FEM 3202 NUTRITION, HEALTH AND ENVIRONMENT GROUP 1 1ST SEMESTER 2012/2013 LAB 1: DIETARY INTAKE METHODOLOGY LECTURES

NAME: DR. NORHASMAH SULAIMAN DEMONSTRATOR: MISS TATIANA SUHAIMI

STUDENT NAME MATRIX NO. JESSICA JENAI ANAK 156179 CHAONG NUR KADIR SHUHAILY ISMAIL ELIANA BT. NABILAH BT. 156377 ABD. 157003

Introduction: Nutritional status of individuals can be evaluated by 5 different methods: 1) Anthropometric is the measurement of body height, weight and proportions. It is an essential component of clinical examination of infants, children and pregnant women. It is used to evaluate both under and over nutrition. The measured values reflects the current nutritional and do not differentiate between acute and chronic changes. 2) Biochemical is a measurement of individual nutrient in body fluids (e.g. serum retinol, serum iron, urinary iodine, vitamin D). It can detect of abnormal amount of metabolites in the urine (e.g. urinary creatinine/hydroxyproline ratio). Biochemical also analysis of hair, nails and skin for micro-nutrients. 3) Clinical it is the simplest and most practical method of ascertaining the nutritional status of a group of individuals. It utilizes a number of physical signs, (specific and non specific), that are known to be associated with malnutrition and deficiency of vitamins and micronutrients. General clinical examination, with special attention to organs like hair, angles of the mouth, gums, nails, skin, eyes, tongue, muscles, bones, and thyroid gland. Detection of relevant signs by clinical method helps in establishing the nutritional diagnosis. 4) Dietary nutrition status can be measured by nutritional intake of humans is assessed by five different methods such as 24 hours dietary recall, food frequency questionnaire, dietary history since early life, food dairy technique, observed food consumption 5) Epidemiology is the science concerned with the study of the factors determining and influencing the frequency and distribution of disease, injury, and other health-related events and their causes in a defined human population. Also, the sum of knowledge gained in such a study. Based on this evaluation, nutritional status of the human can be classified as over nutrition, desirable nutrition, under nutrition and body deficiency. Objective

To learn dietary intake methods (i.e. 24 Hour Dietary Recall, Food Frequency (Questionnaire and Food Weighing) Methodology 3 dietary methods will be use in this lab: A) 24 Hours Dietary Recall i. Interview your friend about his/her food intake 24 hours ago (yesterday). (Note: student should choose any day except weekends and public holidays. B) Food Frequency Questionnaire (FFQ) i. Interview your friends about their food intake using FFQ table in Appendix 2 (Each group identify 15 respondents) C) Food Record / Food Weighing i. Record your food intake for lunch in Appendix 3. ii. Calculate the energy provided from your food intake in lunch meals based on this formula: 1g Carbohydrate = 4 kcal 1g Protein = 4 kcal 1g Lipid = 9 kcal Assumptions: a. Rice/cereal/ bread/rice noodle sources of carbohydrates. b. Fish/chicken/ egg/ meat/sea food sources of protein c. Oil/margarine sources of fat Example: fried chicken contain 10 g oil (1 tablespoon)

RESULT B FREQUENCY OF FOOD THAT RICH IN CARCOHYDRATE BEEN CONSUMED (%) TYPE OF FREQUENCY (TIMES/WEEK) (%) 6-7 4-5 2-3 1 1-3 NEVER FOOD (MONTH) Rice 12 (80) 3 (20) Rice noodles 1 (6.7) 5 (33.3) 5 (33.3) 2 (13.3) 2 (13.3) Noodles 1 (6.7) 8 (53.3) 2 (13.3) 2 (13.3) 2 (13.3) Bread 2 (13.3) 6 (40) 4 (26.7) 3 (20) Biscuits 4 (26.7) 6 (40) 4 (26.7) 1 (6.7) Flour 1 (6.7) 2 (13.3) 8 (53.3) 2 (13.3) 2 (13.3) Potatoes 5 (33.3) 5 (33.3) 4 (26.7) 1 (6.7) Sweet 5 (33.3) 2 (13.3) 5 (33.3) 3 (20) Potatoes Oat 4 (26.7) 1 (6.7) 4 (26.7) 5 (33.3) 1 (6.7) Roti canai 2 (13.3) 7 (46.7) 5 (33.3) 1 (6.7) FREQUENCY OF FOOD THAT RICH IN PROTIEN BEEN CONSUMED (%) TYPE OF FREQUENCY (TIMES/WEEK) (%) 6-7 4-5 2-3 1 1-3 FOOD (MONTH) Eggs 4 (26.7) 6 (40) 3 (20) 2 (13.3) Soy 1 (6.7) 2 (13.3) 3 (20) 6 (40) Prawn 3 (20) 3 (20) 4 (26.7) Cuttlefish 4 (26.7) 4 (26.7) 1 (6.7) 6 (40) Fish 1 (6.7) 5 (33.3) 4 (26.7) 2 (13.3) 3 (20) Chicken 6 (40) 7 (46.7) 2 (13.3) Meat 1 (6.7) 3 (20) 6 (40) 3 (20) Anchovy 2 (13.3) 4 (26.7) 3 (20) 2 (13.3) Salted fish 2 (13.3) 1 (6.7) 2 (13.3) 6 (60) Sardine 1 (6.7) 4 (26.7) 5 (33.3) 4 (26.7) Condensed milk 1 (6.7) 1 (6.7) 3 (20) 1 (6.7) 4 (26.7) Full cream milk 3 (20) 1 (6.7) 1 (6.7) 1 (6.7) 4 (26.7) Fresh milk 3 (20) 2 (13.3) 1 (6.7) 5 (33.3)

