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OSU / Biomedical Science / BIOMEDE 113 / What is herman’s bmi?

What is herman’s bmi?

What is herman’s bmi?

Description

School: Ohio State University
Department: Biomedical Science
Course:
Term: Winter 2016
Tags:
Cost: 25
Name: Practice
Description: practice
Uploaded: 08/18/2016
6 Pages 48 Views 3 Unlocks
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Revised 6/7/2015


What is herman’s bmi?



Katherine Wilson

Case Study #1: Hypertension and CHD

[25 points]

Herman is a 35-year old accountant. He leads a fairly sedentary life – mostly sitting at his desk  at work or watching TV when he’s at home. He is 5 feet, 8 inches tall and weighs 220 lbs; his  pant size is 42 inches. He has never been diagnosed with any medical problems, and he does  not currently take any medications. At his yearly check-up, his physician measured his blood  pressure and found it to be borderline high at 130/85 mmHg. Herman tells his doctor that he  tries to eat healthy. His physician tells him that he is probably salt-sensitive and needs to reduce the amount of sodium in his diet. Here is an example of Herman’s diet before he started to make changes. If you want to learn more check out Who is included in the female athlete triad?

Old diet plan 


How would you characterize his fat distribution?



Breakfast:  

3 slices of bacon (pan fried)

 2 fried eggs

16 oz. black coffee

Lunch:  

2 beef tacos with cheese, lettuce, tomato, & salsa

½ cup refried beans  

1 oz. tortilla chips with ¼ cup salsa

16 oz unsweetened iced tea

Snack:  

¼ cup mixed nuts (dry roasted and salted) We also discuss several other topics like Where are the formed elements produced?

Supper:  

3 oz ham

½ cup canned peas

1 cup mashed potatoes (made with whole milk and butter)

½ cup turkey gravy (canned)

8 oz tomato juice (canned)

Dessert:

½ cup canned peaches (in light syrup)


What does it mean when herman’s physician told him that he is “salt-sensitive”?



2 chocolate chip cookies (1 serving of Chewy Chips Ahoy!)

His physician gives him very little guidance about his diet. Herman thinks he knows  where the sodium is and makes some changes in his food selection. He also stops  using the salt shaker.  

 Herman’s new diet 

Breakfast:

1.5 cups of corn flakes

¾ cup of low-fat milk

16 oz. black coffee

Lunch:  

1 sandwich (made with 2 slices of whole wheat bread, 2 slices of American cheese, 2  slices of oven-roasted, deli-sliced chicken breast, 1 tsp mayonnaise, 1 tsp of yellow  mustard and 3 bread-n-butter pickle chips) Don't forget about the age old question of Why has the islamic faith been singled out?

Salad (1.5 cups - lettuce, tomatoes and carrots) with 2 tbsp of Italian dressing 16 oz. unsweetened iced tea

Revised 6/7/2015

Snack:

1 oz. of whole wheat pita chips

1 medium apple

Supper:

3 oz. baked tilapia, seasoned with ½ tsp lemon pepper (Mrs. Dash)

½ cup canned peas

1 cup mashed potatoes (made with whole milk and butter)

½ cup turkey gravy

8 oz. low-sodium tomato juice

Dessert:

½ cup canned peaches (in light syrup)

Answer the following questions based on the info provided above.

1. What is Herman’s BMI? What BMI category does he fall into? (Hint: I know we haven’t  really covered BMI yet, so please refer to the “Helpful Resources” at the bottom for some  guidance.) Show your work/calculations below. [2 points]

220/(68)^2=.048

.048*703=33.45

Herman’s BMI is 33.45%. Herman falls into BMI category 1.

2. How would you characterize his fat distribution? (Hint: what does his pant size tell you?)  [1 point]

I would characterize his fat distribution as being highly distributed around the waist.

3. Herman’s physician told him that his blood pressure is “borderline high.” What are the  blood pressure cut-offs for each of the following categories:  

a. Desirable Don't forget about the age old question of What are the three components of a fishery?

b. Borderline/prehypertension

c. High risk/hypertension

The desirable blood pressure cut-off is <120/<80. The borderline/prehypertension cut-off  for blood pressure is 120-139/80-89. The high risk cut-off for blood pressure is ≥140/≥90.

[1.5 points]

4. What does it mean when Herman’s physician told him that he is “salt-sensitive”? [1 point] Don't forget about the age old question of How does the nervous system operate?

Salt sensitivity is a measure of how ones blood pressure responds to salt intake. Those who  are salt sensitive are more likely to have high blood pressure when taking in salt. These  people also have the greatest reduction in blood pressure when cutting back on their salt  intake.

