NUTR1023 Lecture Notes - Lecture 3: Recall Bias, Dietitian, Exercise Physiology

Many fad diets claim we should eliminate dietary carbohydrate in order to lose weight. The truth is that calories from all sources need to be managed for weight control For this discussion, read the following article: Rodriquez, D. (2013 Mar 27) Good vs.Bad Carbohydrates. Retrieved from http://www.everydayhealth.com/diet-nutrition/101/nutrition-basics/good-carbs-bad-carbs.aspx Next create a post that answers the following questions in your own words based on what you learned. 1) How does the information in the article compare to what you have heard about different types of carbohydrates? 2) Identify two specific choices (food or beverage) you might make in order to replace a ‘bad carb' with a ‘good carb' in your own diet. (Choose examples beyond those listed in the article and from two different food groups) 3) The average American tends to consume excessive simple and added sugars (‘bad’ carbs), while lacking in ‘good carbs’ from dairy, whole grains, fruit and starchy vegetables. Do you agree? Have you observed this? Think about a time when you have observed others eating at a restaurant, cafeteria, or even family members at home. Discuss your observation and thoughts about carbohydrate consumption of others.

Terry Page is a 42 year old male who presents to an outpatient GI clinic with stomach pain and intestinal complaints. Terry has had both diarrhea and constipation for many years. Ht: 5’8” Wt: 294lbs. Medical History: GERD, obesity, Colonoscopy was negative Diagnosis: IBS Medications: Omeprazole 5o mg BID (proton pump inhibitor) ; Vitamin D 600 IU; 800 mg calcium; Lomotil PRN (for diarrhea), Metamucil 1 Tbsp in 8 oz liquid BID Labs: Negative for stool cultures (bacteria). Significant labs from CBS, CMP: FBG = 115; Cholesterol = 201; LDL- C = 155; HDL-C = 32; Triglycerides = 181; HbA1c = 6.1; Diet History: Terry has a good appetite even with abdominal pain and diarrhea. He has gained 20 pounds in the past 5 years. He does not seem to find any foods that trigger diarrhea more than others but notices increased gas with broccoli or cauliflower. AM: Yogurt smoothie with 1 cup fresh fruit (peaches and cherries) with 8 oz low fat yogurt or dry cereal with dried fruit, nuts mixed with yogurt and 2-3 cups of coffee with half & half and artificial sweetener. Mid-morning: Diet Pepsi, ½ cup dried fruit and nuts Lunch: Salad with kidney beans or lentils, cheese, tomatoes, carrots, asparagus with Italian dressing (1/4 cup) and 12-15 wheat crackers and Diet Pepsi or Sandwich with lunchmeat, cheese and chips PM: Some type of meat with pasta or potatoes and a variety of vegetables and some type of bread or roll with butter. Snacks: Ice cream, cake or cookies, usually each night but lately has been trying sugar free cookies to help with weight loss. Drinks wine or beer 2-3 times per week.

1- What is inflammatory bowel disease? What does your textbook indicate regarding its etiology? (use page numbers from textbook as reference and as part of your answer) (4)

2. Before Terry’s IBS diagnosis, Terry searched his symptoms on Google and he thought he had ulcerative colitis or Crohn’s. How could this happen? What are the similarities and differences between IBS, Crohn’s disease and ulcerative colitis? Use textbook page references with your answer(4)

3. Which of Terry’s laboratory values indicate the presence of inflammation? (4)

4. What would be the primary nutrition concerns for Mr. Page? (3)

5. Prepare a food plan that may help with Terry’s IBS symptoms (6)

6. What is standard treatment for Terry’s diarrhea & abdominal pain with IBS? (4)

This case study involves CJ, a 26 year old married female. CJ’sheight is 64 inches and weight is 180 pounds. Her blood pressure ischronically high and she has a family history of diabetes. She isdomineering and wants everyone to follow all her directions at herwork place. She refuses to eat vegetable. The only vegetable shelikes is iceberg lettuce and tomato in her cheeseburger. Frequentlyshe orders Dunkin donuts for breakfast and pizza for lunch foreveryone while at work. Fresh fruit is a “foreign” to her, and sheloves sweet tea and super size drinks that she gets from the gasstation which is near her work place. Dinner is mostly at home thather husband prepares. To burn calories, she often dances up tomidnight at local bars.

1. Identify the health risk/s with CJ’slifestyle and typical food intake. How would you assess theseriousness of CJ’s weight in relation to her health?

2. What would you estimate to be areasonable amount of weight for CJ to lose over the next sixmonths?

3. What suggestions would you recommendfor CJ to improve her variety of fruit and vegetable intake?

4. CJ would like to lose weight. Plan a1400 calorie diet for one day incorporating meals and an afternoonsnack.

5. What are some advantages for CJ tokeep a food and exercise record? What other habits besides foodintake and physical activity may be especially useful for CJ torecord?

6. Why might strength training be animportant addition to CJ’s exercise regimen?