Question

Case Study 1

Patient background

Frank P. is a 48-year-old landscape architect recently diagnosed with hypoglycemia from a glucose tolerance blood test. He is 69 inches tall and weighs 202 pounds. His usual weight is 190 pounds; he reports an unexpected weight gain of 12 pounds over the past 6 months. Frank reports he often skips breakfast or stops for a donut and coffee on his way to work in the morning. He often eats out with clients for lunch or he grabs a fruit smoothie on his way to a job site. He eats dinner at home with his wife most evenings. He reports feeling hungry, weak, and “anxious” on many occasions during his work day, which he says is relieved somewhat by eating a candy bar or other high-sugar snack food. His diet history reveals no food intolerances although he states he avoids products which contain high-fructose corn syrup and prefers to use products sweetened with sugar.

1. Which of Frank’s symptoms could be due to hypoglycemia? What dietary habits may be aggravating these symptoms?
2. What are the similarities and differences between glucose and fructose that would be important for Frank to understand when making decisions about his diet?
3. In general and based on the glycemic index of foods, what types of carbohydrate-containing foods would you recommend Frank include in his diet to reduce his symptoms? Which foods would you recommend he avoid?
4. Why is it important for Frank to choose high-fiber carbohydrate foods in his diet?
5. Explain to Frank the reasons he should eat a balanced diet at regular intervals.
6. Based on his lifestyle patterns, devise a one-day meal plan for Frank that will help alleviate his symptoms of hypoglycemia and that includes adequate protein and at least 130 grams of carbohydrates. Include 3 meals and at least 2 snacks. You need to keep a tally of how many carbs your food recommendations provide and you need to make sure you state portion sizes of each food you recommend.

Answer 1

Which of Frank’s symptoms could be due to hypoglycemia? What dietary habits may be aggravating these symptoms?

When Frank feels hungry, weakness taking of candy or high sugared food heavily results in hypoglycemia. Intake high sugared food can easily be utilized by the body to meet the energy needs. So he is experiencing hypoglycemia. Lack of carbohydrate food also causes for hypoglycemia as it acts as an energy fuel.

What are the similarities and differences between glucose and fructose that would be important for Frank to understand when making decisions about his diet?

Both glucose and sucrose are simple monosaccharide sugars. Both are similar in the chemical formula. Glucose is absorbed and transported to the body cells to yield energy and the excess glucose are stored in the form of glycogen. Whereas fructose is rapidly absorbed following ingestion which results in a small rise of blood glucose level.

In general and based on the glycemic index of foods, what types of carbohydrate-containing foods would you recommend Frank include in his diet to reduce his symptoms? Which foods would you recommend he avoid?

Generally, fructose has a low glycemic index. So carbohydrate-containing food of whole grains, legumes, vegetables, and fruits are to be included in his daily diet. Frank should avoid packed and processed food. e.g snack prepared by using flours, packed cereals, bread, preserved products.

Why is it important for Frank to choose high-fiber carbohydrate foods in his diet?

Carbohydrates that come from whole grains and whole foods are rich in fiber, vitamins, and minerals. These are essential to regulate the blood glucose level. High-fiber carbohydrate food is essential for the normal function of the body.

Explain to Frank the reasons he should eat a balanced diet at regular intervals.

Eating at regular intervals is essential to meet the nutritional requirement of the body. Intake of adequate amount of carbohydrates, fats, and proteins is essential to yielding energy, bodybuilding, and storage of adipose tissues. A balanced diet helps to regulate the body mechanism and maintaining good health. Eating smaller amounts at frequent intervals reduces the episodes of hypoglycemia.

Based on his lifestyle patterns, devise a one-day meal plan for Frank that will help alleviate his symptoms of hypoglycemia and that includes adequate protein and at least 130 grams of carbohydrates. Include 3 meals and at least 2 snacks. You need to keep a tally of how many carbs your food recommendations provide and you need to make sure you state portion sizes of each food you recommend.

1-day meal plan for Frank

	Menu	CHO level
Breakfast	Whole-grain bagel with peanut butter 1 serve	23
Morning snack	whole-grain cereal bar	30
Lunch	Tuna sandwich - 1, Vegetable salad with low-fat dressing	45
Evening snack	Nuts mixed 1 tablespoon	2
Dinner	Bread -1 slice, Banana - 1/2	30

Total 130