University of the Philippines Manila

The Health Sciences Center

COLLEGE OF NURSING
World Health Organization Collaborating Center for Nursing Development
Pedro Gil Street, Ermita, Manila

Case Analysis
Members:
Abenes, Jannie Ayuste, Audrey
Cañonero, Pia Dayao, Christine
Diosana, Janine Garcia, Alliah
Lontoc, Angel Mendoza, Patricia

I. Introduction
According to the 2006 Big Count FIFA Survey, Football (soccer) is currently the world’s
most sport played by over 265 million people worldwide to which 10% are female (​García-Rovés
et al., 2014). ​Recent studies have shown major developments in football-related biomedical
researches which commonly focused on three main areas: the physiological demands of the
game [1–7]; the anthropometric characteristics and physiological and performance capabilities
of the players [8–15]; and the use and bioavailability of energy substrates during training and
match-play [1,16–18].
Consequently, ​Montecalbo, R. C. and De Jose, E.G. (2012) shared that ​athletes are
among the individuals who have a high concern for their active lifestyle due to the physical
demands of their respective fields. Although performance has been the primary concern,
nutritional intake and dietary habits are often overlooked by athletes, coaches and policy
makers. In this study, the focus will be on the nutritional status of AK who is a 38 year old
retired football player and coach in Manila. Upon reviewing the case, AK’s knowledge about
nutrition has raised a concern, especially on the aspect of adequate dietary intake appropriate
for his physical activity.
Football, the chosen sport of the client, is considered an anaerobic sport which has an
intermittent and high-intensity nature that requires a heavy reliance on glycogen with the
potential to affect its stores (Teixeira et al., 2014). ​Adequate nutrient intake is a key factor
required to cope with the demands of heavy training and promote recovery between activities.
Thus, football players are advised a daily caloric intake of 55 to 60% from carbohydrates,
15-20% from protein and 25-30% from fat (Osgnach et al., 2010). Considering the client’s age,
the average energy, protein, carbohydrate, and fat intake have been optimized to also fit his
physical activity and food preferences. The main nutritional aim of this intervention is for the
athlete to meet the higher energetic needs.
First, carbohydrates are known as the primary energy source for athletes as it gives the
fuel for maintaining muscle tone, controlling blood glucose level, and in providing essential
energy especially before, during, and after exercises. On the client’s dietary intake, a significant
low amount of carbohydrate intake was noted which came from bread and vegetable salad
alone. According to studies, diets that lack in carbohydrates for prolonged periods can lead to
premature depletion of glycogen stores and ensured compromised performance (Bangsbo et
al., 2006). The timing of carbohydrate intake also take part in the preparation and recovery from
a strenuous activity. Thus, the ingestion of signicant amounts (200–300 g) of carbohydrates
before exercise (3–4 hours) is recommended as an effective strategy to enhance carbohydrate
availability and improve athletic performance (Rodriguez et al., 2009). It should also be
emphasized that carbohydrate-containing foods with lower fat content are more advised to be
included in the athlete’s diet. Increased in intake carbohydrate, especially foods containing high
fiber such as fruits and vegetables contain high levels of antioxidant which can aid the client
from tissue damage due to fatigue after exercise.
Unlike other sedentary activities, training requires more dietary protein to support muscle
synthesis, recovery and provide amino acids for oxidation during exercise (Tipton & Wolfe,
2004). The protein requirement of athletes involved in intermittent high-intensity sport, like
football, is suggested to be between 1.2 and 1.7 g · kg -1​ ​ . Numerous studies have also shown
that protein intake near the time of exercise induces positive nitrogen balance which leads to a
more effective adaptation to training (​Hawley et al.; 2006).
Aside from protein and carbohydrates, fat is also an important energy source during
strenuous workouts. Monounsaturated fats are preferred over polyunsaturated fats; giving
importance the age and condition of the client. ​Besides the depletion of glycogen stores,
dehydration may also contribute to the development of fatigue (Castagna et al., 2007). Due to
the physical activity of the client, a daily water intake should be increased to maintain endurance
in performing such strenuous workouts.
On the other hand, recent studies correlated the link between dietary habits and eating
practices which can influence food preferences and eating practices. Behavior towards health
and nutrition, food cost, ease of preparation are also considered as determinants for an athlete’s
food preferences (​García-Rovés et al., 2014). For the client’s situation, he only likes to eat foods
prepared by his significant other, thus, the influence of family environment should be highlighted
when designing and implementing nutritional interventions. This information is essential
because health and nutrition education should focus on both food and eating practice, not only
on nutrients
With these in mind, the aim is to focus more on optimizing during training and
competition through adequate nutrient intake, proper meal planning and preparation to maintain
an optimal body weight and physical condition, and minimize the risk of injury and illness.

