Case Study Ix

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Case SLudy lx: PyperLenslon ln a
Mlddle-Aged Man.
MaLLhew 1homas
12 november 2013 | rofessor uray

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13
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BIE S21S Natthew Thomas Case Stuuy IX pg. 2

!" #$%&'$ )*+$,-$'.&/'0 .122$.- )/3 )&. )&2) 45//6 +,$..1,$ 3/156 4$ 758..&%&$60 8'6 6&.71.. )/3 )&.
)*+$,-$'.&/' 8%%$7-. )&. ,&.9 %/, %1-1,$ )$85-) +,/45$:." (S points)
a. Bypeitension is uefineu as a uisease of the caiuiovasculai system that leaus to chionic elevation in
BP gieatei than 14u mm Bg systolic anu 9u mm Bg uiastolic.
1,2
Bypeitension is fuithei classifieu
as: piehypeitension, stage I hypeitension oi stage II hypeitension uepenuing on the systolic anu
uiastolic BP.
2
Bypeitension is often affiliateu with othei pieexisting health conuitions such as
uiabetes, smoking anu obesity.
S
This client BP is chaiteu as 14S92 which classifies him as stage I
hypeitension. The client having stage I hypeitension oftentimes go asymptomatic meanwhile may
cause many auveise health conuitions incluuing: congestive heait failuie, kiuney failuie, myocaiuial
infaiction, stioke anu aneuiysms if hypeitension continues to go untieateu.
1
uiven that the client is
has a BNI of SS classifies him as obese which can inciease the likelihoou of acquiiing one of these
pieviously mentioneu auveise health conuitions.
Refeience:
1. Nelms N, Suchei KP, Lacey K, Roth SL. !"#$%#%&' )*+$,-. ,'/ 0,#*&-*.1%&2&3.. 2
nu
eu. Belmont, CA:
BiooksCole Cengage Leaining: 2u11: 288-289
2. Emeiy E. 42%'%5,2 4,1+ 6#"/%+1 7&$ #*+ !"#$%#%&' 4,$+ 0$&5+11. Builington, NA: }ones anu Bailett: 2u12:
S9-6S.
S. NNT Class Lectuie PoweiPoint Sliues: Novembei S, 2u1S.

;" <)8- &. )&. =><0 ?=><0 8'6 >@=A B.-&:8-$ )&. 785/,&7 ,$C1&,$:$'-." D)/3 */1, 3/,9"
EF5&$'-. F1,,$'- 3$&2)-G ;HI 54.
EF5&$'-. J$&2)-G KLMN0 OM &'7)$.
a. IBW: (height: S'9" |1u6 + S4= 16u lb.j) !OP 54.
%8 9/:"1#+/ ;<= 7&$ >?+1%#.@ A BCDE F GHIJ K I8DLJM N ;<= O !""#!$ &'#
b. %IBW: | 2S4 - (2S416u) x 1uu = !IO";K?
c. BNI: 2S46969 x 7uS = HI"K
BNI: S4.S = 0besity class I
2

u. CAL0RIC INTAKE: Nifflin St. }eoi
(9.99 x 1u6) + (6.2S x 172.S) - (4.92 x 6u) + (S) = !0QIO"QO
9785R68*
1,846.86 x 1.S (low activity factoi)= ;0IPP"M; 9785R68*
$()** +,-& . /** +,-& 012,34425626 -7713-,8 93 126:,2 2521;<
=59-+2 93 7134392 >2=;89 &3??@A !(B** +,-&C6-<
2

Refeience:
1. NNT Class Lectuie PoweiPoint Sliues: 4,1+ 6#"/. ;'7&, Septembei 18, 2u1S.
nu
eu. Belmont, CA:
BiooksCole Cengage Leaining: 2u11: 249, 264.

H" BS+58&' -)$ #TDJ 6&$-" <)8- 5$U$5. /% .8-1,8-$6 %8-0 7)/5$.-$,/50 %&4$,0 ./6&1:0 +/-8..&1:0 7857&1:0 8'6
:82'$.&1: 8,$ &'7516$6A <)8- 3/156 4$ 8' $S+$7-$6 7)8'2$ &' )&. 45//6 +,$..1,$ 8'6 45//6 5&+&6. &%
)$ %/55/3. -)$ #TDJ 6&$-A (S points)
a. The BASB (Bietaiy Appioaches to Stop Bypeitension) is a compiehensive uietaiy anu lifestyle
P+%3*# %'5*+1!
5Q
BHRJ K BC8SJ O
GTC8S 5Q
=+%3*#@ 2? !U3
CDEVC8CO GIH
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BIE S21S Natthew Thomas Case Stuuy IX pg. S
appioach to ueciease hypeitension. The BASB uiet was uevelopeu in the late 199us as a guiueline
of nutiition theiapy foi hypeitension.
1
The BASB uiet is not only a healthy way of eating but is
uesigneu to be peisonable to the inuiviuual anu has a vaiiety of foous to meet the inuiviuuals
lifestyle, cultuie, anu foou piefeiences.
The BASB uiet consists of a high amounts of fiuits, vegetables, low fat oi nonfat uaiiy, whole giains,
lean meats, fish anu poultiy; nuts anu beans.
2
These foous help contiibute to the 3&,2 &7 #*+ W96P
/%+# X*%5* %1 #& $+/"5+ /%+#,$. 1&/%"Q %'#,U+ ,1 X+22 ,1 %'5$+,1+ -&#,11%"Q Q,3'+1%"QY 5,25%"QY ,'/
7%?+$8 Baseu on a 2,uuu kcal uiet, the BASB uiet pioviues appioximately 47uu mg of potassium, Suu
mg of magnesium, 124u mg of calcium, 9u g piotein, Su mg fibei anu 24uu mg souium.
1
This
tianslates to a BASB eating plan consisting of: 7-8 seivings of giains anu giain piouucts, 4-S
seivings of vegetables, 4-S seivings of fiuits, 2-S seivings of low-fat oi fat-fiee uaiiy foous, <2
seivings of meats, poultiy anu fish, 4-S weekly seivings of nuts, seeus anu uiy means, 2-S tbsp fats
anu oils anu S sweetsweek.
1

