UNIT 3
NS270 NUTRITIONAL ASSESSMENT
AND MANAGEMENT
Amy Habeck, RD, MS, LDN
Unit 3 Learning Objectives:
Case study – 45 year old male
1)
a)
b)
Review- Stanfield and Hui
2)
a)
b)
c)
3)
Found in Doc Sharing and on Seminar tab of Unit 3 Course
Home
Complete a nutrient analysis on a food intake to identify
actual and potential nutrient deficiency
Chapter 5 – Vitamins
Chapter 6 – Minerals
DRI tables
Answer your questions
Case Study
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45 year old male
Ht: 5’10”
Wt: 190 pounds
Calculate BMI
Determine BMI Classification
Calculate energy needs
Assess intake
Recommendations
BMI Calculation-Metric Conversion
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What is his height in meters?
5’10” = _______m
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What is his weight in kilograms?
190 pounds = _______kg
Convert Height to Meters
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Ht: 5’10” = 70 inches
Ht (convert inches to cm)
= 70 inches x 2.54 cm/in = 177.8 cm
Ht (convert cm to meters)
=177.8 cm ÷ 100 cm/m = 1.78 m
Convert Weight to Kilograms
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Weight
 190
pounds x kg/2.2 pounds = 86.36 kg
Calculate BMI
Weight in Kg
(Ht in m)2
=_________
http://www.nhlbisupport.com/bmi/bmi-m.htm
Ht (calculate m2)
=(1.78m)2 =1.78 x 1.78 = 3.17
Calculate BMI
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Using Standard Measurements
Wt (pounds)
Ht (in)2
(x 703)=
Case Study
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45 year old male
Ht: 5’10” = (1.78 m)2 = 3.17
Wt: 190 pounds = 86.36 kg
Calculation
 Kg/m2
 86.36
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÷ 3.17 = 27.3
BMI: 27.3
What is his BMI classification?
BMI
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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
Calorie Assessment
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Mifflin St. Jeor Equation
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Calorie calculator
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http://www.ChooseMyPlate.gov
Mifflin St. Jeor Equation
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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
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1.2 confined to bed
1.3 ambulatory, low activity
1.5-1.75 average activity
2.0 highly active
Mifflin St. Jeor Equation
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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
 =(10
x 86.36 kg) + (6.25 x 177.8 cm) – (5 x 45)
 =863.6 + 1111.25 – 225
 =1749.85 kcal/day
 Multiply by activity factor
 = 1749.85 x 1.3 = 2274.8 kcal/day
 For
weight loss, subtract 250-500 kcal/day to lose ½ -1
pound/week
Calorie Assessment
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Mifflin St. Jeor Equation
 2275
kcal/day – weight maintenance
 1775 kcal/day – 1 pound per week weight loss
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Calorie calculator
 2410
kcal/day – weight maintenance
 1910 kcal/day – 1 pound per week weight loss
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http://www.ChooseMyPlate.gov
 2400
kcal/day – gradual weight loss
Discrepancy
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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?
