Cm
Umur : .............................................................. BB................Kg
IMT (Indeks Masa Tubuh) :............................................................
Kebutuhan Gizi Sehari :
Kalori : Kkal Lemak : gram DIET
Protein: gram
KURANG
................................................................................................................ Tumis kacang Tempe goreng Tahu goreng isi
panjang Sup sayuran daging
Susu coklat Jeruk manis Cap cay sayuran
Siang Jam 12.00 – 13.00 :
Nasi /pengganti: ...................... ....................... Jam 10.00 Jam 16.00 Jam 21.00
Hewani: ...................... ....................... (Selingan) (Selingan) (Selingan)
Nabati: ...................... ....................... Roti bakar isi Puding coklat Susu rasa
Sayuran: ...................... ....................... keju strawberry
Buah: ...................... .......................
Minyak: ...................... .......................