Lifecycle Presentation

Adult
Jennifer Treubig
Lifestyle, Habits, and Family History
● Works at a Mental Institution as a Psych Ward Assistant
● Schedule changes every day but most days, he works night shifts from midnight to 8 AM.
● Sleep Schedule:
○ Typically, he will take one 4 hour nap during the day and run errands throughout the day.
● Habits - Since he has these awkward and long times to be awake, he doesn’t eat the healthiest
through these times. He used to have three Coke cans a day as well as a half gallon of ice cream
while watching TV, and in addition to the Coke, he would drink about 2 Arizona Iced Teas a day.

● Family History:
○ Not many conditions
○ High Cholesterol
Previous Concerns
October 2018 - Symptoms: Cramps, lethargy, couldn’t think clearly, nor see
clearly, bathroom after 2 hours, excessive urination, clear color, couldn’t satisfy
thirst

October 2, 2018 - Went to the Doctor, sent to the Hospital for sugar level test
measuring around 500 mg/dL.

(Normal resting blood glucose level is typically between 70 and 99 mg/dL, give
or take 10 mg).

Diagnosed as Diabetic but currently his levels have reached the normal level
(last reading was 88 mg/dL).
Anthropometrics -
Currently
(During October)

Height - 5’10” Height - 5’10”

Weight - 220 Weight - 250

BMI - 32 BMI - 36

Age - 61 years old Age - 61 years old

Body Mass Index

BMI - 32 (Obese)

During time of hospital

visit, he was a BMI of 36
(still obese) and weighed
about 250 pounds.
Blood Tests
Standards Hospital - October Currently (test 3 weeks ago)
Creatinine - 0.6 - 1.3 mg/dL Creatinine - 1.4 Creatinine - 1.0

Blood Sugar - 74-106 mg/dL Blood Sugar - 492 Blood sugar - 88

A1C - 4.2-6.3% A1C - 12.1% (EAG = 301) A1C - 6.5% (EAG = 62)

HDL - 40-60 mg/dL HDL - 58 HDL - 59

LDL - less than 100 mg/dL LDL - 190 LDL - 135

Sodium and Potassium were in range during both visits, hematocrit during first visit was 48.7% while
the range is 34.0-50.0%. Hematocrit was most likely a problem because he hadn’t eaten that day and
the number was already at an extremely high number.
 Quotes/Attitude towards eating
th y f or me.”
it’s hea l
k an d
c a u se it’s mil
ic e cr ea m be
“I like “Since I
was deh
ydrate d, I had
chocola
te milk.”
e fo o d off.”
w o r k th
lk, I’ ll
go f o r a wa
work ou t o r
“If I just “I’m a s
tar patie
nt now.”
 Sample menu of Before Hospital Visit
Starting from the morning: 8 AM - McDonalds Egg and Cheese

Chocolate Milk on the side and a medium coffee

10 AM - Costco Chocolate Muffin (huge) and some hummus with pretzels

1 PM - Tuna salad on a roll (usually homemade) and afterwards, pudding

4 PM - about 2 servings of potato chips

5:30 PM - dinner of chicken or salmon for that day, veggies, pasta

6 PM - 8 PM- other snacks like sour cream and chips, ice cream

Throughout the night, he used to eat another dinner (usually leftovers from that night’s dinner) and some chip snack bags
Basic Recommendations - Calculations
(Mifflin- St. Jeor Equation)
Men should consume no less than 1500 calories per day

Basal Metabolic Rate = (10 x weight in kg) + (6.25 x height in cm) - (5 x age in years) + 5

(10 x 100 kg) + (6.25 x 177.8 cm) - (5 x 61) + 5

1000 + 1111.25 - 305 + 5 = BMR = 1811.25

1811.25 x 1.2 (sedentary factor) = 2173.5 calories to maintain weight

However, 250-500 calories should be subtracted (at least) to lose weight (specifically
one pound a week) since he’s obese.

I am allowing about 2100 calories per day.

Day 1 Recall (starting from 8 am) March 22nd (Friday) -
work
Drinks: Two Sparkling Waters (Orange Mango and Kiwi Strawberry), two cups of
water

8 AM - Two pieces of whole wheat toast, 2 scrambled eggs 7 PM (slept for one hour) - bowl of t 1% milk

10 AM - About 10 pretzels, hummus snack pack (2.4 oz (Watched TV for an half an hour and slept for about
each) three hours)

12 PM - Quarter of bagel, two whole wheat pieces of bread
with tuna salad
(Sleeping 2.5 hours) 2:30 PM - one chocolate kiss (I put
three in the analysis) and a banana
5:30 PM - Shrimp Tostadas (Meal prep - Hello Fresh?),
spinach, and brown rice
10:30 PM - got up for work
12 AM - two pieces of chicken breast with lemon
(baked), four pieces of broccoli
3 AM - a tupperware container (about a cup and a
half) of bowtie pasta
5 AM - apple, hummus snack pack and saltine
crackers
Diet Analysis - Day 1

Notes:

Cholesterol (300 mg)

All 3 Macronutrients are over

Sugar - 37.5 mg

More water to account for

moisture
Day 2 Recall (starting from 8 am) March 23rd
(Saturday)
Drinks: Two Sparkling Waters (Orange Mango and Kiwi Strawberry), two cups of
water, one “lite” beer, medium coffee