II. Case Study Analysis

Given Case
AK, 38/M, is a retired professional football player and coach in one of the leading colleges in
Manila. His team has practices three times a week and he plays football for two hour after
school hours. His typical food intake in a day is composed of lean chicken, bread, and low-fat
milk. He eats fish that is only cooked by his wife. His favorite food is vegetable salad with
honey-mustard dressing.

Given Anthropometry
Height: ​178 cm Weight: ​62kg
Waist: ​70 cm Hip: 81 cm

Solved Anthropometry
BMI: weight in kg ​÷ height in m​2
62 kg ​÷ 1.78m​2
19.57 (Normal)
 WHR: waist circumference in cm ÷ hip circumference in cm
70 cm ÷ 81 cm
0.86 (Normal) ( - Android Obesity) ( - Gynoid Obesity)

DBW: Tannhauser’s (Broca) Method

height in cm - 100 - 10% of the difference
178 cm - 100 - 7.8
70.2 kg

Though the client’s BMI is within the normal range, his current weight of 62 kg is behind the
desired body weight of 70.2 kg. Achieving his DBW of 70.2 kg would signify achieving the
desirable BMI for men, which is 22.

Derivation of the Total Energy Allowance (TEA)

TEA: Desirable Body Weight (DBW) x Physical Activity Level (PAL)
70.2 kg x 45
3159 kcal

Considering the client’s daily activity of playing football for 2 hours after school hours and the
thrice a week football practice with his team, his physical activity level categorizes into Very
Active with 45 as the value.

Percentage Distribution
CHO: TEA x 0.65 ÷ 4 PRO: TEA x 0.15 ÷ 4 FAT: TEA x 0.20 ÷ 9
3159 x 0.65 ÷ 4 3159 x 0.15 ÷ 4 3159 x 0.20 ÷ 9
513.34 ≅ ​515 g 118.46 ≅ ​120 g 70.2 ≅ ​70 g

III. Meal Planning

Food No. of CHO PRO FAT Energy

Exchanges (g) (g) (g) (kcal)
Vegetable A 2 3 1 - 16
Vegetable B 1 3 1 - 16
Fruit 4 40 - - 160
Milk 2 24 16 10 250
Sugar 6 30 - - 120
Subtotal 100
Rice 18 414 36 - 1800
Subtotal 54
Meat & Fish A 4 - 32 4 164
Meat & Fish B 3 - 24 18 258
Meat & Fish C 1 - 8 10 122
 Subtotal 42
Fat 6 - - 30 270
TOTAL 47 514 118 72 3176

