CELIAC DISEASE CASE STUDY 1 Celine Disease Case Study ‘Medical Nutrition Therapy, FACS 438 ‘Wednesday, October 7th, 2020 Candace Martell Dr. Anstrom CCentification of Authorship: I certify that 1am the author ofthis paper and that any assistance I received in its preparation is fully acknowledged and disclosed inthe paper. Ihave alo cited ‘any sources from which I used data, ideas, or words, ether quoted directly or paraphrased. I also cetly that his paper was prepared by me specifically forthe purpose ofthis assignment, Signature): Candace Martell ONU ID No. 1821596Cased He D acta Di, Celiac Disease AInteoductory Level Objectives ‘fier cempleting this case, the student will be Mrs. Sandra Guernsey i admited te University able to: Hospital with severe weight loss, extreme fa- 1. Apply working knowledge of pathophysiol _tiguesand diarrhea. A small bowel biopoy reveals co} interpret diagnostic procedures for & diagnosis of celiac disease with secondary mal celia disease. absorption and anemia, 2 Interpret anthropometric and laboratory parameters for nutritional assessment. 3. Derermine nutrient requirements for i viduals with celiac disease. 4. Demonstrate ability to determi appropriate medical nutrition therapy for individuals with celine disease Distinguish classifications of malnutrition. * tod Aud Adruy satUp careensire anaes ADMISSION DATABASE Ye Sanden Guernstiy fen 37s age 36 ain Hope SelM Tana esa oe Se i) me) [gts oy out Bac ao Sa] Steams ore re + esns ser fight a TP Pee kn ED ey pe tee ter ated Same ‘ETE Nea Ff Seba pat con EMS ATTA FE reemnd TGnN aoe rime aap ea | ety Rape — Sere chara sano an dng OS ae a aay aE ica Be ay [eee | [tne Dyccimicneapae Ot OW Hawt 7 cater Tig Tia B tiger 8 seer Sonoran 15 Webstats B Grantaretine 5 iwc Bo ian B kare 8 itn ate Beste Ba ieee sa te prhalonaninag sO Taro termina eee Rp OSE Fen 2 teers Commi Se oe see Sees ae ae ei Cretan Tm Bm Dimaegutead em! Bw Os Se Topepatimapiaracaore=? OW OR(cael Cale Diene 145 p> Slient name: Sandra Guernsey Oop: ai Age: 36 Sec Female Education: Bachelor's degree Occupation: Previous secretary for hospital administrator—now at home since recent delivery ofson Hours of work: N/A Household members: Husband age 4 Ethnic background: Caucasian Religious affiliation: None Referring physician: Roger Smith, MD (gastroenterology) son age son age 3 months—all well Chief complaint: “Lhave sta tremendous amount of weight, and I have been having terrible diarthea for awhile now. I don't even have the energy to get off the couch right now” Patient history: (Onset of sense: Patient relates having diarrhea on and off for most of her aul life that she ean re- member “It seems that alot of people in my family have'funny’ stomachs, My mom and grand- mother doth have problems with diarrhea ofFand on. Mine got much worse during my most recent pregnancy, and now itis debilitating” She recently delivered a5 Ib 2 oz healthy san @ 39 weeks gosta ion. She states that she gained.11 Ib during this pregnancy but has since los about 30 Ib. She now (Ovweighs 82 ib. Her greatest nonpregnant weight was 112 Jb just prior to this pregnaney. She describes the diathea a foul smelling and indicates symptoms are not affected by what she eat in that she {generally has diarrhea no matter what she eats. "I started out breastfeeding my son but stopped about 3 weeks ago because | fet so bad.” ‘Type of Tx: None at present PMH: 3 pregnancies—2 live birth, | miscarriage at 22 weeks, No other significant medical history ‘Meds: Prenatal vitamin, Kaopectate Smoker:Yes Family Haz What?CAD_— Whe Father Physia exam: Gener oppenrnce: Thin, pale woman wh complains offs, wesknes and Vite emp 98.2% BP 108227 Ts bpmdnoral, RR 17 opm enc: Regular rate and rhythm. Hear sbunds noc. HEENT. yes ?ERRLA ster pal fond benign Thre: ory clea without posts rsinage Geniats: Deere