8:30 AM - 2 eggs over well, 3 bacon strips, medium size coffee Dessert (8:30 PM) - One slice of carrot cake with
(caramel vanilla) then went to bed for 3 hours cream cheese frosting, two lemon bars

12 PM - Boar’s head honey maple turkey (4 slices), 1
tablespoon mayonnaise, 2 whole wheat slices of bread
Then slept for 3.5 hours
5 PM - (Appetizers and Buffet) 4 slices of prosciutto, four
bruschetta, 2 slices of stromboli, 5 mozzarella sticks, 6 cheese
cubes, 3 rice balls (about an inch and a half wide), 3 tomato
slices and mozzarella slices
(Went home at 9 PM and slept for another hour)
Went to work at 11:30 PM
12:30 AM - Shrimp scampi with leftover shrimp from
night before, spinach (1.5 oz)
4:30 AM - banana, snack bag of pretzels and 2.4
tablespoons of hummus

“Dinner” 6 PM - 5 stuffed mushrooms, string bean salad (cup

and a half), one burger, teaspoon of ketchup, bun, about a cup
of penne alla vodka, and a beer
Diet Analysis - Day 2

Notes:

Cholesterol (300 mg)

All 3 Macronutrients are over

Sugar - 37.5 mg

More water again for moisture

Recommendations
● Try not to eat unnecessary calories and food
○ There’s almost no need to have four pieces of whole wheat toast during the day
● Main problem is not really seeking the right foods but not eating too much
of it and eliminating “empty calories”
● Reduce saturated fat and look for more foods that have less calories
● Increase vitamin D, iodine, calcium
● Decrease vitamin A, E, and K (fat soluble) - BUT, with the calorie reduction, it
most likely will even out
○ Try not to focus on reducing those specific vitamins, mainly because of the potential
mentality
● Reduce sodium
● Increase vegetable and fruit options (as easy foods)
Recommendations (cont.) Age Group in
General
❖ Fiber
➢ May decrease risk of heart disease and type 2 diabetes, try to choose foods with at least 3 grams
❖ Calcium and Vitamin D (healthy bones)
➢ Dark leafy green vegetables, low fat/fat-free milk, yogurt (reduced sugar), fortified cereal
❖ Increasing Potassium and Reducing Sodium
➢ Lowers risk of high blood pressure, (did well with spinach already), “replace salt with herbs/spices”
❖ Switching to healthier fats
➢ Avocados, extra virgin olive oil, almonds
➢ Fats from animal sources like beef should be limited to less than 10% of fats in the diet
❖ More exercise!
➢ During the spring and summer, he exerts a lot of energy doing yard work but he does like going to the
boardwalk to walk/jog with my mom and I’ll go to run.
❖ Ensure Vitamin B12 is sufficient (fortified cereal, lean meat, some fish)
New meal plan - adjustment in calories to
2300
8:30 AM - 2 hard boiled eggs with a cup and a half of oatmeal with just water, to drink: 8-16 fl oz (can split it up throughout day)
1% milk (low fat)

10 AM - Banana as a snack and black iced tea (8 oz)

12:30 PM - 1 FAGE Yogurt Plain (can add some honey if needed), and 1 avocado on a slice of whole wheat bread since he loves
toast, and it’s a great way to get healthy fats in

1:30 PM - Have another 8 oz of 1% milk

3:30 PM - 1 oz of mozzarella cheese (part skim milk) (this could be his salty snack) and an apple , another 8 oz of water

5:30 PM - 4 oz of chicken breast roasted or baked, 1 cup of spinach, .25 cups of brown rice

9 PM - Banana as a dessert and maybe some tea (since it’s decaffeinated) like mom and I

12:30 AM - 2 oz chicken, 2 oz shrimp, 0.5 cup of broccoli

3 AM - 1.5 oz shrimp, 0.5 cup of broccoli

4:30 AM - 2.0 tbsp of hummus classic, another 8 oz of water

6 AM - Banana
Diet Analysis - Improved Day 3

Notes:
Iodine - 3 oz shrimp = 35 mcg
Linoleic- not concerned because of
celebration days and fish days (chicken)
Vitamin D - 75% but calcium is 1000 mg

Calories - not particularly concerned over so it’s mainly sufficient

 Overall Recommendations
● Adjust lifestyle to not sit in front of the TV so much (this is when ALL of my family
will mindlessly eat so many calories.
○ Read books, since it’s getting nicer, walk on the boardwalk, shop?

● I put tea into the meal plan too because my mom and I, since last year, have a
tradition of watching Downton Abbey while we sip our tea (I know we sound 90 lol).
○ During this time, we don’t do anything else (or get other food) to prevent late night snacks.

● Overall, I think he needs to do other things because he tends to either restrict to a

point of starvation or overeat to ridiculous amounts.
References

Brown, J. E., Lechtenberg, E., Murtaugh, M. A., Splett, P. L., Stang, J., Wong, R., . . . Sahyoun, N. R. (2017).

Nutrition through the life cycle. Boston, MA: Cengage Learning.

http://lifetransformingdiet.com/calorie-requirements/

https://www.eatright.org/health/wellness/healthy-aging/nutrition-for-older-men