The iesults of following the BASB uiet shows both systolic anu uiastolic bloou piessuies ieuucing
within two weeks of staiing the BASB eating plan. Eviuence also shows that the lowei youi souium
intake, the gieatei ueciease in BP. Foi example, an inuiviuual consuming a uaily souium intake of
1Suu mguay will see gieatei iesults than an inuiviuual consuming an inteimeuiate souium intake
of 24uu mguay. The BASB uiet is constituteu also consists of a weight loss component. Reseaich
peifoimeu by Netei (2uuS) shows that a weight loss gieatei 11 lbs. ieuuceu both systolic anu
uiastolic BP anu a weight loss of 2u lbs. leaus to even lowei systolic BP.
1

RefeienceG
nu
eu. Belmont,
CA: BiooksCole Cengage Leaining: 2u11: 292-29S.
2. The Bash Biet Eating Plan. Available at http:uashuiet.oigwhat_is_the_uash_uiet.asp Accesseu
Novembei 11, 2u1S.

I" T'85*V$ )&. 6&$- 1.&'2 @*W58-$ X,879$," J/3 :8'* 9785. &. )$ 71,,$'-5* 7/'.1:&'20 8'6 )/3 6/$. -)&.
7/:+8,$ -/ )&. $'$,2* '$$6.A J/3 6/$. )&. 1.185 6&$- 7/:+8,$ -/ -)$ #TDJ ,$7/::$'68-&/'.A (S points)
8" Accoiuing to NyPlate SupeiTiackei in which the uata was inputteu baseu upon given usual uiet, this
client consumeu appioximately 227S caloiies. 0f those 227S caloiies, 8u6 caloiies weie empty caloiies.
This client uiet exceeueu the iecommenueu total caloiies, empty caloiies, satuiateu fat anu souium.
1
Refei to *Table 1.1 below foi a fuithei in-uepth uietaiy analysis of the client's usual uiet.* The client
has suipasseu the uaily allowance of 1,9uu kcal which will iesult in fuithei weight gain. uiven that the
client is categoiizeu as a class I obesity, this tianslates to having a high iisk of uisease.
2
As pieviously
mentioneu, hypeitension is oftentimes associateu with othei chionic uiseases which is fuithei eviuence
of why the clients neeu to ueciease caloiies in impetiative. The client consumeu appioximately 47u8
mg of Na that is almost uouble of the iecommenu uaily 2Suu mg Na allowance the BASB uiet
iecommenus. The clients potassium, magnesium anu calcium levels aie also unuei the BASB
iecommenuations. The clients consumption of fiuits, vegetables, anu giains aie below the BASB uiet
guiuelines. The client consumeu about half of the iequiieu seivings of vegetables, the client consumeu
no fiuit anu the client consumeu about half of the uaily seivings of giains but most of the giains weie
iefineu anu not whole giains. The client consumeu auequate uaiiy amounts but the type of uaiiy
consumeu was not low-fat oi fat-fiee as suggesteu. The clients piotein was uouble the BASB uiet uaily
seivings. 0veiall, the clients uiet uoes not abiue by the BASB uiet nutiient guiuelines of caloiies,
souium, potassium, magnesium, anu calcium along with the the following foou gioups: giains,
vegetables, fiuit, low-fatfat-fiee uaiiy, anu meats, poultiy, fish.

Refeiences:
1. NyPlate SupeiTiackei: https:www.supeitiackei.usua.govfooutiackei.aspx Accesseu on Novembei
8, 2u1S.
nu
eu. Belmont, CA:
BiooksCole Cengage Leaining: 2u11: 294, 296.

K"<)8- -*+$ /% :$6&78-&/' &. )$ /' %/, )&. 45//6 +,$..1,$A #/$. &- )8U$ 8'* %//6Y6,12 &'-$,87-&/'.A ZH
+/&'-.[
a. The client is meuication is hyuiochloiothiaziue that is classifieu as an antihypeitensive, uiuietic anu a
K-uepleting Thiaziue. The function of this meuication is to flush out watei, souium, anu chloiiue fiom
the bouy via uiine excietion to ieuuce seium souium thus loweiing bloou piessuie. The use of taking
hyuiochloiothiaziues affect the uiet by incieasing the neeu of K anu Ng
1
theiefoie it is encouiageu to
inciease the consumption of potassium-iich foous such as piune juice, avocauoes, bananas, cantaloupe,
honey uew anu mango. These fiesh anu unpiocesseu foous aie the most abunuant in K. Ng iich foous
incluue halibut, spinach black beans anu pumpkin seeus.
2

BIE S21S Natthew Thomas Case Stuuy IX pg. S

Refeience:
1. Ciowe }P, Pionsky ZN. Z&&/ [+/%5,#%&' ;'#+$,5#%&'1. 17
th
eu. Biichiunville, PA: Foou-Neuication
Inteiactions: 2u12: 199-167.
2. Nanoie NN, Thompson }L, vaughan LA. )*+ 65%+'5+ &7 !"#$%#%&'. 2
nu
eu. San Fiancisco, CA:
Peaison Bigheieu: 2u11: 28S, 4Su.