Nevo tact ler and oriented xref No edema, stents 9/3 Shin Pv without sons CPllesting ngs lear to percussion and auscultation Otome Not distended dinshed bowel sounds146 Unis Three Medi Natron Theropy or Gselatetna Disorders Nateton Hi Cnc Patt ac that hei urge al the ine." do et bt it scm that everytime eatin any [egeamount that ano mediately have Garo do not Reve ase or vomiting Foods that tid and mental bet-tnd to moke the dares worse Rett hat she haben ing chicken naodeoup.cacher, and Sprite hela several ay Patent sas tat er gres- SEsonprgnan weit wa prior oer st pregnancy. when she weighd 1121 She pied 11 1b wr her pregancyad her falcrm son waphed 52 on Usual dietary intake: Likes all foods but has found that she avoids eating because it causes her diarrhea to start 2 eeall (prior to admission): ‘AM: Teast—1 slice, hot tea with 2 tsp sugar. Limeli: Vechicken noodle soup, 2-3 sltine crackers, applesauce, 12.02 Sprite: throughout res ‘of day sips of Sprite Food allergiesintolerances/aversions: NEA Previous MNT? No Food purchase/preparaion: Self Viurnin intake: Stil taking prenatal vitamins Anthropometric measures: TSF 7.5mm, MAC 180 mm ‘Txplon: 24-hour stool collection for direct visual examination; white blood ells: occult blood: Sudan black 8 Tat stain; ova and parasites electrolytes and osmolality; pH: alkalizaton; 72-hour fecal @ Upper gastrointestinal endoscopy for small bowel biopsy and possible duodenal aspirate Diet: 1OO-g ft diet x 3 days Hospit ‘Small bowel biopsy indicates Mat mucosa with villus atrophy and hyperplastic crypts—inflammatory infiteae in lamina propria. Fecal fat indicates steatorrhea and malabsorption. Positive AGA, EMA antibodies Dx: Celiac disease with secondary malabsorption and anceniaOD Uppumvensiry woserrar suis sandra Gurrnsey nak: 36 oe: 3724 Sax F FYSICIAN: Roger Sih MO Cored CalacDiene 147 oe. ‘Tne ‘loonie Prestbenie Franeteret a sone Ghlorige . ages Osnotaliey oral C0, Chucose> Ereacintne Use aie oy cee, ore arg we vot poo & boo x T Nes aectoogses (e gretboates a : : =D <3 Ges Jet bn Geen see on {6:6 Gone) S35 Soo Sie Pes ere ova ora ora ovat set sate att one =e ral/ig Mo ool ara. va sa moral a/a ara cmt in wa un ve wn, maf aa maya at ose(8 ole Tiree Medical Noten Therapy fr Gosteneton Disorders Upunvecesire aasersa ay Sandra cutrncey oe: 37n4 ces 36 See: FMSICIAN: Roger Swieh, 1 Bins i Bee e Be, BS : ae Bo 4 Oo Bs ee : ® & 8 bb Ee Bag town ae | SS a Sorat T eatts Theloec eels orcue 14 Caae Disease 149 > Case Questions What = 72-hour feel fat tes Mrs. Guernsey's laboratory report shows her (ecal fat wae 11.5 gm fat/24 hour. What docs this mean? ‘Why was the patent placed on a 100-gm fat diet when her diet history indicates that her symp toms are much worse with fried foods? ‘The small bowel biopsy results state,“fat mucosa with villus atrophy and hyperplas inflammatory infiltrate in lamina propr the anatomy of thesmall intestine? crypts — ‘What do these results el you about the change in How is celiac disease related tothe damage tothe small intestine thatthe endoscopy and biopsy results i What isthe etiology of celia disease? Is anything in Mrs. Guernsey's history typical of patients with celiac disease? Expl What are AGA and EMA antibodies? Evaluate Mrs. Guernsey's laboratory measures for nutritional significance. Explain the rationale {or your evaluation ofthe laboratory value. ‘Areany symptoms from Mes, Guernsey's physical examination consistent with her labotalory values? Explain, Calculate the patient's BW, 961BW, 96UBW, and BMI, and explain the nutritional risk associ ated with each value2 13. rs 15. 16. Ww. 18, 1. 