1. UNIT 3 NS270 NUTRITIONAL ASSESSMENT AND MANAGEMENT Amy Habeck, RD, MS, LDN

2. Recognition Excellent sources Critical thinking skills

3. Unit 3 Learning Objectives: 1) Case study – 45 year old male a) Found in Doc Sharing and on Seminar tab of Unit 3 Course Home b) Complete a nutrient analysis on a food intake to identify actual and potential nutrient deficiency 2) Review- Stanfield and Hui a) Chapter 5 – Vitamins b) Chapter 6 – Minerals c) DRI tables 3) Answer your questions

4. Case Study  45 year old male  Ht: 5’10”  Wt: 190 pounds  Calculate BMI  Determine BMI Classification  Calculate energy needs  Assess intake  Recommendations

5. BMI Calculation-Metric Conversion  What is his height in meters? 5’10” = _______m  What is his weight in kilograms? 190 pounds = _______kg

6. Convert Height to Meters  Ht: 5’10” = 70 inches 70 inches x 2.54 cm/in = 177.8 cm 177.8 cm ÷ 100 cm/m = 1.78 m (1.78m) 2 =1.78 x 1.78 = 3.17 m

7. Convert Weight to Kilograms  Weight  190 pounds x kg/2.2 pounds = 86.36 kg

8. Calculate BMI Weight in Kg (Ht in m) 2 =_________ http://www.nhlbisupport.com/bmi/bmi-m.htm

9. Calculate BMI  Using Standard Measurements Wt (pounds) (x 703)= Ht (in) 2

10. Case Study  45 year old male  Ht: 5’10” = 1.78 m 2 = 3.17  Wt: 190 pounds = 86.36 kg  Calculation  Kg/m 2  86.36 ÷ 3.17 = 27.3  BMI: 27.3  What is his BMI classification?

11. BMI  BMI: 27.2  BMI Classification: Overweight  BMI Categories: Underweight = <18.5 Normal weight = 18.5-24.9 Overweight = 25-29.9 Obesity = BMI of 30 or greater

12. Calorie Assessment  Calorie calculator  MyPyramidTracker.gov

13. Calorie Calculator  Based on the Mifflin-St Jeor equation  BMR for a man = 10 x wt (kg) + 6.25 x ht (cm) – 5 x age (years) + 5  BMR for a woman = 10 x wt (kg) + 6.25 x ht (cm) -5 x age (years) – 161  Multiply by an activity factor:  P 233 Lee and Nieman  1.2 confined to bed  1.3 ambulatory, low activity  1.5-1.75 average activity  2.0 highly active

16. Discrepancy  Why do you think there is a difference between the calorie recommendations determined by MyPyramidTracker.gov and Calorie Calculator?  Do you think this is a significant difference?

20. 2005 Dietary Guidelines Calories 2542 Dietary fiber (RDA) 20-25 gm Fat (%) 20-30% Sodium (RDA) 1500-2300 mg Saturated fat (%) <10% Potassium (RDA) 4700 mg Carbohydrate (%) 45-65% Calcium (RDA) 1000 mg Protein (%) 10-35% Magnesium (RDA) 420 mg

21. Dietary Analysis http://www.MyPyramidTracker.gov Nutrient Analysis Actual Intake 24 hour recall Calories3295 Grams% kcalsGrams/Mg%RDA Fat115.331.5%Dietary Fiber13 gm52-65% Saturated fat 46.812.6%Sodium3798 mg165-253% Carbohydrat e 44053%Potassium4205 mg89% Protein12916%Calcium1684.5 mg168% Magnesium361.7 mg86%

22. Dietary Analysis http://www.fitday.com Nutrient Analysis Actual Intake 24 hour recall Calories3234 Grams% kcalsGrams/Mg%RDA Fat116.933%Dietary Fiber13.8 gm52-65% Saturated fat47.513%Sodium3650 mg237% Carbohydrate42452%Potassium4297 mg91% Protein13016%Calcium1688 mg169% Magnesium363.5 mg87%

23. 2005 Dietary GuidelinesFitDay.comMyPyramid.gov Calories240032343295 Fat20-30%116.9115.3 Saturated Fat<10%47.546.8 Carbohydrate45-65%424440 Protein10-35%130129 Fiber20-25 gm13.813 Sodium1500-2300 mg36503798 Potassium4700 mg42974205 Calcium1000 mg16881684.5 Magnesium420 mg363.5361.7

30. Identify nutrients below RDA/AI  Fiber  Omega-6  Omega-3  Vitamin C  Vitamin E  Folate  Magnesium  Potassium

31. 2005 GuidelinesActual IntakeExcess or Shortage Fruits2 cups0-2 cups Vegetables3-3.5 cups2.7 cups-0.3-1.2 cups Grains8-9 oz6.3 oz-2.3-3.3 oz Meats and Beans6.5 oz8.2 oz+1.7 oz Milk3 cups4.9 cups+1.7 cups Fats and Oils7 tsp Discretionary362 kcal

32. Inside the Pyramid Food GroupKey Health BenefitsKey Nutrients Grain Vegetables Fruit Milk Meat and Beans Healthy Oils

33. Inside the Pyramid Food GroupKey Health BenefitsKey Nutrients GrainCHD, constipation, weight management, neural tube defects Fiber, B vitamins, Fe ++, Mg ++, Se VegetablesStroke, CV diseases, Type II DM, GI cancer, CHD, kidney stones, bone loss, lower calorie intake K +, fiber, folate, Vitamins A, E and C FruitStroke, CV disesases, Type II DM, GI cancer, CHD, Kidney stones, bone loss, lower calorie intake K +, fiber, vitamin C

34. Inside the Pyramid Food GroupKey Health BenefitsKey Nutrients Milk and milk productsOsteoporosis, bone health, higher overall nutritional quality Ca ++, K +, Vitamin D Lean Meat and BeansCholesterol and heart disease B vitamins, vitamin E, Fe ++, Zn, Mg ++ Healthy OilsEFA deficiency, cholesterol levels Vitamin E

35. Health Risks  What are the major problems you see with the subject’s diet?  What are the health risks of the type of diet our subject is following?  What recommendations would you give him?  What are the limitations of the data and how could you improve the accuracy of this assessment?

36. Questions About Measurement and Assessment of Intake?

37. Farewell  Thank you for your kind attention and participation!  Email any time - ahabeck@kaplan.eduahabeck@kaplan.edu  Call if your concern or question is urgent  630 323 3307