Aileen is a 28-year-old woman who lives in an urban neighborhood with her husband and 12-year-old daughter. She is 5 ft, 10 in tall and currently weighs 165 pounds. In the past 2 years she has gained 10 pounds. At a recent neighborhood health fair at the YMCA, Aileen’s blood glucose and blood pressure screening results were higher than they had been a year ago but were still in a good range. She has a family history of heart disease and diabetes and recognizes that her weight gain is an issue. Both she and her husband work full time, and blending their schedules with that of their daughter is hectic. Aileen does all the cooking and shopping, they have a kitchen with a range, oven, microwave, and refrigerator/ freezer. She describes her food shopping habits as chaotic and last minute, often stopping at the local convenience store. They eat out (fast food or take out) for most lunches and at least two dinners a week. They have no regular activity or exercise. They have the minimum health insurance with a large copayment; thus they do not have an ongoing health care routine. Aileen made an appointment with a locally based health care source. She asked for dietary counseling and was asked to bring a 1-day food recall for the registered dietitian. She reported the following: breakfast: egg and sausage on a bagel, coffee; midmorning: low-fat snack bar from vending machine with coffee; lunch: double burger with cheese on a bun and large fries, ketchup, and extra pickles, diet soda; dinner: frozen dinner that included chicken, rice, and corn. She had an iceberg lettuce salad with diet ranch dressing “to add something green.” Beverage was a diet soda. During the evening she had a dish of chocolate ice cream and sweet tea. She reports that in her coffee she likes two packets of sugar and some nondairy creamer.
Nutrition Diagnostic Statements
1. Physical inactivity related to lifestyle issues as evidenced by no regular physical activity and a 10-lb weight gain.
2. Undesirable food choices related to high fat and low fruit and vegetable intake as evidenced by diet history revealing high-fat foods at every meal and an average of one fruit or vegetable each day. Sodium level questionable.
Nutrition Care Questions
1. What lifestyle factors and nutrition triggers are likely to be identified by the dietitian?
2. What foods should Aileen consider including in her diet to build a prevention-related meal plan?
3. Plan a meal pattern and two sample meals that illustrate your recommendations, including at least one at-home and away-from-home breakfast, lunch, and dinner.