21.) ‘Uni These Medic Ntetan Therapy or Gestinetnn Disorders Evaluate Mrs, Guersey’s other anthropometric measurements. Using the avalable dats, cal- Int her upper arm muscle area and upper arm fat are. nterpret thisinformation fr nutci- tional signfieanee. Can you diagnose Mrs. Guernsey with melnutrition? Ifo, what type? What is your rationale? (Calculate this patents energy and protein needs. ‘Gluten restriction ie the major component of the medical nutrition therapy for li disease. ‘What isploten® Where sit foun? CCan patients on a gluten-free diet tolerate oats? ‘What sources other than foods might introduce gluten to the patient? ‘Are patients with celiac disease also lactose intolerant? ‘Are there any other considerations you might need to make when inating sold food for this patient? ‘Mrs. Guernsey's nutritional status is so compromised that she might benefit from high-calorie high-protein supplementation. What would you recommend? ‘Would gluta low could she receive i? ine supplementation help Mrs, Guernsey dng the lcaling process? ‘What result can Mrs, Guernsey expect from restricting all foods with gluten? Will she have to follow this diet for very long?cst 4 GalueDsese 151 --\ 22+ Braluate the following excerpt from Mrs. Guernsey's food diary. Identify the Foods that might 1) notbe tolerated on a gliadin. ree diet. Por cach food identified, provide an appropriate substitution, Cornflakes Bologna slices Lean Cuisine bee tips on rice ‘Skin milk, Cheddar cheese spread Green bean casserole (mushroom soup, onions, green beans) — Coffee 49,101, 14, 1b a al152 Uni'Tvee_ Medea Nobis herp for Gstnnestnl Disorders Bibliography _Amerean DicticAsaciation, Cf dts: In Manna "of Csi Dewi, hed Chips: American Di tte Asoeaton, 2000:181-191 Heyer LL Medial mation therapy fr tower gst sol ect so, Malan UK, Eat tS {ea Keane’ od urinate They. Tod cd dlp: Saunders, 200:606-654. Chartrand I Sida G. Calne diaseisaiebong dis onde. Cl Int Mol 196195387. Commision on Aecrediation for Deities Eduction. ‘Know, sb ane comptencies fr deans. c- ‘tation Mew or Divs Ect Pogns. ‘veh od. Ciegor American Diet Assodation, n:45-49. Coping wt cine den. Tif University Ha & N- rio Later No or: September 1988 {InfoTrac Resources {CD30 expression my be prognostic in patins with re Aeactory prc. Caner edly, Oe 22,2009 p28. line cae VS. aa, sera Vat Orginal ne ers, Dec 2001 v8 p92) Cline Dic Hana Patet Pag) (ymptoms and re ‘cet Liv M, Stee JAMA, Th our of the ‘erin Met Aseation March 20, 2002287 {1 pls) maya: HOGS, Celia ies up 0 20 times more ly o occur in p> tints with type | dsb (Use Serologic Tests To eat Case). Diana Maloney. Fay Paice Nr Oat, 202 ¥32 19 pS) Dereeting ela ies in yor patents (incdes patient Information hpdout) Harold. Prucssnet American Fay Phys, arch 1,198 87 5 102313). Diagnosing clin ics 2002: Who, why. an how ‘Comments Linda Shak, Peres May 202 10915 p952( Gluten eave. fe diet advise for sfferrs of Celine disease Chemist &- Dring Jun 22, 2002p. Luong, hen fe et boos cle disease outcomes, (ods Anema, Increased Gl Canes). Brace ncn. Inna Meine er, May 15,2002 ¥38 10 pl) More cide fo di alin clin diese. (News ite) Till University Hlth Nutri Lette Now 2001 +19 px) Mog Call: 108.3408 FrigheryC Coie disse Br Mal 1990319:236-239, empprnen Ty Kosa VeMsanatinen EKeetal. ( Nutronal ate of newly dinguosed eeiac disease -patnt before and fete inition of 3 elie ‘se gt seociton with he yade of mucosal i To trophy. A Cl Mar 199867482 fel Charan Lf Seman F Compra ‘alysis of srl eeening tet forint agro feof ela scse. Pirie. 