Smith 61 year old female here for evaluation and treatment for essential hypertension, possible hyperlipidemia, and a diabetes screening.  After seeing the physician, she is sent to talk with you, the nutritionist

Medical History:  

1.Ms. Smith reports that her father died of a myocardial infarction at 63 years of age; her mother is alive and generally well, with treated hypertension. 

2.Medications:  Advil as needed for mild back pain, Prilosec daily for prevention of heartburn.

3.She appears to be anxious about her health.  

Complete the following sections of the nutrition case study by answering the questions below.  Focus on the nutritional aspects of Ms. Smith’s health.  Though she may have medical concerns, limit your recommendations here to diet and lifestyle.  

Nutrition Assessment:  

1.According to these lab values, does Ms. Smith have diabetes?  What type?  Explain. 

2.Assess Ms. Smith’s risk for cardiovascular disease (CVD), based on the available information.  

3.Assess Ms. Smith’s 24-hour dietary recall for its impact on her blood glucose levels and her risk for CVD.  (I recommend using nutrient analysis software to analyze her dietary intake.  We have Nutritionist Pro professional software in the department office, but a reasonable quick substitute is Cronometer.com  Be sure to enter the profile information [height, weight, age, gender] for Ms. Smith.) 

4.What other information would you like to know from Ms. Smith before making any dietary recommendations?  Nutrition Diagnosis:  

5.Use your observations from the nutrition assessment step to identify at least two nutritional/lifestyle problems that exist in Ms. Smith’s record and are likely contributing to her diabetes and/or CVD risk.  How do you know they are a problem?  Can you identify the underlying cause of the problem?  

6.Briefly explain the physiological connection between the problems identified in #5 and the disease outcome/risk. 

Nutrition Intervention:

7.Prioritize your nutrition diagnoses from #5.  For the most important dietary problem you’ve identified, describe the changes you would most like to see Ms. Smith make to her diet. 

8.Write a dietary SMART goal for Ms. Smith to aspire to for the next two weeks.  (You can write two if you think they are achievable, but no more than that.)  SMART goals are Specific, Measurable, Attainable, Relevant, and Time-bound.  How will you explain this goal to Ms. Smith?