O" \/ -/ )--+GRR333"9&6'$*"/,2R+,/%$..&/'85.R96/C&R2%,]7857158-/,"7%: 8'6 $'-$, )&. 82$0 ,87$0
2$'6$,0 8'6 7,$8-&'&'$ 5$U$5 Z7)$79 *$. %/, ^-,87$845$ -/ =#@DN[" X)&. 7857158-$. 8' $.-&:8-$6
25/:$,158, %&5-,8-&/' ,8-$ Z\_`[0 3)&7) &. 8 :$8.1,$ /% 9&6'$* %1'7-&/'" <)8- &. )&. $.-&:8-$6 \_`
Z@#`# \_` &' :aR:&'R!"bH :;[A =% -)$.$ ,$86&'2. +$,.&.-$6 %/, 8- 5$8.- -),$$ :/'-).0 3)8- 3/156
&- .122$.- 84/1- -)$ $%%$7-. /% )*+$,-$'.&/' /' )&. 9&6'$*.A (S points)
a. Aftei pioviuing the client age: 6u, genuei: male, iace: unknown (imputeu both) anu cieatinine
levels: 1.2 mguL, the clients estimateu glomeiulai filtiation iate (uFR) is 76mLmin1.7S m
2
if the
client is Afiican-Ameiican. If the inuiviuual is not Afiican Ameiican (thus the "All othei Races
option"), his uFR value is 6SmLmin1.7S m
2
.
1

If the client hau these uFR values foi gieatei than thiee months, he woulu be ux with Chionic
Kiuney Bisease (CKB). CKB is uefineu as eithei having kiuney uamage oi a uFR value of
<6umLmin1.7S m
2
foi gieatei than S months. The uFR value of 76mLmin1.7S m
2
foi if he is
Afiican Ameiican oi 6SmLmin1.7S m
2
foi all othei iaces foi gieatei than S months classifies him
as stage 2 CKB having kiuney uamage with milu ueciease in uFR. The iange foi stage 2 CKB is a uFR
of 6u-89mLmin1.7S m
2
. The action is to estimate the piogiession.
2

Refeience:
1. National Kiuney Founuation: uFR calculatois foi the Bealthcaie Piofesisonals. Available at
http:www.kiuney.oigpiofessionalskuoqigfi_calculatoi.cfm Accesseu Novembei 11, 2u1S.
nu
Peaison Bigheieu: 2u11: S26.

b" =6$'-&%* 8' 8++,/+,&8-$ '1-,&-&/' 6&82'/.&. 8'6 3,&-$ 8 WBD .-8-$:$'-" (S points)
a. WG Excessive souium intake
B: Foou anu nutiition knowleuge ueficit conceining foou anu supplemental souices of mineials
D: Excessive intake of souium iich foous, uiet histoiy of uaily souium intake is appiox. 47uu
mguay, elevateu BP of 14S92, uFR <6u mLmin1.7Sm2 anu piesciiption of hyuiochloiothiaziue.

PES STATENENT: Excessive souium intake ielateu to foou anu nutiition knowleuge ueficit
conceining foou anu supplemental souices of mineials as eviuence by excessive intake of souium
iich foous, uiet histoiy of uaily souium intake is appiox. 47uu mguay, elevateu BP of 14S92, uFR
<6u mLmin1.7Sm
2
anu piesciiption of hyuiochloiothiaziue.

`$%$,$'7$G
!" Acauemy of Nutiition anu Bietetics. ;'#+$',#%&',2 W%+#+#%51 \ !"#$%#%&' )+$Q%'&2&3. B;!W)J ]+7+$+'5+
[,'",28 4
th
eu. Chicago, IL: The Acauemy of Nutiition & Bietetics: 2u1S: SuS

Q" D122$.- .+$7&%&7 :/6&%&78-&/'. /% 6&$- 8'6 5&%$.-*5$ Z&'-$,U$'-&/'.[ -)8- :&2)- 5/3$, -)&. 75&$'-L.
45//6 +,$..1,$" (S points)
a. Some specific mouifications of uiet anu lifestyle inteiventions that may lowei the client's bloou
piessuie incluue: BASB uiet implementation, minuful eating tactics. 0ne chaiacteiistic of the BASB
uiet that makes it unique compaieu to many othei uiets is the stiuctuie of this uiet is paiieu with
having a healthy lifestyle. The RBs goals foi the client that incluue, weight loss, ueciease souium
intake, inciease potassium, magnesium, anu calcium intake anu inciease physical activity aie all
components of the BASB uiet. uiven that the client is class I obese, it is impeiative to place the
client of a iestiicteu caloiie uiet to aiu in loweiing his pieexisting hypeitension as well as also
pieventing fuithei onset uiseases such as CBF, uiabetes, anu ienal uisease which aie often
expeiienceu along with hypeitension. Eviuence shows that the gieatei the weight loss is, the
gieatei ieuuction of BP is expeiienceu. Although it is impoitant to note that the RB shoulu cieate a
caloiie iestiicteu that will piomote weight loss on the long teim scope thus the uiet shoulu not
below 12uu kcal as that may leau to client ielapse.
The seconu mouification that can be achieveu thiough the BASB uiet is souium contiol. The client
can make a few easy mouifications that will have a gieat positive impact on his souium levels. 0pon
the obeuience of the BASB uiet, the client is capable of loweiing his souium intake to <2Suu mguay
as well as having a vaiiety of foou methous. The client states that his only ielaxation is cooking
especially savoiy uishes can still be accomplisheu on the BASB uiet. The BASB uiet pioviues an
aiiay of useful tips to ieuuce souium consumption in ianging fiom foou piepaiation to oiueiing
foou at a foouseivice location. The client state that he only consumes alcohol socially with is
acceptable on the BASB uiet along as it is in moueiation of 2 uiinks pei uay. 0n the contiaiy, the
BASB uiet also incieases potassium, magnesium, calcium, anu fibei while uecieasing his souium
levels which is ciitical accoiuing to his uiet histoiy that shows him being ueficient in potassium,
magnesium, anu fibei. The patient is alieauy engaging in physical activity as well as woiking 16-
houi woikuays that aie gieat accomplishments. This health piomoting behavioi of exeicise shoulu
be acknowleuge anu continueu to be encouiageu. It shoulu be suggesteu to finu ways to inciease
physical activity.
1

Refeience:
nu
Peaison Bigheieu: 2u11: 29S-297.