198104757, “To Ps Crisnger KD. Overview of distin and absorp ‘in Span M, He), olga Physio: lage Apes of Hun rir, Padi ‘Stunders, 2000:76-90. Water. Schmit 5, Schumetting let Revised ert 1 for diagnos of cane disease. Ach Dis Chl 19065: 900-81 Cons may nw be ay for poopl with ten sensitivity. ‘ow Should Know), Enrioumental Murti, aly 200 57 3. Paint ice dae can sca moderate movi of ot nnnanaterpy Wek March 13, 2002p), , spectrom urns inate ptt and ea ther (Digatve Denes and Sones). (Absit) Fant Morphy Ramor da Ros Use. TAMA, The otra ofthe American Maa soca tio rch 620029287 plOBH1) Mag Cll nora, ‘Toe extra world of gluten and autoimmunity. (discus. Son afconnetion tee engi often expsure in preagnosed cele dese andthe isk of sui ‘mune dete) M, Lond, GO 2001 9 i p63 “Two cline mare (Clinical Copa) ely Koch Ks etic Meticine Nea Fe 1200238 13 pat) het arth lad andthe glten Sc dt. (Persp. "es in Prat). Thompson. aura of the ‘amernn DicteAscation, Dee 201101 2 plas.Zusvad wk = 92 lbs laura) y 004 B22) i 121s usa) Q) Signi ight s Salbs , 0 = 9a” be 4 iglpc —__Jop~ ga > [1Q"* 184 Is 9 signi ;CaQurlations Cont) by ASD Lobbous br Va weiprtgain 2 sho mus) hy Is = Ds. Ip) BM = oath. (uO. 02¢m Vem 4M \oo = iw.) Tis. anaes ti fakent uundarune ah (2% VWWNasusted wughts { wgitainr in bi Lin. @. [| piloss + (2.6 x Yang) 4185 x 1u0,0Xcm) = (ule x Bla Io) = u + Yoo 240 — (oe 4k 1ZSU.2y~ |p. 4k= {18U yh flea pina wack uae a ZAd: selfitapin hs. Uitlia St boy ~ REG ual dala) ¥L.as flo 5( [= ua) 1000.2 = iD {ol = 1074. 1 {0 (5eddon) J “aie i talaol N-CoWewlabions (eon) Maret Cahion —) Recto = “bags =I] aun vat Ta tii) Seaton Id) PLO = Ya Kg X10 = Yaglka +f 48 5 lta /day = So. TY Elwds = —1T4ak beads labs (iad st. ganado change val tad. =\atak or pe misy Ie = |7 reups| 2400s 1) Serum Pom larity = (Ax \2Goiml/t) F712. | 2 ao + 3.214 42 ( 239, Alive) | a ee TyWY y, Oe ey e CELIAC DISEASE CASE STUDY deo 0 (HV) » Mee eit Creme ZA and Kaopete, Ascoingt May Cline (2020) ost prenatal vain wil contin lc acid “5 (Goat) and iro, both of which the patient is curently deficient in. Prenatal vitamins will also \P*y 97 244 ne, ine, B vitamin, vitamin A, C, and D, an caleum. Zine sone a fandamena HS mineral in poe with sie disease, Kaopectat i medication to hep reduce symptoms of diarhea. Kaopectate products contain bismuth subsaiylte, which isa subsite for gluten, indicating the medication i gltene and wil ot interfere with the patent ecivng gluten from hee medieston, 4. The Small bowel biopsy results state “flat mucosa with villus atrophy and hyperplastic crypts-inflammatory in rate in lamina propria.” What do these results tll you about the change in the anatomy of the small intestine? oo 5 (27 Theansony o the smal intestine sogess that malebsorpton of vitamins and nels SSP such & BIZ iro, ais the case within his cle, happens within the smal intestine. The & we “98 src ofthemal inet scant oh incon ha ao ees ngs ee ‘ Ulvaeus ustet does bletmucese seca CSUER Vittics: an ophy Meets 7 8, Evaluate Mrs. Guernsey's laboratory measures for nutritional significance, Explain the ‘rationale for your evaluation of the laboratory value. Mix. Guernsey is moderately depleted in her Alb With vale of 2.9 yan ily depleted In Pre, With value of 1 gf. The lb results show glucose as 72 mga. (onal), BUN 9 (Nora), Cholesterol 128 mel (low), sodium 138 (norma), potassium 3.7 (nema), magnesium 1.6(sormal) feratin 12 ppl (low), vitamin B12 2 p/m. lw), and folate ‘ng/mL (normal). Nutritionally, the iron directly relates to her anemia, Increasing her intake ofPd o” ¥ CELIAC DISEASE CASE STUDY ery 3 KK, MS SOF WD vitamin C may help with the absorption ofthe iron. Vitamin B12, iron, and folate are low as a result of her Celiac Disease condition because of the damage done othe small intestine which {oes not allow it to properly absorb nutrients, Calculate the p jent's LBW, *%IBW, UBW, and BMI, and explain the nutritional risk associated with each value. ‘The patient's IBW is 115410%, %IBW is 80%, %SUBW is 82%, and her BMI is 16 ‘(ncerweight) As the patients values indicate, she has los a significant amount of weight since _siving her last birth. The nutritional complications include high risk for malnutrition as she is ready experiencing malabsorption from her chronic disease knovm a celine disease, 13, Caleulate this patients energy and protein