Natalie Butler NFSC 340 Julie Schenider 11 May, 2012 Case Study I.

Nutrition Assessment Suzy Student is a 22 year old student in college, aside from school she works 20 hours a week and volunteers for 9 hours every week. She is 54 and weights 140 with a BMI of 24.0, thus meaning she currently has a healthy weight. Over the past six months her weight has fluctuated, she was on a diet for a while and lost 17 pounds, her habits while on diets are not exactly advised as she tends to skip some meals, replacing them with diet shakes. Suzy has recently been diagnosed with type 1 diabetes and is not very good at maintaining a constant blood glucose level; she is also a little bit lactose intolerant. Suzy is also not pregnant or suffering from any other conditions that may alter food intake, aside from those previously listed. Currently it is not clear if she is taking any supplements or medications. Her most recent libratory test showed that she had blood glucose of 165mg/dL, serum iron was 132mcg/dL, serum ferritin was 201mcg/L, and her total cholesterol was 150mg/dL, as HLD cholesterol was 52mg/dL, LDL cholesterol was 98mg/dL. After acquiring the patient, Suzy Students background information her EER, or energy expenditure requirement was calculated to be 2189.5 kcal per day, this meaning, she should be consuming about 2189.5 kcal per day to sustain her current weight. This compared to her current habits shows that in a typical day she is consuming less calories than her body needs, her average calorie consumption after three days of recording were, 1469 kcals per day. This represents quite a large discrepancy between her energy intake and her energy expenditure, of about 720.5 kcal. Her intakes also express that her protein intake is above average, her individualized protein DRI was calculated at 50.9 g/day, while she is consuming on average 63.2g/day. Currently Suzy

is not consuming the recommended amounts of some of her micronutrients, for example, she is currently low in Magnesium, Vitamin E, and Vitamin C. There were a few nutrients that she was low in when comparing her intake to the recommended RDA, however when comparing them with the EAR she had adequate intakes, these micronutrients included, Calcium, Iron, Vitamin A, Thiamin, and Vitamin D. Aside from the micronutrients that Suzy has inadequate amounts of, she is following the recommended dietary guidelines for the rest of the micronutrients. Her distribution of kcals, has one large flaw, she is currently consuming a high amount of fat in her diet. The recommended amount of fat in a diet should be between 20-35% of ones kcal intake; however Suzy is consuming 43.5% on average per day. From her fat, 17.9% is from saturated fat, which is considered high as the recommended guideline should be 10% or less. It would also be recommended that her carbohydrate and protein intake increase as they are 41.2% and 17.2% respectively. Each of those intakes does fall inside of the recommended guidelines, but they are on the low end of the spectrum. Her intake patter is definitely not following the Dietary Guidelines for Americans. Most of Suzys grain intake is not coming from whole grains; she is consuming a lot of white bread/buns, which are not coming from whole grains. She is not in taking very high amounts of vegetables, the vegetables that she is consuming are in the forms of starchy vegetables (potatoes) and dark greens (salad greens), while she is missing red/orange vegetables, as well as beans. The client is not making many nutrient dense choices; a lot of her calories are in the form of fat, mainly saturated fats, as well as from carbohydrates, in the form of sugars, however she does choose low fat milk. There doesnt seem to be a patter to the clients eating behavior, however it is rather apparent that she does not know how to make good and healthy choices when choosing food.

II. Nutrition Diagnosis Problem: Excessive fat intake Etiology: Related to eating a lot of high fat foods, ice cream, cheese, and pastries. Symptoms: As evidenced by three day food record with daily fat intake of 70.5, accounting to 43.2% of daily recommended guideline. III. Nutrition Intervention To allow the patient, Suzy Student to get closer to the Dietary Recommended Intakes, it would be advised for Suzy to start to eat more whole grains, exchange her white breads, buns and cereals to whole grain breads, this will allow more nutrients as well as fiber to be added to her diet. She also should increase her intake of vegetables, more orange and red vegetables and dark leafy greens. The client should also eat more fruit, eating more fruit could potentially replace her intake of processed sugar in the form of desserts; fruits contain natural sugar as opposed to added sugar. Also being that Suzy is partially lactose intolerant, it would be recommended that she does not eat as many dairy products; however she will need to have more protein in her diet to replace the removal of protein in the milk. I would also recommend a supplement of vitamin D also, as she is not getting her recommended dietary allowance. Suzy should also reduce her intake of fats, while increasing her amount of carbohydrates and protein. It would also be recommended that this client try and be more regular about eating her meals, with specific meals, instead of snacking through the day.