M" <)8- 8,$ */1, /U$,855 2/85. %/, -)&. 75&$'-0 8'6 )/3 3/156 */1 :/'&-/, -)$ ,$.15-. /, /1-7/:$. /%
*/1, &'-$,U$'-&/'.A (S points)
a. uiven that the client came to the RB foi suggestions on ways to lowei his BP without taking
auuitional antihypeitensive meuication, this shows that the client is in the action phase of the
Stages of Change. The RB shoulu cieate goals baseu on his ieauiness to change. 0pon this nutiition
euucationcounseling session with the client, the RB shoulu cieate goals baseu on the following
objectives: Assess, Auvice, Agiee, Assist anu Aiiange.
i. T..$..:$'- of anthiopometiic measuiements, biochemical uata, nutiition-focuseu
physical finuings, client histoiy, foounutiition ielateu histoiy anu meuications. All of these
factois shoulu be caiefully ievieweu so the RB can set goals such as incieasing F &v intake,
ueciease caloiie consumption, maintain oi inciease physical activity. The ieuuction of
souium when piepaiing foous as well as oiueiing foou. Inciease consumption of watei.
ii. When 86U&.&'2 the client, the Ru shoulu give cleai, specific anu peisonalizeu behavioi
change auvice that then influences the goal setting piocess. The RB shoulu emphasize how
the powei of uiet changes, exeicise, anu weight loss can ieuuce his BP as much as meuicine.
Anothei woiu of auvise foi the client is hos uiet choices can help the meuicine uo a bettei
job thus pieventing the inciease of meuications neeueu foi a paiticulai task.
iii. In the goal setting piocess, it is impoitant foie the RB to 82,$$ anu collaboiate with the
client. The RB shoulu collaboiate with the client about a follow up session as well as
keeping a foouexeicise log to inciease client's awaieness if he is willing to uo so.
iv. Aftei setting the clients goals, it is ciitical to 8..&.- the client by pioviuing him with
liteiatuie, hanuouts anu euucational aiues that will benefit the client in ieaching his goals.
v. The final step aftei the goals aie set anu how to achieve those goals the RB shoulu 8,,8'2$
a follow-up appointment with the client.

Refeience:
!" Nanoie NN, Thompson }L, vaughan LA. )*+ 65%+'5+ &7 !"#$%#%&'. 2
nu
Peaison Bigheieu: 2u11: 29S-294.

!P" <,&-$ 8 '/-$ &' T#=@B %/,:8- -)8- .1::8,&V$. */1, 8..$..:$'-" (S points)
a. ABINE
i. TDDBDD@BcX: This client is a 6u-yeai-olu male whom is S'9' anu cuiient wt 2S4. The client
has BNI S4. Biochemical Bata states that clients total cholesteiol is >2uumguL (
2S8mguL), LBL cholesteiol >1SumguL (174mguL), anu BBL <4umguL (S7mguL).
Client's BP is 14S92 anu states of having some pain in legs anu feet. The clients consiueis
himself a "woikaholic" with a type A peisonality anu has little ielaxation, except cooking
savoiy uishes with excessive salt. Be wants to lowei his bloou piessuie without taking
moie meuications. Client is cuiiently taking hyuiochloiothiaziue. Be exeicises moueiately
by walking 2u minutes 2xweek 2u minutes two to thiee uays pei week.
ii. #=T#cdD=D: Excessive souium intake ielateu to foou anu nutiition knowleuge ueficit
conceining foou anu supplemental souices of mineials as eviuence by excessive intake of
souium iich foous, uiet histoiy of uaily souium intake is appiox. 47uu mguay, elevateu BP
of 14S92, uFR <6u mLmin1.7Sm
2
iii. =cXB`eBcX=dc: BASB uiet implementation, ueciease in souium intake, inciease in K, Ng ,
Ca anu fibei intake, maintenance oi inciease in physical activity, anu caloiie iestiiction to
19uu kcaluay.
iv. @dc=Xd`=c\RBeTafTX=dc: Fu appointment to ieview foouexeicise logs, ieevaluation
of LBL, BBL anu Total Cholesteiol, cuiient weight of pt, ie evaluate BP. Review the goal
setting status of the client.
b. S.0.A.P
i. Df>gBFX=eB: Client states of having some pain in legs anu feet. The clients consiueis
himself a "woikaholic" with a type A peisonality anu has little ielaxation, except cooking
savoiy uishes with excessive salt. Be wants to lowei his bloou piessuie without taking
moie meuications. Be exeicises moueiately by walking 2u minutes 2xweek 2u minutes
two to thiee uays pei week.
ii. d>gBFX=eB: This client is a 6u yeai olu male whom is S'9' anu cuiient wt 2S4. The client
has BNI S4. Biochemical Bata states that clients total cholesteiol is >2uumguL (
2S8mguL), LBL cholesteiol >1SumguL (174mguL), anu BBL <4umguL (S7mguL).
Clients BP is 14S92. Client is cuiiently taking hyuiochloiothiaziue.
iii. TDDBDD@BcX: Excessive souium intake ielateu to foou anu nutiition knowleuge ueficit
conceining foou anu supplemental souices of mineials as eviuence by excessive intake of
souium iich foous, uiet histoiy of uaily souium intake is appiox. 47uu mguay, elevateu BP
of 14S92, uFR <6u mLmin1.7Sm
2
iv. WaTc: Counsel client about BASB uiet implementation, ueciease in souium intake, inciease
in K, Ng , Ca anu fibei intake, maintenance oi inciease in physical activity, anu caloiie
iestiiction to 19uu kcaluay. fu with client at latei uate to ie-measuie anthiopometiic anu
biochemical uata.
Refeience:
1. Emeiy E. 42%'%5,2 4,1+ 6#"/%+1 7&$ #*+ !"#$%#%&' 4,$+ 0$&5+11. Builington, NA: }ones anu Bailett:
2u12: S9-6S.

