XS3600 Nutritional Biochemistry 2022
Assessment 1: Case Study (60% of module mark)
Submission Date: On or before 11th March 2022
The first assessment involves writing a report of 2000 ± 10% words based on a case study.
All material should be relevant to the case study. You should explain the biochemistry and pathophysiology that underpins the condition identified and the rationale for the dietary changes you recommend. You must not simply describe facts without explaining how they relate to the case study and your recommendations should be person centred (not general). Ensure you justify your recommendations with a current evidence base. Evidence of understanding is important so be mindful to explain in your own words. Excessive reliance on direct quotes from source texts/journal articles, the use of undefined jargon and inappropriate word-choices suggest a lack of understanding. Take time to proof-read before submission. Paragraph structure, sentence structure and spelling are important. Presentation is important so format your report before submission (e.g. justify your paragraphs).
References: These should be clear and consistently accurate using a recognized system of citation in the text and of listing in the references section.
Krishna, a 45-year-old man from Burnley, presents for a routine physical examination for his new job. He states that he generally feels “pretty good” and has no recent history of illness or injury. Krishna is a married, newly employed salesperson with two children (10 and 12 years). He states that he has experienced good health except for a “few aches and pains every now and then.” His last physical examination was over 10 years ago for a job-related injury to his knee. Krishna has no allergies, takes no prescription medications, and can perform all activities of daily living. Nutritional Assessment Domain Measure/Notes Anthropometry, body composition and functional Weight: 107.7 kg Height: 173 cm) Waist circumference: 112 cm
Fasting blood glucose: 6.0 mmol/L
Fasting Lipid profile:
Total Cholesterol: 5.8 mmol/L
HDL-Cholesterol: 1.0 mmol/L
LDL-Cholesterol: 4.4 mmol/L
Triglycerides: 2.26 mmol/L
Clinical No Significant Past Medical History Blood Pressure: 145/90 mm Hg Alcohol: Beer 8 pints over a weekend, occasional glass of red wine Family History: Father and Mother are immigrants from Kerala, India who moved to England before Krishna was born. His father died from heart attack at 65 years and his mother has stage 2 hypertension and is taking Candesartan.
Krishna reports he has an unhealthy diet that he attributes to frequent travels associated with his job. He also reports a dislike for vegetables and an over-reliance on lunches and snacks purchased from Motorway service stations.
Breakfast: Black Tea + 2 tsp sugar, Marmalade on toast (2 thick slides white bread)
Mid-Morning: Black Tea + 2 tsp sugar and 2 rich tea biscuits.
Lunch: Service station chicken & mayonnaise sandwich (180 g), apple (112 g), ready salted crisps (40g), bottle of water
Afternoon: Black Tea + 2 tsp sugar and blueberry muffin (80 g).
2 medium chapattis (2 x 60 g), lamb curry (300 g), vanilla ice cream (120 g) Environmental Krishna does not do any exercise other than weekend playing in the garden with his kids for 2-3 hrs. Krishna does not smoke, and Krishna’s wife cooks the evening meals. Krishna has no financial worries but is now finding the travel associated with his job stressful.
With respect to the case study, answer the following questions:
a. What condition does Krishna present with and explain your reason for this diagnosis?
(10% of marks)
b. Identify the risk factors from the nutritional assessment and explain the pathophysiological mechanisms that increase Krishna’s risk of disease.
(25% of marks)
c. Provide a diet and lifestyle intervention plan for Krishna and clearly explain the aims of the intervention.
(30% of marks)
d. What barriers do you think Krishna may have to making dietary changes?
(10% of marks)
e. How would you ensure Krishna is engaged with the intervention and what outcome measures would you suggest for monitoring Krishna’s goals?
(15% of marks)
f. Krishna asks about dietary supplements such as fish oil, garlic oil and vitamin D and whether these would be beneficial considering his family history. How would you advise him?
(5% of marks)
g. Explain why Krishna should be referred to his doctor for further tests.
(5% of marks)