Unit 9 Assignment

Olivia G. Chappell

NS310 Nutritional Analysis and Assessment

Dr. Mara Davidson

3/6/2024
 Unit 9 Assignment

The comprehensive evaluation of the nutritional status of a 45-year-old Hispanic mother

of three involves considering multiple factors that demonstrate the intricate relationship between

dietary patterns, lifestyle decisions, and genetic predispositions. This particular patient's situation

poses a multifaceted obstacle, requiring a comprehensive assessment and a customized

intervention plan to address her health issues, particularly her elevated susceptibility to

cardiovascular disease, diabetes, and the necessity for weight control.

The initial step in the nutritional assessment involves calculating the patient’s Body Mass

Index (BMI). The patient’s BMI is calculated using the formula with the metric system, BMI =

weight (kg) / (height (m))^2 (About adult BMI 2022). Given the patient’s weight of 100 kg and

height of 165 cm (1.65 m), her BMI was calculated with the formula, BMI = 100 kg / (1.65 m)^2

= 36.7. A BMI of 36.7 places the patient in the "Obese" category. According to the World Health

Organization, a BMI greater than or equal to 30 is obese (2024).

Considering the specific calorie and nutrient totals determined previously, the patients’

total calories (2,927g) exceed the daily recommended intake, especially given the high amounts

of processed foods, sweets, and sugar-sweetened beverages. The patient’s fat totals are high

(134g), especially when considering the consumption of cream-based soup, mayonnaise, glazed

doughnuts, cheese lasagna, ranch dressing, and ice cream. The total carbohydrates (340g) are

also very high, largely from sugars (donuts, candy, ice cream) and refined grains (Texas Toast,

lasagna). The dietary fiber totals are low (11g), as the only significant sources are the vegetables

in the salad and possibly the granola bar, depending on the type. The patient’s protein intake is at

a moderate to high level (99g), with her protein sources including luncheon meat and lasagna.
The patient’s sodium intake is high (4,019g), considering the processed nature of her many

consumed foods (luncheon meat, soup, lasagna, salad dressing).

For estimating the patient’s energy needs, I utilized the Mifflin-St Jeor equation. Given

the patient is female, the equation used was Calories/day = (10 * weight in kg) + (6.25 * height

in cm) - (5 * age in years) – 161 (Fletcher, 2020). Using the patient’s specific data, the result was

1645.25 kcal/day for basal metabolic rate. Furthermore, adjusting for light activity I used the

equation BMR * 1.2, for very light exercise/sedentary job with low movement (Hall, 2023). The

total estimated energy needs are 2262.22 kcal/day. The patient’s current caloric intake of 2022

kcal significantly exceeds her estimated energy needs, a discrepancy that contributes to her

obesity. The high caloric density of her diet, driven by processed foods and sugary snacks,

underpins the need for a dietary overhaul. By aligning her intake with her caloric needs, we can

set the stage for sustainable weight loss and improvement in her overall health.

The lab results for the patient show significant deviations from the recommended values,

indicating a heightened risk for conditions such as cardiovascular disease and diabetes.

Specifically, her blood pressure is notably high at 150/90 mmHg, compared to the optimal range

of less than 120/80 mmHg (LeWine, 2022). The glucose levels are considerably elevated across

all three measurements (1hr, 2hr, and 3hr postprandial), with values of 300 mg/dl, 248 mg/dl,

and 195 mg/dl, respectively, all well above the recommended threshold of less than 140 mg/dl

(Hoskins, 2023). Furthermore, the total cholesterol level at 250 mg/dl surpasses the

recommended limit of less than 200 mg/dl (Lipid panel 2020). The HDL cholesterol is low at 36

mg/dl, falling short of the desired level of more than 60 mg/dl, while the LDL cholesterol is

excessively high at 200 mg/dl, double the recommended maximum of less than 100 mg/dl (Lipid

panel 2020). Triglycerides are also elevated at 200 mg/dl, exceeding the recommended level of
less than 150 mg/dl (Lipid panel 2020). These results suggest an urgent need for medical

intervention to mitigate the risk of serious health issues.