DAY 1: Meal Plan & FCT

FOOD Food Group No. of Amount CHO PRO FAT kCal
Exc
Breakfast
Lugaw Rice 2 3 cups 46 4 0 200
Pan de sal, toasted Rice 2 6 pcs 46 4 0 200
Tuna spread, canned Meat B 3 6 tbsps. 15 24 18 258
Pulvoron Sugar 3 1 ½ pcs 0 0 0 60
AM Snacks
Mixed Fruits
Banana Lakatan, sliced Fruit 1½ 1 1/2pc. 15 0 0 60
Grapes Fruit 1½ 15 pcs. 15 0 0 60
Watermelon Fruit 1 1 cup 10 0 0 40
Yoghurt Milk 1 ½ cup 12 8 0 80
Lunch
Tinola
Chicken breast, cooked Meat A 4 1 pc 0 32 4 164
Chayote, cooked, diced Veg A 1 ½ cup 0 0 0 0
Pepper leaves, cooked Veg A 1 ½ cup 0 0 0 0
White rice Rice 5 2 ½ cups 115 10 0 500
Biko Rice 2 2 slices 46 4 0 200
Green tea free free 0 0 0 free
Honey Sugar 3 3 tsps. 15 0 0 60
PM Snacks
Whole wheat bread Rice 1 2 pcs. 23 2 0 100
Peanut Butter Fat 4 8 tsps. 0 0 20 180
Dinner
White rice Rice 5 2 ½ cups 115 10 0
Adobo 500
Pork kasim, diced Meat C & Fat 3 1 slice 0 8 28 212
Potato, boiled Rice 1 2 ½ pcs. 23 2 0 100
Mungbean sprout Veg B 1 ½ cup 3 1 0 16
Bedtime Snacks
Low fat milk Milk 1 1 12 8 5 125
tetrabrick
TOTAL 47 511 117 75 3115
 FOOD Dimension Amount No. of Wt Total EP(%)/ Actual
Exc (g)/Exc Wt. (g) 100 (g) EP%
Lugaw 3 cups 2 250 500 100 5
Pan de sal 5 x 5 cm 6 pcs 2 40 80 100 0.8
Tuna spread 6 tbsps 3 30 90 100 0.9
Pulvoron 4x2½ x1 1 ½ pcs 3 10 30 100 0.3
cm
Banana lakatan 9 x 3 cm 1 ½ pc 1½ 40 60 69 0.82
Grapes 2 cm 15 pcs 1½ 55 82.5 80 1.03
Watermelon 12 x 6 x 3 cm 1 cup 1 140 140 62 2.26
Yoghurt ½ cup 1 125 140 100 1.25
Chicken breast 6 cm long 1 pc 4 30 120 84 1.43
Chayote fruit ½ cup 1 45 45 100 0.45
Pepper leaves ½ cup 1 45 45 100 0.45
White Rice 5 cups 10 80 800 100 8
Biko 10 x 5 x 1 2 slices 2 40 80 100 0.8
cm
Green tea 1 cup free 15 15 - -
Honey 3 tsps 3 5 15 100 0.15
Whole wheat bread 11 ½ x 8 ½ 2 pcs 1 45 45 100 0.45
cm
Peanut Butter 8 tsps 4 10 40 100 0.4
Pork kasim matchbox 1 slice 3 55 165 100 1.65
Potato 7 x 4 cm 2 ½ pcs 1 165 165 100 1.65
Mungbean sprout ½ cup 1 45 45 100 0.45
Low fat milk 1 1 250 250 100 2.5
tetrabrick

FOOD Actual H2O (g) Energy PRO FAT CHO Fiber Ash
EP% (kcal)
Lugaw 5 414 355 7 5.5 69.5 0.5 4
Pan de sal 0.8 17.28 264 8.08 3.36 50.32 2 0.96
Tuna spread 0.9 42.57 297.9 22.68 23.04 0 0 1.71
Pulvoron 0.3 0.81 140.7 2.04 4.92 22.08 0.36 0.15
Banana lakatan 0.82 59.16 109.62 1.22 0.17 25.75 2.87 0.7
Grapes 1.03 81.68 85.49 0.412 0.309 20.29 1.03 0.412
Watermelon 2.26 208.6 70.06 0.23 0.45 16.27 0.9 0.45
Yoghurt 1.25 104.5 103.75 6.63 5.63 6.75 0 1.5
Chicken breast 1.43 104.43 187.14 30.86 7.14 0 0 1.43
Chayote fruit 0.45 43.2 7.2 0.135 0.045 1.575 0.315 0.045
Pepper leaves 0.45 39.06 23.4 0.81 0.135 4.725 0.225 0.27
White Rice 8 540.8 1032 16.8 1.6 237.6 3.2 3.2
Biko 0.8 34.88 181.6 2.08 0.32 42.56 1.36 0.16
Green tea - 7.4 357 21.7 1 65.3 11.2 4.6
Honey 0.15 5.34 38.7 0.015 0.015 9.615 0.03 0.015
Whole wheat bread 0.45 9.765 140.85 5.445 0.405 28.845 2.16 0.54
Peanut Butter 0.4 0.12 246.4 10.16 18.16 10.56 2.32 1
Pork kasim 1.65 81.675 638.55 22.11 61.05 0 0 0.99
Potato 1.65 138.27 102.3 2.805 0.165 22.605 2.145 1.155
Mungbean sprout 0.45 39.06 24.3 2.16 0.315 3.15 0.72 0.315
Low fat milk 2.5 218.75 162.5 8.25 9 12 0 2
TOTAL 2191.35 4568.46 171.62 137.23 649.5 31.34 25.6

