Question

Gina has been head chef at a local Italian restaurant for the last 15 years. She is from a large Italian family that loves not only cooking but also eating. Although Gina has grown up around large amounts of food and hearty appetites, she has learned to control her weight and eat moderately.

However, Gina's husband, Anthony, has difficulty moderating his eating habits. They have been married for three years, and in that time Anthony has put on 20 kg, most of which went straight to his belly (waist circumference is 104cm). As a software analyst, Anthony gets very little exercise.

To make matters worse, he often has large, rich meals with his in-laws. Last week, the couple celebrated Anthony's 55th birthday with a traditional Italian five-course meal. However, after his birthday, Anthony realised that he really needed to change his eating habits.

He is now 55, about the same age as his father and grandfather were when they died of heart attacks, and in addition, he has recently learned that both of his brothers have high total and LDL-cholesterol. Anthony has never had his blood cholesterol checked, but wouldn't be surprised if his levels were high, too. Anthony went to his family doctor for a physical. Anthony weighed in at 97.7kg, substantially overweight for his 183 cm frame.

The doctor asked Anthony to describe his daily routine and eating habits. Anthony reported that he sleeps late and needs to rush to work. He rarely eats breakfast, although he drinks coffee with full-cream milk and sugar. He usually brings a small, freshly made sandwich from home for lunch, which is usually filled with leftover chicken Parmigiana or veal cutlets from the night before. Anthony’s small lunch sandwiches merely tide him over until the evening's feast.

When Anthony gets home, he likes to relax by helping to prepare the evening meal. Dinner is the meal he lives for.
His typical supper consists of a tossed salad with an olive oil and vinegar dressing, followed by pasta with tomato sauce and grated cheese or a cheese sauce. Fresh mozzarella with sliced tomatoes is usually served, as well.

Anthony likes Italian sausage or veal with his pasta. Anthony fills his plate with pasta, has a second helping of sausage, and can't resist a bowl of gelato, which is always found in the freezer, for dessert.

Anthony knows he needs to change his eating habits, but refuses to deny himself the foods he loves, so he asks the doctor for some advice.

1. The doctor begins by determining Anthony's BMI. Calculate Anthony's BMI, recalling that he is 183 cm and 97.7 kg.

2.    What would be a healthy BMI for Anthony? What is the corresponding weight range?

3. We know a little about Anthony's family history, his lifestyle and health status; why is it particularly alarming?

4. Although satiation sets in about 20 minutes into a meal, Anthony usually does not respond to this. What changes to his diet could influence the satiation he feels?

Answer 1

1) BMI is an indication whether your body weight is in a healthy balance or not. It can also predict whether you are suseptable to weight - gain health problems or not. It is calculated by dividing weight by square of height.

Antony's BMI is 29.2 which indicate he is in the border of obesity, now in overweight categority max limit. He is more susceptible to health problems.

2) BMI value shows the healthy maximum weight we should maintain inorder to avoid health problems. The healthy BMI of a person is between 19 to 24. As BMI donot take age and sex into account, it is common for everyone. And the healthy weight corresponding to his height is 64Kg- 82Kg. Compared to his age, he can go upto 86 Kg which is near healthy BMI.

3) Antony's family history, lifestyle and health status shows his health is at alarming risk. We can analyze Anony's lifestyle.

a. Physical status

• He is a large framed person with 183 cm height which is above normal and 97.7kg weight in his 55 year age.
• His BMI is nearly 30 which is obese. In his age, it is more prone to health risks.
• He gained 20kg in 3 years, this states that his genetic composition favours weight gain. His body nature is like so.
• Belly size is 104cm which is too high from a healthy range.

b. Family history & health statusH

• He is having a not so healthy family history. Heart attacks are more common in their family through generations and they died at age of 55 which is not a healthy story.
• The siblings, as they are having high LDL level, they have high cholesterol and more prone to have heart diseases.
• So, already Antony is genetically more suseptable to have health issues and his own contributions made him an individual with high chance of cholesterol.

c) Lifestyle

• He is a software employ. So physical exercise may be too low.And the job style is stressfull to eye and brain. As brain need more energy, more urge of eating. Stress may lead to hypertension.
• He is not having healthy sleep. Sleep is very important. 6 hours of minimum sleep in correct time is needed for all the normal metabolic process. So he is breaking it daily.
• He is having no breakfast.Our body demands more amount of calcium, iron etc.. in the early period of a day. So it is more absorbed from breakfast. So these nutrients are not effectively absorbed in later meals. So if breakfast is missed, these nutrients may miss.
• Often he is having rich meals. Though it is often, the irregularity in food habits leads to serious health issues.

d) Food habits

• Missing the breakfast, he is having coffee with full cream and sugar. Coffee is a bevarage and not food. Having cream and sugar leads to get fatter. Though in breakfast leads to severe conditions.
• Lunch helps to level the blood sugar level and thus it is very important. He is having sandwich alone in lunch. Not a healthy meal. More chances to get hungry faster.
• Sandwich is having chicken which lasts an overnight in freezer. It may undergo oxidation which causes an increase in LDL.
• He is having a heavy dinner. Dinner must be the lightest of meals. Because at night no physical activty is there. He is helping in preparation. So his stomach must be in a condition of receiving food from that time. This causes the acid in stomach to increase.
• Dinner has pasta, tossed salad, olive oil and vinegar dressing which are good for health. They have less calorie and helps in reducing blood sugar level. But pasta is hard to digest. Sauces and not that good as it may cause cancer. Gelato in freezer is also not good as the milk content promote lactic acid production.
• He is having a very heavy dinner which causes heaviness and leads to avoidance of breakfast next day.

His daily food routines are not healthy at all.

4) Satiation refers to the end of desire to have food or a feeling of fullness. His satiation time is 20 minutes which means he usually feels fullness in 20 minutes and he doesnt respond to it. Which means it eats after that too.

He must have foods which influences his satiation he feels. Means he has to eat foods which is low in calories and which gives a feeling of satiation easily. He must eat foods with high score of satiation index. They are cooked potatoes, oats, fish, soup, eggs etc.. This helps to give a fullness much easier and thus urge for eating lowers.
For making a healthy lifestyle, he must follow,
• A healthy diet.
• Exercise regularly, eventhough mild.
• Healthy sleep
• Have breakfast daily
• Nutrient rich lunch
• Light dinner
• check health status often.