Madeleine Holloway-Tjan Friday Section Part A The patient is a 40 year old male who has Type II DM and Crohns.

The patient is Caucasian and has a BMI of 27. !"#m2 $o%erwei"ht&. The patients fa%orite foods include' Chipotle (urritos) tuna melts and ice cream * to name a few. The patient does not en"a"e in physical acti%ity (esides ta!in" his do") Buster) for a wal! for 20 minutes a day +,-. per wee!. Independent /ro0ect Date' 12,-,1+ 2ecorder' Madeleine 3olloway Nutrition Assessment , Dia"nosis' Type II DM) Crohns) o%erwei"ht , 4"e) "ender' 40) male , 564' Moderate malnutrition , 5ocial h.' +,4 alcoholic drin!s 4.#wee! ) pt rarely does not eat until 11am , Diet related meds' Corticosteroids) 3umira , 5ymptoms' diarrhea) e.cessi%e hun"er and thirst , 4nthropometric measurements o 3t#wt' -711 # 180 cm and 1109# :0 !" o BMI ; 27. !"#m2 $o%erwei"ht& , <ner"y) protein and fluid needs o 6i%e a ran"e Total ener"y ; 2100 !Cal#day /rotein ; 72, :0 "#day =luid ; 2100 ml#day o Basis for estimations $Based on wt' -0 !"& =or ener"y) 2+ !cal# !" =or protein) 0.8,1.0 "# !"#day =or fluid needs) 1ml#!Cal#day , >a(#tests o 3(41C' :.4? $hi"h& o =astin" (lood "lucose' 280 m"#d> $hi"h& o C2/' 4.+ m"#d> $hi"h&

Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section Nutrition Diagnosis , <le%ated (lood "lucose 2#T type II DM 4<B a(normal 3(14C and fastin" (lood "lucose la( %alues. Nutrition Intervention 1. Meals and snac!s a. =ollow 2100 !Cal meal plan) 2 day sample attached (. 3i"h fi(er i. 4%oid refined and processed foods ii. @hole "rains) fruits and %e"eta(les c. <at (rea!fast d. 2educe alcohol consumption to 1,2 drin!s in moderation 2. Autrition education a. Dia(etes <ducator i. Blood 6lucose B 1-0 m"#d> (. 2efer to e.ercise physiolo"ist 6oals 1& To achie%e a normal BMI) wei"ht loss of 1,2 l(s per wee! 2& To sta(iliCe and re"ulate (lood su"ar without spi!es a. To understand how to interpret an e.chan"e list and follow meal plan +& To en"a"e in physical acti%ity Monitoring and Evaluation , =ollow up phone call after + days or 1 wee! later , 4s! pt to do +,day wt food record $includin" fluids& and (rin" it to clinic to reassess diet) see if pt has adhered to nutrition inter%ention immediately o Monitor refined C3D inta!e and inta!e of fruits and %e"eta(les , Immediately' 4s! pt to lo" (lood "lucose le%els throu"hout the day and (rin" lo" to clinic to assess (lood "lucose control Part B
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section 6rocery >ist Trader Eoes) @indmill =arms Dr"anic 5pinach) oC Dran"e) lar"e Cut and /eeled Carrots) 1 oC 3ummus Dip ) 7 oC Bananas $2& Canned Tuna =ish in water) 6round Tur!ey) 1 l( 4%ocado) lar"e Gellow Dnion) lar"e @hole @heat Bread) 24 oC Brown Easmine 2ice ) 24 oC =a"e 6ree! Go"urt $2& Buttermil!) Huart /ome"ranate ) lar"e I doCen or"anic free ran"e e""s oC F1.4: F1.:: F0.+8 F1.1: F+.:: F1.2: F0. : F1.:: F1.2: F2.:8 F1.2: F1.-0 F2. : = $25.44 Part C Autritional 4nalysis was preformed for two,day meal plan usin" www.=itDay.com. Autrient 4nalysis Day 1
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

F1.:: F0. :

Madeleine Holloway-Tjan Friday Section

Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section

Autrient 4nalysis Day 2

Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section

Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section

Compared to the D2I $4-, -? car(ohydrates) 20,+-? fat) 10,+-? protein&) the patients inta!e durin" the two,day meal plan

Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section is sufficient. Dn Day 1) the patient consumes -+? of total Calories from car(ohydrate) 28? of total Calories from fat and 1:? of total Calories from protein. Dn Day 2) the patient recei%es 48? of total Calories from car(ohydrate) +0? total Calories from fat and 2+? total Calories from protein. 4ccordin" to the nutrient analysis on www.=itDay.com) the patients meal plans are (etween 20-+ and 207+ total Calories per dayJ which adheres with the recommendation of 2100 Calories. The total Calories estimated from the e.chan"e list $/art B& differ from the total Calories from the nutrient analysis (y 100 Calories) (ut lie in the same macronutrient (rea!down ran"es. In relation to My/late "uidelines) the patient consumes two times more %e"eta(les on Day 1 than the recommended inta!e of 2,+ ser%in"s per day * (ut the consumption of %e"eta(les adheres with the recommendation of a hi"h fi(er diet for the patient. The patient also consumes more fruit than recommended (y My/late) (ut consumption is spaced e%enly throu"hout the day in order to maintain (lood "lucose le%els * critical to the patients health and well(ein". It is safe to say that the patients Kplate7 is comprised of I %e"eta(les and fruits. The patient consumes an adeHuate amount of "rains and dairy) and is adherent to the su""estions of ser%in"s per day and 2 ser%in"s per day) respecti%ely. The patient consumes more fat than the My/late su""estion of eatin" K fats sparin"ly7) (ut the ma0ority patients fat inta!e comes from a%ocado) oli%e oil and hummus. The patients meal plan strays away from processed and refined products as well as refined su"ar. The nutritional "oals for this patient are met) and the two,day sample menu plan falls within close ran"e to the "uidelines set for a 2100 Calorie per day diet' -0? Calories from car(ohydrate) 20? Calories from protein and +0? Calories from fat. The total Calories of the patients meal plan falls within -0 Calories of the "oal * 2100 Calories. The patients diet plan is hi"h in fi(er and rich in whole "rains) fruits and %e"eta(les and low fat protein sources. Part D I was surprised how difficult it was to create a meal plan within a restricted (ud"et comprised of items from a "rocery list of
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section whole %e"eta(les) fruits and lean proteins. My ori"inal "rocery list contained -L items that I thou"ht to (e %ital to the creati%ity of the menu) and with a (ud"et of F2-) I had to oust these items from the "rocery list. This pro0ect put in to perspecti%e how challen"in" it can (e to meet dietary "uidelines and (ud"et restrictions while maintainin" %ariety and fla%or in a meal plan. @or!in" with only a handful of in"redients o%er a two,day span) it (ecame apparent how repetiti%e the use of in"redients was (ecomin" and how imperati%e it was to create interestin" ways offer su""estions of com(inations of in"redients. @hile adherin" to a restricted (ud"et) it (ecame clear that processed foods and ready,to,eat products are out of the picture. In order to chan"e eatin" ha(its and patterns) it may (e (eneficial to physically show someone how to smartly shop and most importantly how to find satisfaction preparin" a meal from start to finish. It also (ecame apparent that the person followin" the meal plan has to ha%e a si"nificant portion of time on their hands to prepare three meals a day) and for some) solely the preparation of meals would (e a tas! in itself. <ducation on how to allocate time in the day to prepare meals would (e (eneficial to the success of followin" a meal plan.

Independent Project Diet Rx: $ia%eti& $iet: 2100 kCal/day 50% '&als (H)*
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Name: Madelei#e Holloway

1050 k(al

2+3 gm (H)

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section 20% '&als ,ro * 30% '&als .at * DAY 1 B Star& es .ruit Milk 4egeta%les Meats/Su%stitutes .ats C#$ C+oice* 2l 2 1 2 1 1 skim 1 2 2 -l 1 5 2 3 3 3 3 l 3 ! 2 1 1 2 D ! "otal C#$ %&'
015g1 -!0 015g1 2-0 012g1 2+ 05g1 120

-20 k(al +30 k(al

105 gm ,ro /0 gm .at Pro %&'

03g1 2+ 0!g1 +02g1 -! 0/g1 252 5+

(at %&'
01g1 /2 01353!g1 1!

)cal* +-! 2-0 1/! 1+!

1 2 skim skim + 2l52 5

03353!g1 2-3 12+ 05g1 225

-25 1!2 225 "$"A! )cal*: 21,-

20 )cal*/&m 23+ .)cal* -5%

51+ 2-%

+!32%

62-3 servi#gs of #o#star& y vegeta%les 62 servi#gs of fruits 6+ servi#gs of grai#s3 %ea#s3 a#d star& y vegeta%les 62 servi#gs of low-fat or fat-free milk 6+ o7 of meat or su%stitutes 6Small amou#ts of fats a#d sugars Day 1 /en0 Plan:
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section 8reakfast: 2 sli&es of w ole w eat toast 02 e9& a#ges1 : large %a#a#a 01 e9& a#ge1 ; ( .age lowfat yogurt 01 e9& a#ge1 - egg w ites 02 e9& a#ge1 1 o7 avo&ado 01 e9& a#ge1 1 ts< olive oil 01 e9& a#ge1 == Mi9 : large %a#a#a a#d .age lowfat yogurt toget er3 toast %read a#d sa#dwi& s&ram%led egg w ites &ooked i# olive oil a#d avo&ado for %reakfast sa#dwi& == S#a&k 1: 2/3 ( ummus 02 e9& a#ge1 1 ( raw &arrots 01 e9& a#ge1 Lu#& : 1 ( &ooked %row# ri&e 03 e9& a#ges1 : ( &ooked o#io# 01 e9& a#ges1 - o7 grou#d turkey 0- e9& a#ges1 : ( &ooked s<i#a& 01 e9& a#ge1 1 ts< olive oil 01 e9& a#ge1 == (ook vegeta%les i# oil3 add grou#d turkey a#d %row# a#d serve over ri&e > seaso# wit salt3 <e<<er a#d red & ili flakes== S#a&k 2: : large %a#a#a 01 e9& a#ge1 2 o7 avo&ado 02 e9& a#ge1 2 sli&es of %read 02 e9& a#ges1 == ?oast %read a#d s<read avo&ado o# toast a#d seaso# wit <e<<er a#d garli& salt==
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section

$i##er: 1 ( of grated &arrots 01 e9& a#ges1 3 o7 grou#d turkey %reast 03 e9& a#ge1 1/3 ( %row# ri&e 01 e9& a#ge1 1 ( raw s<i#a& 3 : ( &ooked o#io# 02 e9& a#ge1 == ?urkey a#d &arrot %urger: &om%i#e grou#d turkey3 grated &arrots a#d &ooked o#io#s i#to <atty a#d grill3 <la&e over %ed of s<i#a& == S#a&k 3: ; ( .age <lai# lowfat yogurt 0 1 e9& a#ge1 1 ( <omegra#ate seeds 02 e9& a#ge1 ==.ree7e <omegra#ate seeds a#d serve over .age lowfat yogurt ==

Independent Project Diet Rx: $ia%eti& $iet: 2100 kCal/day 50% '&als (H)*
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Name: Madelei#e Holloway

1050 k(al

2+3 gm (H)

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section 20% '&als ,ro * 30% '&als .at * DAY 2 B Star& es .ruit Milk 4egeta%les Meats/Su%stitutes 2m 2 1 1 skim 1 1 skim 1 3l5 1 1 1 2 2 2 ! 3 1 D / 5 "otal C#$ %&'
015g1

-20 k(al +30 k(al

105 gm ,ro /0 gm .at Pro %&'

03g1 !-

(at %&'
01g1 /2

)cal* +2/ 300

-!0
015g1 300 012g1 1-05g1 +0

2 3 l

1 3 skim skim 3 + l 52 m 5 1 3 2

0!g1 2-0 02g1 20/g1 1+! 5+ 2!

01353!g1 2/

-11 !-

.ats C#$ C+oice*

1 -

1 5

03353!g1 1+2 20 /2 05g1 135

330 1-+ 100 135 "$"A! )cal*: 21,,

1! )cal*/&m 2!.)cal* -+%

+00 2!%

55! 2+%

62-3 servi#gs of #o#star& y vegeta%les 62 servi#gs of fruits 6+ servi#gs of grai#s3 %ea#s3 a#d star& y vegeta%les 62 servi#gs of low-fat or fat-free milk 6+ o7 of meat or su%stitutes 6Small amou#ts of fats a#d sugars

Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section Day 2 /en0 Plan: 8reakfast: 2 sli&es of w ole w eat toast 02 e9& a#ges1 : large ora#ge 01 e9& a#ge1 2 w ole eggs 02 e9& a#ge1 1 ts< %utter 01 e9& a#ge1 1 ( %uttermilk 01 e9& a#ge1 == 8uttered toast wit ard %oiled eggs o# to<3 ora#ge o# t e side==

S#a&k 1: : large %a#a#a 01 e9& a#ge1 Lu#& : 2 sli&es of w eat toast 02 e9& a#ges1 : ( raw o#io#3 : ( raw s<i#a& 01 e9& a#ges1 3 o7 &a##ed tu#a i# water 03 e9& a#ges1 1/3 ( ummus 01 e9& a#ges1 ; ( .age lowfat yogurt 01 e9& a#ge1 1 o7 avo&ado 0 1 e9& a#ge1 == (om%i#e tu#a wit .age yogurt3 o#io# a#d olive oil > add salt3 <e<<er a#d ot sau&e to taste > o<e# fa&ed sa#dwi& o# %read wit ummus3 avo&ado a#d s<i#a& == S#a&k 2: : large ora#ge 01 e9& a#ge1 : ( <omegra#ate seeds 01 e9& a#ge1 $i##er: 1 ( &ooked %row# ri&e 03 e9& a#ges1 3 o7 grou#d turkey %reast 03 e9& a#ge1
Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat

Madeleine Holloway-Tjan Friday Section 1 ( &ooked o#io# 02 e9& a#ge1 1 ts< olive oil 01 e9& a#ge1 == ?a&o 8owl: Seaso# grou#d turkey wit Mrs@ $as Me9i&a# seaso#i#g3 <la&e &ooked grou#d meat over ri&e == S#a&k 3: ; ( .age <lai# lowfat yogurt 01 e9& a#ge1 : large %a#a#a 01 e9& a#ge1

Low-fat meats: 3g fat Medium-fat meats: 5g fat Hig -fat meats: !g fat

Skim/very low-fat milk: 0-1g fat 2% milk: 5g fat " ole milk: !g fat