needs. The pts pein seis were evn be 4 fh ey 50.40 pt. ing he 10-12 range or mild depeton of Atami Ke ates energy neds wee cael oe 1,542kcal/day, however, «planned weight change of gaining /stweek allowed for a calorie inrease 01,792 healing t |, Gluten restriction is a major component of the medical nutrition therapy for celine ‘disease. What is glaten? Whereis it found? we Gluten isa pepide protein that eeates the elastic Lexture for bread. Gluten contains protein fa 2s (prolamines) that are found in bazley, wheat and tye, or grain products. Gluten ‘can trigger inflammatory responses in individuals with elie disease that results in the Mlattening ofthe intestinal vil, which can lead to malabsorption and malnutrition ae de 16, What sources other than foods might introduce gluten to the patient? (Y.5L“ nee pre‘CELIAC DISEASE CASE STUDY 4 ‘Sourees other than foods that may introduce gluten would include cosmetics, medications, or being in contact with gluten prods eventhough you are not consuming the gluten. My vilamins Contain Ufoat! 21. What result can Mrs. Guernsey expect from restricting all foods with gluten? Will she ‘have to follow this diet for very long? ‘The results that Mrs. Guernsey may expect by restricting all foods wit gluten would be {improved absorption of nutients and restoration to her small intestine health, Therefore, where he is experiencing ron defciney (anemia) and low levels of B12 and folate, she will now be able to properly absorb those vitamins and minerals. As a result, she may not experience anemi, fatigue, ce weakness. The pationt’s lab values in regard fo albumin and prealbumin may also show improvements, Additionally, her symptoms of dirthea wil dissipate, and she can return to cating sigiticantly more calories than her 24-hour eal suggested she was geting (518 keals). Excluding gluten would bea lieing, set adherence as itis the ony safe and known treatment for individuals with cline disease.wy Os ee eramariny — LPR NS ccc terme, eb kale sconrenens yu oben Zo win 54 zat HO PRO. a = a y. TeHISs= 800-5029) OK ave 80D a Barrchol (5D (ete d COaFAN ing te formation iv Game gd=W ema nig 1. Take the number of servings from each ofthe food group and place them under the meal they wil be included, Fr example if you are going to provide 3 fut servings then you may want to ‘place 1 serving at breakfast, Lserving at lunch and 2serving a dinner 2 mecenmiperan rnmernenoeese Incorporate the correct ABS eon MealPlanningis 7 z ook PY Breakfast /{toneh fbi 3 Tale on Tilson Meat ‘Starch able Fut 7 i ‘30,3, and’ ae snack times ~this grids a general se grid and canbe used whenever you are ‘aculting a pattern. Weight reduction meal plans do not usually include snack, There are ceptions a0 ge 7 oP Cart wg, is ey we ay °”CELIAC DISEASE CASE STUDY Breakfast ‘Ecup oatmeal (1 starch serving) ~good soluble fiber choice Pair oatmeal w/ handful raisins & cinnamon oF topping of your choice & 1 Tbsp peanut butter (1 fat serving) 36x Yogurt (fermented product) (1/2 serving) % cup blueberries (I fruit serving) 4 18.02 water (1 up) 18 oz hot ta (1 cup) (eV Tach Soayogin (ami sewing) 2 hardboited eggs (2 meat servings) “good BI2source 173 cup quinoa (1 starch serving) Pie wi cup black beans (1 meat serving & 1 starch) Pair w! 1/4 cup cooked bell pepper & 1/4 cup ‘cooked mushroom (1/2 cup cooked = 1 ‘vegetable serving) cooked wi | Tbsp olive oil (fat serving) ‘4.cup pineapple or other fruit of your choice (fruit serving) 18 az water (I up) 18 oz Sprite (1 cup) 3 oz baked chicken (I meat serving) [7 ont cop mashed sweet pot @ sch ings & 2 vegetable servings) 1 orange (boost vitamin ¢ fr better iron absorption) (1 fruit serving) ow, u oi > Sy‘CELIAC DISEASE CASE STUDY ‘ = “Top w/' Tap lowfat margarine (fat serving! 