Question

Case Study: Julia Roberts Julia Roberts, a 66 year-old female has scheduled an appointment to meet with you and find out how the quality of her diet is. She also wants to know how to improve her habits and make more items at home instead of eating out so often. She reports she has a sweet tooth and often eats out because she likes to try new desserts at restaurants and her husband passed away last year so she does not like to make meals for herself. Julia suffered a stroke 2 years ago, but regularly follows up with her doctor and he said she "is in pretty good health now, but her inflammation markers are higher than he would like." She is 5 foot, 6 inches tall and weighs 75 kilograms. She reports not doing much exercise except walking around the mall when she is shopping She reports this is what her usual diet looks like: Breakfast: 2 cups of black coffee, 1 glass of orange juice, instant oatmeal with almonds in it Lunch: tuna fish sandwich from Subway on white bread with Lay's Potato chips, and a chocolate chip cookie Snack: Twinkie and a cup of coffee Dinner: Large bowl of pasta with Alfredo sauce, green beans, garlic bread, and glass of Riesling wine from Macaroni Grill Bedtime: 1 small cup of water and her daily medications, which include Coumadin, 2000 IU vitamin E, 1000 mg calcium, and she just started taking a fish oil because she heard about its benefits on the news related to reducing inflammation. Supplemental Facts Serving Size: 1 Softigel Capsule(s) Ingredients Per Serving % DV Natural Vitamin E (ns d-alpha tocopherol 1000 ku 3333% Notes: VITAMIN E 1000 LU. d-ALPHA TOCOPHEROL AND MXED TOCOPHEROLS. 100 % NATURAL SOURCE VVITAMIN E. Each capsule of Vitamin E contains 100 % naturaly occurring d-apha, beta, gamma and delta tocopherols. Other Ingredients: Gelatin, glycerin, water, (May contain soybean oil andlor beeswax)

1)   LIST 3 QUESTIONS YOU WOULD ASK JULIA TO CLARIFY THE INFORMATION YOU WERE GIVEN ABOVE.

2)   What would you calculate as Julia’s daily protein requirements?

Answer 1

Questions to be asked to Mrs. Julia

1. Any present medical history of Diabetes or Hypertension?

Diabetes mellitus( abnormal carbohydrate metabolism and increased sugar level) and Hypertension( increased Blood pressure) patients should be in control of Carbohydrate( in Diabetes) and sodium chloride, salt ( in Hypertension) . These informations are necessary to plan a diet.

2. How often do take fish and what type of fish you like?

Omega 3 fatty acids are good for recovery from stroke. Fish that contain omega 3 fatty acids can be added more to the diet.

3. Did you consult with your Doctor regarding the additional intake of fish oil

Too much intake of Vitamin E interferes with Coumadin action( anti coagulant effect). Mrs. Julia's case study tells that she started to take fish oil by seeing the advertisement. Fish oil interact with Coumadin( anticoagulants). Fish oil also decreases the process of clotting thereby increases the risk of bleeding.

2. Daily protein requirements for Mrs. Julia

Daily requirements of protein is 0.36gms/ weight in pounds for a female who is above 65 years.

Mrs. Julia's weight is 75 kg

75 kg= 165.34

protein requirements= 0.36× 165.34

= 59.52 gm

Protien requirements increases with the age. So older adults need to take adequate protein amount in their diet.