#1:Andy's Carb Concerns
Andy's mother thinks he needs to lose weight and recommends he go on a high-protein diet such as the Atkins Diet. She tells him that you can eat all the meat, eggs, cheese, and chicken you want but need to limit your intake of breads, cereals, potatoes, rice, vegetables, and fruits. Andy agrees he would like to be more fit (at 28, he's 5'10" and weighs 195#), and since he loves meat, he starts to seriously consider this plan. He mentions this to his girlfriend Molly and she tries to dissuade him, recommending increasing his physical activity and reducing how much energy he takes in to promote weight loss. Andy said he's heard that losing weight through diet and exercise can take a long time, and he would prefer to drop the weight more quickly. He buys a book about the Atkins Diet and begins modifying what he's eating. When you see him, he has lost 7 pounds in one week (now weighting 188#) and his 24-hour recall includes:
- Breakfast: 2 scrambled eggs with 2 pork sausage links
- Snack: 1 mozzarella string cheese (whole milk) and half of an avocado
- Lunch: 3 oz. roast beef on 4 cups of mixed greens, 5 black olives, 2 T vinaigrette
- Snack: 10 green olives, 1 1-oz. slice cheddar cheese
- Dinner: 5 oz. baked salmon, 6 asparagus spears, 2 cups of arugula with 5 cherry tomatoes, ½ cup sliced cucumbers, and 2 T Italian dressing
Assessment and Diagnosis:
Describe patient's health condition and diet. What clinical data are used to assess and diagnose or observe this condition? What are the nutritional considerations for this patient and how does their diet impact the progression of their disease or experience? How common is this disease and what are the different approaches to treatment? What are the food groups and nutrients of interest for this patient and why? What are some specific food sources of these nutrients? Are there certain aspects of this patient's diet that are concerning to you?
Please conduct a nutrient analysis of the 24-hour recall that is provided. Include calorie calculations and appropriate reports from dietary analysis software and cite specific nutrient amounts.
Asses patient's readiness to change. At what level of readiness to change is this patient for which specific behaviors? What are some areas of strength for this patient and what are some resources? What are some areas of weakness for this patient?
Intervention:
Describe your strategy for counseling this patient. Considering your above assessment, what behaviors would you focus on? What counseling strategies would you implement?