Hardship Letter - Nutritional Analysis

Hardship Letter - Nutritional Analysis

CASE HISTORY

The subject of this study, Mr. a, was a 30-year-old, married male of South Korean descent residing in London.

Mr. a's height was 175cm and his weight was 82.6kg, with a BMI of 27. His fat to lean ratio was 16.5% (13.6kg) to 83.5% (69kg). His dry lean weight was 20.4kg and his water mass was 58.8% with a calculated volume of 48.6 liters. His Base Metabolic Rate (BMR) was 2101 kcal with an extrapolated BMR/body weight of 25.4kcal/kg and Estimate Average Requirement (EAR) of 3152 kcal.

He reported a medium activity level specified as once weekly basketball and twice weekly gym workouts.

His waist measured 85cm and his hips measured 100cm, resulting in a waist to hip ratio of 0.85.

Subject reported neither family history nor personal medical history that would affect dietary advice or indicate compliance issues with recommendations.

METHOD

The nutritional analysis was performed by recording all food and beverage ingested by the subject over the time period of Thursday, January 22, 2009, Friday, January 23, 2009 and Saturday, January 24, 2009.

Measurements were obtained and reported by the subject using common household measuring devices and were obtained from commercial food purveyors.

Initial nutritional analyses were performed utilizing the Nutritional Analysis Tool version 2.0, which is based on U.S. Recommended Daily Allowances.

These analyses were averaged for the 3 day study to determine the percentages consumed vs. The British DRV's.

Tables with recorded data can be referenced in the Appendix.

RESULTS

Table 1: Intake of nutrients as % of UK DRV (3 day weighed intake: Mr. a)

Day Avg.

Calories

2550 kcal/d

Pro (g)

61.95g

Fat (g)

Carb (g)

1275g

Fiber (g)

18g/d

Cal (mg)

700 mg/d

Iron (mg)

8.7mg/d

Na (mg)

1600 mg/d

Pot (mg)

3500 mg/d

Phos (mg)

Ash (g) vitA (IU)

700µg/d vitC (mg)

40 mg/d

Thia (mg)

1.0mg/d

Ribo (mg)

1.3mg/d

Nia (mg)

17 mg/d

H2O % satF (g)

255g monoF (g)

306g polyF (g)

153g

Chol (mg)

Graph 1: Percentages of DRV's consumed by Subject: Mr. a

Table: Nutritional Analysis of Food Intake Thursday, January 22, 2009 using NAT 2.0

Rec

Calories

Pro (g)

Fat (g)

Carb (g)

Fiber (g)

Cal (mg)

Iron (mg)

Na (mg)

Pot (mg)

Phos (mg)

Ash (g) vitA (IU) vitC (mg)

Thia (mg)

Ribo (mg)

Nia (mg)

H2O %

Male 19-30 satF (g) monoF (g) polyF (g)

Chol (mg)

Table: Nutritional Analysis of Food Intake on Friday, January 23, 2009 using NAT 2.0

Nutrient

Rec

Calories

Pro (g)

Fat (g)

Carb (g)

Fiber (g)

2055.23%

Cal (mg)

Iron (mg)

Na (mg)

Pot (mg)

Phos (mg)

Ash (g) vitA (IU) vitC (mg)

Thia (mg)

Ribo (mg)

Nia (mg)

H2O %

Male 19-30 satF (g) monoF (g) polyF (g)

Chol (mg)

Table: Nutritional Analysis for Saturday 24, 2009 using NAT 2.0

Nutrient

Rec

Calories

Pro (g)

Fat (g)

Carb (g)

Fiber (g)

Cal (mg)

Iron (mg)

Na (mg)

Pot (mg)

Phos (mg)

Ash (g) vitA (IU) vitC (mg)

Thia (mg)

Ribo (mg)

Nia (mg)

H2O %

Male 19-30 satF (g) monoF (g) polyF (g)

Chol (mg)

ANTHROPOMETRY

Table 4: Results of Anthropometric Measurement (Mr. a)

Healthy Ranges

Subject: Mr. A BMI

18.50-24.99 per WHO Waist Circumference or = 90cm cutoff

85 cm

Hip Circumference

Only as it relates to WHR

Waist to Hip Ratio

0.9 per Mayo Clinic

Table 5: Average energy intake and output (Mr. a)

Caloric Intake

Caloric Output

DVR - EAR difference

Intake - EAR difference

DRV intake

2550 kcal/d

602 kcal or 123.6%

BMR

2101 kcal

EAR

3152 kcal day avg. intake

2340 kcal/d

812 kcal or 134.7%

EVALUATION

Subject's nutritional intake clearly displayed that despite caloric intake well below the DVR range, the majority of nutrients were well above the DVR ranges, with the exception of the fats, cholesterol, calcium, potassium and carbohydrates.

A preference for protein was shown as evidenced by the consumption of almost twice the DVR for same.

Fat consumption was 10.2% or less in every category. Should this pattern continue, consistent and sustained weight loss would be expected in the subject.

Subject should actively seek to increase consumption of calcium and potassium in order to avoid deficiencies of these crucial minerals. Subject should also increase fat intake to better balance his diet.

Subject's fiber consumption was so far in excess of DRV that negative digestive consequences cannot be ruled out.

Salt intake was more than the DVR, but could be easily corrected with some minor dietary changes.

The Food Standards Agency has developed the Eat Well Plate as an easy to follow nutritional guideline.

The Eat Well Plate is a visual display and quick reference for consumers to better balance their diets in compliance with the DVR's. Analysis revealed a shortfall in fruits and vegetables as well as bread, rice and pasta - the two largest sections of the plate. Subjects fat consumptions were well below the DVR's, but per the Eat Well Plate are the smallest category recommended.

Recommendations for Subject's improved nutritional balance would include increased caloric intake, weighted heavily in the fruits and vegetables, breads, rice and pasta categories. Targeted changes in these areas would correct the deficiencies identified in calcium and potassium consumption and likely the cholesterol and fat categories as well, due to the preparation methods frequently used in these categories.

Subject should also consider increasing his fluid intake to at least direct proportion of his alcohol intake.

The British Nutrition Foundation recommends no more than 4 units of alcohol per day for males.

Subject's alcohol consumption average was over double the recommended amount as each pint of beer counts as two units.

Subject did not report any health history problems or issues which could result in compliance issues with recommendations at the time of the study.

However, at the time of this study, the World Health Organization was conducting a study regarding the Waist to Hip ratio as more specifically applied to Asian cultures.

The Waist to Hip Ratio has gained prominence as a strong indicator of cardiovascular disease. Individuals who carry their weight in their hips are less likely to have specific serious health conditions, including cardiovascular disease.

Finally, Subject may resist changing his diet initially.

However, the effects of improved diet can usually be felt and seen almost immediately and should aid with subject's compliance.

As summarized below, a few very simple changes and additions could have a tremendous impact on the Subject's willingness to improve his nutritional balance and because there are so few changes recommended, make it easier for the Subject to adhere to them.