!!" W58' 8 !QPP 9785/,&$ 6&$- 3&-) .+$7&%&7 :$'1 &6$8.0 U8,&$-*0 %/, .$U$' 68*. 1.&'2 #TDJ 8'6
,$8./'845$ +/,-&/' 8'6 3/,9.)$$- %/,:8- 8. 4$5/3" Z;P +/&'-.[
)--+GRR333"68.)6&$-/,$2/'"/,2R%&5$.R68.)R+6%R!]<$$9]#TDJ]@$85]W58''$,];PPP"+6%

W,&'-845$ #&8,* %/, @-)/:8.%-5

c/U$:4$, !!0 ;P!H
_dd#D F85/,&$. F8,4. _8- W,/-$&' F)/5$.- D/6&1: D128,. _&4$,
>,$89%8.-
Ceieals - 0ats, iegulai anu quick anu
instant, uneniicheu, cookeu with
watei, without salt (oatmeal), 1 cup
147 2Sg 2g 6g umg 2mg Sg 4g
Spices - Cinnamon, giounu, 1 tsp 6 2g ug ug umg 1mg ug 1g
Bieau - Whole-wheat, toasteu, 1 slice 69 1Sg 1g Sg umg 148mg 6g 2g
Piomise - Light Naigaiine (}), u.S tbsp. 2S ug Sg ug umg 4Smg ug ug
Nilk - Nonfat (fat fiee oi skim), 1 cup 86 12g ug 8g Smg 127mg ug ug
0ianges - Raw, navels, 1 seiving 7S 19g ug 1g umg 2mg 1Sg Sg
a1'7)
Whole Wheat Floui Toitilla - Nission
1uu% Whole Wheat Floui Toitilla
(47g), 1 toitilla
14u 22g 4g 6g umg S4umg 1g 17g
Chicken - Bieast, meat only, cookeu,
ioasteu, u.6 cup, choppeu oi uiceu
1S9 ug Sg 26g 71mg 62mg ug ug
Apples - Raw, with skin, u.S cup,
quaiteieu oi choppeu
SS 9g ug ug umg 1mg 6g 2g
BIE S21S Natthew Thomas Case Stuuy IX pg. 1u
Bellmann's - Light Nayonnaise (12
the Fat anu Caloiies of Regulai
Nayonnaise), 1.S Tbsp (14 g)
SS 2g Sg ug umg 188mg ug ug
Spice - Cuiiy, uiounu, u.S tsp u ug ug ug umg umg ug ug
Caiiots - Baby, iaw, 8 meuium 28 7g ug 1g umg 62mg 4g 1g
La Cioix - Natuial Lime Flavoieu
Spaikling Watei, 1 can (12oz)
u ug ug ug umg umg ug ug
#&''$,
Bakeu Cou Fish - With Lemon &
Peppei (No 0il oi Buttei), 1 (4 oz)
9S ug 1g 2ug 49mg 69mg ug ug
Rice - Biown, meuium-giain, cookeu,
u.S cup
1u9 2Sg 1g 2g umg 1mg ug 2g
vegetable - Aspaiagus - Bakeu With
0live 0il & Seasoning, S meuium stalks
41 4g Sg Sg umg 6Smg ug 2g
Binnei Roll - Whole Wheat Binnei Roll,
1 ioll
1uu 18g 2g 4g umg 17umg ug 2g
Raw - Blue Beiiies, 1 cup 82 21g ug 1g umg 2mg 14g Sg
Bomemaue - 0nsweeteneu Beibal Iceu
Tea, 16 fluiu oz.
D'879.
0sua - Peach, 1uu g S9 1ug ug 1g umg umg 8g 2g
ueneiic - Coffee With 2% Nilk, 12 oz 62 1ug 1g 2g umg 41mg 12g ug
Chobani - Stiawbeiiy Non-fat uieek
Yoguit (8 0z), 6 oz
8u 2ug ug 16g umg 6Smg 1ug ug
Keeblei - vanilla Wafeis, 8 cookies 14u 22g Sg 1g umg 12umg 9g 1g
Watei - Nunicipal, S cup (8 fl oz) u ug ug ug umg 14mg ug ug
XdXTaG !0KOQ ;HM2 HI2 !P!2 !;K:2 !0KOO:2 QO2 I;2
c/U$:4$, !;0 ;P!H
_dd#D F85/,&$. F8,4. _8- W,/-$&' F)/5$.- D/6&1: D128,. _&4$,
>,$89%8.-
Fiuit Salau - Fiuit Salau (Cantaloupe,
Boneyuew, uiapes) Stiawbeiiy,
Pineapple, 1 Cup
7S 21g 1g Sg umg 2Smg 19g 2g
Yoguit - Yoplait Light Flavois, 1
containei (6oz)
9u 16g ug Sg Smg 8umg 1ug ug
Kauffman - uianola, u.S cup 9u 1Sg 2g 2g umg S6mg ug 2g
Rbss - English Nuffin Nulti-giain, 1
muffin
1uu 26g 1g Sg umg 16umg 1g 8g
a1'7)
Spinach* - 1 Cup Raw, 4 cup 28 4g ug 4g umg 96mg ug Sg
Fiuit - Peai Baitlett - Raw - Neuium, 1
peai
81 21g ug 1g umg 1mg 1ug Sg
Bole - Nanuaiin 0ianges In 1uu%
}uice, u.S can (11oz)
1uu 24g ug 1g umg 1Smg 7Sg 1g
Blue Biamonu - Finely Biceu Walnuts,
14 cup (Sug)
2uu 4g 2ug Sg umg umg 1g 2g
Newman's 0wn - Light Balsamic
vinaigiette Biessing, 2 Tablespoons
4S 2g 4g ug umg 47umg 1g ug
(Sug)
Watei - Nunicipal, 2 cup (8 fl oz) u ug ug ug umg 9mg ug ug
Ciystal Light - Raspbeiiy Lemonaue,
12 packet
S ug ug ug umg umg ug ug
Stoneu Wheat Thins - Lowei Souium -
Whole uiain Ciackeis, 6 ciackeis
18u S2g 4g 4g umg 19umg ug 2g
#&''$,
Cooking Light - Beef anu vegetable
Kebabs, 1 kebab
218 Sg 1ug 27g S6mg S29mg ug 1g
Wilu iice - Cookeu, 1 cup 166 SSg 1g 7g umg Smg 1g Sg
Suniiuge Faims - Pinapple Rings, 1
pieces (4u giams)
87 2ug 1g 1g umg Smg 18g 1g
Peas - uieen, cookeu, boileu, uiaineu,
without salt, u.S cup
67 1Sg ug 4g umg 2mg Sg 4g
D'879.
Biinks - Beibal Tea, 0nsweeteneu, 2Su
ml
Apples - Raw, with skin, 1 small (2-
12" uia) (appiox 4 pei lb)
