Heart Disease Case Study
Patient Data: (Peter Johnson)
68 year old male
Height: 6' 1"
Weight: 190 pounds
Body Fat: 29%
Blood Pressure: 180/98
Total cholesterol: 330 mg/dl Triglycerides: 350 mg/dl HDL: 23 mg/dl LDL: 112 mg/dl
Social: Divorced, 4 grown children, 7 grandchildren, retired, likes to read and do woodworking
Medical: Had a heart attack at age 45 and bypass surgery at age 52
He has diabetes, high blood pressure, and high cholesterol. He rarely takes his medications
for these conditions.
He does not exercise currently.
He smokes 1 pack of cigarettes daily and drinks two 3 ounce scotch's a night.
He adds about a half of a teaspoon of salt to his lunch and dinner.
Food Record:
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MEALS/Portions
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FOODS/BEVERAGES
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Food Group(s)
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# servings
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Kcal (approx)
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BREAKFAST
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3 cups
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Rice Krispies
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2 cups
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2% milk
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3 slices
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Bacon
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1 cup
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Regular black coffee
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LUNCH
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|
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2 cups
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Split pea soup
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6
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Saltine crackers
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1 cup
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Regular black coffee
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SNACK
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|
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1
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Small orange
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|
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DINNER
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|
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3 ounces
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Bratwurst
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1 cup
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Corn
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½ cup
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Cooked broccoli
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2 teaspoons
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Butter
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1 cup
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Regular black coffee
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SNACK
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1 medium
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Plain cake doughnut
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1 cup
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Regular black coffee
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QUESTIONS
1) Evaluate his anthropometric data. What is his BMI? What is his body fat category? What does each one tell us?
2) Evaluate his laboratory data (cholesterol measures) and blood pressure. What should his goal levels be compared to what they are?
3) Analyze his food consumption. A. How many servings of each food group is he getting compared to what he should be?USE MYPLATE TO ASSESS. B. How many kcal is he getting? (Estimate using metrics handout) How many should he be getting (for his age and activity level)?
4) How much fiber do you think he is getting? Which specific foods are contributing? Look up their fiber content.
5) Check the saturated fat content of his meat choices and his butter. (Look it up) Compare to the recommended amount.
6) Discuss his beverage choices and fluid intake.(8-9 cups/day of non-alcoholic fluid is recommended. Each alcoholic beverage should be matched with an equal or larger amount of non-alcoholic fluid).)
7) What is your opinion about his sodium consumption and added salt habit? How could he improve in this area? *
8) What are the factors that put him at risk for having another heart attack?
9) Write up a sample menu for Mr. Johnson (1500-1700 kcals). Be sure to meet the minimum food group recommendations.
10) Counsel Mr. Johnson with your evaluations and recommendations as if you were his dietitian. Point out and describe the relationships between LDL and HDL cholesterol levels and a. saturated fatb. exercise and c. fiber.
*Excess salt can be an aggravating factor for people with elevated blood pressure. 1 tsp of salt ~ 2300 mg. Look up the DV and UL for salt (can be found in the cover material of your text)