Nutrition

An analysis of a 24 dietary recall Client details Age 31 Sex: Female Height: 5’ 6” Weight: 11 stone 7 pounds Background information The client is a mother of 3 children, 2 boys and 1 girl, the children are of relatively self sufficient age and can do a lot of things themselves such as walking to school and preparing their own food. The client does however, still perform jobs around the house such as the ironing, washing clothes, vacuuming and other typical household jobs and as a single parent these jobs are performed solely by the client. The client has been a parent since finishing school and has found it hard to maintain any routine of physical activity and exercise. The client owns their own salon and is currently the main employee working in the salon does not require the client to be very active as the job is mainly sitting down painting nails or plucking eyebrows etc. . . . However the maintenance of the premises such as dusting, general cleaning and replenishing stock may help increase the client’s physical activity levels. Recently the client has taken up walking a 3 mile round trip in the evenings 5 days a week and is looking to start using the local gym. When analysing a person’s diet there are certain key areas that need to be highlighted, such as calorie intake, nutrients, water, fats and so on... So to break it down into a simpler form, the client’s dietary analysis can be found in table format (See Appendix 1) toward the back of this report. The table shows clearly the total intake of each particular nutrient. The information shown on the second table (Appendix 2) is the recommended daily allowance (RDA) Vs the actual nutrient intake of the client. Perhaps second to the ‘calorie’ in terms of the general knowledge of food is proteins, carbohydrates and fats. Many people are made aware of these nutrients due to particular diets such as that of Dr Atkins() who prescribed a low carbohydrate, high fat intake during stages of his famed diet, or body builders that canvas their protein intake to build mass through hypertrophy of the muscular fibres Tortora & Derrickson (2007). These measures however, are extremes and not necessarily endorsed by government standards. One particular method adopted by the government is that of the food pyramid guide Jeukendrup & Gleeson (2004). CARBOHYDRATES The base of the pyramid gives way to carbohydrate based foods such as potatoes, pasta and bread etc . . . the client’s carbohydrate intake was only 42% when the typical RDA is 60%, it can be easy to assume that the client is not eating enough carbohydrates, which is typical according to Jeukendrup & Gleeson (2004) who states it is estimated that carbohydrate intake in western society is typically 40%-50% however it should also be seen that the client has eaten far more calories than the RDA and the amount of carbohydrates consumed by the client may well be over 60% if the calorie intake had been within or up to the RDA. The booklet (Appendix 3) allows a view of the portions of carbohydrates consumed by the client and with the amount of portions of 7½, the client is eating a healthy amount and well within the RDA of 6-11 portions. Carbohydrates contribute the largest source of energy in a diet Miller (1994), and because of this the client should maintain their intake levels of carbohydrates especially as they have recently been taking part in more physical activity such as walking, McArdle et al (2009) suggest intake for an active individual to be similar to that of the food pyramid guide at 60%, also stated that it should be predominantly from unrefined foods, such as fruits, grains and vegetables. FATS Fat in foods also gives us energy approximately 9 Kcals to carbohydrates 4 Kcals per gram Mainwood & Renaud (1985). The client’s fat intake is more than double what it should be, possibly more than that when considering the RDA of calorie intake Vs the actual amount. To get a better idea of the amount