In order to mitigate the risk of more serious health issues one must go in-depth when

looking at specific foods consumed withing the diet. According to Mayo Clinic, the patient must

reduce her intake of saturated and trans fats by choosing lean proteins, increasing her fruits and

vegetables, and opting for whole grains (2023). To help her blood pressure levels, the patient

must reduce sodium intake by limiting processed foods and choosing fresh or frozen vegetables

over canned ones (Grillo et.al, 2019). Increasing potassium intake through fruits and vegetables

can also help. Focusing on the patient’s blood glucose levels, a balanced diet rich in fiber (Crank

up.., 2020), such as whole grains, legumes, fruits, and vegetables, and reducing consumption of

refined carbohydrates and sugary foods is very important (Clemente-Suaurez, 2022).

A comprehensive strategy is suggested for the patient's follow-up appointment, which

involves utilizing different nutritional assessment tools. In order to gain a deeper understanding

of her dietary habits and provide more personalized dietary advice, a 3-day food diary will be

utilized instead of a 24-hour recall. Additionally, anthropometric measurements such as weight

and waist circumference will be taken to monitor any physical changes. Repeat blood tests will

also be conducted to track improvements in glucose and cholesterol levels. Lastly, blood

pressure measurements will play a crucial role in evaluating the effects of these dietary and

lifestyle modifications on her cardiovascular health.

This patient’s case exemplifies the many intricacies involved in assessing and intervening

in nutritional matters within the context of obesity, cardiovascular risk, and diabetes. By

conducting a thorough analysis of her dietary habits, accurately estimating her energy

requirements, and carefully considering her laboratory results, a clear course of action emerges
for intervention. Tailored dietary recommendations, along with lifestyle modifications, hold the

potential to significantly enhance the patient's health outcomes. The planned follow-up,

incorporating a variety of assessment tools, will play a crucial role in evaluating progress and

making necessary adjustments to interventions. By comprehensively addressing her nutritional

status, we can strive towards mitigating her health risks and improving her overall quality of life.
 References

Centers for Disease Control and Prevention. (2022, June 3). About adult BMI. Centers for

Disease Control and Prevention.

https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html

Clemente-Suárez, Vicente Javier et al. “The Burden of Carbohydrates in Health and Disease.”

Nutrients vol. 14,18 3809. 15 Sep. 2022, doi:10.3390/nu14183809

Crank up your fiber intake to manage blood sugar and diabetes. Harvard Health. (2020, June 1).

https://www.health.harvard.edu/staying-healthy/crank-up-your-fiber-intake-to-manage-

blood-sugar-and-diabetes

Fletcher, J. (2020, March 9). Basal metabolic rate: What it is, calculation, and more. Medical

News Today. https://www.medicalnewstoday.com/articles/basal-metabolic-rate#definition

Grillo, Andrea et al. “Sodium Intake and Hypertension.” Nutrients vol. 11,9 1970. 21 Aug. 2019,

doi:10.3390/nu11091970

Hall, T. (2023, July 7). A comprehensive guide to calculating basal metabolic rate (BMR).

ASFA. https://www.americansportandfitness.com/blogs/fitness-blog/a-comprehensive-

guide-to-calculating-basal-metabolic-rate-bmr

Hoskins, M. (2023, March 16). Normal glucose levels after eating. Healthline.

https://www.healthline.com/health/diabetes/normal-glucose-level-after-eating
Mayo Foundation for Medical Education and Research. (2023, June 14). Can eating certain

foods help improve your cholesterol levels?. Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/

cholesterol/art-20045192

LeWine, H. (2022, August 1). What is the ideal blood pressure number?. Harvard Health.

https://www.health.harvard.edu/staying-healthy/what-is-the-ideal-blood-pressure-number

Lipid panel. Johns Hopkins Medicine. (2020, December 4).

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lipid-panel

World Health Organization. (2024, March 1). Obesity and overweight. World Health

Organization. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight