Question

Barbara is a 72-year-old woman with a "Type A" personality who was diagnosed with a peptic ulcer more than 40 years ago. At that time, her doctor told her to follow a bland diet and eat
three meals per day with three snacks per day of whole milk to "quiet" her stomach. She meticulously complied with the diet to the point of becoming obsessive about eating anything that may not be "allowed." She lost 15 pounds by following the bland diet because her intake was so restricted. She recently began experiencing ulcer symptoms and has put herself back
on the bland diet, convinced it is necessary in order to recover from her ulcer. Yesterday, she ate the following as shown below:

Breakfast: 1 poached egg, 2 slices of dry white toast, 1 cup whole milk

Morning Snack: 1 cup whole milk

Lunch: 3/4 cup cottage cheese with 1/2 cup peaches

Afternoon Snack:1 cup whole milk

Dinner: 3 oz boiled chicken, 1/2 cup boiled plain potatoes, 1/2 cup boiled green beans, 1/2 cup gelatin

Evening Snack: 1 cup whole milk

Barbara's 1600-calorie My Plate plan calls for 1.5 cups of fruit, 2 cups of vegetables, 5 grains, 5 oz of meat/beans, 3 cups of milk, and 5 teaspoons of oils. How does her intake compare

• What food groups is she undereating? Overeating? What are the potential nutritional consequences of her current diet?

• What other information would be helpful for you to know in dealing with Barbara?

• Barbara clearly wants to be on a bland diet; what would you tell her about diet recommendations for PUD?

• What recommendations would you make to improve her symptoms and meet her nutritional requirements while respecting her need to follow a "diet"?

Answer 1

¤She is under eating foods containing grains ,vegetables and fruits .She is over eating milk and milk products .The potential nutritional consequences of this diet are constipation due to low fiber diet .This low fiber can also lead to loose stools .The protein deficiency can occur in bland diet thus leading to poor muscle mass.Low fat can lead to decreased weight. Vitamin deficiency

¤The other information which has to be known are

• Use of any medication
• Drinking, smoking or substance use information
• Any specific compliant like nausea ,vomiting
• Psychological assessment for any depression
• Any other medical conditions

¤The diet recommendations for PUD can be following

• BRAT diet
• Increase vegetables ,fruits and grains
• Add foods like yogurt which is rich in probiotics to produce good intestinal bacteria

¤Some of the recommendations which can provide are

• To add a good quantity of protein in the diet through meat ,grains
• Vegetables to reduce nutritional deficiency
• Eat small and frequent meals instead of eating foods with large quantity.