Revised 6/7/2015

Herman returns to the doctor two months later and there is no change in his blood  pressure. Use the diet analysis posted at the bottom of this document to answer the  following questions.

5. Critique Herman’s old diet plan. Using the analysis provided below, identify FIVE specific foods that he was consuming that are the highest in sodium. Are there any foods that  surprised you?

[2.5 points]

Herman’s old diet consisted of over 6,000 mg of while the daily recommendation is 2,300  mg. Five specific foods that he was consuming that were the highest in sodium were 1)3  oz. of ham 2).1 cup mashed potatoes 3). ½ cup turkey gravy 4). 8 oz. tomato juice and 5).  ½ cup refried beans. One of the foods that surprised me was the tomato juice. Normally I  don’t associate high sodium levels with juice. Don't forget about the age old question of What is an argumentative structure?

6. Now using the analysis for his new diet, list at least THREE good changes that Herman  made in his diet to lower sodium. How did these changes impact the amount of sodium  Herman was consuming? [2 points]

One good change that Herman made in his diet to lower sodium was changing the heat  used in his supper from ham to tilapia. A second change that Herman made that lowered  his sodium was switching from tomato juice to low sodium tomato juice. A third change  that Herman made that lowered his sodium was switching from eating a side of refried  beans at lunch to eating a salad. These changes significantly decreased his overall sodium he was taking in at each meal and as a whole.

7. List changes that he made that had little impact on his sodium intake. Cite at least THREE specific examples from the analysis. Are there any foods on his new diet for which the  sodium content surprised you? [2 points] Three specific examples that had little impact on his diet was switching from taco beef to deli meat, switching from eating bacon and eggs  for breakfast to corn flakes cereal, and switching from salsa to Italian dressing as a  condiment used for lunch. One food that surprised me was the corn flake cereal. I wouldn’t have thought cereal as having such a high sodium concentration.  

8. Why do you think Herman’s blood pressure did not change at his 2 month follow up? [1  point]

The recommended lifestyle change should last for at least 3-6 months before seeing major results. I think Herman’s blood pressure did not change also due to the fact that he didn’t  cut out some of the foods with the highest sodium content such as the mashed potatoes  and gravy and some of the switches in foods had similar sodium levels.

9. Describe at least 4 lifestyle modifications Herman could make to reduce his blood  pressure. [2 points] Four lifestyle modifications that Herman could make to reduce his  blood pressure would be to increase his physical activity, increase his intake of potassium,  magnesium, and calcium, avoid smoking and decrease alcohol levels.

Revised 6/7/2015

10.What is the name of the diet that Herman could follow that may help to lower his blood  pressure? What foods should be emphasized and what foods should be limited in this  diet? [2 points] Herman could follow the DASH diet to help lower his blood pressure.  Nutrient dense foods are emphasized in this diet such as lean protein, fruits and  vegetables, and whole grains. Saturated and total fat should be limited while on this diet.

11.Help Herman prepare a sample one-day menu that follows the pattern of the diet listed in  #10. Your sample menu should include 3 meals and 2 snacks. [4 points]

Meal 1: 1 cup whole grain oats

1 cup fat free fruit yogurt

1 cup orange juice

1 cup low-fat milk

1 medium banana

Snack 1:1/3 cup almonds unsalted  

1 cup apple juice

Meal 2: Turkey breast sandwich with:

2 slices whole wheat bread

Romaine lettuce

Low-fat mayonnaise

1 cup steamed asparagus  

1 clementine

Snack 2: 3 apple and peanut butter sandwiches (size of the width of an apple) 1/3 cup dried fruit

Meal 3: 3 oz tilapia with:

1 tbsp lemon juice

1 small baked potato

1 cup of steamed broccoli  

Herman’s doctor has decided to have Herman do fasting blood work to further assess  his CHD risk. The results of his blood work are as follows: total cholesterol = 250  mg/dL, LDL cholesterol = 165 mg/dL, HDL cholesterol = 35 mg/dL, triglycerides = 160  mg/dL, glucose = 110 mg/dL.

12.Assess Herman’s CHD risk, using the American Heart Association, Heart Attack Risk  Calculator: https://www.heart.org/gglRisk/main_en_US.html. [1 point] Herman’s is at  borderline high risk for total cholesterol, high risk for HDL cholesterol, moderate risk for  blood pressure(systolic), and a low risk (4%) for a heart attack.

Revised 6/7/2015

13.Does Herman meet the criteria for Metabolic Syndrome? If yes, how so? [1 point]

Yes, Herman meets the criteria for Metabolic Syndrome because he had all five of the  metabolic risk factors. You need to have three of more to meet the criteria. The risk factors  are abdominal obesity, high blood pressure, high blood triglycerides, low HDL, and high blood  sugar.