2Bozvater(Qeups) Thar © Com) Net te 18.5 02 Gatorade (1.5 cup) - electrolytes Flas aps PRO: 42 50.40 ykptay Calories: 1792 kellny for V2 # weight pin/wesk ths plan follows 1,7S3keady (450 kel '¢**NOTE: Please avoid the consumption of wheat, barley, and rye and read nutrtion labels for ingredients ADIME NOTE: Az 36 ylo female, Med ds: Celine Disease w/ secondary malabsorption and anemia Med hx: 3 pregnancies, 2 live births, 1 miscarriage. Meds: Kaopectate 27 gid every 3-4 hours. Prenatal 2 ‘vitamins 1a. Vitals: 110/74 (noma), RR 17 (aormal) HR 71 BPMMnonmal. Labs (3/4) Alb 29 8 (aerate depletion, AI. (nd depletion, coe 72 (oral). BUN / v/ a / ‘ snl. (aonmal), cholesterol 128 mg/L (low), HOB 105 g/L ow), HCT38% (iow, fora 2”, > / A eee le 12 yp/dL low), vitamin B12 82 pg/mL. (low). Hi: $83 i _a/day,792 mls for weigh in Pas not had previous MNT and hs ben refered, oe Regidered Deans | TEclonctOu eh Umous alcied oh Noe D: Altered Gl funtion reed Cela Disease as evidenced hy a BMI of 16 (underweigh) -wth symptoms of dares sigan weight los, gue & wekness. ay Corporcle X4ehecemhaon ie CELIAC DISEASE CASE STUDY 5 7 vl wor bebe IS! bow muathrecommenc 2 cut fe hollows ee oo Provide nao dunon on esi dene and ods aid (whe bre. and 90 ye “while addressing sample meal plan. Plan for weight gain of 4 #veck with an inerease of 250 keals from calculated needs of 1.542 Crreay 2) KO Increase vitamin B12 and iron levels through education on foods rich in these sources 4. Request client keep food journal — Crt Cour Mono, thas 7 7 Loett Lyon actucte, nd to Andan oo udest Will follow up with client every 2 weeks to monitor client understanding of nutrition education on Celiac Disease. ey Evaluate client understanding ofthe meal plan provided (could 9 follow it?) Evaluate weight changes (sight gin of 12 # per west) ose Evaluate changes in lab values Candace Martell, Dietetes Student, 10/8/20,CELIAC DISEASE CASE STUDY 8 ae pee References Prenatal vitamin: Why they matter, how to choose, (2020, May 01). Mayo Clinic. Retrieves PeTsbSe BFR: htps//www.mayoclinic-org/healthy-lifestyle/pregnancy-week-by- ‘weeklin-depth/prenatal-vtamine/art 20046045Combination Report ‘repo that capes alo the dy repo ino one document. ExmIE Persona: S.G. Female 36yrs 5f3in 92008 Dey(s} 20200018 ‘Activity Level Sedertary Steve for an Active sty eve, Weight o: Gain 0.501 perwock Best not io exceed 2 bbs per week, BMI: 16:3 Normal is 18.50 25. Cinically Obese is 30 or higher. Recommendations “The Recommendations Reports the recommended daly nuient intake for @ person based on the fematon entered. Often referred io as ths DRI (Dietary Reference inal), Bese Components ‘Total Calves 1190751 Protain (9) 33.38 10% - 95% of Calories (aduts 19-70 years)” (Carbohyarais (@) 252.28 45% - 65% of Calories (adults 19-70 yeare)* ‘Added Sugar (3) 23.84 Less han 10% of Calories Dietary Fiber (a) 271 “ota Ft (9) 58.34 20%- 95% of Calories (adults 19-70 years) ‘Saturated Fat) 19.08 Loss than 10% of Calories + Monounsaturated Fat (9) 2119 Polyunsaturated Fat (a) 19.08 Cholesterol (9) 300.00 Water (te) 270 Vtamins ‘amin BY = Thiamin (mg) 440 ‘Vitamin 82 = Rinflovn (ng) a0 kami 82 - Niacin (mg) 1400 Vitamin 86 (ma) 1130 Do not exceed 100.mg * Vem 812 cg) 2.40, Over 50 should tke a suplemient* Vitamin C (mg) 75.00 iar © - meg (ic) 18.00 De not exceed 100 meg” Vitamin « (mca) 80.00 amin E- Alpha Tocopherol (ng) 18.00 Do not exesed 1000m9* Folate (mcg OFE) 400.00 tain A= RAE (eo) 700.00 De not exceed 3000m9* Moore (caer (ra) 1190.00 De not exceed 2500 mg * Copper (9) 0.90ron (ng) 18,09 Donet exceed 45 mg" Magnesium (ro) 120.00 Do not exceed 350 mg by supplement * Phosphor (na) 700.00, D9 not exceed 4000 mg" Potassium (ng) 2600.09 Selenium (nea) 15.00 Soxiur (mg) 2,900.00 Less than 2300 mg pe day -lower for some people + ‘ine (mg) '8.00| De not excbed 40 mg * other nol Aci (a) 1200 Unotenic Acs (9) 10 Chine (ra) 425.00 Mypiato Values