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able to communicate effectively. Skin, hair and nails are excellent. Pt does not
appear fatigued and looks well nourished.
Medical History:
No significant medical history reported.
Nutrition Recommendations:
Energy- Pt has a BMR of 1300 kcals. Based on extremely high activity level and
importance of maintaining high percentage of lean body mass, pt is advised to
consume 2300 kcals per day.
Fluid- increased need, at least 1 ml/kcal, monitor urine color and increase as needed
Carbohydrate- increased need, pt needs to consume 30g of carbohydrates per hour
starting at 1230 while at practice. Pt needs 288g CHO daily. (2300 kcal x .50)/4 =
288
Protein- increased need. Pt should consume 144g protein daily. (2300 kcal x .25)/4
= 144
Nutrition Diagnosis:
Inadequate energy intake related to extreme practice schedule that results in
increased energy requirements as evidenced by pts reported hunger at the end of
the day and reported diet history and lack of meal times.
Inadequate energy intake related to decreased ability to consume sufficient energy
during the day as evidenced by pt reported inability to eat while at practice.
Nutrition Intervention:
Determined kcal needs, provided sample menu and eating pattern. Encouraged
variety in eating habits by adding different fruits and vegetable at typical meal
times. Suggested adding a quick snack like a banana or carrots with ranch dressing
in between breakfast and lunch while in between classes. Discussed how to read
food labels and determine carbohydrate amount. At practice, discussed adding
supplements to increase energy consumption slowly so upset stomach can be
avoided. Pt was shown several different supplementation options including: sport
beans, GU, energy bars, energy biscuits, and Gatorade. Pt was advised to start
eating 30g of carbohydrates every hour of practice. She will start out with one
supplementation and progress slowly to more as she gets used to the practice. Pt
stated she would be open to trying sport beans and Gatorade. She can mix
Gatorade with her water since she is accustomed to drinking from her water bottle
throughout practice. Pt acknowledges understanding and good compliance is
expected.
Monitor and Evaluate:
Weight
Energy level
Pt reported performance