FOOD Actual EP% Ca Pho Iron Retinol B Caro

Lugaw 5 35 75 0 0 0
Pan de sal 0.8 19.2 60 2.4 - -
Tuna spread 0.9 24.3 107.1 1.53 310.5 292.5
Pulvoron 0.3 20.4 27.9 1.17 0 -
Banana lakatan 0.82 18.27 29.58 0.7 0 313.2
Grapes 1.03 6.18 24.71 0.412 0 20.6
Watermelon 2.26 18.08 15.82 0.452 0 226
Yoghurt 1.25 225 156.25 0.125 106.5 50
Chicken breast 1.43 34.32 231.66 1.43 42.9 7.15
Chayote fruit 0.45 11.25 4.5 0.18 0 9
Pepper leaves 0.45 39.15 7.2 0.765 0 913.5
White Rice 8 88 288 4.8 0 0
Biko 0.8 11.2 26.4 1.2 0 0
Green tea - 656 258 18.4 0 0
Honey 0.15 4.35 0.9 0.48 0 0
Whole wheat bread 0.45 19.35 39.6 0.945 0 0
Peanut Butter 0.4 46.4 148 0.32 0 0
Pork kasim 1.65 26.4 184.80 1.485 8.25 3
Potato 1.65 56.1 72.6 1.32 0 trace
Mungbean sprout 0.45 8.55 38.7 0.54 0 9
Low fat milk 2.5 347.5 232.5 1 87.5 62.5
TOTAL 1715 2029.23 39.65 555.4 1936.45

