Deck 17: Adult Nutrition: Conditions and Interventions

Question 1

List the main considerations in developing a diet plan (nutrition prescription) for an individual with diabetes.

Answer 1

The main considerations to develop a diet plan for a diabetes patient are:
• Weight of the individual: the individual should maintain healthy weight, so meal planning is necessary if he has over weight. In his meal plan all the nutrients should be present and it should be with low fat and low calories. Carbohydrates should be between 40-60% in entire day meal plan including snacks.
• Amount of protein and fat should be considered and adjusted to avoid other disorders
• Carbohydrate counting and blood glucose monitoring also required.
• Diet plan should be affordable and basing on his budget and lifestyle. Variety of food should be added diet plan to meet basic nutrient needs
• Macronutrients presence should also be considered

Question 2

What are a dietitian's priorities for nutrition intervention in each of the four stages of cancer care?

Answer 2

The dieticians had to develop different diet plans depending on the stages of the cancer care.
Prevention:
To prevent or minimize the risk of cancer, proper healthy diet and physical activity is needed. Diet plan should include dark green and orange colour fruits and vegetables, whole grains and other foods form plant sources. Daily physical activity is also required to maintain weight.
Treatment:
During the cancer therapy like radiation, chemotherapy, surgery dieticians should take care for patients at individual level. Nutrition plays a major role in speed recovery of patients. During treatment there are lot of complications may occur like nausea, vomiting, diarrhoea, constipation, loss of appetite, fatigue and weight loss.
So, dieticians should develop the meal plan basing on symptoms, treatment, nutritional status and taste for food for each patient. Diet plan should include more calories and proteins for fast healing and improve immunity.
Periods of remission: For general population, individual diet plan is recommended to maintain healthy weight and to get good nutritional status.
Nutritional care during advanced stages of cancer: Diet plan should be according to the patient's desires and requirements. Diet should contain all the nutrients to manage symptoms and increase quality of life.

Question 3

What nutrition-related concerns develop as a result of having HIV?

Answer 3

Individualized nutritional diet plan is necessary for HIV (human immunodeficiency virus) patient under therapy.
• They should consume sufficient amount of calories to get strong immunity, maintain the healthy weight and prevent rapid weight loss
• Their diet should contain more protein and other nutrients
• They have to take foods which are healthy for heart to reduce cardiovascular diseases
• HIV patients should consume more calcium and vitamin D either in the form of supplementation to avoid decreasing in bone density
• They have to be monitored for lipid profile and insulin resistance to avoid other complications

Question 4

The following six questions concern Rebecca, who is 36 years old, weighs 182 pounds, and is 5 feet 4 inches tall. She just found out her LDL cholesterol is 170 and her HDL is 37.

A) Rebecca is obese.
B) Rebecca should be assessed for metabolic syndrome.
C) Rebecca needs to lose over 20 pounds to reduce her risk of developing type 2 diabetes.
D) Eating high-fiber foods a few times a week will help lower her LDL cholesterol.
E) What other information do you need to determine Rebecca's 10-year risk of having a heart attack?
F) Rebecca quit smoking a few years ago. What else can she do to reduce the development of cardiovascular disease?

Question 5

Identify and discuss at least three themes that are common across all the conditions-overweight and obesity, cardiovascular disease, metabolic syndrome, diabetes, cancer, and HIV disease-presented in this chapter.

Question 6

Assessment
Calculate Adam's current BMI. How would you classify his weight status based on the clinical classifications in Table 17.2?

Question 7

Assessment
What would you consider a healthy BMI and "healthy weight" for Adam?

Question 8

Assessment
What lifestyle and dietary factors are related to Adams weight status?

Question 9

Diagnosis
What is Adam's nutrition diagnosis? What modifiable factors cause or contribute to this problem? What evidence do you have for the problem?

Question 10

Intervention
What dietary prescription would you have for Adam? What goal would you recommend?
Hint: Calculate a calorie intake level and estimate the number of weeks it would take for Adam to reach a healthy weight.

Question 11

Intervention
What interventions would you use to help Adam reach the goal? What topics and suggestions would you discuss with Adam?

Question 12

Monitoring and Evaluation
What would you measure later to determine if Adam was making progress?

Question 13

How would you design a lifestyle-change program based on cognitive behavioral therapy?

Question 14

From the information gathered at his medical visit, how well do you think Dan is managing his metabolic syndrome? Why?

Question 15

What three things differentiate population recommendations to minimize cardiovascular disease risk from therapeutic lifestyle changes for individuals at high risk?

Question 16

What are the desired goals for metabolic syndrome factors (i.e., anthropometric and laboratory indicators)?

Question 17

List the metabolic changes that characterize metabolic syndrome. How many are required for a diagnosis of metabolic syndrome? What is the easiest way to screen for metabolic syndrome?

Question 18

List the primary sequelae of poorly managed metabolic syndrome.

Question 19

Why is it better to start intervention in the prediabetic state rather than waiting for the diagnosis of diabetes?

Question 20

What sort of lifestyle modifications would you discuss with Dan in order to improve the management of his condition?