Question

We will continue to evaluate Fred and his health in this second case study. From the first case study: Fred is a 56 year old, single male. He is employed in sales and spends a great portion of his day either behind his desk making calls or in his car. Fred has a base salary but depends on sales for commission. He has a limited income and attempts to use finances wisely. Due to his schedule, he has few friends and little leisure time. He relays that he has been diagnosed with high blood pressure and has a family history of cardiovascular disease. In a typical day, Fred sets his alarm for 7 am and tries to get to the office by 8:30. He always drives through a donut shop and picks up a blueberry muffin and a large latte. For lunch he packs a bologna sandwich, a bag of Corn chips and a Cola and eats at his desk. After making calls and finalizing several deals, he leaves the office around 6 pm. Several times a week, he meets clients for dinner. Today he is having dinner with a couple of guys at a local steak house. After dinner and a business session, he returns home around 10 pm. Fred is exhausted but decides to unwind and watch the nightly news before bed. This is Fred’s second visit and you complete an assessment. Age: 56 Height: 5 feet 10 inches Weight: 270 pounds Healthy Weight: 129-173 pounds You check his blood pressure and it remains elevated. Fred appears to be having difficulty walking and is short of breath.

1.Thinking about the ABCDE method of assessments, what 2 types of assessment did you complete on this patient?

2.Using your assessment and the information you have gained from the first case study, name three diseases that Fred may be at risk for: a. b. c.

3. You explain to Fred that you reviewed his diet intake record and that there are several changes that he could make to improve his health. Using the dietary guidelines and myplate provide 4 suggestions to Fred to improve his diet and his health. (any of the below would be acceptable) a. b. c. d.

4.As you discuss some of the suggestions, Fred mentions that his PCP told him that he was at risk for diverticulitis. However, he is not familiar with this term. All he knows is that he should increase his fiber. Explain to Fred what has occurred in the colon when the diagnosis of diverticulitis is made. (3 points) Include two reasons that diverticulitis occurs.

5.Fred requests information on soluble fiber and insoluble fiber and how each can help improve his health. Give a brief overview and explain the difference between the two types of fiber. Give an example of a health concern or disease that each type can prevent.

6. As the session concludes, you recommend that Fred consider a vegetarian style of eating, at least for several days a week. Review the difference between a semi vegetarian, a lacto ovo vegetarian and a pesco vegetarian.

Answer 1

1) Looking at Fred's conditions majors assessment performed on him are B- breathing as he is having shortness of breath and C- circulation due to his elevated blood pressure and risk of development of stroke and coronary heart disease.

In nutritional view the assessment performed on him are A- anthropometric due to his highly elevated body mass index. B- biochemical- for measuring the triglycerides level in blood as he is obese with BMI of 38.5. D- dietary: due to his unbalanced dietary intake including junk food and fatty greasy food.

2) As Fred's weight is 5 ft 10 inches and weight is 270 pounds His BMI (body mass index) is around 38.5 which means he is highly obese. Health conditions associated with obesity are:

• High blood glucose (sugar) or diabetes.
• High blood pressure (hypertension).
• High blood cholesterol and triglycerides (dyslipidemia, or high blood fats).
• Heart attacks due to coronary heart disease, heart failure, and stroke.
• Bone and joint problems, more weight puts pressure on the bones and joints. This can lead to osteoarthritis, a disease that causes joint pain and stiffness.
• Stopping breathing during sleep (sleep apnea). This can cause daytime fatigue or sleepiness, poor attention, and problems at work.
• Gallstones and liver problems.
• Some cancers.

3) According to myplate the dietary guidelines for obesity are:

Some additional advice includes:

HEALTHY EATING PLATE WATER Use healthy oils (like olive and canola oil) for cooking, on salad, HEALTHY and at the table. Limit OILS butter. Avoid trans fat. Drink water, tea, or coffee (with little or no sugar). Limit milk/dairy (1-2 servings/day) and juice (1 small glass/day). Avoid sugary drinks. WHOLE GRAINS VEGETABLES The more veggies- and the greater the variety-the better. Potatoes and french fries don't count. Eat a variety whole grains (like whole wheat bread, whole-grain pasta, and brown rice). Limit refined grains (like white rice and white bread). HEALTHY PROTEIN FRUITS Eat plenty of fruits of all colors. Choose fish, poultry, beans, and nuts; limit red meat and cheese; avoid bacon, cold cuts, and other processed meats. STAY ACTIVE! Harvard University BOB Harvard T.H. Chan School of Public Health The Nutrition Source www.hsph.harvard.edu/nutritionsource Harvard Medical School 0.00 Harvard Health Publishing www.health.harvard.edu

Reduce junk food intake and avoid fatty and greasy food

Add roughage to your diet

Avoid cola a soft drinks as it contains large amount of sugar.

4)Diverticula are small, bulging pouches that can form in the lining of your digestive system. They are found most often in the lower part of the large intestine (colon). Diverticula are common, especially after age 40, and seldom cause problems.

Sometimes, however, one or more of the pouches become inflamed or infected. That condition is known as diverticulitis (die-vur-tik-yoo-LIE-tis). Diverticulitis can cause severe abdominal pain, fever, nausea and a marked change in your bowel habits.

Cause for diverticulitis:

Diverticular disease develops when pouches form along your digestive tract, typically in your colon (large intestine). These pouches are known as diverticula. They form when weak spots in your intestinal wall balloon outward.

Diverticulitis happens when diverticula become inflamed and in some cases infected. This can occur when feces or partially digested food blocks the opening of the diverticula.

Various conditions responsibility for diverticulitis are:

Sedentary lifestyle: it hampers peristaltic motion causing feces to stick on the walls of colon

Obesity

History of low fiber diet

5) Soluble fiber is "soluble" in water. When mixed with water it forms a gel-like substance and swells. Soluble fiber has many benefits, including moderating blood glucose levels and lowering cholesterol. The scientific names for soluble fibers include pectins, gums, mucilages, and some hemicelluloses. Good sources of soluble fiber include oats and oatmeal, legumes (peas, beans, lentils), barley, fruits and vegetables (especially oranges, apples and carrots).

Insoluble fiber does not absorb or dissolve in water. It passes through our digestive system in close to its original form. Insoluble fiber offers many benefits to intestinal health, including a reduction in the risk and occurrence of hemorrhoids and constipation. The scientific names for insoluble fibers include cellulose, lignins, and also some other hemicelluloses. Most of insoluble fibers come from the bran layers of cereal grains.

Since soluble fibers moderates blood glucose it prevents diabetes

And by lowering blood cholesterol levels it prevents many cardiovascular diseases such as stroke, coronary heart disease.

6) A semi-vegetarian diet (SVD), also called a flexitarian diet, is one that is plant-based or with the occasional inclusion of meat.

Common reasons for adopting a semi-vegetarian diet include religious restrictions, weight management,health consciousness.

An ovo-lacto vegetarian or lacto-ovo vegetarian is a vegetarian who consumes some animal products, such as eggs and dairy. Unlike pescatarians, they do not consume fish or other seafood.

Pescetarianism or pescatarianism is the practice of adhering to a diet that incorporates seafood as the only source of meat in an otherwise vegetarian diet. Most pescetarians are ovo-lacto vegetarians who eat seafood along with dairy products and eggs.