Question

In this case study, you will help the patient achieve a healthy, high fiber (38g/d) meal plan.

Part 1: Assess the patient’s current diet

Case: Jim is a 47-year-old, Hispanic male recently diagnosed with diverticulosis. Jim is 5’ 10” tall, moderately active, and weighs 190 pounds. Jim has been instructed to increase the fiber in his diet to 38 grams per day. Jim is single, does his own shopping and cooking. He works long hours and rarely eats out. Below is a typical day’s intake for Jim. He reports liking most foods but tends to eat a very monotonous diet due to time restraints and ease of preparation.

Use the following resources to assist you in planning: For the fiber content of foods: Krause: APPENDIX 35. Nutritional facts on a high-fiber diet (p. 1049) 2015 DGA, Appendix 13. Food Sources of Dietary Fiber https://health.gov/dietaryguidelines/2015/guidelines/appendix-13/ Nutrient Profiles for Food Groups and Subgroups in the 2015 USDA Food Patterns https://www.cnpp.usda.gov/sites/default/files/usda_food_patterns/NutrientProfiles.pdf For assigning food to the appropriate DGA Food Group 2015 DGA Chapter 1- Key Elements of Healthy Eating Patterns) https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/

PART ONE: Assess the patient’s current diet

Using the resources above, evaluate a typical day’s fiber and food group intake for Jim. Complete the columns of the chart below.

This is what Jim currently eats:

Current Intake		DGA Food Group	Number of Servings *other food group has no serving size
Food	Amount
Coffee	12 oz
Creamer	2 tsp
Toast (white bread)	2 slices
Butter	2 tsp
Scrambled Eggs	3
Bacon	2 slices
Hamburger	1 Bun, 3 oz meat, No veg, Mayo 1 Tbs
French Fries	1 C
Soft drink	32 oz
Broiled Steak	8 oz
Fried Potatoes	2 C
Bread (white)	4 slices
Iced tea	32 oz
Sugar	4 tsp
Cake	2 slices
Beer	24 oz.

Total Jim’s current fiber intake by food group

Daily Total Servings/d		Fiber g/d * fiber content using averages from the CNPP site
Vegetables
Fruits
Grains
Dairy
Protein Foods
Oils
Other
	Total daily fiber

Answer 1

Recommended fibre intake of Mr.Jim

DGA food groups	Number of servings
Bread, soy & linseed,	1 slice
All Bran, 45 g	1 serve
Strawberries	1/3 punnet
Green peas, frozen	3/4 cup
Pistachio	30 g
Muesli bar, fruit	35 g
Mars bar	36 g

Total Jim’s current fiber intake by food group

Daily Total Servings/d	Fiber g/d
Cereals	20,3
Fruits	2.1
Vegetables	8.8
Nuts and seeds	2.7g
Grain	3.6g
0thers	0.5g

Thus the total recommended daily fibre intake of Mr.Jim is 38g/d