moderately
Practise healthier cooking methods for fish,
meat, poultry & egg dishes
Choose meat & poultry that are low in fat &
cholesterol
Consume legumes daily
Include nuts & seeds in weekly diet
 7. Consume adequate amounts of
milk & milk products
Consume milk & milk products everyday
Replace sweetened condensed milk &
sweetened condensed filled milk with
unsweetened liquid or powdered milk
For individuals with lactose intolerance,
they can choose
lactose-free predigested milk
predigested milk products such as yoghurt
more calcium fortified or enriched milk
products to meet their calcium requirement
8. Limit intake of foods high in fats &
oils in food preparation
Limit the intake of unsaturated fats to less
than 10% of total daily calorie intake
Increase the intake of unsaturated fats
monounsaturated fatty acids (MUFA) &
polyunsaturated fatty acids (PUFA)
Limit the intake of foods with high
cholesterol
Limit foods containing trans fatty acids
(TFAs)
Minimise the use of fat in food preparation
to keep total daily fat intake between 20-
30% energy
 9. Choose and prepare foods with
less salt & sauces
Limit salt intake to one teaspoon/day
Reduce consumption of highly salted foods
& condiments
 Additional Recommendations:
Infants & Children
Breastfeed babies exclusively at least up to
6 months
After 6 months of age, mother can feed the
baby with homemade complementary foods
with no salt
Children should limit the intake of high
sodium snacks & fast foods
10. Consume foods & beverages low
in sugar
The title says it all
 11. Drink plenty of water daily
Drink 6 8 glasses of plain water daily
Maintain fluid intake from other food sources
Avoid alcoholic beverages
Additional recommendation:
Children (2-6 y.o.) require 4-6 glasses of plain
water since excessive intake of water may displace
intake of nutritious foods & milk
Lactating mothers need to increase water intake
up to at least 2 glasses daily
The elderly - Remind & encourage them to drink
sufficient plain water & continue intake of other fluid
sources eg fruits, vegies, juices & soups
12. Practice exclusive breastfeeding from
birth until 6m.o., continue until 2y.o.
Prepare for breastfeeding during pregnancy
Initiate breastfeeding within one hour of birth
Breastfeed frequently & on demand
Give only breast milk to baby below 6 months with
no additional fluid or food
Continue to give babies breast milk even if the
baby is not with the mother
Introduce complementary foods to baby beginning
at 6 months of age
Lactating mothers should get plenty of rest,
adequate food & drink to maintain health
Husbands & family members should provide full
support to lactating mothers
 Additional Recommendations:
Breastfeeding & babies of HIV+ mothers
In adherence to the Ministry of Healths
policy, infants born to HIV-positive mothers
are strictly NOT to be breastfed
HIV+ mothers should receive counselling
on infant feeding & guidance on safe &
appropriate use of infant formula
 Additional Recommendations:
Breastfeeding & working mothers
For successful lactation to continue after
the mothers return to work, supportive
workplace health-promotion policies are
required that provide/facilitate:
Frequent feeding
Frequent expression & storage of breast
milk
Mothers should be encouraged to think
positively & not to assume that
breastfeeding will not be possible when
they return to work
 13. Consume safe & clean foods &
beverages
Repeat the title above
Store foods appropriately
Prepare foods hygienically
Cook foods thoroughly
Hold foods appropriately
When eating out, choose safe and clean
premises
 14. Make effective use of nutrition
information on food labels
Use Nutrition Information Panel (NIP) as a
guide in making food choices
Make use of nutrition claims wisely
Educate children on the use of NIP
 By measuring energy expenditure, energy
requirements can be estimated
Food intake in excess of energy expenditure
leads to obesity
Food intake less than expenditure leads to
emaciation & wasting (marasmus &
kwashiorkor-will be discussed in later lesson)
Obesity & severe undernutrition are
associated with increased mortality
Body Mass Index (BMI) to measure/to
express relative obesity or adiposity
 BMI = Weight (kg)
Height (m)2

Score of 20-25 least risk of early death

Score higher than 27 or more indicates
obesity & increased risk of developing
health problems
Obesity is categorized into 3 grades:
Grade I : 25 29.9
Grade II : 30 40
Grade III : 40+
 ENERGY EXPENDITURE =

Basal Metabolic Rate (BMR)

+
Physical Activity
+
Energy Cost of Synthesizing Reserves
Basal Metabolic Rate (BMR)
Definition: The amount of energy used in 24
hours by a person who is lying quietly, 12 hours
after the last meal, in a comfortable temperature
and environment. (Expressed as: kcal/kg body
weight/hour)

BMR is influenced by:

Age decrease with increasing age (why?)
Weight increase with increasing weight
Gender higher in males than in females
(why?)
Level of physical activity increase with
higher
level of physical activity
Physical Activity
Energy cost of physical activities is
measured by multiplying with BMR
Sedentary activities:
1.1 1.2 x BMR
Vigorous activities:
6 8 x BMR
Energy Cost for Reserve
Formation
Metabolic rate increases after meal
(diet-induced thermogenesis)
10% of the energy yield of a meal is
expended in forming reserves:
A small part of this is the energy cost
of secreting digestive enzymes & of
active transport of the products of
digestion
The major part synthesizing
reserves of glycogen, triacylglycerol &
 What is calorie?
The recommendation is based on:
Gender
Physical activity
Weight status
 1500 kcal 2000 kcal 2500 kcal

Sedentary Children Teenage

women Teenage boys
Older adult girls Active men
Moderately Very active
active women
women Underweight
Sedentary men &
men women
Macro- & Micronutrients
Macro: Nutrients required by human in
large quantities which provide
calories. They are:
PROTEIN, FAT & CARBOHYDRATE

Micro: Nutrients required by human in

small quantities throughout life. They
are:
VITAMINS & MINERALS
Macronutrient: PROTEIN
Macronutrient: FATS

We have bad fat

foods, and we have
good fat foods
also
Macronutrient:
CARBOHYDRATE
Micronutrient: VITAMINS
Organic compounds vital for specific
metabolic reactions that cannot be
synthesized by human tissue cells
from simple metabolites
Two classes of vitamins:
1. Water soluble Vitamin B, C
2. Fat soluble Vitamin A, D, E & K
Vitamins
Micronutrient: MINERALS
MINERALS

MACROminerals
-required at 100 MICROminerals aka
mg/day TRACE minerals
- required at small amount

M
Ca P Fe Zn Cu I
g

Na Cl K Mn Fl Mb Co

S Se Cr Ni V

Al Si
Main References
Krauses Food, Nutrition & Diet
Therapy 9th Ed (1999)
Malaysian Dietary Guidelines
URL:
http://dg.cnsoc.org/upload/affix/20140818104029708.pdf
 ASSIGNMENT
Create a PERSONAL PORTFOLIO by including:

Your full picture

Your biodata (please include your BMI)
Your perception of your physique
If you feel dissatisfied with your physique, what is/are
your plan(s) for improvement
3-day food diary at home & 3-day food diary at campus
Describe your dietary habits and compare your diet at
home and at campus, mention if you are taking any
supplements or not; if you do, elaborate on that

PLEASE SUBMIT YOUR handwritten PORTFOLIO BY

17 Nov 2014
Food Diary : Example #1
Food Diary: Example #2
MEAL DAY/DATE DAY/DATE DAY/DATE
Breakfast TIME: TIME: TIME:

Morning Snack TIME: TIME: TIME:

Lunch TIME: TIME: TIME:

Afternoon Snack TIME: TIME: TIME:

Dinner TIME: TIME: TIME:

Supper TIME: TIME: TIME: