Question

Candace is a 36-year-old sales clerk who was recently diagnosed with fatty liver disease after she went to her doctor complaining of chronic fatigue. She is 62 inches tall and weighs 186 pounds. She works 6 days a week and states she gets little exercise outside her job at a retail store. She was diagnosed with type 2 diabetes four years ago after the birth of her second child. She admits her diet “isn’t the best,” although she attended nutrition classes when she was first diagnosed with diabetes. She frequently skips breakfast and eats lunch in a fast-food restaurant. She does not drink alcohol. Laboratory tests reveal elevated blood glucose, triglycerides, and total cholesterol. Liver enzymes (AST and ALT) are elevated. Albumin and HDL are abnormally low.

In this step you will answer the following questions:

1. Calculate Candace’s body mass index (BMI) using the table on the inside back cover. What does her BMI indicate about her weight status? How do excess weight and diabetes contribute to fatty liver disease?
2. What would be the goal of your nutrition plan for this patient? Why?
3. Why is it important to counsel this patient to lose weight? What precautions should she take regarding weight loss?

Answer 1

1. Candace’s body mass index (BMI)

BMI = Weight in kg/height in meter2

186 pound = 85kg

62 inch = 1.57m

Then = 85kg/1.57m2 = 27

So, Here BMI is 27.

BMI 27 Suggest that she is over weight. (Normal BMI Is 18.5 to 24.9)

Obesity increases level fatty acids in the blood, which causes insulin resistance and it leads to diabetes. Diabetes increases blood glucose levels by preventing their usage.

This increases the deposition of fat in the liver(Excess Carbohydtare converts to fat in the liver).

2.

The goal of nutrition plan includes

- Decrease intake of Carbohydrate (To maintain blood glucose level and reduce the complication of diabetes)

- Get rid of Bad fat like Transfat and Saturated fats (Because she is overweight, having diabetes and a high cholesterol level so, she should reduce intake of these fats to reduce her cholesterol and reduce risk of other diseases like heart disease and stroke)

- Increase intake of Good fats like Unsaturated fatty acid (It increases HDL level, which is good cholesterol. HDL decreases total cholesterol level and it is also heart-healthy)

- Eat more whole fruit and vegetables (To get more vitamins and minerals)

3. It's important to counsel the patient regarding weight loss because obesity is the main risk factor for many diseases like Liver diseases, heart disease, stroke, hypertension and many more. Obesity can increase the risk of diabetes complications. so, it's very important for her to lose weight.

She should do regular exercise, eat low carb diet, leave saturated fat and trans fat diets, eat more fruit and vegetables, and leave a active lifestyle to lose weight.