The nutritional status Essay Example for Free

The nutritional status Essay The individual (a male patient) was about 5’9† in height and weight 105 kilograms, was obese (classified as fat by the Food Standard Agency, UK). He was overweight by about 30 kilograms for his height. His waist circumference was about excess by about 6 to 7 centimetres, meaning that he had accumulated excessive subcutaneous fat in the abdominal and the hip region. His body mass index (BMI) was also suggesting that he was obese and needed to lose weight (according to the Food Standard Agency, UK). His BMI was about 36. 3 and that of normal ranges from 18. 5 to 24. 9, and overweight ranges from 25. 0 to 29. 9. Any value about 30 is considered to be as obese (NHLBI). The individual’s blood pressure is about 165/92 mm Hg which suggests that the individual is suffering from stage 2 or severe hypertension. Any value above 160 mm Hg systolic or 100 mm Hg diastolic can be considered as severe hypertension (according to Mayo Clinic, 2007). The exact cause for the hypertension is really not known, but several risk factors such as increased body weight, physical inactivity, high sodium intake, elevated blood glucose levels, high cholesterol and triglyceride levels, etc may play a major role in the development of the disease. The blood pressure is a product of the cardiac output and the peripheral vascular resistance. Since these are both raised, the blood pressure is elevated (Mayo Clinic, 2007). The individual is at a risk of developing stroke, heart attacks, heart failure and kidney failures due to the severe hypertension (Medline Plus, 2007). The normal blood pressure ranges from 115 to 120 mm Hg for systole and 75 to 80 mm Hg for diastole (Mayo Clinic, 2007). The individual’s cholesterol levels are about 7. 5 mmol/L which puts him at a very high risk of developing heart disease (anything above 6. 2 mmol/L are considered as high-risk) (according to the NHBLI, 2001). The individual’s plasma triglyceride level is slightly high which puts him at a higher risk of developing atherosclerosis, heart disease and stroke. Individuals with diabetes mellitus not undergoing treatment are also at a higher risk of developing elevated plasma triglyceride levels. The individuals fasting blood glucose level is about 8. 4 which is very high compared to the normal limits. This suggests that he could be suffering from type II diabetes mellitus (Mayo, 2006). Individuals who are suffering from diabetes mellitus are more likely to develop several complications including a fatal outcome when they are affected with a cardiovascular episode such as a heart attack or angina. The plasma sodium levels are slightly higher suggesting an increased risk of hypertension and developing heart diseases such as heart failure and left ventricular hypertrophy (LVH) (Better Health Channel, 2007). The plasma potassium levels are within normal ranges. The mean corpuscular value of the red blood cells is reduced (the individual could be suffering from microcytic anaemia) which usually develops in iron deficiency anaemia (Lab Tests Online, 2005). The haemoglobin levels are also below normal suggesting that the individual is suffering from anaemia (Lab Tests Online, 2005). The Blood urea nitrogen levels are within normal limits, but are towards the higher side, suggesting that the individual could be having a risk of developing a heart attack or kidney failure in the future (Richards, T, 2005). The creatine kinase levels are within the normal limits in the body, but are towards the higher side suggesting that there is a risk of damage occurring to the muscles of the heart (MDA, 2000). The AST levels (a liver enzyme) are within normal limits. The individual is following a sedentary lifestyle and is consuming about 3500 cal per day which is far too much. His actual calorie consumption per day should be about 2500 calories per day (Nutri-Facts, 2000). The individual is consuming a diet of 45% carbohydrate, 40% fat and 15% protein. The intake of fats is very high. An idea ratio would be 60-70 % carbohydrates, 15 % proteins and 20 % fats. A high-fat diet is further contributing to the cholesterol levels, the arthrosclerosis process and increasing the risk of hypertension and cardiovascular disease (Diabetes India). What dietary recommendations and life style changes would you recommend? Discuss the issues you would need to consider when constructing a suitable dietary regimen for this patient. The individual should ensure that he consumes a balanced diet not only containing adequate amounts of macronutrients (that is carbohydrates, fats and proteins), but also sufficient amounts of micronutrients (that is vitamins and minerals). The individual is suffering from iron deficiency anaemia, and hence a diet containing vitamin B12, folic acid and iron should be administered. Iron and Vitamin B supplements may also be required. Blood tests should be frequently conducted to ensure that the haemoglobin levels and the MCV are monitored (NHS, 2007). As the individual is suffering from diabetes mellitus, the intake of calories and fats should be reduced or modified. Simple sugars should be avoided and instead complex polysaccharides should be consumed (in the form of starch). The fibre quantity in the diet should also be increased. The individual should be treated for diabetes through insulin and/or oral-anti-diabetic drugs, as the sugar level is very high. The blood glucose levels should be constantly monitored to ensure that modifications are initiated as early as possible (Mayo, 2006). The individual should consume a low fat diet, which is about 20 % of the macro-nutrient ratio. More of High density lipoproteins (HDL) should be consumed instead of the low density lipoproteins (LDL). The LDL contributes to the bad cholesterol present in the body and could worsen the risk of developing heart disease (Diabetes India). The salt intake should be reduced as it could worsen the hypertension and could also cause heart failure and fluid retention (Diabetes India). The individual requires treatment of hypertension so that the blood pressure is brought within limits and the risk of developing cardiovascular disease is lowered. Antihypertensive medications are required to control the blood pressure. Some of the different groups of drugs that may be required include diuretics, beta blockers, ACE inhibitors, calcium channel blockers, vasodilators, etc (Mayo, 2007). These should be consumed as recommended by the physician. The individual’s blood pressure should constantly be monitored to ensure that modifications are made as early as possible. Besides, lifestyle changes are also required, which are also required to control the diabetes and hypertension (Mayo, 2007). Medications should be taken regularly and on time. Meals should not be skipped and should be consumed on time as directed by the nutrients. Smoking should be stopped and alcohol consumption should be minimised. Feasting or fasting should be avoided. Regular exercises are necessary to ensure that the weight is brought to a level which is less damaging for the body. The individual should take adequate rest and consume plenty of water in a day (Mayo, 2006). References: American Heart Association 2007. Triglycerides, [Online], Available: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Salt?open