Cm
Umur : .............................................................. BB : ................ Kg
IMT (Indeks Masa Tubuh) :............................................................
Kementerian Kesehatan RI
Kebutuhan Gizi Sehari : 2011
Kalori : Kkal Lemak : gram
Protein: gram Karbohidrat : gram
DIET
PEMBAGIAN MAKANAN SEHARI
LAMBUN
Nasi /pengganti : ...................... .......................
Hewani/nabati : ...................... ....................... Contoh Menu Sehari
Sayuran : ...................... .......................
Minyak : ...................... .......................
G
Gula pasir : ......................
Pagi Siang Malam
.......................
Nasi Tim Nasi Tim Nasi Tim
Selingan Jam 10.00 : Telur Dadar Semur daging Ikan panggang
................................................................................................................ Setup Wortel Tim Tahu bumbu tomat
Teh manis encer Sayur Bening Tumis Tempe
Siang Jam 12.00 – 13.00 : Pepaya Setup Buncis
Nasi /pengganti : ...................... ....................... Pisang
Hewani : ...................... ....................... Selingan Selingan
Nabati : ...................... ....................... Snack Snack Selingan
Sayuran : ...................... ....................... Biskuit Poeding Susu
Buah : ...................... ....................... Susu rendah - Susu
Minyak : ...................... ....................... lemak