14.What, if any, additional recommendations would you suggest to Herman to help him  improve his heart health and decrease his CHD risk? [2 points]

Some additional recommendations I would suggest to Herman would be to lower his total  cholesterol as well as increase his HDL cholesterol.  

Helpful Resources 

 OR  

Remember: 2.2 lbs per kg, 2.54 cm in 1 inch

Online Medical Dictionary:  

http://www.nlm.nih.gov/medlineplus/mplusdictionary.html 

Herman’s Old Diet Plan – Sodium Analysis 

Item Name Amount Sodium 

Eggs, Fried 2 item 190.44 mg 3% 

Bacon, Pork, Cured, Broiled,  Pan Fried or Roasted

3 sl. 554.4 mg 9%

Coffee, Brewed 16 fl. oz. 9.48 mg 0% 

Taco or Tostada, Beef, with  Cheese, Lettuce, Tomato and 

2 item 398.4 mg 7%

Revised 6/7/2015

Item Name Amount Sodium 

Eggs, Fried 2 item 190.44 mg 3% 

Bacon, Pork, Cured, Broiled,  Pan Fried or Roasted

Salsa 

3 sl. 554.4 mg 9%

Salsa 0.25 c. 384 mg 6% 

LIPTON PURELEAF Iced Tea, Unsweetened

16 fl. oz. 0 mg 0%

Beans, Refried, Canned 0.5 c. 534.31 mg 9% Chips, Tortilla, Plain 1 oz. 119.35 mg 2% 

Ham, Cured, Boneless, 11%  Fat, Roasted

3 oz. 1275 mg 21%

Peas, Green, Canned, Drained 0.5 c. 238.88 mg 4% 

Potatoes, Mashed, Prepared  with Whole Milk and Butter

1 c. 662.39 mg 11%

Gravy, Turkey, Canned 0.5 c. 686.63 mg 11% Juice, Tomato, Canned 8 fl. oz. 653.67 mg 11%

CHIPS AHOY! Cookies,  Chocolate Chip, Chewy

Nuts, Mixed, with Peanuts, Dry  Roasted, with Salt Added S&W Sun Peaches, Canned in  Light Syrup

1 svg. 80 mg 1% 0.25 c. 229.13 mg 4% 0.5 c. 20 mg 0%

Totals: 6036.08  mg *A gold star marks foods containing more than 20% of the DV. A silver star marks foods containing 10% to 20% of the DV.

Herman’s New Diet Plan – Sodium Analysis 

Item Name Amount Sodium 

KELLOGG'S CORN FLAKES  Cereal

1.5 c. 300 mg 7%

Milk, Low Fat, 1% 0.75 c. 80.52 mg 2% Coffee, Brewed 16 fl. oz. 9.48 mg 0% Salad Dressing, Italian 2 T. 299.29 mg 7%

Deli Meat, Chicken Breast,  Oven Roasted, Fat Free, Sliced

2 sl. 456.54 mg 10%

Bread, Whole Wheat, Prepared 2 sl. 318.32 mg 7% Cheese, American, Processed 2 sl. 701.83 mg 16% Mayonnaise, with Soybean Oil 1 t. 26.13 mg 1% Mustard, Yellow 1 t. 56.75 mg 1% 

CLAUSSEN Pickles, Bread 'N  Butter, Pickle Chips

Salad, Lettuce with Tomatoes  and Carrots, No Dressing LIPTON PURELEAF Iced Tea, Unsweetened

3 sl. 135 mg 3% 1.5 c. 20.81 mg 0% 16 fl. oz. 0 mg 0%

Tilapia, Cooked, Dry Heat 3 oz. 47.6 mg 1% 

MRS. DASH Seasoning, Lemon Pepper

Juice, Tomato and Vegetable,  Low Sodium

0.5 t. 0 mg 0% 1 c. 169.4 mg 4%

Peas, Green, Canned, Drained 0.5 c. 238.88 mg 5% 

Potatoes, Mashed, Prepared  with Whole Milk and Butter

1 c. 662.39 mg 15%

Gravy, Turkey, Canned 0.5 c. 686.63 mg 15%

ATHENOS Chips, Pita, Whole  Wheat

1 oz. 270 mg 6%

Apple, Medium 1 item 2.23 mg 0% 

S&W Sun Peaches, Canned in  Light Syrup

0.5 c. 20 mg 0%

Totals: 4501.79  mg *A gold star marks foods containing more than 20% of the DV. A silver star marks foods containing 10% to 20% of the DV.

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