Medical Nutrition Therapy
Question 1.
Joe is a 67 year old male who lives in a small town in rural Queensland. He is the owner and operator of the only pub in town, and spends most of his days working in various roles (behind the bar, helping in the kitchen, cleaning and fixing things) and is often up at night doing paperwork. Joe is married and his wife works alongside him at the pub, and they live in the apartment above. They don’t have children, but have 2 large dogs. Joe and his wife do try to go for early evening walks when they can with the dogs, but otherwise he does little activity. He enjoys fishing and going on camping trips. Both Joe and his wife are very tired at night, and enjoy sitting down to a good steak or leftover meal from the pub kitchen. They do not cook a lot.
Joe saw his GP recently complaining of chest pain, shortness of breath and some dizziness. He was diagnosed with type 2 diabetes approximately 6 months ago, and is currently managed on insulin (intermediate acting insulin 20 units in the morning, levemir 30 units in the evening). He has received minimal education for his type 2 diabetes due to limited access to any sort of allied health professionals in town. He has a family history of heart disease and type 2 diabetes.
Joe has been referred to the UQ Telehealth clinic by his GP, who has also sent his latest blood results (HbA1c 9%, TC 7.1mmol/L, LDL 4.6mmol/L, TG 2.5mmol/L). Joe’s current weight is 105kg, his height is 1.8m and his waist circumference is 110cm. Joe tells you that he was a healthy weight and generally fit in his twenties and thirties, but since purchasing the pub 20 years ago; his weight has been slowly increasing. Joe expresses his concerns regarding his health when speaking to you; however, he is unsure of how to change things given where he lives, the limited services available, and the demanding nature of owning and running the pub.
Joe’s typical 24-hour recall was as follows:
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Breakfast 2 fried egg, tomatoes and bacon 3 white toast with butter Orange juice 2 cups tea FCM, 2 sugar |
Dinner T-bone steak, fried Potatoes and peas 2 white bread or 2 dinner rolls with butter Custard and canned peaches OR large serving of leftover pub meal (chicken schnitzel / nachos / fish and chips) Tries to drink some water with dinner |
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Lunch 2 x sandwiches (roast meat and salad – leftover from pub roast the previous night) Slice cake Soft drink |
Supper Will usually have a beer or 2 (330mL mid-strength) and nuts/crisps while doing paperwork in the evening |
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Snacks Doesn’t have a lot of time to sit and eat snacks – will grab food from the kitchen as he goes about his day. Cakes and biscuits, occasionally fruit, cheese on bread. |
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Medical Nutrition Therapy Question 1. Joe is a 67 year old male who lives in a...
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