Food intake
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Breakfast – 2 pop tarts, 20 ounce Pepsi
AM snack – Snicker’s Candy Bar
Lunch – McDonald’s Double Cheese Burger, large
fries, 32 ounces Mt. Dew
PM Snack – Snicker’s Candy Bar
Supper – 6 ounce boneless chicken breast, large
baked potato, tbsp butter, tbsp light sour cream, 1
cup mixed greens salad, 1 tbsp shredded cheddar
cheese, 1 tbsp ranch dressing, 32 fluid ounces of
milk
2005 Dietary Guidelines
2005 Dietary Guidelines
Calories
______
Fat (%) ______%
Saturated fat (%)
Dietary fiber (RDA) ____gm
Sodium (RDA) ____
<____%
mg
Potassium (RDA) ____
mg
Carbohydrate (%) ____%
Calcium (RDA) ____
mg
Protein (%) ____%
Magnesium (RDA) ____
mg
2005 Dietary Guidelines
2005 Dietary Guidelines
Calories
Fat (%)
2542
Dietary fiber (RDA)
20-30%
Sodium (RDA)
1500-2300 mg
Saturated fat (%)
<10%
Potassium (RDA)
Carbohydrate (%)
45-65%
Calcium (RDA)
Protein (%)
10-35%
20-25 gm
4700 mg
1000 mg
Magnesium (RDA)
420 mg
Dietary Analysis
http://www.ChooseMyPlate.gov
Nutrient Analysis
Actual Intake 24 hour recall
Calories
3295
Grams
% kcals
Grams/Mg
%RDA
Fat
115.3
31.5%
Dietary Fiber
13 gm
52-65%
Saturated
fat
46.8
12.6%
Sodium
3798 mg
165-253%
Carbohydrat
e
440
53%
Potassium
4205 mg
89%
Protein
129
16%
Calcium
1684.5 mg
168%
Dietary Analysis
http://www.fitday.com
Nutrient Analysis
Actual Intake 24 hour recall
Calories
3234
Grams
% kcals
Grams/Mg
%RDA
Fat
116.9
33%
Dietary Fiber
13.8 gm
52-65%
Saturated fat
47.5
13%
Sodium
3650 mg
237%
Carbohydrate
424
52%
Potassium
4297 mg
91%
Protein
130
16%
Calcium
1688 mg
169%
Magnesium
363.5 mg
87%
Recommendations
His Intake
2005 Dietary Guidelines
FitDay.com
ChooseMyPlate.gov
2400
3234
3295
20-30%
(116.9 g) 32%
(115.3 g) 31%
Saturated Fat
<10%
(47.5 g ) 13%
(46.8 g) 13%
Carbohydrate
45-65%
(424 g ) 52%
(440 g) 53%
Protein
10-35%
(130 g) 16%
(129 g) 16%
20-25 gm
(13.8 g ) 55-69%
(13 g) 52-66%
1500-2300 mg
(3650 mg)
159-243%
(3798 mg)
165-253%
Potassium
4700 mg
(4297 mg) 91%
(4205 mg) 89%
Calcium
1000 mg
(1688 mg) 169%
(1685 mg) 169%
Magnesium
420 mg
(364 mg) 87%
(362 mg) 86%
Calories
Fat
Fiber
Sodium
Identify nutrients below RDA/AI
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1.
2.
3.
4.
5.
6.
7.
Identify nutrients below RDA/AI
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Fiber
Omega-3
Vitamin C
Vitamin E
Folate
Magnesium
Potassium
2005 Guidelines
Actual Intake
Excess or Shortage
2 cups
0
-2 cups
3-3.5 cups
2.7 cups
-0.3-1.2 cups
Grains
8-9 oz
6.3 oz
-2.3-3.3 oz
Meats and Beans
6.5 oz
8.2 oz
+1.7 oz
Milk
3 cups
4.9 cups
+1.7 cups
Fats and Oils
7 tsp
Discretionary
362 kcal
Fruits
Vegetables
Inside the Pyramid
Food Group
Grain
Vegetables
Fruit
Milk
Meat and Beans
Healthy Oils
Key Health Benefits
Key Nutrients
Inside the Pyramid
Food Group
Key Health Benefits
Key Nutrients
Grain
CHD, constipation, weight
management, neural tube
defects
Fiber, B vitamins, Fe++,
Mg++, Se
Vegetables
Stroke, CV diseases, Type II
DM, GI cancer, CHD, kidney
stones, bone loss, lower
calorie intake
K+, fiber, folate, Vitamins A,
E and C
Fruit
Stroke, CV disesases, Type II
DM, GI cancer, CHD, Kidney
stones, bone loss, lower
calorie intake
K+, fiber, vitamin C
Inside the Pyramid
Food Group
Key Health Benefits
Key Nutrients
Milk and milk products
Osteoporosis, bone health,
higher overall nutritional
quality
Ca++, K+, Vitamin D
Lean Meat and Beans
Cholesterol and heart
disease
B vitamins, vitamin E, Fe++,
Zn, Mg++
Healthy Oils
EFA deficiency, cholesterol
levels
Vitamin E
Health Risks
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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?
Questions About Measurement and
Assessment of Intake?
Farewell
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Thank you for your kind attention and
participation!
Email any time - ahabeck@kaplan.edu
Call if your concern or question is urgent
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630 323 3307