Escolar Documentos
Profissional Documentos
Cultura Documentos
ANALYSIS
My subject is Brenda Tursugian, a 43-year-old woman who is 52 (1.6
m), currently weighs 187 lbs (85 kg). Her current BMI is 33 (Obese I).
She had a gastric band placed 12/2009 at which time her BMI was 51
(Obese 3); her weight just prior to gastric banding was 287 lbs (130 kg)
see back of page 1 on Form B for hand calculations. Brenda has
successfully lost a total of 100 lbs so far and has successfully
maintained her weight loss. Brenda came to me for help losing her last
47 lbs to reach her goal weight of 140 lbs (set by Brenda and her
surgeon). Brendas job requires her to travel to different clients each
week, sometimes commuting up to 2 hours or more one way. She is
usually at a client location Monday-Thursday and works from home on
Friday. While Brenda is not an athlete, she strives to stay active. She
does Tae Kwon Do (high intensity) 3 times/week and also goes to
Zumba class 3 times/week (medium-high intensity). The week Brenda
tracked her diet and activity; she was out of town at a client and was
not able to attend Tae Kwon Do or Zumba.
SUMMARY
Food Guide Analysis: Brendas intake of Grains was just below
adequate (88%, or 4.4 oz out of the recommended 5.0 oz). Brenda
consumed 100% of her daily-recommended amounts for Vegetables
(2.0 cups). Brenda only consumed 23% of her recommended amount
of Fruits (0.3 cup out of the recommended 1.5 cups). Brenda only
consumed 50% of her daily Dairy recommended amount (1.5 cup out
her blood levels check to know where she stands with Vitamin and
Mineral levels. This will help determine if Brenda needs to start taking
supplements to ensure adequate micronutrient intake.
Brenda and her doctor have set a goal weight of 140 lbs. She now
weighs 187 lbs, giving her a total of 47 lbs more to lose. Losing at a
rate of 2 lbs/wk, it will take Brenda 24 weeks (just short of 6 months) to
meet this goal weight. In order to lose 2 lbs/wk, Brenda will have to
consume 7000 kcal/wk, or 1000 kcal LESS per day. I calculated
Brendas BMR to be 2014 kcals; using a PAL of 1.27 as a coefficient,
her TEE calculates out to be 2615 kcals. In order to lose 2 lbs/wk,
Brenda will need to consume 1000 kcal/day LESS than her calculated
TEE, giving her a total of 1615 kcal/day. Her average kcal intake for
the three days tracked was 1914; thus, she will need to decrease her
kcal intake by approximately 300 kcals. During interview, it was
learned that Brenda often skips meals (most notably: breakfast). In
order for her to get a total of 98 g of protein per day (per her doctors
recommendation) and stay within her caloric intake required to lose 2
lbs/wk, I have come up with a manageable plan that will be easy for
her to follow. I recommend that Brenda consume 6 small meals
throughout the day. Due to the fact that she has a gastric band, she is
only able to eat small amounts at one sitting. Consuming small meals
will help ensure that she 1) does not skip meals and 2) meets her total
See your Primary Care Physician and get your blood levels
checked. This will help determine if you need to supplement
Some easy, portable breakfast ideas to make ahead and grab and
go:
Make individual crustless quiches in a muffin tin using egg, and
various veggies, such as spinach, kale, bell peppers. Add some low-fat
cheese to get in some dairy.
Breakfast #1:
150 kcal
1 medium banana
105
120
kcal
kcal
Total:
375
kcal
Breakfast #2:
140
kcal
1 Tbsp cream cheese
50
23
kcal
kcal
Protein drink (20 g Pro)
120 kcal
Total:
333
kcal
Reflection:
I loved doing this project! I have actually done this same type of
project 4 other times for other classes. The difference this time is I am
able to practice and apply what I am learning AND I was able to apply
it to someone who has had gastric band surgery and needs help losing
her last 47 lbs. This is what I want to do as a registered dietitian!
Doing this assignment made me remember WHY I quit my job as a
Bank Auditor (making decent money) to go back to school and start a
new career. Not only was I able to use my academic knowledge, but I
also used my personal experience as a bariatric patient. I feel this
personal experience gives me an advantage working with bariatric
patients that most Registered Dietitians do not have.
References:
www.nutricalc3.mheducation.com
www.myplate.gov
10