Mini Case Study Assignment
Instructions
Read the provided case study below and reply to each of the questions, following the prescribed
order and formatting. Please limit each response to no more than a half page. Include in-text
citations throughout your responses and a works cited list (formatted using APA style guidelines)
at the end of this assignment. Please submit your completed assignment as a .pdf or .doc via
Blackboard by the scheduled due date.
Case Study #1: Betsy’s Bones
Betsy is a 72-year-old retired teacher who lives alone. She used to love gardening, but since
moving to a condo, doesn’t get much time outside, and spends most of her days reading or
talking on the phone. She presents to her doctor complaining of right leg and knee pain and
weakness. Her laboratory results showed deficient vitamin D and reduced bone density, and a
diet recall included:
·
Breakfast: two hard-boiled eggs, 1 whole grapefruit with 1 tsp sugar, 12 oz. black coffee
· Lunch: cucumber sandwich (made with a ½ cup of sliced cucumber, 2 slices white bread,
and 1 T mayonnaise), 1 oz. potato chips, 16 oz. unsweetened iced tea
· Dinner: pasta (1 c.) with meatless marinara sauce (1/2 c.), small white roll, 1 glass red wine,
fun-size milky way
Betsy is 5’4” and weighs 126# (57kg). She says she loves to cook, but since it’s just her, she
usually just prepares something quick and easy. Every Sunday she goes to church and to the
grocery store, but otherwise, she doesn't leave the house much.
Case Study Questions
1. Estimate how much protein Betsy is getting. How much does she need? Is her intake
adequate? What recommendations do you have regarding Betsy’s protein intake?
For breakfast Betsy had approximately 12 grams of protein for the boiled eggs, 0.9 grams of
protein grapefruit, 0 grams protein of 1sp sugar and 0 grams of black coffee. For lunch she had
approximately 0.65 grams of sliced cucumber, 5.4 grams of protein for two slices of white bread
and 0.13 grams of protein in mayo, and 2 grams protein for 2 oz of potato chips and 0 grams of
unsweetened ice. For dinner in 1 cup of pasta there is 2.9 grams of protein, 2 grams of protein in
the meatless marinara sauce, 2.7 grams of protein for the small white roll, 0.1 grams of protein
for the wine and 0 grams of protein in the fun size milky way (USDA, 2023). These estimates are
from the USDA.gov website. The daily protein recommendation for an adult is 0.8g per kg of
weight (USDA, 2023). Betsy weighs 126 at 5’4 inches which is considered a healthy weight. The
average sedentary woman should eat about 46 grams of protein for the day. In total, Betsy had
about 28 grams of protein for the day which falls short of the average amount. In regards to Betsy
protein intake, I would recommend for her to eat more chicken, fish and eggs to increase her
protein consumption because these foods are highly enriched in protein.
2. Talk about Betsy’s total fluid intake relative to her needs? Is she getting enough water?
What are potential consequences of not taking in enough fluid and why is dehydration of
particular concern for the elderly?
Betsy appears to have not drunk any water for the day. The recommended amount of water for
women per day is nine cups. Lack of water intake can lead to dehydration, fatigue, headaches,
tiredness, irritability, etc. (Healthdirect, 2023). The elderly is particularly susceptible to dehydration
since not drinking enough water can result in headaches, constipation, memory problems, inability
to function properly, falls, and strokes (Healthdirect, 2023). Furthermore, elders suffering from
dehydration may develop complications such as stroke, urinary tract infection, kidney stones, or
blood clots (Pawley, 2021).
3. Betsy’s mom had osteoporosis and she’s concerned about developing it too. How
does her current diet impact her risk for osteoporosis? What steps can Betsy take to
maintain her bone health?