SS 1Sg ug ug umg 1mg 11g Sg
Peanut Buttei - Smooth 0nsweeteneu,
1 T.
9S 4g 8g 4g umg Sumg 1g 2g
XdXTaG !0bQM ;OM2 KK2 QH2 OO:2 !0Q;b:2 !K!2 Hb2
c/U$:4$, !H0 ;P!H
_dd#D F85/,&$. F8,4. _8- W,/-$&' F)/5$.- D/6&1: D128,. _&4$,
>,$89%8.-
Thomas' - 1uu% Whole Wheat Bagel, 1
Bagel
2Su 49g 2g 12g umg S4umg 7g 7g
Smuckei's - Reu Raspbeiiy }am, 2 tbsp 1uu 26g ug ug umg umg 24g ug
Nelons - Cantaloupe, iaw, 1 cup, cubes S4 1Sg ug 1g umg 26mg 1Sg 1g
a1'7)
Staikist - Chunk Light Tuna (Canneu,
In Watei), S oz
7S ug 2g 1Sg S8mg 27umg ug ug
Celeiy - Raw, u.S cup choppeu 7 1g ug ug umg 4umg 1g 1g
ueneiic 0sua - Banana (7" to 7-78"
Inch), 1 Neuium
1uS 27g ug 1g umg 1mg 14g Sg
Romaine Lettuce - Lettuce, 4 leaf S6g 2u 4g ug ug umg 8mg ug 4g
#&''$,
Ronzoni - Bealthy Baivest - Whole
Wheat Blenu Pasta - Thin Spaghetti (16
oz), 2 oz S6g17 package) uiy
18u S9g 2g 9g umg umg 2g Sg
Sauce - Pasta, spaghettimaiinaia,
ieauy-to-seive, 1 cup
18S 28g 6g Sg umg 1,2uSmg 22g 1g
Nixeu uieen Salau - Fielu uieens, 2
cups
4u 4g ug 2g umg 4umg 2g 2g
Ken's Steakhouse - 16 oz. Lite Caesai
Biessing & Naiinaue, 1 Tbsp
SS 2g Sg 1g umg 27Smg 1g ug
Piomise - Light Naigaiine (}), u.2S
tbsp.
11 ug 1g ug umg 21mg ug ug
1 ioll
Fiesh vegetables - Sliceu Eggplant -
uiilleu With Skin, 1 cup
SS Sg ug 1g umg 2mg 2g Sg
D'879.
Coffee - Bieweu fiom giounus, 1 cup (8
fl oz)
2 ug ug ug umg Smg ug ug
Coffee - Coffee 12 uz Balf Balf, 1
tablespoon
2u 1g Sg 1g 1Smg 2Smg 1g ug
uiapes - Raw, 1.S cup 92 24g ug 1g umg Smg 22g 1g
0sua - Peach, 1uu g S9 1ug ug 1g umg umg 8g 2g
Nilk - Nonfat (fat fiee oi skim), u.7S
cup
64 9g ug 6g 4mg 96mg ug ug
uieat value Smokeu Whole Almonus -
Almonus, 1.2S ounce (28g)
21S 6g 19g 8g umg 188mg 1g 4g
XdXTaG !0bM; ;Qb2 IK2 bb2 O;:2 H0PMM:2 !;I2 Hb2
c/U$:4$, !I0 ;P!H
_dd#D F85/,&$. F8,4. _8- W,/-$&' F)/5$.- D/6&1: D128,. _&4$,
>,$89%8.-
Pineapple, 1 Cup
7S 21g 1g Sg umg 2Smg 19g 2g
Eggs - Baiu-boileu (whole egg), 2 laige 1SS 1g 11g 1Sg 424mg 124mg 1g ug
a1'7)
(Sug)
2S 1g 2g ug umg 2SSmg 1g ug
(47g), 1 toitilla
Piouuce - Cucumbei Slice, 4 slices 6 ug 1g ug umg umg ug ug
Boaisheau Thin Sliceu Tuikey Bieast -
Lunch Neat, 1 slices
2u 1g ug Sg 7mg 14umg ug ug
0ianges - Raw, navels, 1 cup sections,
without membianes
81 21g ug 2g umg 2mg 14g 4g
#&''$,
None - Salmon Fillet, uiilleu, 4 oz
11Sg
227 ug 1Sg 2Sg 6umg 7Smg ug ug
Ken's Steakhouse - 16 oz. Lite Caesai SS 2g Sg 1g umg 27Smg 1g ug
BIE S21S Natthew Thomas Case Stuuy IX pg. 1S
Biessing & Naiinaue, 1 Tbsp
Nixeu uieen Salau - Fielu uieens, 2
cups
4u 4g ug 2g umg 4umg 2g 2g
without salt, u.S cup
67 1Sg ug 4g umg 2mg Sg 4g
Cous Cous - Isiaeli Cous Cous, 1 cup
cookeu
22u 46g 1g 8g umg umg 1g 2g
1 ioll
D'879.
tablespoon
fl oz)
Banana - Neuium (7-7 78" Long)
(118g), 1 Banana (118g)
Keeblei - vanilla Wafeis, 8 cookies 14u 22g Sg 1g umg 12umg 9g 1g
Alui uouimet Buttei Popcoin - 1uu
Caloiie Popcoin - Buttei (Poppeu), 6
cups poppeu
1uu 2ug 2g Sg umg 29umg ug 4g
XdXTaG !0bQP ;KO2 KI2 QM2 K!!:2 ;0;OI:2 bM2 IQ2
c/U$:4$, !K0 ;P!H
_dd#D F85/,&$. F8,4. _8- W,/-$&' F)/5$.- D/6&1: D128,. _&4$,
>,$89%8.-
Tiopicana Puie Piemium - 0j W
Calcium & vitamin B, No Pulp, 8 fl oz
11u 26g ug 2g umg umg 22g ug
Rbss - English Nuffin Nulti-giain, 1
muffin
1uu 26g 1g Sg umg 16umg 1g 8g
uieat value - Peanut Buttei 1 Tbsp, 1
tbsp
1u4 4g 8g 4g umg 1Sumg 2g 1g
Fiesh - Nelons, Cantelope, Raw, S4
cup
6u 16g ug 1g umg 28mg 14g 2g
a1'7)
(47g), 1 toitilla
Ciystal Light - Raspbeiiy Lemonaue,
12 packet
S ug ug ug umg umg ug ug
Apples - Raw, with skin, u.S cup,
quaiteieu oi choppeu
SS 9g ug ug umg 1mg 6g 2g
ioasteu, u.6 cup, choppeu oi uiceu
1S9 ug Sg 26g 71mg 62mg ug ug
Kiaft - Shieuueu Paimesan, Romano,
anu Asiago Cheeses, 2 giam
8 2g 2g 2g 12mg 2uumg ug ug
Tomato 18u - Tomato Slice, 4 slice (1S
g)
S2 1g ug ug umg Smg ug ug
#&''$,
Ronzoni - Bealthy Baivest - Whole
Wheat Blenu Pasta - Thin Spaghetti (16
oz), 2 oz S6g17 package) uiy
18u S9g 2g 9g umg umg 2g Sg
Bomemaue - 0nsweeteneu Beibal Iceu
Tea, 16 fluiu oz.
Bakeu Cou Fish - With Lemon &
Peppei (No 0il oi Buttei), 1 (4 oz)
9S ug 1g 2ug 49mg 69mg ug ug
Lemon juice - Raw, 2 weuge yielus S 1g ug ug umg umg ug ug
Fiesh vegetables - Sliceu Eggplant -
uiilleu With Skin, 1 cup
SS Sg ug 1g umg 2mg 2g Sg
Aiiston - Balsamic vinegai, 1 Tbsp
(1Sml)
1u Sg ug ug umg 4mg Sg ug
Bomemaue - Steam Fiesh Bioccoli,
Cauliflowei, S4 cup
S8 Sg ug 2g umg SSmg 2g Sg
Bfc - Bell Peppeis - Reu,yellow &
0iange (u C2 S), 1 meuium
Su 8g ug 1g umg umg 2g 2g
D'879.
Banana - Neuium (7-7 78" Long)
(118g), 1 Banana (118g)
Chobani - Stiawbeiiy Non-fat uieek
Yoguit (8 0z), 6 oz
8u 2ug ug 16g umg 6Smg 1ug ug
Natuie valley - 0ats 'n Boney, Ciunchy
uianola Bais, 2 bais (42g)
19u 29g 6g 4g umg 16umg 12g 2g
fl oz)
tablespoon
uiapes - Raw, 2 cup 12S S2g 1g 1g umg 4mg Sug 2g
XdXTaG !0bQb ;M;2 HO2 !!P2 !K;:2 !0OIP:2 !;I2 K;2
c/U$:4$, !O0 ;P!H
_dd#D F85/,&$. F8,4. _8- W,/-$&' F)/5$.- D/6&1: D128,. _&4$,
>,$89%8.-
Ceieals - 0ats, iegulai anu quick anu
instant, uneniicheu, cookeu with
watei, without salt (oatmeal), 1 cup
147 2Sg 2g 6g umg 2mg Sg 4g
Smuckei's - Reu Raspbeiiy }am, 1 tbsp Su 1Sg ug ug umg umg 12g ug
Apples - Raw, with skin, 1 seiving 8u 21g ug ug umg 2mg 16g 4g
a1'7)
Fiu - Peai, 1 peai, meuium (18ug) 1u1 26g ug 1g umg Smg 16g 6g
Tomato 18u - Tomato Slice, 4 slice (1S
g)
S2 1g ug ug umg Smg ug ug
ioasteu, u.7S cup, choppeu oi uiceu
17S ug 4g SSg 89mg 78mg ug ug
Piouuce - Cucumbei Slice, 4 slices 6 ug 1g ug umg umg ug ug
(Sug)
2S 1g 2g ug umg 2SSmg 1g ug
BIE S21S Natthew Thomas Case Stuuy IX pg. 1S
Stoneu Wheat Thins - Lowei Souium -
Whole uiain Ciackeis, 6 ciackeis
18u S2g 4g 4g umg 19umg ug 2g
Spinach* - 1 Cup Raw, 4 cup 28 4g ug 4g umg 96mg ug Sg
#&''$,
Butteiball - Tuikey Buigei Patties All
Natuial 9S7 Lean, 1 patty 112g4oz
1Su ug 8g 22g 8umg SSumg ug ug
Thomass - 1uu% Whole Wheat Bagel
Thin, 46 giams
11u 24g 1g 6g umg 19umg Sg Sg
Sweet potato - Cookeu, bakeu in skin,
without salt (Sweetpotato), 1 cup
18u 41g ug 4g umg 72mg 17g 7g
ueneiic - Povalone Cheese, 1 Slice 7u ug Sg Sg 1Smg 17umg ug ug
without salt, u.7S cup
1u1 19g ug 6g umg 4mg 7g 7g
D'879.
Alui uouimet Buttei Popcoin - 1uu
Caloiie Popcoin - Buttei (Poppeu), 6
cups poppeu
1uu 2ug 2g Sg umg 29umg ug 4g
ueneiic - Coffee With 2% Nilk, 12 oz 62 1ug 1g 2g umg 41mg 12g ug
XdXTaG !0bb; ;bO2 H!2 !P!2 !QI:2 !0QOH:2 !!K2 II2
c/U$:4$, !b0 ;P!H
_dd#D F85/,&$. F8,4. _8- W,/-$&' F)/5$.- D/6&1: D128,. _&4$,
>,$89%8.-
Kiiklanu - Rasin Bian Ceieal, S9 g (1
cup)
19u 46g 2g 6g umg 1uumg 17g 7g
Bananas - Raw, 1 meuium (7" to 7-
78" long)
a1'7)
Bomemaue - Peanut Buttei anu }elly
Sanuwich uiape, 1 sanuwich
4uu 44g 14g 12g umg S68mg 16g 4g
Sabia - Classic Bummus (Bjs), 2 Tbsp
(28 g1 oz)
7u 4g Sg 2g umg 1Sumg ug 2g
Biinks - Beibal Tea, 0nsweeteneu, 2Su
ml
Caiiots - Baby, iaw, 1u laige SS 12g ug 1g umg 117mg 7g Sg
Celeiy - Raw, 2 stalk, meuium (7-12" -
8" long)
11 2g ug 1g umg 64mg 1g 1g
#&''$,
Piomise - Light Naigaiine (}), u.2S
tbsp.
11 ug 1g ug umg 21mg ug ug
Cooking Light - Bam anu Cheese
Quiche, 1 seiving
22u 2Sg 7g 1Sg 24mg SS7mg ug 1g
Thomass - 1uu% Whole Wheat Bagel
Thin, 46 giams
11u 24g 1g 6g umg 19umg Sg Sg
Pineapple, 1.S Cup
11u S2g 1g 8g umg SSmg 29g Sg
Conuiment - Smuckei's Stiawbeiiy
}am, 1 tbsp
Su 1Sg ug ug umg umg 8g ug
D'879.
Beikley anu }ensen - Bj's - Caibonateu
Flavoieu Watei, 8 fl. oz.
Blue Biamonu - Almonus 1uu Caloiie, 1
bag
1uu Sg 9g 4g umg umg 1g 2g
Apples - Raw, with skin, 1 meuium (2-
S4" uia) (appiox S pei lb)
72 19g ug ug umg 1mg 14g Sg
Caii's - Table Watei Cickeis W
Roasteu uailic anu Beibs, 8 ciackeis
1uu 2ug 2g 2g umg 2Sumg ug 2g
XdXTaG !0bMQ HPb2 I;2 OQ2 ;M:2 !0MKP:2 !H;2 HO2

