Running head: CASE STUDY 11

Lesson 11 Case Study

Determine Basic Concepts of Medical Nutrition Therapy
Angela Martin
United States University

CASE STUDY 11

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Lesson 11 Case Study- Al

Introduction
This case analysis is about Al who is a retired professional football player. He won many
awards for his outstanding athletic ability. After he retired from football he spends his time
speaking to high school athletes and managing his investments. While speaking at his son's
school he feels light headed and has blurred vision. After a few minutes he feels better, but
decides to call his doctor. His doctor diagnoses his problems over the phone as probably low
blood sugar, but suggests Al come in the next day for some blood tests.
1. How old is Al?
According to the information presented in the case study, Al was born in 1965 and as of
today (2012) he is forty-seven years old.
2. What is Als IBW? What is his percentage of IBW?
Als Ideal Body Weight is 91.4 kg based on the fact that he is currently weighing 131 kg
and his height is 78 inches.
Percentage of Ideal Body Weight = Original Weight/ Ideal Weight * 100
Percentage of Ideal Body Weight = 131kgs / 91.4 kg *100
Percentage of Ideal Body Weight = 143%
3. What does his lab report tell you about his iron status? What are normal iron status lab
values for adult males?
The problem of anaemia is the most intractable and common nutritional problems today.
The main reasons of anaemia are: inherited conditions (thalassaemia), deficiencies of key
micronutrients (Vitamin A, Vitamin B12 and flotae), schistosomiasis and hookworm infections,
malaria and most importantly dietary iron deficiency (Pinkney, Johnson & Gale, 2010). The
dietary iron deficiency is measured by evaluating patients iron status. Als iron status can be
evaluated by his HCT and HGB stats. Al seems to have normal hemoglobin count as his Hgb is
17 g/dL. On the other hand, Als hermatocrit of 44% means that there are 44 milliliters of red

CASE STUDY 11

blood cells in 100 milliliters of blood and its also normal. The normal value of Hgb in adult
males is 13.8 to 17.2 grams per deciliter (g/dL) and for Hermatocrit its 45% to 52% for adult
men.
4. What does his lab report tell you about his risk for diabetes? What is normal lab values
reflecting blood glucose control?
Al is at higher risk of diabetes because his Fasting Blood Sugar is very high (212) while
the normal range is between 70 to 100 mg/dl. On the other hand, Als hemoglobin A1c (HgAlc)
is also high as it should be 5.7% normally. Lastly Al has higher cholesterol of 299 mg/dl while
the normal value should be 180 to 200 mg/dL or less.
5. What does his lab report tell you about his risk for heart disease? What is normal lab
values reflecting cardiac status?
The risk of heart disease depends on various risk factors such as, uncontrolled stress and
anger; high C-reactive protein; uncontrolled diabetes; Obesity; Physical inactivity; Uncontrolled
hypertension; High LDL; and smoking. According to the analysis of Als lab report, he has a high
risk for heart disease. First of all Al has higher Fasting Blood Sugar indicating him to be a patient
of diabetes. Al also has higher blood pressure that increases his risk for cardiovascular disease.
Various researches have indicated a positive relationship between insulin resistance and
hypertension that increases risk for heart disease. Moreover Al has highly elevated cholesterol
level that is also a factor behind heart disease.
6. His doctor is not pleased with the initial blood tests and tells AI to "cut back on the
sugar" and come back in one week for more blood work. Listed below is AI's diet for the
next day. Using the AND (Academy of Nutrition and Dietetics, formerly known as the
American Dietetic Association [ADA]) Exchange lists estimate about how many calories are

CASE STUDY 11

in AI's 24 hour record. Estimate how many grams of carbohydrate and fat are in his 24hour record. Determine the percentage of calories from fat.
FOOD ITEM

Grams

Carbohydrate
3 Scrambled Eggs
2 Slices Bacon
0.28
2 Biscuits with 2 tsp Butter
30
2 tsp Diet Jelly
0
1 Cup Orange Juice
30
1 Cup Black Coffee
0
6 Oz, Chicken Breast, Broiled
0

Grams

Percentage of calories

Fat

from fat
9
8
10
0
0
0
18

49%
70%
40%
0%
0%
0%
36%

no Skin
1 Cup White Rice, Fat-Free
Cup Green Beans
1 Cup Melon Cubes
1 Cup Frozen Yoghurt (Fat

45
5
13
35

0
0.1
0.3
0.65

0%
6%
6%
4%

Free)
1 Cup Iced Tea, Unsweetened
of 10 Cheese Pizza
1 Light Beer (12 Oz)
1 Cup Tossed Salad
3 Brownies (2 sq)
3 Oz. Potato Chips
12 Oz Diet Soft Drink
TOTALS

0.67
72
6
3
63
42
0.84
428

0
28
0
4
15
32
0.07
147

0%
38%
0%
51%
33%
62%
25%

CASE STUDY 11

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References

Pinkney, J. H., Johnson, A. B., & Gale, E. A. M. (2010). The big fat bariatric
bandwagon. Diabetologia, 53(9), 1815-1822.