Question

Case Study: Ellen is a 55-year-old African American woman with multiple medical problems, including chronic back pain. She is 66 inches tall (5’6”) and weighs 286 pounds. She takes medications for high blood pressure and hypercholesterolemia, both of which are currently under control, and she is a non-smoker. She also takes pain medications every day and has difficulty walking but attends a water exercise class at the local sports center one day a week. She states that she has been overweight most of her life and confesses that foods, especially sweet foods, are a comfort to her when she experiences physical or emotional pain. Her diet history reveals an intake of two or three cans of regular soft drinks each day. Her usual meals with her husband include meat or chicken (she does not like fish) and starchy vegetables, such as corn and potatoes. She snacks on several types of frozen desserts between meals. A recent visit to her doctor reveals a weight gain of 15 pounds over the past 6 months and an increase in her fasting blood glucose level into the “pre-diabetes” range. She has a family history of diabetes. Her doctor has recommended she lose weight and make lifestyle changes to prevent her from developing type 2 diabetes. 4. What are 5 heath behaviors that need to be changed? 5. Describe 5 specific dietary recommendations you would encourage Ellen to implement in order to plan healthy meals to manage her multiple health concerns? (5pts) 6. Based on your reading and research, what specific meal plans or diets would benefit Ellen based on her multiple diagnoses? What are they, why should she consider them, how may they improve her condition? (5pts)

Answer 1

4.obesity is the most serious problem that is arising nowadays. It cause other serious medical conditions. Ms. Ellen not have a healthy behaviour

•Avoid smoking /try to control smoking

•avoid usage of pain medication regularly. Identify the cause of pain and treat that.

•avoid drinking too much drinks. /limit the intake of drinks

•avoid more sweets in the dietand starchy foods these also same like sweets.it increase the blood sugar level.

•avoid daily intake of meat and chicken and also avoid eating too much deserts and snacks, it enhances obesity and cause worsening of hypertension and other medical conditions.

•exercises, includes aerobic exercises, walking jogging, etc

5. dietry recommendation of ellen includes

•Eat more fruits, vegetables, and low-fat dairy foods
•Cut back on foods that are high in saturated fat, cholesterol, and trans fats
•Eat more whole-grain foods, fish, poultry, and nuts
•Limit sodium, sweets, sugary drinks, and red meats

•Eat Foods Rich in Soluble Fiber

These diets helps to control hypertension, obesity and high cholesterol.

6.for a hypertensive,obese patient should not follow the lifestyle as Ms.ellen has.because that behaviour enhance the worsening of her conditions. Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure.

Grains: 6 to 8 servings a day
Grains include bread, cereal, rice and pasta. Examples of one serving of grains include 1 slice whole-wheat bread, 1 ounce dry cereal, or 1/2 cup cooked cereal, rice or pasta.

Vegetables: 4 to 5 servings a day
Tomatoes, carrots, broccoli, sweet potatoes, greens and other vegetables are full of fiber, vitamins, and such minerals as potassium and magnesium. Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetables.

Fruits: 4 to 5 servings a day
Many fruits need little preparation to become a healthy part of a meal or snack. Like vegetables, they're packed with fiber, potassium and magnesium and are typically low in fat coconuts are an exception.

Examples of one serving include one medium fruit, 1/2 cup fresh, frozen or canned fruit, or 4 ounces of juice.

Dairy: 2 to 3 servings a day
Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. But the key is to make sure that you choose dairy products that are low-fat or fat-free because otherwise they can be a major source of fat and most of it is saturated.

Examples of one serving include 1 cup skim or 1 percent milk, 1 cup low-fat yogurt, or 1 1/2 ounces part-skim cheese.

Lean meat, poultry and fish: 6 one-ounce servings or fewer a day
Meat can be a rich source of protein, B vitamins, iron and zinc. Choose lean varieties and aim for no more than 6 one-ounce servings a day. Cutting back on your meat portion will allow room for more vegetables.

Examples of one serving include 1 egg or 1 ounce of cooked meat, poultry or fish.

Nuts, seeds and legumes: 4 to 5 servings a week
Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family are good sources of magnesium, potassium and protein.

They're also full of fiber and phytochemicals, which are plant compounds that may protect against some cancers and cardiovascular disease.

Serving sizes are small and are intended to be consumed only a few times a week because these foods are higher in calories.

Examples of one serving include 1/3 cup nuts, 2 tablespoons seeds or nut butter, or 1/2 cup cooked beans or peas.

Fats and oils: 2 to 3 servings a day
Fat helps your body absorb essential vitamins and helps your body's immune system. But too much fat increases your risk of heart disease, diabetes and obesity.

Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.

Sweets: 5 servings or fewer a week

Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet, or 1 cup lemonade.

Healthy diet contributes to reduction of hypertension through limiting sodium intake, managing weight, limiting alcohol and increasing consumption of vegetable, fruit, whole grain and low-fat dairy products.

It helps for

•early intervention

•Reduce salt intake

Reducing salt intake to less than 5 grams of salt per day can result in a decline in both systolic and diastolic blood pressure of > 10 mmHg.

•Reducing fat intake

Avoid animal fat, stick margarine, vegetable shortenings and commercial bakery and deep-fried foods. Reduce fat intake in general and avoid eating food rich in animal fat, such as red meat, processed meat and butter, and eat olive oil and fish oil instead.

•Weight management

Maintain a healthy body weight (body mass index of 18.5 to 24.9). Lose weight if you are overweight.

•stress management