Activity 3.2.

5: PLTW Nutrition Client Report for

Hans Spielman
Client Name: Hans Spielman
Health History (including any specific health goals):

Hans Spielman is a 22-year-old college senior who has not worried much about his
weight in the past four years. He has never been involved in sports and he rarely
exercises. He would prefer to walk from his campus apartment to class, but he is often
running so late,he just takes his car. Hans spends countless hours a day in the library or
in his apartment at his computer. He reports snacking constantly, although many times
he does reach for fruit or nuts. Hans is allergic to seafood. He will cook most nights of
the week, but he sticks mainly to pasta, hamburgers, and frozen pizza. He does not
have time to prepare side dishes or vegetables.
Hans has a strong family history of cardiovascular disease. His father died of a stroke at
age 39 and his maternal grandmother has battled high blood pressure for years. His
mother runs marathons and is in perfect health. His uncle just found out that his routine
colonoscopy revealed some cancerous polyps. There is no family history of diabetes.
Recent lab work revealed that Hans LDL cholesterol is 162 and his HDL cholesterol is
39. His triglycerides are 180. His average resting blood pressure was 130/80.
Hans is bothered by his classification as obese and wants to make a change. He would
like to lose at least 50lbs. He needs help to design a healthy strategy for getting his
health back on track.
Height: _______5 11________ Weight: _______274lbs___________
BMI:

Calculate Hans BMI based on his height and weight and describe the
implications of this number.
o Hans is considered to be obese, based on his BMI of 38.2. For his height,
Hans needs to weigh 133 to 179pounds.
Activity Level: BMR and TDEE (Output):
Hans only walks to campus about once or twice a week. He used to play basketball with
his friends on weekends, but now he becomes too winded to keep up.
Compute Hans BMR.
o BMR: 2525.12

 Discuss the activity factor used in the Harris-Benedict Equation and

calculate TDEE.
o
TDEE is the total daily energy expenditure. Based on his very low activity
level, Hans TDEE is 2718 calories.
Food Intake (Input):
Hans completed a food diary for one week. Analysis of his food choices revealed
the following results:
Average calories consumed per
day

3780

Average fat consumed per day

90g

Average saturated fat consumed

per day

60g

Average carbohydrates consumed

per day

455g

Average protein consumed per

day

40g

Average sodium consumed per

day

3,520
mg

Hans reports eating 1-2 servings of fruits or vegetables per day. Hans does not drink
coffee, but he drinks about 4-5 sodas per day. He goes out drinking with his friends
about twice a week and usually drinks a six pack of beer.
Hans eats on campus every day for lunch. Most days he skips breakfast, so lunch is
normally a big meal. He is a not a picky eater and he likes trying new foods, he just
does not have time.

Calorie Deficit or Surplus (Compare Inputs and Outputs):

Compare. calories consumed versus calories expended

Hans needs to cut back on his intake in order to lose weight and meet his goal of losing
50 lbs. His intake is much higher than normal thus is gaining more weight.

Describe what will happen to Hans weight over the next month if he
continues the same eating patterns. Show your work.
If Hans continues to take in more fat, calories and carbs he will have serious health
risks. Some examples include cardiovascular disease that his family has a history of.
Also can lead to type 2 diabetes and can cause a stroke.
Overall Assessment:

Discuss overall implications of BMI and any energy imbalance on overall

health.
o Some limitations:
BMI include the overestimation of fat in athletes

This can not be an implication in Hans case because he is not

physically active thus does not have a lot of muscle that is increasing his
BMI.
May underestimate body fat in older people that have not lost muscle.

This can not be an implication in Hans because he is 22 years old.

In order to maintain weight: must have the same amount of energy in and out
In order to lose weight, as Hans needs to do, he needs to lose more energy.
If Han continues he will be consuming more energy than losing it.

Analyze food choices

Fruits: 1 cup is recommended for Hans of this food group per day
Vegetables: 3 cups is recommended for Hans of this food group per day
Grains: 8 ounces is recommended for Hans of this food group per day
Proteins: 6 ounces is recommended for Hans of this food group per day
Dairy: 3 cups is recommended for Hans of this food group per day
o Is the client getting enough of each of the designated food groups?
No, Han is not getting enough of the designed food group. His usual consumption is
hamburgers, pasta and processed food.

o How does consumption of fats, carbohydrates, proteins and sodium compare

to recommended values?
Fats:
Hans- 90g

Recommended-80g
Carbs:
Hans- 455g
Recomended
Protein:
Hans- 40g
RecomendedSodium:
Hans- 3,520 mg
Recommended-2400g

Propose ways to bring the energy input and output in line with Hans health
goals. Describe final recommendations to improve Hans overall health and meet
his fitness goals. How should Hans alter his eating habits and his activity? Link
your recommendations to his personal health history and his family history.
Since Hans has type 2 diabetes, he must:
Hans needs to eat breakfast because failure to eat in the morning will lead to overeating
later.
I recommend that Hans balances and reduces his food intake. To improve his overall
health and to meet his fitness goal:

Breakfast: ( Hans needs to start eating breakfast)

1.
2. Lunch:Spread 2 tablespoons hummus on wrap. Top with 3 ounces turkey,
cup cucumber, cup tomatoes, 1 tablespoon feta cheese and 1 diced olive.
Fold wrap to close.
3. Repeat procedure for remaining 3 wraps.
o
Dinner:
Pizza gets a bad rap, but when topped with
veggies like bell peppers, it's a great source of
calcium and vitamin C. Try using a whole-wheat
crust for an extra boost of fiber.

Snacks: Turn an everyday sandwich into

a guilt-free dessert treat. No-sugar-added peanut butter is a great option for
diabetic recipes, but a lot of natural peanut butters are also low in sugar. Serve
with a glass of fat-free milk for a boost of protein.

How Hans Can Improve:

Best options:
Fruits, such as strawberries, grapes, and apples.
Naturally low in fat, sodium and calories, doesnt contain
cholesterol.
Health Benefits: containing fiber that reduce Type 2
Diabetes.
Best options:
Vegetables, such as broccoli, spinach, and carrots
Important sources for many nutrients, including potassium,
dietary fiber, folate, vitamin A, and vitamin C
Best options:
Grains, such as brown rice, oatmeal, or wild rice

Exercise:
Hans should start to do exercise in order to lose his weights.
Exercise which is good for people with diabetes:
Swimming
Swimming does not jar your joints, and it can keep your body moving for
long time. Swimming also exercises both upper and lower body muscles at
the same time, and it burns 350 to 420 calories per hour.For everyone with
diabetes, swimming can keep us active and healthy.
Yoga
Yoga can help lower body fat, fight insulin resistance, and improve nerve
function all important when you have type 2 diabetes. One of the
advantages of yoga as an exercise is that you can do it as often as you like.
Walking
Walking is probably one of the most prescribed activities for people with
diabetes. Through walking every day, for 30 minutes to an hour, diabetics can
improve glucose control. By walking at a brisk pace, you can raise your heart
rate, which gives your heart and lungs a better workout.

 Weight Training
Weight Training can builds muscle mass. Weight training reduced diabetes
risk independent of aerobic exercise. But when the strength training was
combined with aerobic exercise, the benefit grew even more.
Tai Chi
Tai Chi is a series of movements performed in a slow and relaxed manner
over 30 minutes. Tai chi is ideal for people with diabetes because it provides
fitness and stress reduction in one. Tai chi also improves balance and may
reduce nerve damaged.