7. Nutrition 150 Due Monday, March 7, 2016 HYPERTENSION Rashamel is a 43-year-old African-American man. His father died of a stroke at the age of 54 as a result of undiagnosed and untreated high blood pressure. Rashamel wants to live to see his grandchildren, so he exercises as often as he can, about three times a week, quit smoking, and watches his diet and weight. Despite these efforts, at his recent physical his blood pressure was 138/87, in the prehypertension category. To try to reduce his blood pressure to a healthier level, his doctor suggests a change in diet and refers him to a dietitian. A 24-hour recall reveals that Rashamel is maintaining a normal body weight of 175 lbs at 6 feet 2 inches height, by consuming ~ 2600 kcalories per day. After evaluating his current diet, the dietitian recommends he follow the DASH Eating Plan to reduce his blood pressure. Rashamel’s current diet is shown here. Current Diet: Breakfast: Dinner: Orange Juice 1/2 cup Baked Chicken 5 ounces 1% Milk 1 cup Rice 1 cup Wheaties 1 cup (1 oz) Lettuce 1 cup Whole Wheat Toast 1 slice Salad dressing 1 Tb Jelly and Margarine 1 tsp each Dinner Roll 1 small (1 slice equiv.) Coffee, black 2 cups Margarine 1 tsp Cantaloupe ½ cup Lunch: Iced Tea (sweetened) 12 fl.oz. Tuna fish w/ mayo ¾ cup (3 oz tuna) Wheat Bread 2 slices Snacks: Cola 20 ounces Cola 1 can Dried apricots 5 halves (1/4 c) Milky Way Candy Bar 1 fun size Rashamel’s Current Diet Analysis Results: NUTRIENT INTAKE Sodium 2466 mg Potassium 2886 mg Calcium 670 mg Magnesium 281 mg What is Rashamel’s %DRI for: Sodium______ %DRI Potassium ______ %DRI Calcium ______%DRI Magnesium______ %DRI Hint: All DRI recommendations are listed in the front of your text. There are 1000 mg in 1 gm. Vitamin D and Calcium DRI’s have since been updated. Check the class slides for these or go to: http://www.nal.usda.gov/fnic/DRI/DRI_Tables/RDA_AI_vitamins_elements.pdf These are all micronutrients directly linked to hypertension. Go to www.choosemyplate.gov and go to SuperTracker program. Click on “Food-A-Pedia” and enter your suggested sources of dietary sources of nutrients of concern in the search box. Next to the bar labeled “Food Info” click on the “Nutrient Info” tab. Scroll down to check micronutrient contents. (Look for dietary sources for potassium on page 431 of your text. Calcium and Magnesium are listed in Ch 11 of your text.) Can you get Rashamel to meet 100% of his DRI for potassium? (Remember the DASH Diet recommendations from previous page.) Food (include volume/amount!) Amount of Potassium mg i.e. ½ cup of cereal……etc. Current intake 2886 mg Do the same as above for magnesium: (Also consider the DASH Diet recommendations from previous page here as well.) Food (include volume/amount!) Amount of Magnesium mg Current intake 281 mg If Rashamel added the DASH diet servings of recommended foods, what foods might he need to omit from his diet to keep his total kcal in line with his recommendations so that he doesn’t gain weight? (i.e. What foods does he consume which are not nutrient dense?) ___________________________________________________________________________________ OSTEOPOROSIS Mia is 55 years old. Although she has no symptoms, she is worried about her risk for osteoporosis. Her mother is 75 and recently suffered a fractured hip due to reduced bone density caused by osteoporosis. Her previously independent mother is now living in a nursing home and struggling to return to her former life. Mia is frightened that she will face the same future. Although Mia does not drink a lot of milk, she knows that other dairy products and many other foods are good sources of calcium. She records what she eats and drinks for a day (shown below) to estimate her typical calcium intake. TOTALS: 1989 kcal 695 mg Calcium What is Mia’s DRI (AI) for calcium? ____________ How does Mia’s intake compare to her recommendations for calcium intake? _________ %DRI? What non dairy foods could she add to improve her calcium intake? List at least two other dietary strategies Mia could address (besides increasing calcium intake – what other nutrients impact bone health?) and two lifestyle changes which Mia could consider (if necessary) which may affect her current osteoporosis risk? Dietary Strategies: 1) 2) Lifestyle Change: 1) 2) ANEMIA Hanna is a 23-year-old student from South Carolina. She has been feeling tired and run down all semester. She recently read an article about iron deficiency in young women and became concerned about her iron status. She decides to go to the health center where she has her blood drawn. The results of her tests indicate that she does not have iron deficiency anemia, but her iron stores are very low. Hanna decides to try to increase the amount of iron she gets from her diet before considering iron supplements. She consumes a lacto-ovo vegetarian diet meaning she consumes dairy products and eggs but no meat. Her typical diet is shown on the right. Diet Analysis Results for Hanna: NUTRITENT INTAKE Iron 11 mg As a 23 year old female vegetarian, what is Hanna’s DRI for iron? %DRI? DRI: _________ mg Iron %DRI? __________ What non meat non fortified foods could Hanna add to increase the iron content in her diet? What one other strategy could Hanna add or subtract to her diet above to increase the absorption of iron in her meals? (Do not suggest she take an iron supplement, or for her to add meat!)