FOOD Actual EP% Total Vit. A Thiamin Riboflavin Niacin Vit. C

Lugaw 5 0 0.05 0.1 1 0
Pan de sal 0.8 - 0.184 0.12 2.4 0
Tuna spread 0.9 359.1 0.02 0.225 6.12 0
Pulvoron 0.3 - 0.063 0.051 0.6 0
Banana lakatan 0.82 52.2 0.0261 0.435 0.435 21.75
Grapes 1.03 3.09 0.062 0.021 0.206 3.09
Watermelon 2.26 38.42 0.0452 0.0678 0.453 15.82
Yoghurt 1.25 115 0.0875 0.275 0.125 0
Chicken breast 1.43 44.33 0.0858 0.0858 13.871 0
Chayote fruit 0.45 1.35 0.0045 0.0045 0.0135 4.5
Pepper leaves 0.45 152.1 0.0405 0.036 0.27 2.25
White Rice 8 0 0.16 0.16 4 0
Biko 0.8 0 0.016 0.032 0.4 0
Green tea - 0 0.01 0.07 6.8 0
Honey 0.15 0 0 0.0015 0 0
Whole wheat bread 0.45 0 0.126 0.0045 1.035 0
Peanut Butter 0.4 0 0.004 0.028 3.4 0
Pork kasim 1.65 13.2 0.5775 0.264 5.28 4.95
Potato 1.65 trace 0.1155 0.0825 2.805 39.6
Mungbean sprout 0.45 1.35 0.0495 0.0405 0.45 13.05
Low fat milk 2.5 97.5 0.1 0.45 0.25 5
TOTAL 887.64 1.83 2.64 50.03 110.01
 DAY 2: Meal Plan
FOOD Food No. of Amount CHO PRO FAT kCal
Group Exc
Breakfast
Breakfast Cereal Rice 5 2 ½ cups 115 10 0 500
Lite Low Fat Milk Milk 2 2 tetrabricks 24 16 10 250
Banana, Lakatan Fruit 1 1 pc 10 0 0 40
AM Snacks
Sponge Cake Rice 2 2 slices 46 4 0 200
Mango Juice Sugar 4½ 1 tetrabrick 5 0 0 110
Lunch
Rice, boiled Rice 5 2 ½ cups 115 10 0 500
Bulalo
Beef Shank Meat A 4 4 slices 0 32 4 164
Baby Corn Veg B 1 2 pcs. 3 1 0 16
Petsay Veg A 1 ½ cup 1.5 .5 0 8
Papaya Fruit 2 2 slices 20 0 0 80
PM Snacks
French Toast
Whole Wheat Bread Rice 1 2 slices 23 2 0 100
Chicken Egg Meat B 1 1 pc. 0 8 6 86
Butter Fat 1 1 tsp 0 0 5 45
Dinner
White rice Rice 5 2 ½ cups 115 10 0 500
Sweet & Sour Fish, Fried
Karpa Meat B 2 2 slices 0 16 16 172
Sugar Sugar 3 1 ½ tsp 23 2 0 100
Canola Oil Fat 2 2 tsp 3 1 0 16
Pepper Fruit, Sliced Veg A ½ ¼ cup .75 .25 0 4
Onions, Sliced Veg A ½ ¼ cup .75 .25 0 4
Garlic Free free 2 tbsp 0 0 0 0
Spam, Fried Meat C & 1 3 slices 0 8 21 167
Fat 1
Pineapple Fruit 1 1 slice 10 0 0 40
Bedtime Snacks
Peanut Butter Fat 2 4 tsp 0 0 10 90
TOTAL 47 515 121 72 3192
 DAY 3: MEAL PLAN
FOOD Food No. of Amount CHO PRO FAT kCal
Group Exc
Breakfast
​Boiled chicken egg Meat B 1 1 piece - 8 6 86
Fried bacon
Bacon Fat 2 2 strips - - 10 90
Canola oil Fat 2 2 teaspoons - - 10 90
Rice, cooked Rice 4 2 cups 92 8 - 400
Papaya, ripe Fruit 2 2 slices 20 - - 80
AM Snacks
Kutsinta Rice 3 3 pieces 69 6 - 300
Taho w/ syrup and Sugar 3 ¾ cup 15 - - 60
sago
Lite low-fat milk Milk 1 1 tetrabrick 12 8 5 125
Lunch
Rice, cooked Rice 4 2 cups 92 8 - 400
Sweet corn
Golden sweet Veg B 1 2 tbsps 3 1 - 16
corn, canned
Butter Fat 1 1 teaspoon - - 5 45
Bopis
Pig’s heart, boiled Meat C 1 ¾ cup - 8 10 122
and diced
Corn oil Fat 1 1 teaspoon - - 5 45
Onions Veg A 1/2 ½ cup 1.5 0.5 - 8
Annatto seeds, Free
diluted
PM Snacks
Binatog Rice 3 1 ½ cups 69 6 - 300
Mango, ripe Fruit 2 1 cup 20 - - 80
Powdered sugar Sugar 3 3 teaspoons 15 - - 60
Dinner
Rice, cooked Rice 4 2 cups 92 8 - 400
Sarciadong Lapu-lapu
Lapu-lapu Meat A 4 4 slices - 32 4 164
Chicken egg Meat B 2 2 pieces - 16 12 172
Tomatoes Veg A 1 1 cup
Onions Veg A 1/2 1/2 cup 1.5 0.5 - 8
Fish sauce free
Bedtime Snacks
Warm lite low-fat milk Milk 1 1 tetrabrick 12 8 5 125
TOTAL 47 514 118 72 3176
 DAY 4: Meal Plan
Food No. of
FOOD Amount CHO PRO FAT kCal
Group Exc

Breakfast
Tocino, lean Meat A 1 1 pc. - 8 1 41
Olive oil Fat 1 1 tsp. - - 5 45
Tinapa (Galunggong) Meat A 1 1 pc. - 8 1 41
Chicken egg, hard-boiled Meat B 2 2 pcs. - 16 12 172
Rice, cooked Rice 5 2 ½ cups 115 10 - 500
Apple Fruit 1 1 pc. 10 - - 40
Lite low fat milk Milk 1 1 tetra brick 12 8 5 125