NEVER

3 (20) 2 (13.3)

2 (13.3) 4 (26.7) 4 (26.7) 1 (6.7) 5 (33.3) 5 (33.3) 4 (26.7)

FREQUENCY OF FOOD THAT RICH IN LIPID BEEN CONSUMED (%)

TYPE OF FOOD Butter Oil Coconut milk

6-7

6 (40) 6 (40)

FREQUENCY (TIMES/WEEK) (%) 4-5 2-3 1 1-3 (MONTH) 2 (13.3) 2 (13.3) 2 (13.3) 5 (33.3) 1 (6.7) 2 (13.3) 3 (20) 3 (20) 1 (6.7) 2 (13.3) 3 (20) 3(20)

NEVER 4 (26.7)

FREQUENCY OF FOOD THAT RICH IN VITAMIN BEEN CONSUMED (%) TYPE OF FREQUENCY (TIMES/WEEK) (%) 6-7 4-5 2-3 1 1-3 FOOD (MONTH) Guava 1 (6.7) 5 (33.3) 7 (46.7) Papaya 1 (6.7) 2 (13.3) 4 (26.7) 7 (46.7) Banana 1 (6.7) 1 (6.7) 6 (40) 6 (40) Orange 1 (6.7) 2 (13.3) 2 (13.3) 8 (53.3) 1 (6.7) Pineapple 7 (46.7) 7 (46.7) Watermelon 1 (6.7) 1 (6.7) 2 (13.3) 6 (40) 3 (20) FREQUENCY OF FOOD THAT RICH IN MINERAL BEEN CONSUMED (%) TYPE OF FREQUENCY (TIMES/WEEK) (%) 6-7 4-5 2-3 1 1-3 FOOD (MONTH) Nuts 3 (20) 5 (33.3) 1 (6.7) 5 (33.3) Soy 2 (13.3) 2 (13.3) 3 (20) 5 (33.3) Seafood 2 (13.3) 5 (33.3) 4 (26.7) 2 (13.3) 2 (13.3) Carrot 3 (20) 2 (13.3) 3 (20) 2 (13.3) 3 (20) Spinach 2 (13.3) 3(20) 3 (20) 6 (40) Chilies 5 (33.3) 3 (20) 2 (13.3) 1 (6.7) 4 (26.7) Kangkung 1 (6.7) 1 (6.7) 4 (26.7) 4 (26.7) 4 (26.7) Long bean 1 (6.7) 4 (26.7) 4 (26.7) 4 (26.7) French bean 3 (20) 2 (13.3) 5 (33.3) Ladys finger 1 (6.7) 4 (26.7) 5 (33.5) Cucumber 3 (20) 4 (26.7) 3 (20) 2 (13.3)

NEVER 2 (13.3) 1 (6.7) 1 (6.7) 1 (6.7) 1 (6.7) 2 (13.3)

NEVER 1 (6.7) 3 (20) 2 (13.3) 2 (40) 1 (6.7) 1 (6.7) 3 (20) 5 (33.3) 5 (33.3) 3 (20)

FREQUENCY OF WATER BEEN CONSUMED (%) TYPE OF FREQUENCY (TIMES/WEEK) (%) 6-7 4-5 2-3 1 1-3 FOOD

NEVER

Plain water Tea Coffee Milo Syrup Fruit Juice Soft drink

13 (86.7) 3 (20) 1 (6.7) 2 (13.3) 2 (13.3) 4 (26.7)

1 (6.7) 4 (26.7) 4 (26.7) 8 (53.3) 6 (40) 4 (26.7) 2 (13.3)

4 (26.7) 1 (6.7) 1 (6.7) 2 (13.3) 3 (13.3) 2 (13.3)

3 (20) 6 (40) 5 (33.3) 4 (26.7) 4 (26.7) 3 (20)

(MONTH) 1 (6.7) 1 (6.7) 2 (13.3) 1 (6.7) 2 (13.3) 4 (26.7)

RESULT C (Appendix 3) Name Body weight (kg) Height (cm) Age Sex Date/day : : : : : : Jessica Jenai Anak Chaong 91.6 kg 167 cm 22 Female 20 September 2012/Thursday

C. Food Record Form Meal time Lunch Place Makmal Kesihatan Pengguna Food Rice Ikan Kembung Goreng Terung Goreng Bersambal Food Quantity Food (Household Quantity Measurement) (g) 187.6 101.9 78.9 Residue Quantity (g) 11.3 40.5 18.3 Edible Portion (g) 176.3 61.4 3.386

Edible portion for Terung Goreng Bersambal, 78.9g 18.3g = 60.6g, EP = 60.6 x 4.8 86 = 3.386g RESULT TYPE OF FOOD Carbohydrate Rice

EDIBLE PORTION (g) 176.3

KILOCALORIES (kcal) 176.3 x 4 = 705.20

Brinjal Protein Fried Fish Lipid Cooking Oil TOTAL

3.386 61.4 40.0

3.386 x 4 = 13.54 61.4 x 4 = 245.60 40.0 x 9 = 360.0 1324.34

Name Body weight (kg) Height (cm) Age Sex Date/day

: : : : : :

Nur Nabilah Binti Abd Kadir 39 kg 151.2 cm 21 Female 20 September 2012/Thursday

C. Food Record Form Meal time Lunch Place Makmal Kesihatan Pengguna Food Quantity Food (Household Quantity Measurement) (g) Rice 230.0 Kari Ikan 233.8 Tongkol Sup Sayur 219.4 Campur Food Residue Quantity (g) 114.5 193.2 190.2 Edible Portion (g) 115.5 40.6 29.2

Edible portion for Mustard, 219.4g 190.2g = 29.2g, EP = 29.2 3.6 100 = 1.0512g

RESULT TYPE OF FOOD Carbohydrate Rice Mustard

EDIBLE PORTION (g) 115.5 1.05

KILOCALORIES (kcal) 115.5 x 4 = 462 1.05 x 4 = 4.2

Protein Kari Ikan Tongkol Lipid Cooking Oil TOTAL

40.6 60.0

40.6 x 4 = 162.4 60.0 x 9 = 540.0 1168.6

Name Body weight (kg) Height (cm) Age Sex Date/day

: : : : : :

Shuhaily Eliana Binti Ismail 44.6 kg 157 cm 22 Female 20 September 2012/Thursday

C. Food Record Form Meal time Lunch Place Makmal Kesihatan Pengguna Food Rice Ayam paprik Sayur sawi putih masak air Food Quantity Food (Household Quantity Measurement) (g) 160.8 330.1 112.0 Residue Quantity (g) 44.5 124.1 79.5 Edible Portion (g) 116.3 206 32.5

Edible portion for sayur sawi masak air 112.0g - 79.5g = 32.5 EP = 32.5g x 4 100g = 1.3g

