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Cardiac Case Study: Dash Diet ( MUNEERA)


Module 4

SITUATION: Mark is a single 58-year-old African American. He works as a traveling salesman for a large
corporation. He has hypertension (high blood pressure). His resting blood pressure was 158/90 at his
last appointment. His current weight is 250 pounds and he stands 5 feet 9 inches. The doctor recom-
mends attempting to control his high blood pressure with diet changes before adding medications.

McDonalds Sausage, Egg and Cheese Biscuit


Breakfast
Large orange juice

Small bag of chocolate chip trail mix


Mid-morning Snack
Water bottle

BLT on white bread with mayo


Lunch Salted Potato chips (individual bag)
Can of Diet Soda

Small Apple with individual Peanut butter cup


Afternoon Snack
Water Bottle

2 Fried Catfish strips


2 hushpuppies
Dinner
1 cup of green beans
large sweet tea

As his nurse, you are asked to evaluate his dietary journal and assist in developing a 3-day sample meal
plan he can easily use with his busy lifestyle.
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Answer the following questions.

1. Calculate his BMI (show your work):


Answer :- BMI= WEIGHT ( Kg)/ HEIGHT ( meter)2
= 113.4kg / 1.75mx 1.75m
= 113.4 / 3.06
= 37 kg/m2

2. Calculate appropriate amount of calories he should meet (show your work):


Answer:- The Mifflin-St Jeor formula is being used to calculate Mark’s daily requirement
as it is found to be most accurate.
Men
10 x weight (kg) + 6.25 x height (cm) - 5 x age (y) + 5

= 10x 113.4 + 6.25 x 175cm -5 x 58years +5


= 1134 +1093.75 - 290 + 5
= 1942.75 calories/ day

3. Short answer questions: Does the above diet meet the nutritional guidelines for a patient that
should be on a DASH diet? Discuss your answer using your textbook as a resource. (You may
also use the MyPlate tracker as a second resource.) Cite your references appropriately using
APA format

Answer:-
THE total calorie intake of MARK is about 2600 calories daily which is way above the recom-
mended and calculated 2000 calories. His diet includes Total sodium intake of 4000mg ,
contrary to recommended 2300mg, total saturated fat of 33 grams /day contrary to recom-
mended 24gram. The overall daily fruit intake and protein intake are higher than the rec-
ommended limits with lower intake of vegetables in diet per day.
The diet has to be moderated with increased intake of vegetables and decreased proteins and
moderation in fruit intake in form of juices and whole fruit. Also important would be
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strictly cut down on daily sodium and saturated fat intake to aim to restrict sodium intake
to less than 2300mg and saturated fat intake to less than 33grams/day to meet the daily
calorie recommended intake of 1942 calories/day ( as calculated) and achieve a healthy
BMI of less than 25kg/m2.

The DASH eating plan requires no special foods and instead provides daily and weekly nutri-
tional goals. This plan recommends:
• Eating vegetables, fruits, and whole grains
• Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
• Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products,
and tropical oils such as coconut, palm kernel, and palm oils
• Limiting sugar-sweetened beverages and sweets.

REFERENCES:-
1. Description of the DASH Eating Plan - NHLBI, NIH. (n.d.). Retrieved October 02, 2016,
from http://www.nhlbi.nih.gov/health/health-topics/topics/dash/
2. Meal, B. (n.d.). SuperTracker: My Foods. My Fitness. My Health. Retrieved October 02,
2016, from https://www.supertracker.usda.gov/foodtracker.aspx

4. Create a 3-day diet plan sample for Mark that meets his caloric intake requirements
and the nutritional guidelines for the DASH diet. The plan should include breakfast,
lunch, dinner, and snacks for each day and be formatted as a table. Remember to
include condiments and beverages.