AM Snacks
Palitaw Rice 1 4 pcs. 23 2 - 100
Melon Fruit 2 2 slices 20 - - 80

Lunch
Alimango, laman Meat A 2 ½ cup - 16 2 82
Longanisa, chorizo style Meat C 1 1 pc. - 8 10 122
Mungbean sprouts, cooked Veg B 1 ½ cup 3 1 - 16
Olive oil Fats 3 3 tsps. - - 15 135
Rice, cooked Rice 4 2 cups 92 8 - 400
Pastillas, gatas Sugar 3 3 pcs. 15 - - 60

PM Snacks
Pulvoron Sugar 3 1 ½ pcs. 15 - - 60
Kutsinta Rice 1 1 pc. 23 2 - 100

Dinner
Tortang Talong
Eggplant, cooked Veg A 2 1 pc. 3 1 - 16
Chicken egg, cooked Meat B 1 1 pc. - 8 6 86
Olive oil Fat 2 2 tsps. - - 10 90
Rice, cooked Rice 5 2 ½ cups 115 10 - 500
Grapes Fruits 1 10 pcs. 10 - - 40

Bedtime Snacks
Sapin-sapin Rice 2 2 slices 46 4 - 200
Lite low fat milk Milk 1 1 tetra brick 12 8 5 125

TOTAL 47 514 118 72 3176

 DAY 5: Meal Plan
FOOD Food No. of Amount CHO PRO FAT kCal
Group Exc
Breakfast
Rice Rice 4 2 cups 92 8 - 400
Chicken egg, boiled Meat B 1 1 piece - 8 6 86
Corned Beef, sauteed Meat B 2 6 tbsp - 16 12 172
Canola oil Fat 3 3 tsp - - 15 135
Cabbage, steamed Veg. A 1 ½ cup - - - -
Fresh cow’s milk Milk 1 1 cup 12 8 10 170

AM Snacks
Watermelon Fruit 2 2 slices 20 - - 80
Green tea Free - 1 cup - - - -
Brown sugar Sugar 3 3 tsp 15 - - 60
Espasol Rice 2 4 pieces 46 4 - 200

Lunch
Sinigang na Tilapia
Tilapia Meat A 2 4 pieces - 16 2 82
Pechay, cooked Veg A 1 ½ cup - - - -
Rice Rice 4 2 ½ cups 115 10 - 500

PM Snacks
Buko water Fruit 2 2 cups 20 - - 80
Hamburger roll Rice 2 2 pc 46 4 - 200
Hamburger Meat C, 1 2 ½ pcs - 8 10 122
Sugar & 1 5 - - 20
Fat 1 - - 5 45
Pastillas, gatas Sugar 2 2 pcs 5 - - 20
Sapin-sapin Rice 1 1 slice 23 2 - 100

Dinner
Sirloin steak, grilled Meat A 2 2 slices - 16 2 82
Asparagus tips, sautéed Veg. B 1 1 cup 3 1 - 16
Canola oil Fat 2 2 tsp - - 10 90
2​
Potato, mashed Rice 2 2 ​ /​3 ​cups 46 4 - 200
Kutsinta Rice 2 2 pcs 46 4 - 200
 Bedtime Snacks
Skimmed Milk Milk 1 1 cup 12 8 Tr 80
TOTAL 506 117 72 3140

