nutrition

Diabetes and Hypertension Discussion
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Please make sure you read chapters 20 and 21 prior to posting in this discussion. You can use the powerpoint notes as well. Please avoid searching for diabetes information on the internet – there is a lot of inaccurate and/or not scientific based information out there!

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For this discussion, you will be analyzing a case study on someone with Type 2 diabetes and hypertension. To print a copy of this case study (which is listed below), click here
.

Case Study:

Mr. Goren is a 54 year old man who was diagnosed with type 2 diabetes 6 months ago. He also has hypertension. He is currently taking Glucophage® to help control his diabetes, and Lopressor® for his blood pressure. At his checkup, he reports that his blood sugars have been inconsistent (both high and low) and he is having a hard time getting them under control. His blood pressure is also slightly high at the visit. He is 5’7” and weighs 175 pounds. He gets a moderate amount of physical activity by walking for 20 minutes three days a week. The nurse asks him what he ate yesterday. The client states that he is Jewish and follows some basic Kosher diet guidelines, and he is currently celebrating Hannukah with his family. He provides the following 24 hour recall:

Breakfast

(8:00am)

Lunch

(1:00pm)

Dinner

(6:30pm)

Snacks

1 cup chopped tomato

1 cup chopped cucumber

1 cup 4% fat cottage cheese

1 large bagel

1 cup herbal tea

6 ounces Roasted Chicken

Breast

2 Pita Bread (white)

½ cup hummus

¼ cup chopped onions

¼ cup chopped red pepper

4 ounces apple juice

8 ounces grilled Tilapia

3 potato pancakes

(cooked in oil)

½ cup sliced carrots

½ cup steamed broccoli

½ jelly doughnut

1 cup light yogurt

(10:30am)

1 oz. roasted peanuts

(4:00pm)

1 small apple

1 cup 1% milk

(11:00pm)

Breakdown of Macronutrient Ranges for this Diet:

Macronutrient

% of Calories

Carbohydrate

45%

Protein

28%

Fat

28%

Other Results:

Nutrient

Recommended

Actual Intake

Calories

2702

(to maintain current weight)

2957

Saturated Fat

Less than 27 grams

22 grams

Cholesterol

Less than 200 mg.

351 mg.

Dietary Fiber

25-40 grams

28 grams

Sugar

(no official recommendations)

115 grams

Sodium

Less than 1,500 mg.

3,664 mg.

In your posting(s), discuss the following:

What would you change about the macronutrients? More or less carbs, protein, and fat?
Look at the amount of carbohydrate he is consuming at each meal and snack. Is it balanced? What changes would you recommend to better balance his carbohydrate intake?
How can he better control his hypertension? Be specific
Overall, what dietary changes would you recommend for him?

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