Question

Mr. D is a 62 year old male weighing 239 lbs, and is 5’9” tall. He smokes a few cigarettes per day and usually drinks 1 glass of red wine at night after a stress-filled day at work. Due to a hectic schedule, he finds it difficult to exercise during the week, but bikes on the weekend, and occasionally swims laps at a local gym. Both parents had a history of hypertension, and his brother experienced a heart attack at 45 years of age. At a recent physical exam, his BP and fasting blood labs were as follows:

BP: 140/98

Total cholesterol: 199 mg/dl

LDL: 164 mg/dl

HDL: 26 mg/dl

TG: 195 mg/dl

Glucose: 148 mg/dl

A typical day of meals includes:

Breakfast

​2 cups coffee with cream and sugar

​Plain bagel with egg, cheese, and bacon

Lunch

​Deli sandwich (alternates between turkey, ham, tuna)

on white bread with cheese and mayo

​Diet Coke

Dinner

(often dinner business meetings)

​steak (loves red meat!), baked potato with sour cream and butter

​tossed salad with bleu cheese dressing and bacon bits

​roll and butter

​cocktail or wine

Before Bed

​glass of red wine

​handful of peanuts or pretzels

Consider the chronic diseases reviewed in Chapter 18 (cardiovascular disease, hypertension, diabetes, and cancer). Evaluate Mr. D’s weight, lifestyle factors, family history, labs (including BP), and diet information.

Answer each question below in a few sentences only, simply stating your assessment of the information provided. (each question = 5 pts)

1. What is Mr D’s BMI and what is his weight classification? (can use BMI table

from Chapter 8, p. 242) Is his weight a risk factor for any of the chronic diseases

noted in Chapter 18? If yes, which one(s)?

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2. Is his family health history of concern for chronic disease risk? If yes, which diseases? Which lifestyle factors may affect his risk of chronic diseases?

3. Compare his lab values to normal values - Which are outside the range of “normal” and may increase his risk for chronic diseases?

4. Of Mr D’s dietary choices, which two do you consider to be of the greatest concern to increase his risk of chronic disease and why?

5. Of the risk factors that Mr D may have for chronic diseases, which are modifiable and which are non-modifiable?

In addition to answering the above questions, provide 5 suggestions (each suggestion = 5 points) as to appropriate changes (diet and/or lifestyle), and note how/why they would reduce his risk of the chronic diseases identified.

Answer 1

1. Mr D'S bmi is 35.3

Under obese class 2nd - severely obese

2.Very highly risk of diabetes mellitus, atherosclerosis, coronary artery diease. This person bad cholesterol levels (LDL ) is very high and good cholesterol (HDL) is very low and higher blood pressure, family history of heart attack So he is hrisk of coronary artery diease.

Lack of excersie and bad food habits like cheese ,coke , sandwich, Butter,sugar, all are high cholesterol diet

3. Person bp are increase (normal bp 120/80)

Bad cholesterol (LDL) are increase not good for body

Good cholesterol (HDL ) decrease

Total cholesterol high

Blood glucose above normal value

4.use of cheese, coffee with cream