DAY 1 DAY 2 DAY 3

1 SLICE WHOLE WHEAT 1 CUP WHOLE OAT RINGS CE- 1 GRANOLA BAR, LOW-FAT
BREAD: 1 TSP SOFT (TUB) REAL: 1 MEDIUM BANANA 1 MEDIUM BANANA
MARGARINE 1/2 CUP FRUIT YOGURT,
1 CUP MILK, LOW-FAT FAT-FREE, NO SUGAR
1 CUP FRUIT YOGURT, FAT- ADDED 1 CUP ORANGE JUICE
1 MEDIUM RAISIN BAGEL: 1
BREAKFAST FREE, NO ADDED SUGAR 1 ME- 1 CUP MILK, LOW-FAT
DIUM PEACH TBSP PEANUT BUTTER

1/2 CUP GRAPE JUICE 1 CUP ORANGE JUICE


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HAM AND CHEESE SANDWICH: TUNA SALAD PLATE: TURKEY BREAST SAND-
1/2 CUP TUNA SALAD* WICH:
2 OZ HAM, LOW-FAT, LOW-SO- 1 LARGE LEAF ROMAINE LET- 3 OZ TURKEY BREAST
DIUM TUCE 1 SLICE WHOLE WHEAT 2 SLICES WHOLE WHEAT
BREAD BREAD
1 SLICE (3/4 OZ) CHEDDAR CUCUMBER SALAD: 1 LARGE LEAF ROMAINE
CHEESE, NATURAL, 1 CUP FRESH CUCUMBER LETTUCE
SLICES 1/2 CUP TOMATO 2 SLICES TOMATO
REDUCED FAT WEDGES 2 TSP MAYONNAISE, LOW-
1 TBSP VINAIGRETTE DRESS- FAT
2 SLICES WHOLE WHEAT ING 1 TBSP DIJON MUSTARD
LUNCH BREAD 1/2 CUP COTTAGE CHEESE, 1 CUP STEAMED BROCCOLI,
LOW-FAT: COOKED FROM FROZEN
1 LARGE LEAF ROMAINE LET- 1/2 CUP CANNED PINEAPPLE, 1 MEDIUM ORANGE
TUCE JUICE PACK
1 TBSP ALMONDS
2 SLICES TOMATO

1 TBSP MAYONNAISE, LOW-


FAT

1 CARROT STICKS

CHICKEN AND SPANISH RICE* 3 OZ TURKEY MEATLOAF** 1 3 OZ SPICY BAKED FISH*


1 CUP GREEN PEAS, SAUTÉED SMALL BAKED POTATO: 1 CUP SCALLION RICE**
WITH: 1 TBSP SOUR CREAM, FAT- SPINACH SAUTÉ:
1 TSP CANOLA OIL FREE 1/2 CUP SPINACH, COOKED
1 CUP CANTALOUPE CHUNKS 1 TBSP CHEDDAR CHEESE, FROM FROZEN
1 CUP MILK, LOW-FAT NATURAL, REDUCED FAT, 2 TSP CANOLA OIL
GRATED 1 TBSP ALMONDS, SLIVERED
1 SCALLION STALK, CHOPPED 1 CUP CARROTS, COOKED
DINNER 1 CUP COLLARD GREENS, FROM FROZEN
SAUTÉED WITH: 1 TSP CAN- 1 SMALL WHOLE WHEAT
OLA OIL ROLL:
1 SMALL WHOLE WHEAT 1 TSP SOFT (TUB) MARGA-
ROLL 1 MEDIUM PEACH RINE
1 SMALL COOKIE

1/3 CUP ALMONDS 1 CUP FRUIT YOGURT, FAT- 2 TBSP PEANUTS, UNSALTED
1 CUP APPLE JUICE 1/4 CUP FREE, NO ADDED SUGAR 2 1 CUP MILK, LOW-FAT
APRICOTS TBSP SUNFLOWER SEEDS 1/4 CUP DRIED APRICOTS
SNACKS 1 CUP MILK, LOW-FAT

TOTALS: 2,024 CALORIES 1,976 CALORIES 1,939 CALORIES


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SATU-
RATED FAT 12 grams 11 GRAMS 12 GRAMS
FIBER 35 GRAMS 30 GRAMS 36 GRAMS
SODIUM 2,312 MG 2,373 MG 1671MG
POTASSIUM 4,575 MG 4,769 MG 4,710 MG

SERVINGS 7 SERVINGS 5 SERVINGS 5 SERVINGS


OF FRUIT

SERVINGS 4 3/4 SERVINGS 1 5 3/4 SERVINGS


OF VEGE-
6 /4 SERVINGS
TABLES

CALCIUM 1,417 MG 1,470 MG 1,210 MG


MAGNE- 538 MG 495 MG 548 MG
SIUM

PROTEIN 110 G 111 GRAMS 105 GRAMS


SUGAR 10 GRAM 17 GRAMS 15 GRAMS

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