Julianne Borba

FSN 429
Dr. Papathakis
12/02/13
Follow the Diet
I.)
A.) EER: 30kcal/kg; weight: 130#; 130/2.2=59kg, 59kgx30kcal/kg=
1770kcals/day
Est PRO: 70gPRO/day (1.1g/kg, 16%kcals)
EST CHO: 252gCHO/day (57%kcals)
Est FAT: 53gFAT/day (25%kcals); <11g saturated fat/day (<7%kcals)
Fluid Requirement: 1770ml/day (1ml/kcal)
Menu plan: CHO exchanges: 16 (4 fruits, 2 dairy, 9 starch, 1 veg), FAT
exchanges: 9, PRO exchanges: 3oz) *See Exchange Table attached
Exchange Totals: 1800kcals (goal=1770kcals), 65gPRO (goal=70g),
244gCHO (goal=252g), 52gFAT (goal=53g)
B.) Breakfast:
-1/2c oatmeal
-1 tsp peanut butter
- 1 Tbsp honey
-2 cups coffee w/ 1 Tbsp n
am snack:
-1 apple
-1 oz trail mix (dried fruit based)
Lunch:
-1 cup cooked broccoli and peppers
(cooked in 2 tsp olive oil)
-1 cup baked sunshine winter squash
-1 fat free greek yogurt
- 1 persimmon
pm snack:
-1/2 cup cherry tomatoes
-1/2 cup carrots
-1/3 cup hummus
-1 regular banana
-2 tangerines
Dinner:
-1 whole grain tortilla
-2oz turkey breast
-1/2 cupped cooked peppers and shallots
(cooked in 1 tsp olive oil)
-2 Tbsp avocado
-chopped lettuce and tomatoes
-2 tsp mustard

-diet iced green tea

hs snack:
-1/2 cup Special K Red Berries, whole grain cherrios
-8oz non fat milk
- dark chocolate kisses
C.) Na restriction:
The patient should consume less than 1500mg daily. Even
distribution between her 3 meals and 3 snacks throughout the day may
make it an easier diet restriction to follow (~200-300mg each). She
should eat a diet rich in fresh fruits and vegetables and fresh lean
meats like chicken, turkey, or fish. When grocery shopping she should
look for products that say low sodium, no salt added, sodium
free, ect and try to purchase snacks containing less than 100mg
sodium per serving. She should avoid processed and canned foods
which are typically very high in sodium, as well as cheeses, sauces,
and snack foods like chips or crackers.
A DASH (Dietary Approaches to Stop Hypertension) diet would be
an appropriate approach for her. This type of diet would be high in
fruits, vegetables, and low fat dairy providing high potassium,
magnesium, and calcium which are of increased concern in controlling
blood pressure. It would also be rich in whole grains, poultry and nuts.
Fat should be kept to less than 27% of kcals, with saturated fat being
less than 6% of kcals. Processed foods and foods high in sodium, high
fat foods (especially saturated fat), and alcohol should be limited for a
patient with pre-HTN.
II.) There was no deviations from the above menu plan when following
the diet.
III.) ESHA
IV.) The computer analysis was a little bit off from the plan I made with
my exchanges and from what I actually consumed. The choices we
limited and a few of the foods (like the greek yogurt, the hummus)
were too high in calories, protein, and carbohydrates which threw off
the results making the values higher than intended. The fat ranges
(total and saturated) fell within appropriate ranges as did the sodium
levels. The hummus from the ESHA report was much higher in sodium
than the one I ate which made the afternoon snack over 400mg of
sodium which is much higher than recommended. Due to the
beneficial components of the DASH diet, the majority of vitamin and
mineral levels looked good in the ESHA report. The only one that
looked of special concern was a very low Vitamin D consumption. The
only intake that really contributed to Vitamin D levels was a glass of
milk since the other serving of dairy came from a greek yogurt which

contained none. To improve the outcome I would include a second

dairy option that provided Vitamin D like a second glass of milk.
V.) Reflection:
A.) The main barrier to following my low sodium diet was being at
school. I had to make sure I picked a day that I wouldnt be
away from home for too long because many of the foods on my
menu plan either required refrigeration (ie milk, yogurt,
hummus) or required cooking (ie oatmeal, winter squash,
broccoli, turkey, peppers and onions). Packaged, processed
foods are the most convenient foods to eat on the go but they
are often very high in sodium so I avoided them in my planning.
My family owns an organic farm which served as an enabling
factor since the fresh produce in my diet plan was readily
available to me without any cost. Only a few items on my diet
plan contained food labels, and those that did were generally low
in sodium because they were either whole grain or low fat dairy
products. Websites containing information on DASH diets were
readily available and were very helpful in planning the diet.
B.) Following this diet long term wouldnt be an issue for me
because my dietary routine now is very similar to the one I had
to follow. I generally stay away from processed foods and foods
high in fat, and eat a diet very high in fruits vegetables, whole
grains, and low fat dairy which is exactly what the DASH diet
suggests for controlling blood pressure.
C.) I would advise any patient trying to follow this diet to eat at
home or pack meals/snacks from home as much as possible that
way they know exactly how much sodium they are consuming
and can better control it. When they do eat out, Id advise them
to:
-select steamed, grilled, broiled, baked, or roasted dishes
instead of fried
-choose dishes with vegetables as main component
-avoid red meats and stay away from foods that are
pickled, cured, or smoked
-avoid sweets, alcohol, and sugar containing beverages
-ask for food to be prepared without salt
-limit condiments high in salt like ketchup, sauces, pickles,
ect
-ask for dressing or sauces on the side and use modestly
A couple reputable and helpful online resources for the
patient to use would be the US Department of Health and Human
Services National Heart, Lung, and Blood Institute and the
American Heart Association (AHA). I chose these websites
because they are easily assessable for patients and provide a ton

of great, easy to follow tips. They are well-known and reputable

sites that would be extremely helpful for patients looking to
advise on how to implement a DASH diet into their lifestyle.
D.) This study took data from a number of previous studies of
various types and designs and analyzed the data, concluding
that certain dietary patterns play a role in the development of
hypertension. Changes in diet, like decreasing sodium intake,
increasing potassium intake, limiting alcohol consumption, and
overall adherence to a DASH (Dietary Approaches to Stop
Hypertension) diet can lower blood pressure, prevent the
development of hypertension, and lower the risk of hypertension
related complications. I liked that the study focused on
individual behavioral and dietary changes that can be made in
order to promote healthier food choices and reduce the burden
hypertension related complications. This study promoted the
same diet I advised my patient to adhere to. She was diagnosed
with pre-hypertension, and to limit and control her sodium intake
and stop hypertension, advising a DASH diet was most
appropriate
E.) From the overall experience, I realized that following a diet with
this many restrictions would likely be difficult for a lot of
patients. Though I didnt have to stray too far from my normal
routine when following the diet, many patients (especially those
with HTN or pre-HTN who normally dont follow DASH
recommendations) may not adapt to the lifestyle change so
easily. I also learned that planning a menu based on exchanges
and recommendations has to be a basic guideline because, due
to the variability between types of foods and brands, many of
the values (like kcals, gPRO, gCHO, gfat, Na, ect) may be quite a
bit off than the original values. Also, following a diet plan isnt
as easy as I thought it would be. Though the menu was full of
foods I normally eat, it was hard not to stray from the plan and
snack on the food lying around my house throughout the day.