MyPlate Fruits (cup) 2.00 MyPiate - Vegetables (cu) 250 IMyPiste- Grain (2 09) 6.00 MyPinte- Protein Foods (oz 09) 550 MyPtste- Dairy (cup) 3.00 Mypiate - Os (tsp) 6.00 Sources: * Dietary Reference intakes + Dietary Guidetnes for Americans ~ Proteins not adjusted fr endurancelsrengh ales at an Active or Very Active acti level. ‘Reference Daly IntakeBar Graph Report ‘The Bar Gah Report splays gophicaly the amount fhe nuit consumed and compares that othe etary Intake recomsmencatons, Basic Components “Total Calories sien 1907s: 27 Protein (9) 1030 3338" 31% Carbohyerates (0) 10986 2522842 Diary Fiber () 407871 18% Tota Sugar () 68.50 ‘Aded Sugar (2) 898 23a 35% Tota Ft) 533504 KBD Saturated Fat (9) 1280 1808 7% B Monounsaturated Fat (¢) 1880219 KB Polyunsaturated Fat (¢) 171 19088 % Cholesterol (ma) 216 3000-7 8B Water (te) osz 270 34 % ED _ Vitamins ‘Vitamin 81 - Thiamin (mg) oi 1017 % Vitamin 82 - Riboflavin (9) 02 11018 % Vitamin 83 -Neacn (ng) 22040016 % Vitamin 86 (ma) oo = 10 S&B Vitamin 812 (meg) oot 240% | Vitamin ¢ (mg) 29 © 75003 %D ‘tama © = meg (ea) 00 18000 % | tami K (eg) 439 9000 S&B vitamin € -8:To0a (mg) 38 15003 Folate (cg DFE) 5852 4000014 % ‘Vtamin A NE (reg) 048 70000 0 % | Niners 2s Caleim (mg) eo7s 4000008 % Copper (mg) 013090 14% iron (ra) 308 180017 % Ba Magnesium (ma) S116 3200016 % Phosphorus (mi) waa1 700.00 Potassium (mg) 30671 260000 12% B ‘Selenium (mes) 935 $500 17% BD ‘Socium (mg) 213856 20000- 93 % SE Ze (mg) jot ano 3 - iter Loli Ac (0) ose 1207 %D LUnotenie cid (9) on 10 10% Omega 3-EPA (a) 0.00 (Omega 3 - DHA (g) 0.00 Chine (ng) 1340425008 4D‘Alcohol (a) 0.00 * Protein isnot adjusted for endurancelstongt alles at an Active or Very Active act lavel. Ths vaie fs a recommended coneumpion it, nat goSpreadsheet Report The Spreadsheot shows al the values for al nuvionts. Nusienls are cgpayed horizontally, wih tae at he botom ofthe st Tut 0. grata! ben, wes ete (USDA) 1c) itt ae lack, reed with wala ton 24 00 ora suger whe, rele (SDA) 2p ws) a0 as 00 Luneh sup, honeshecicen ol, hop mms 59 0 20 ‘cocks, saline (USDA) Sea srs) a9) e703 sppeeace, canned, swceared 08 op ms 02 518 2a, Sa (USDA: 05a.) alter jens) 02) 2) 00 ay Tos ~ sie 403 WOES 49 ‘Average Day Teta 7 sis 03 mes 49 Ton 10” Breakfast bead, wheat, ast (USDA) 158 10) a2 O4 i) lua. bock brewed, wihisrwnier «00S 00 00 eager, wt, rales (SDA) ax) aa) oo. 000 Linch soup, hones chicken moe, 28 a2 408 ‘ackrs,stine (USDA) 01 on 0204 sppoeme,camed,swewaned 180 oz a) ‘Spits (USDA: Coasca) 358 oo) oo Cyto S WT ‘AverpeDeyToil «665 BAS wo ‘Tue 10" reatan red, when, ssid USDA) O80) 04 Os N80 ceoee tea, back brewed, wihiapwete gd_—S=Sa2 doa ‘sige, we, genie (USDA) 29) 00! oo! oo! on o0 Lunch soup, hemestYe chicken mode, «20202 ‘crackers ste (USDA) op) aol oa a0) oe) on operas, canad, sweden oo 01 00 oat ‘soda Spi (USDA: Cone Cot) (opine ool oo os on mz 08 020g a2 0s Tue 10 Break! best wha iaesad (USDA) 00) 00) 00 4a oa mo neta toa, back brewed, wihtapwaier «sods ‘sugar, lle, grenlod(LSDA) CS Lunch coup, nomeste cheken mode, os ‘rte sli (USDA) Ce ‘pplesauc, canned, sweetened oo 21 «00s? a2 42 ‘0, Sore (USDA. Coca ol) 00) a0) foo) oot oo on ‘DeyTal ——~00~=« =~ 8 0S AvengeOyTosl «002k 04k10 00 00 10 01 04 a 00 oa 04 00 02 10 19 42) 00 m2 a7 ac oa o4 a8 455 Te Beate ban eal eset USN) a0) ce20e0 les black brewed, wihiapwater 00000 ‘ger, wht, rent (USDA) op 0100 Lunch soup, homestyechikan noodle, ar ‘racer, ste (USDA) oa zea anplesauce,caned,swetenes 043700 ‘sa, Spe (USDA. Covs-Coa)| oo) irs eo Deyo OSC OT a ‘Average Day Toa as a TT "Tue 10+ Behan trod, whos, esd (USDA) an 142) 2) es back brewed, win apwater 87700 Tt per, wht, granted (USDA) ozo aa Luren soup, hamastyechekan noodle, $54 ‘eez2 tmcher, ste (USDA) sar) aa) ear sopesauca,canod,evoetened 220428 Ses, Spite (USDA: Coes Cola) ao) oo) ae, DeyTaa «3057888 Average