]+7+$+'5+1 B9[9 7&$Q,#J
TABLE 1.1
CLIENT BIET BIST0RY REP0RT

MNT CS9's Nutrients Report 11/08/13 - 11/08/13
Your plan is based on a 2200 Calorie allowance.

Nutrients Target Average Eaten Status
Total Calories 2200 Calories 2273 Calories Over
Protein (g)*** 56 g 126 g OK
Protein (% Calories)*** 10 - 35% Calories 22% Calories OK
Carbohydrate (g)*** 130 g 139 g OK
Carbohydrate (% Calories)*** 45 - 65% Calories 24% Calories Under
Dietary Fiber 30 g 9 g Under
Total Fat 20 - 35% Calories 53% Calories Over
Saturated Fat < 10% Calories 22% Calories Over
Monounsaturated Fat No Daily Target or
Limit
18% Calories No Daily Target or
Limit
Polyunsaturated Fat No Daily Target or
Limit
8% Calories No Daily Target or
Limit
Linoleic Acid (g)*** 14 g 17 g OK
Linoleic Acid (% Calories)*** 5 - 10% Calories 7% Calories OK
!-Linolenic Acid (g)*** 1.6 g 2.7 g OK
!-Linolenic Acid (% Calories)*** 0.6 - 1.2% Calories 1.1% Calories OK
Omega 3 - EPA No Daily Target or
Limit
4 mg No Daily Target or
Limit
Omega 3 - DHA No Daily Target or
Limit
39 mg No Daily Target or
Limit
Cholesterol < 300 mg 846 mg Over
Minerals Target Average Eaten Status
Calcium 1000 mg 978 mg Under
Potassium 4700 mg 2912 mg Under
Sodium** 1500 mg 4708 mg Over
Copper 900 "g 1128 "g OK
Iron 8 mg 15 mg OK
Magnesium 420 mg 244 mg Under
Phosphorus 700 mg 1584 mg OK
Selenium 55 "g 160 "g OK
Zinc 11 mg 19 mg OK
Vitamins Target Average Eaten Status
Vitamin A 900 "g RAE 754 "g RAE Under
Vitamin B6 1.7 mg 2.1 mg OK
Vitamin B12 2.4 "g 6.5 "g OK
Vitamin C 90 mg 30 mg Under
Vitamin D 15 "g 4 "g Under
Vitamin E 15 mg AT 7 mg AT Under
Vitamin K 120 "g 84 "g Under
Folate 400 "g DFE 299 "g DFE Under
Thiamin 1.2 mg 1.5 mg OK
Riboflavin 1.3 mg 2.6 mg OK
Niacin 16 mg 26 mg OK
Choline 550 mg 679 mg OK
Information about dietary supplements.

** If you are African American, hypertensive, diabetic, or have chronic kidney disease, reduce your sodium
to 1500 mg a day. In addition, people who are age 51 and
older need to reduce sodium to 1500 mg a day. All others need to reduce sodium to less than 2300 mg a
day.

*** Nutrients that appear twice (protein, carbohydrate, linoleic acid, and !-linolenic acid) have two
separate recommendations:

1) Amount eaten (in grams) compared to your minimum recommended intake.
2) Percent of Calories eaten from that nutrient compared to the recommended range.

You may see different messages in the status column for these 2 different recommendations.

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