Case Study: Ronald is a 62 y/o male who was referred by his doctor to a nutritionist for diet education. Ronald is not eager to talk to someone who might make him give up all the food he likes to eat on a regular basis. Ht: 5’10”’ Wt: 235# Wt in kg: IBW (+10%): % upper IBW: PMH: HTN, hyperlipidemia, smoker Meds: Statin Labs: Total Chol 250 mg/dl Normal: LDL 191 mg/dl Normal: HDL 35 mg/dl Normal: mg/dL mg/dL mg/dL Social hx: married with 1 grown daughter; retired accountant Typical diet intake: Breakfast- Danish or toast with coffee, eggs, French toast, sometimes cold cereal with 2% milk Lunch- Burger and fries, Subway sandwich, or leftovers such as roasted chicken and potatoes Dinner- grilled BBQ chicken, spaghetti with meat sauce, chili con carne, dinner roll, canned vegetables, 2% milk or sweetened iced tea Snacks- ice cream, pretzels, potato chips, cookies, M&Ms, cheddar cheese slices Fluids (besides milk and coffee) – 1-2 cans of soda per day, sweetened ice tea Likes- meat, cheese, sweets such as pastries and cookies, ice cream, fresh fruit, some veggies such as carrots and tomatoes, sweet or salty snacks Dislikes- salads, broccoli, yogurt, “vegetarian food”, “fat free food” Food allergies- shellfish Questions: 1. Define heart disease. Discuss the process of developing atherosclerosis. (5 pts) From the book: “a term encompassing several disorders affecting the heart, of which coronary heart disease is the most common.” – 2 pts 2. Identify Ronald’s risk factors for heart disease. Which ones can Ronald impact with diet and lifestyle changes? Which ones are out of Ronald’s control? (6 pts) 3. Define lipoprotein. Identify the four basic types of lipoproteins, where they are each produced, and their functions. Outline lipid transport by lipoproteins. (9 pts) 4. Discuss some specific ways Ronald could improve his diet, keeping in mind his dietary likes and dislikes. Provide three examples of possible food substitutions and how those might improve Ronald’s diet/healthy (Ex: substitute salmon or other fatty fish 2x/wk at dinner to increas