ay Tota 2168 Tuo 10- Breast bree weal casted (USDA) ae oa Bac, bowed wih ap water spar, wht, raul (USDA) Lunch soup, nonectcichen noodle, tracer, eatin (USDA) sepeanuco,caned, swocared Spa (USDA: Coca. Coa) ‘ay To ‘Average Day Total Tye 10 erate! babdl wheat tasted (USDA) oman tes Dac, Dewed, wih ap water ‘Wor whl, raalted (USCA) aren sou, homes cicen rood, racers, saline (USDA) srpesauce, cored, swoalarad a, Sprite (USDA: Coea-Cla) Oey Tot ‘Average Day Toa ry oo) oo oo 00 00 0 aa 00 08) 00 00 00 00 00 00 90 ra a 45 a Ta aa 00) oo 00 00 0s 05 ca oo oo 8) ’0 00 20 00 00 a0 a0 00 00 00 00 00 to a0 Ms ina 00 00 00 ox 00 00 00) oa oo 00 00 00 00Calorie Assessment ‘close-up picture of ho Calros consumed, Calorie to maintain cient weght 1058 Calor auton for wiht change oF 0.501 (per wk) 250 Goal calories 1908 ES ‘erage ike se ‘erage Exzeetre 1058 “atl Cloes 1908 318 Below Gost Proan (038% Colones) se110007 ” Bow Goal Converts (45-65% Calo) 5010 240 a Blew Goal Aaded Suge (<10% Calories) ove 198 u tnRange Toa Fat ae 067 ” sow Goal Sats Fat (0% Clos) ote 198 2 InRange ‘echo! : ° ~ rate 101035 8 Below Goal Carbohydrates 451065 8s ‘Above Goal ‘Added Sugar 0t0 10 6 In Range “otal Fat 201035 8 Below Goal ‘Soturatod Fat ow 10 2 In Range Polyunsaturated Fat E 3 = Monounsaturated Fat 5 4 - noe Aes 51010 1 Below Gost note Ack oste2 ° Below GoalActivity Summary Ustof the Actes performed, the METS, duraton ad Caloris bumed Profle Calais Gost 1008 Daily Activity Detail uraon| Mos Exercse Calories ‘Sedentary Acts of Day Living" 1658 Total Calories (Sedentary) 1658 Calories ‘Secertay Actives of Day Lvng™= 1658, ‘Average Day Calories Exponded © Daly Average" 1658 [°/The Sedentary acy love nudes basic dally tasks sich as geting ready forthe day, housework, Walking to work oF class, and ight yard work. These tasks are calle Aces of Daly Living (ADL) Ifyou ‘engage in physical actly beyond tal included inthe acivaes of dal ving, you may increase your acy leva o Low Active, Active cr Vary Active. The Actve activity level recommended bythe government for [P71 Your Daly Average put youn theSedentary activity level, and suggests 1658 Calories to maintain your ‘currant wight Caerie Goal Calories Expendes 1908 1658MyPlate ‘The MyPlate Food Guide repo pays graphical how close the fod compares to he lastest USDA Diary Guidelines 66 CneoseMyPat gr for moreno). Intake vs. Recommendation 2000 Calorie Pattern Ee ent Como on Grains Intake 30% 2.3 az equvalent Grains Recommendation =z 6.0 az equivalent Whole Gans rake owl 0.0 ox acivalnt \Whole Gane Recommendon a 2.0 ox ecivelnt Retned Grans inate ox! 0.0 ae equient Refined Grins Recormendaon a 20 oz ocuivelnt Vegetables intake ox 0.0 ep equvaont Vegetables Recommencation a 25 ap equvalent Frits Intake 25%1 0.5 ex exivalet Fruits Recommendation a 20 ax eauveent Day Intake om! 0.0 an equivalent Dairy Recommendation = 3.0 an equivalent Protein Foods Intake T#l 0.4 cxequvatent Protein Foods Recommendation = 5,5 ozequivalent Oils intake 0%! 0.0 Oils Recommendation a 6.0 : ERIE eee 88 cre weakly ‘Limit your extra fats & sugars to 267 Calories a day ‘range Vestas 20 cups westy Dry Beans & Pees 20 cups weekyy Stacy Vegetables 30 cipeweety ter vecetales 65 cups westy oz equivalents. 21 ounce estate, rounded ta consumer fendy unts. For example, an cz equivalent of Grains is 1 sce of tread, o 1p of lea. An a2 eguvslent of Protain Foods 1 oz of meal. 1 epg. oF 1/4 cup cooked beans —X—MyFoodList Report “The MyFoodLst Report shows the foode you have ented and their calories Tu 10-06-2020 10 soe ‘braad, wheat, toasted (UEDA) ve Ute tn dct med eter (USOA) 2 2.0,ap sr wt, rad S00) a8 ‘2. sw hone ctr rood camed, condoeed(USBK Carob) 1 230, once tre USDA) % 05 a __aianen, corm rrwees (SOA) t “a0 tad ein Spee (USDA Cason) 1 raat (sie)-YENW) bovine Sie LOD tom Arg “ 1020 10:9 ae Page toot ib