IV. Nutrition Education (Normal Male Client)

Based on the client's present condition, the following activities will be considered in creating the
teaching plan:
1. Health education on the importance of variety of food in his diet.
○ Rationale:​ For the client to have more initiative on adjusting to his new diet, he should
know the importance of varying his food. The discussion will help the client understand
the importance of having different variants of food in his diet as these have different
types and nutrients which can help the diet of the client. Since he has deficient
carbohydrates in his daily food intake, he should be aware of its recommended portion in
a healthy plate (as well as the other food groups) and the required number of servings
per food group based on his physical activity. Moreover, giving a variety of food to not
only be healthy but be also capable to perform intensely and compete successfully
without putting their health into risk and injury (Montecalbo, 2015).
2. One to one health discussion of the recommended daily nutritional intake
appropriate for the client's age and activity level.
○ Rationale:​ Based on the client's lifestyle, the discussion will aid him on understanding
the importance of maintaining an adequate intake of all essential nutrients for his health.
His knowledge of what and which foods can be incorporated into his diet increases the
participation of the client in planning and preparing his meals. In addition, other food
sources that are readily available will also be considered to suit the client's preferences.
Meeting his high energy requirement due to a very active lifestyle would be more
convenient and easier for him to comply for the reason that he would be able to have
more choices of his preferred food. The Daily Nutritional Guide Pyramid for Older
Persons will aid the client to compare and contrast his suggested diet and physical
activity level to the population that falls within his age group (30-49 y/o). In this manner,
A.K. would be able to reach his DBW of 70.2 kg from his actual weight of 62 kg and have
more balanced nutrients.
○ Nutritional Requirements​. Based on the client's present condition, we recommend the
following adequate nutrient intake:
■ Carbohydrates- Athletes need to incorporate carbohydrates in their diet since it
provides the primary fuel source during an intense training, muscle growth and
development (Megan, 2011). For the client, an increase in carbohydrate intake is
suggested because his physical activity requires his diet to be composed more on
carbohydrates. According to RENI (2006), the recommended amount of caloric
 intake of carbohydrates should be 55​70% of TDE and 70% of which should come
from complex carbohydrates. Not greater than 10% should come from simple
sugars. Instead of refined grain, the client's diet focused more on whole grains
which provide longer sustained energy and can be found in oatmeal, whole wheat
bread, brown rice and etc. Moreover, eating a high-carbohydrate meal will help
restore glycogen stores more efficiently allowing the client to regain energy for his
daily training sessions (Andeng, R. & Silver, S).
■ Fruits and Vegetables- ​Fruits and vegetables are necessary in an athlete's diet as
these help them have an optimum performance and recover from a strenuous
exercise. Lack of these can lead to fatigue, muscle damage, impaired immune
function, and dehydration (Egeland, 2014). Another reason is that certain nutrients
cannot be synthesized by the body which is why incorporating vegetables and
fruits in the diet is important (Georgiou, n.d.). In the client's case, he has to have
three (3) exchanges of vegetables at most and four (4) exchanges for fruit.
■ Protein- For athletes, protein is a necessary component to aid in muscle repair
and development. Being more physically active coincide with higher protein needs
due to increased risk of damaged muscles after workouts (Tipton & Wolfe, 2004).
In the client's case, the recommended protein intake is 120 g per day.
■ Fat- ​Fat is an essential energy source during exercise and as a vehicle of
fat-soluble vitamins (Rodriguez et al., 2009). Upon reviewing the client's lifestyle
and food preferences, the recommended consumption of fat suggested is less than
10% of his daily from saturated fats and less than 1% of daily calories from
trans-fat. For instance, low fat milk is included in his meal plan to lessen the
unhealthy fats that can increase risk of having heart disease and other chronic
diseases.
■ Water and Electrolytes- ​Hydration is an important part for an athlete's overall
performance (Castagna et al., 2007). The lack of water intake can compromise a
person's health, thus the recommended water intake for adults under average
conditions of physical activity and environment is 2500 mL based on a desirable
intake of 1 mL per kcal of energy expenditure (NRC, 1989). Fluid needs vary
among individuals especially to those who involve themselves in heavy training.
For the client, the recommended daily water intake is 500 to 600 ml of fluid about
two hours before exercise and 200 to 300 ml about 15 minutes before exercise
(Modric, 2013). During training, the client may need to drink about 250 ml of water
every 15 minutes to have minimum water intake.
3. Teaching of meal preparation of the recommended meals in adherence to his diet,
schedule and preferences
○ Rationale:​ The client should know different ways to prepare his food to ensure its quality
in terms of its nutrients. He should know the effects of different kinds of preparation on
the amount of nutrients in his food in order to avoid deficiency or excess of nutrients in
his daily food intake (especially his carbohydrates because of physical activity level).
Moreover, the wife will be also included in the health education related to food
preparation to encourage the client to comply on his new diet based on his preferences.
This is correlated with a study which talks about the influence of family environment in an
athlete's food preferences and dietary habits (García-Rovés et al., 2014).
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eggies
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Nutrients,​ ​6​(7), 2697-717. doi:10.3390/nu6072697
Georgiou, C., B. HSc ND. (n.d.). Fruit and Vegetables for Improved Exercise Performance | Joe
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