Currently, Betsy's diet does not meet the recommended daily protein intake. Protein is an
essential nutrient to build and repair body tissues, including bones, which are made up of calcium,
other minerals, and protein. In osteoporosis prevention and bone health, protein is an important
nutrient. Besides providing bone with strength and flexibility, calcium is also an important
component of muscles, which are crucial for mobility and fall prevention, as well (Sizer & Whitney,
2023). Consuming adequate amounts of calcium can result in increased bone mass and fewer
fractures in diets that include recommended amounts of protein (Sizer & Whitney, 2023). The risk
of bone loss and fractures is high in adults who consume limited amounts of protein (Sizer &
Whitney, 2023). Vitamin D, which restores bone integrity, can be consumed more frequently by
Betsy in order to maintain bone health (Sizer & Whitney, 2023). Vitamin D plays an important role
in calcium balance, bone formation during growth, and bone health throughout life. DRI values
are determined by these functions (Sizer & Whitney, 2023).
4. What is the role of vitamin D in preventing bone loss? How is Betsy's leg and knee
pain related to her vitamin D status? Why is vitamin D deficiency more common in the
elderly?
Calcium is the main building block of our bones, and vitamin D helps our bodies absorb
it. As well as keeping bones and muscles strong, it reduces the risk of falls by ensuring
their proper renewal and mineralization (IOF, 2023). Having low vitamin D levels can
cause muscle weakness, and bone pain in Betsy, who has leg and knee pain. In order to
build and maintain bones, vitamin D plays an important role in maintaining calcium
balance in our blood and bones (professional, 2023). As a result of a lack of Vitamin-D,
the bones are not getting the nutrition they need, causing leg and knee pain. Elderly
people are more likely to develop Vitamin- D deficiency due to decreased dietary intake,
reduced sunlight exposure, a thinner skin layer, impaired intestinal absorption, and
impaired liver and kidney hydroxylation and other various reasons. (Janssen et al., 2002).
5. Her doctor recommended a vitamin D supplement. What other ways can Betsy improve
her vitamin D status? List some foods that are good sources of vitamin D.
By taking supplements daily that are coated with vitamin D, Betsy can improve her vitamin
D status. She will be able to easily obtain the necessary amount of vitamin D each day
thanks to this (Karthik Kumar, 2022). She can also obtain some appropriate sun exposure
in this manner. A particular form of cholesterol found in our skin produces vitamin D when
exposed to sunshine (Karthik Kumar, 2022). However, factors such as the color of your
skin, the exposed area of your body, age, and others affect how much vitamin D your
body can produce (Karthik Kumar, 2022). The best strategy to maintain the body's vitamin
D levels is by regular sun exposure between the hours of 1000 and 1500 (Karthik Kumar,
2022). Salmon, eggs, cheese, cod liver, sardines, tuna, and mushrooms are among foods
that are good sources of vitamin D (Karthik Kumar, 2022).
References
USDA. (2023). Food and nutrition. USDA. https://www.usda.gov/topics/food-and-nutrition
Healthdirect. (2023). Drinking water and your health. healthdirect.
https://www.healthdirect.gov.au/drinking-water-and-your-health#what-happens
Pawley, S. (2021, October 1). Dehydration in seniors: An often-overlooked health risk.
DailyCaring. https://dailycaring.com/dehydration-in-elderly-is-dangerous/
Sizer, F. S., & Whitney, E. N. (2023). Nutrition: Concepts & controversies. Cengage.
IOF. (2023). Vitamin D: International Osteoporosis Foundation. IOF International Osteoporosis
Foundation. https://www.osteoporosis.foundation/patients/prevention/vitamin-d
Professional, C. C. medical. (2023). Vitamin D deficiency: Causes, symptoms & treatment.
Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-ddeficiency
Janssen, H. C., Samson, M. M., & Verhaar, H. J. (2002, April 1). Vitamin D deficiency, muscle
function, and falls in elderly people. The American Journal of Clinical Nutrition.
https://www.sciencedirect.com/science/article/pii/S0002916523061695?via%3Dihub
Karthik Kumar, M. (2022, September 22). Ten effective ways to increase your vitamin D levels dosage. MedicineNet.
https://www.medicinenet.com/ten_effective_ways_to_increase_vitamin_d_intake/article.htm