Question

Nora, 55 yrs. female, present to her family physician with a 3-month history of fatigue and lethargy. Her height: 166 cm, Weight: 75 kg, her lab value showed that high fasting blood sugar and her HbA1C 8%, sedentary physical activity

Diet History: estimate energy intake of approximately 2300 kcal/day, Nora states that she consumes soft drink more than (24 oz.), ice cream and chocolate candy daily

24 hr- recall:

Breakfast: 1 sandwich of egg English muffin + 2 pancake 4 inches across + 1 Tbsp. honey

Morning Snack: one can soft drink – 12 pc Pistachio

Lunch: 1 1/3 cup rice – 3 oz. meat – 1-cup salad

After lunch: 3 pieces hard candy

Snack: One can soft drink – 1-cup regular ice cream

Dinner: 6 Patties Falafel 2 inches across + 2 Chapatti, small, 6 inches across + 1-cup fruit drink

Evening snack: one medium doughnut+ 1 can soda

She is diagnosed with type 2 DM, after setting with the dietitian, she is advised to eat three regular meals with three snacks, distribute here CHO intake as recommended in meals and snacks and avoid consuming simple sugar.

Question :

1.Determine the grams of macronutrients (CHO, Fat and Protein) using the total energy requirements you get from part 2 if the caloric distribution as follows (50%, 30%,20%)? Please show all your calculations?

2. Compare her CHO intake from 24 hr recall with the caloric distribution percentage of the normal range of CHO?

Answer 1

1. The distribution of macronutrient is

Carbs 50%

Fat 30%

Protein 20%

Suppose if she takes 2300 Kcal then its distribution would be

Carbs 1150 Kcal (~287 grams as four Kcal in one gram carbs)

Fat 690 Kcal (76.67 gram as 9 Kcal in 1 gram of fat)

Protein 460 Kcal (115 gram of protein; 1 gram of protein typically have ~4 kcal).

2. She is taking too much CHO in her diet, which starts from the

Break fast

CHO rich food

1. Breakfast- Muffin, Pancake, Honey (More than 400 Kcal)

2. Morning snack soft drink (~140 Kcal in a single cane)

3. Lunch-Rice (significant source of calories from Carbs; ~280 Kcal)

4. Hard candy (sugar, bad calories from carb)

5. Snack- Soft drink (150 Kcal) + Ice cream (more than 200 Kcal)

6. Dinner-falafal, Capatti and cup fruit drink is also having hundreds of Kcalories (more than 400 Kcal from carbs)

7. Evening snack will have more than 350 kcal from donut and soda.

On the basis of her diet we can say that she is eating too much carbs which is more than 80% in her diet and it is more then 30% as compared to the normal range.