Florence, 58 years old, has been healthy all of her adult life until recently. Two months ago she had her gallbladder removed for an acute gallstone attack; this was her first surgery. This week her physician told her that she has high cholesterol and needs to pursue medical nutrition therapy for six weeks. At the end of six weeks, her cholesterol will be re-tested and her physician will make a decision regarding the possible addition of lipid-lowering medications. Florence is very disappointed by this second health concern in such a short amount of time. She is 30 pounds lighter than she was last year. Both of her parents passed away from vascular diseases, so she has additional reason for concern.
For exercise, Florence attends Curves® (resistance training) three times each week. Currently Florence is 5’ 8.25” tall and weighs 203#. Her waist circumference is 38.5”.
Her most recent labs were:
Total cholesterol = 252 mg/dL,
LDL cholesterol = 166 mg/dL,
HDL cholesterol = 40 mg/dL,
Triglycerides = 133 mg/dL.
She expresses the need to improve her health, as she is the primary caregiver for an adult son with schizophrenia and her husband, who is ill with complications from T2 diabetes.
Her food recall shows a limited intake of fruits and vegetables, approximately 15 grams of fiber daily, limited dairy intake, and frequent consumption of foods high in saturated fat.
1. What is Florence’s BMI? Calculate Florence’s body weight for a BMI of 26.
How many calories and grams of protein does she need at a body weight reflective of a BMI of 26?
2. What risk factors for coronary artery disease (CAD) does she have?
3. Describe dietary recommendations to assist her with lowering her cholesterol levels and reducing her risk for CAD. Include in your description how your recommendations will improve her health.
4. Describe lifestyle modifications to help her lower her risk for CAD. Give specific recommendations and justify or support your recommendations.