Unit 3 NS270 Nutritional Assessment and Management

UNIT 3NS270 NUTRITIONAL ASSESSMENT AND MANAGEMENT

Amy Habeck, RD, MS, LDN

Recognition

Excellent sourcesCritical thinking skills

Unit 3 Learning Objectives:

1) Case study – 45 year old malea) Found in Doc Sharing and on Seminar tab of

Unit 3 Course Homeb) Complete a nutrient analysis on a food intake

to identify actual and potential nutrient deficiency

2) Review- Stanfield and Huia) Chapter 5 – Vitaminsb) Chapter 6 – Mineralsc) DRI tables

3) Answer your questions

Case Study

45 year old male Ht: 5’10” Wt: 190 pounds Calculate BMI Determine BMI Classification Calculate energy needs Assess intake Recommendations

BMI Calculation-Metric Conversion What is his height in meters?

5’10” = _______m

What is his weight in kilograms?

190 pounds = _______kg

Convert Height to Meters

Ht: 5’10” = 70 inches70 inches x 2.54 cm/in = 177.8 cm177.8 cm ÷ 100 cm/m = 1.78 m(1.78m)2 =1.78 x 1.78 = 3.17 m

Convert Weight to Kilograms

Weight 190 pounds x kg/2.2 pounds = 86.36 kg

Calculate BMI

Weight in Kg (Ht in m)2 =_________

http://www.nhlbisupport.com/bmi/bmi-m.htm

Calculate BMI

Using Standard Measurements

Wt (pounds) (x 703)= Ht (in)2

Case Study

45 year old male Ht: 5’10” = 1.78 m2 = 3.17 Wt: 190 pounds = 86.36 kg Calculation

Kg/m2

86.36 ÷ 3.17 = 27.3 BMI: 27.3 What is his BMI classification?

BMI

BMI: 27.2 BMI Classification: Overweight

BMI Categories: Underweight = <18.5 Normal weight = 18.5-24.9 Overweight = 25-29.9 Obesity = BMI of 30 or greater

Calorie Assessment

Calorie calculator

MyPyramidTracker.gov

Calorie Calculator

Based on the Mifflin-St Jeor equation BMR for a man = 10 x wt (kg) + 6.25 x ht (cm) – 5 x

age (years) + 5 BMR for a woman = 10 x wt (kg) + 6.25 x ht (cm) -5 x

age (years) – 161 Multiply by an activity factor: P 233 Lee and Nieman

1.2 confined to bed 1.3 ambulatory, low activity 1.5-1.75 average activity 2.0 highly active

Discrepancy

Why do you think there is a difference between the calorie recommendations determined by MyPyramidTracker.gov and Calorie Calculator?

Do you think this is a significant difference?

2005 Dietary Guidelines

2005 Dietary Guidelines

Calories 2542 Dietary fiber (RDA) 20-25 gm

Fat (%) 20-30% Sodium (RDA) 1500-2300 mg

Saturated fat (%) <10% Potassium (RDA) 4700 mg

Carbohydrate (%) 45-65% Calcium (RDA) 1000 mg

Protein (%) 10-35% Magnesium (RDA) 420 mg

Dietary Analysishttp://www.MyPyramidTracker.gov

Nutrient AnalysisActual Intake 24 hour recall

Calories 3295

Grams % kcals Grams/Mg %RDA

Fat 115.3 31.5% Dietary Fiber 13 gm 52-65%

Saturated fat

46.8 12.6% Sodium 3798 mg 165-253%

Carbohydrate

440 53% Potassium 4205 mg 89%

Protein 129 16% Calcium 1684.5 mg 168%

Magnesium 361.7 mg 86%

Dietary Analysishttp://www.fitday.com

Nutrient AnalysisActual Intake 24 hour recall

Calories 3234

Grams

% kcals Grams/Mg %RDA

Fat 116.9 33% Dietary Fiber

13.8 gm 52-65%

Saturated fat 47.5 13% Sodium 3650 mg 237%

Carbohydrate 424 52% Potassium 4297 mg 91%

Protein 130 16% Calcium 1688 mg 169%

Magnesium 363.5 mg 87%

2005 Dietary Guidelines

FitDay.com MyPyramid.gov

Calories 2400 3234 3295

Fat 20-30% 116.9 115.3

Saturated Fat

<10% 47.5 46.8

Carbohydrate

45-65% 424 440

Protein 10-35% 130 129

Fiber 20-25 gm 13.8 13

Sodium 1500-2300 mg 3650 3798

Potassium 4700 mg 4297 4205

Calcium 1000 mg 1688 1684.5

Magnesium 420 mg 363.5 361.7

Identify nutrients below RDA/AI Fiber Omega-6 Omega-3 Vitamin C Vitamin E Folate Magnesium Potassium

2005 Guidelines

Actual Intake Excess or Shortage

Fruits 2 cups 0 -2 cups

Vegetables 3-3.5 cups 2.7 cups -0.3-1.2 cups

Grains 8-9 oz 6.3 oz -2.3-3.3 oz

Meats and Beans 6.5 oz 8.2 oz +1.7 oz

Milk 3 cups 4.9 cups +1.7 cups

Fats and Oils 7 tsp

Discretionary 362 kcal

Inside the PyramidFood Group Key Health Benefits Key Nutrients

Grain

Vegetables

Fruit

Milk

Meat and Beans

Healthy Oils

Inside the PyramidFood Group Key Health Benefits Key Nutrients

Grain CHD, constipation, weight management, neural tube defects

Fiber, B vitamins, Fe+

+, Mg++, Se

Vegetables Stroke, CV diseases, Type II DM, GI cancer, CHD, kidney stones, bone loss, lower calorie intake

K+, fiber, folate, Vitamins A, E and C

Fruit Stroke, CV disesases, Type II DM, GI cancer, CHD, Kidney stones, bone loss, lower calorie intake

K+, fiber, vitamin C

Inside the PyramidFood Group Key Health Benefits Key Nutrients

Milk and milk products Osteoporosis, bone health, higher overall nutritional quality

Ca++, K+, Vitamin D

Lean Meat and Beans Cholesterol and heart disease

B vitamins, vitamin E, Fe++, Zn, Mg++

Healthy Oils EFA deficiency, cholesterol levels

Vitamin E

Health Risks

What are the major problems you see with the subject’s diet?

What are the health risks of the type of diet our subject is following?

What recommendations would you give him?

What are the limitations of the data and how could you improve the accuracy of this assessment?

Questions About Measurement and Assessment of Intake?

Farewell Thank you for your kind attention

and participation! Email any time - ahabeck@kaplan.edu Call if your concern or question is

urgent 630 323 3307