of potions being consumed by the client the booklet (Appendix 3) can be used. The booklet shows the client to be consuming +9 RDA portions of high fat foods. This, if maintained should be an area of concern for the client as according to frank et al (1997) individuals that were subject to a 5%t increase in dietary fat suffered a 17% increase of the risk of coronary heart disease(CHD) when compared to subjects who increased their carbohydrate intake by 5%. The client’s diet consisted of animal fat that was fried and fats such as chocolate, perhaps these foods could be substituted for healthier low fat options such as oat bars or fruit instead of chocolate. The NHS 5-a-day campaign is all about helping people eat more fruit and vegetables in place of high fat foods as this may help an individual maintain a healthy weight. PROTIEN The client could possible increase their protein intake but again it is more than likely that this is due to the volume of calorie consumed by the client and they may well be eating enough. The RDA for protein is 15% of total calorie intake and the client is eating roughly the correct ratio. The client could however, reduce fat intake by changing the way these high protein foods are prepared such as fried chicken, perhaps grilling the chicken could be a healthier option. One website comments on rumours that the benefits of grilling chicken over frying are recognised by major fried chicken distributors and that the famous Kentucky fried chicken may soon become Kentucky grilled chicken. Proteins are made up from Amino acids (AA), one major difference between protein and carbohydrates and fats is that protein is the only one to contain nitrogen, which is said to constitute around 16% of dietary protein Williams (2005). Branched chain amino acids (BCAA) are the building blocks of protein but not all AA are essential in a diet as the body can synthesis these AA Jeukendrup & Gleeson (2004). There are however, some AA’s that are essential in a diet. BCAA’s that are oxidized during exercise, such as Valine, Isoleucine and Leucine Tippett & Cleveland (1999), need to be replenished to help the homeostasis of the body. Athletes or regular exercise may look at the types of food that contain these AA’s and use them as part of their recovery process. Vitamin A, C and E It’s clear from the table (See Appendix 2) that the client is not consuming enough vitamin A,C or E, Food |Carbohydrate grams % |Total fat % |Protein % |Vitamin A |Vitamin C |Vitamin E |Vitamin B12 |Iron |Fluid grams |Energy Kcal | |RDA (rounded) |60% |20% |15% |1-2mg |~50mg |~15mg |1-10mg |~15mg |1200 (water) |2000-2500 | |Client intake (rounded) |42% |47% |11% |0.75mg |78mg |60mg |3.64mcg |26mg |1756 |4115 | | Food |Carbo-hydrate grams |Total fat grams |Protein grams |Vitamin A |Vitamin C |Vitamin E |Vitamin B12 |Iron |Fluid grams |Energy Kcal |Serving weight | |2 slices white bread |26.32 |1.73 |3.79 |0 |0 |0.11mg |0 |1.94mg |18.95 |138 |52g | |2.5 x teaspoon butter |0.15 |12.98 |0.03 |176mcg |0 |1.08mg |0.02 |0 |7.94 |115 |21.5g | |2 x tea spoon peanut butter |3.13 |8.06 |4.01 |0 |0 |1.44mg |0 |0.03mg |0.29 |94 |16g | |1 x bag prawn cocktail crisps |14.81 |9.69 |1.96 |0 |8.7mg |2.55mg |0 |0.46mg |0.53 |150 |28g | |2 x fried chicken with skin |19.9 |34.36 |44.44 |78mcg |0 |0.48mg |0.5mcg |3.06mg |97.94 |578 |200g | |1 x table spoon beans |2.03 |0.3 |0.56 |0 |0.2 |0.01mg |0 |0.28mg |6.9 |12 |10g | |1 x tablespoon coleslaw |3.71 |5.21 |0.14 |3 mcg |0 |0.48mg |0.03 mcg |0.03mg |6.22 |61 |15.6g | |1 x handful of fries |31.9 |14.48 |3.2 |0 |2.4mg |0.65mg |0 |1.16mg |33.8 |271 |85g | |Full bar chocolate |118.8 |59.32 |15.3 |118mcg |0 |1.02mg |1.5mcg |4.7mg |3 |1070 |200g | |1 x handful Malteasers |67.43 |33.19 |8.63 |73mcg |0.7mg |0.56mg |0.5mcg |2.99mg |1.72 |603 |113g | |1.5 x cup pasta |62.31 |1.75 |11.38 |22 mcg |12mg |1.82mg |0 |3.87mg |293.66 |309 |372g | |0.25 x Cucumber |2.57 |0.19 |0.7 |5mcg |3.8mg |0.04mg |0 |0.26mg |115.11 |14 |119g | |6 x plum tomatoes |14.58 |0.74 |3.27 |156mcg |47.2mg |2.01mg |0 |1mg |351.54 |67 |372g | |0.5 smoked sausage |2.63 |19.19 |7.29 |2mcg |2.4mg |0.16mg |1.08mcg |0.94mg |34.8 |214 |66g | |1.5 pints diet coke |2.18 |0.22 |0.82 |0 |0 |0 |0 |0.82mg |746.55 |15 |750g | |3 x baguette slices garlic bread |54.8 |13.34 |11.43 |118mcg |0.4mg |1.47mg |0.01mcg |3.51mg |29.05 |383 |111g | |1 x tablespoon BBQ sauce |5.08 |0.04 |0 |2mcg |0.1mg |0.09mg |0 |0.03mg |8.45 |21 |14g | |Totals |432.33 grams |214.79grams |116.95grams |753mc grams |77.9m grams |59.93m grams |3.64mc grams |25.08 mg |1756.4 grams |4360 Kcal |2545.1 grams | |APPENDIX 1: A detailed nutrient breakdown of the clients 24 hour food intake APPENDIX 2: Recommendations of daily allowances (RDA) Vs the daily food intake of the client. Information of RDA’s have been taken from Mann & Truswell (2002), The NHS healthy choices website (LU-25/09/2007) & Williams (2005) Food |Carbohydrate grams % |Total fat % |Protein % |Vitamin A |Vitamin C |Vitamin E |Vitamin B12 |Iron |Fluid grams |Energy Kcal | |RDA (rounded) |60% |20% |15% |1-2mg |~50mg |~15mg |1-10mg |~15mg |1200 (water) |2000-2500 | |Client intake (rounded) |42% |47% |11% |753mcg |78mg |60mg |3.64mcg |26mg |1756 |4115 | | Workings out of calorie intake: Client daily Carb intake = 432.33 X 4 = 1729.32 =41.86% Client daily fat intake =214.79 X 9 = 1933.11 = 46.80% Client daily protein intake = 116.95 X 4 =467.8 = 11.32% Total calorie intake from Carb’s, fat and protein = 4130.23 Reference to APPENDIX 3: Booklet To review the clients 24 hour recall the United States Department of Agriculture (USDA) search tool has been used to break down the client’s food intake into individual nutrients. Within the booklet that the client completed for this analysis there is a table at the back which is used to break down the client’s intake into daily portions of carbohydrates, fats and dairy produce etc. . . . and the information for recommended daily portions was taken from the United States Department of Health and Human Services(DHHS) food guide pyramid. The food pyramid can be found on many websites and in many nutritional books, the food guide for the one used in the back of the booklet was taken from Fox & Cameron (2006). Fox, A.B, & Cameron, G.A (2006), Food Science, Nutrition & Health. (7th ED) Hodder Education, 338 Euston Road, London NW13BH. Frank B. Hu, M.D., Meir J. Stampfer, M.D., JoAnn E. Manson, M.D., Eric Rimm, Sc.D., Graham A.Colditz, M.D., Bernard A. Rosner, Ph.D., Charles H. Hennekens, M.D., and Walter C. Willett,M.D.(1997) Dietary Fat Intake and the Risk of Coronary Heart Disease in Women. New England Journal of medicine Volume 337:1491-1499 Jeukendrup, Asker. & Gleeson, Michael (2004) sport nutrition: An introduction to energy production and performance. Human Kinetics 107 Bradford, Leeds, LS286AT Mainwood GW & Renaud JM (1985) The effect of acid-base on fatigue of skeletal muscle. Can J physiol, Pharmacol 63:403 Mann, JIM & Truswell, Stewart. A. (2002) Essentials of human nutrition 2nd ed. Oxford university, Great Clarendon Street, OX26DP Miller, Brand. J. (1994) the importance of glycemic index in diabetes. Am J Clin Nutr, 59(suppl.), 747s-52s. Tippett , KS. & Cleveland, L.E (1999) How current diets stack up-comparison with dietary guidelines. Agriculture information bulletin number 750, 51-70. United states Department of Agriculture, Economic research service: Washington, DC. Tortora, Gerard, J & Derrickson, Bryan. (2007) principles of anatomy and physiology. John Wiley & sons. 111, River Street, Hoboken, NJ07030 Williams, Melvin.H. (2005) Nutrition for Health, Fitness & Sport.7th ed. McGraw-Hill. 1221 Avenue of the Americas, NY 10020 Dr atkins Websites referenced / visited: http://www.nhs.uk/Conditions/Diet/Pages/Recommendations.aspx http://www.5aday.nhs.uk/topTips/default.html http://politisite.wordpress.com/2008/03/24/kentucky-fried-chicken-to-change-name-to-kentucky-grilled-chicken/