RESULT TYPE OF FOOD Carbohydrate Rice Mustard

EDIBLE PORTION (g) 116.3 1.3

KILOCALORIES (kcal) 116.3 x 4 = 465.2 1.3 x 4 = 5.2

Protein chicken Lipid Cooking Oil TOTAL

206 10.0

206 x 4 = 824 10.0 x 9 = 90 1384.4

DISCUSSION There are three method that have been used which are 24 hours dietary recall, food frequency questionnaire and food record (food weighing). These methods have their own advantages and disadvantages. 24 hours dietary recall is a method where we need to list all the foods of a person consumed within the previous 24 hours or quantifying dietary intake for a group average and is not suited for individual dietary characterization although it is often used for this purpose. It will be started from the food that respondent take in the previous morning. A person's previous 24hour food intake is probed by an interviewer to provide detailed descriptions of portion sizes, condiments used, cooking method, and brand names. Quantities are often estimated in household measures or using food models for assistance to more accurately quantify intake. The advantage of the 24-hour recall is inexpensive, quick, and places little burden on the patient. Single 24-hour recalls do not provide sufficient information on nutrient intakes and cannot account for day to day variation in intake, however, repeated 24 hour recalls can be used to more precisely estimate intake. According to Erica Odom (2000), the advantages of 24 hour recall include precision and, when multiple days assessed, validity. The disadvantages include cost and administration time, the need to obtain multiple recalls to reliably estimate usual intake; participant burden; and literacy demands in the estimation of portion size. Food frequency questionnaire (FFQ) is the dietary measure which provides qualitative data regarding food consumption patterns rather than nutrient composition and intake. We can assess to the frequency at which certain foods are consumed, for example daily, weekly and monthly. The food item that have been asked must be used reasonably often by an appreciate number of individuals, a substantial content of the nutrients interest and the use of the food must vary from person to person. The advantages by using FFQ is easy for respondents to complete,

quick, inexpensive and can be administered by respondent themselves. Based on Johnson (2002), quick screening questionnaires have been developed to identify people with high-fat and lowfiber/fruit/vegetable intake. These questionnaires could be used to identify patients with dietary patterns associated with successful weight loss and weight maintenance. Unfortunately, this method cannot provide an adequate quantitative data to use for individuals. The researcher cannot find the additional information because the questionnaire restrict imposed by a fixed list of foods. Then, the respondent answered the questionnaire dependent on their memory. Other than that, FFQ does not provide valid estimates of absolute intake of individuals food. It also cant assess meal patterning of respondent. Food record or food weighing is a method where assessing the current intake of food. Thus, the respondent does not rely on memory during the session. The amounts of food consumed are actually weighed and recorded so more accurate measurements of actual intake than calculations based on food composition tables can be obtained. Weighed intakes may be used as the comparison method with other dietary methods. The disadvantage of this method, however, is that it is costly in both time and money, and requires highly motivated subjects with high levels of literacy. Food record method is useful for the assessment of intake of a variety of nutrients and assessment of meal patterning and food group intake.

RECOMMENDATION After we complete the food Frequency Questionnaire (FFQ) which filled by 15 respondents, we know that these respondents do not have a balanced diet in their daily life. Our respondents have taken the enough portions of carbohydrate and protein to make energy. Protein gives us the energy to get up and go and keep going. Protein in food is broken down into the 20 amino acids that are the bodys basic building blocks for growth and energy, and essential for maintaining cells, tissues, and organs. A lack of protein in our diet can slow growth, reduce muscle mass, lower immunity, and weaken the heart and respiratory system. Protein is particularly important for children, whose bodies are growing and changing daily. A healthy diet should have a balance macronutrients and micronutrients. Macronutrients such as carbohydrate, protein, lipid and water should be balance in our body. Micronutrients such as mineral and vitamin need to be small portion. In our survey, we found that our

respondents have intake less vegetables and fruits with contain vitamin and minerals that important to our body. The antioxidants and other nutrients in fruits and vegetables help protect against certain types of cancer and other diseases. While advertisements abound for supplements promising to deliver the nutritional benefits of fruits and vegetables in pill or powder form, research suggests that its just not the same. Our suggestion for healthy diet, we should practice balance diet to ensure our life free from disease. CONCLUSION Student should take care about the food or nutrition they need in their daily live. They need more energy to do many activities. Besides, poverty also can result in hunger and compromised food quality and nutrition status. Inadequate dietary intake interferes with learning. Especially for the active student, they should take the foods that can contribute more energy into their body. They also can take supplement diet if necessary. Unfortunately, too much of one type of food can cause an imbalance in our bodies which may lead to health problems. A healthy diet is one that is arrived at with the intent of improving or maintaining optimal health. This usually involves consuming nutrient by eating the appropriate amounts of the food guide pyramid, including an adequate amount of water.

REFERENCES 1. Kenneth R., Erica O., Terry W., William N. Dudley, Diane M., Roger V., Alice J., and Thomas B. ( 200). Validation of Three Food Frequency Questionnaires and 24-Hour Recalls with Serum Carotenoid Levels in a Sample of African-American Adults. American Journal of Epidemiology, 152 (11), 1072-1080. 2. Rachel K. Johnson. (2002). Dietary IntakeHow Do We Measure What People Are Really Eating?. Obesity Research, 10, 63-68.