Download NUTRITION MEALPLAN CASE STUDY

NUTRITION MEALPLAN CASE STUDY
BRIAN DANLEY
NUTR 123
22 OCT 2007
1. Estimated Calories for each food utilizing USDA Food Search Tool 2.0 computer
program (see attached data tables) for the food quantities indicated in Karen’s menu
are the following:
Cheerios:
166 kcal
Non-fat milk:
83 kcal
Whole wheat bread: 69 kcal
Canned Tuna:
33 kcal
Banana:
105 kcal
Peanut butter:
188 kcal
White cooked rice:
204 kcal
Cooked pinto beans: 199 kcal
Iceberg lettuce:
8 kcal
Plain bottled water:
0 kcal
Orange juice:
112 kcal
Total Calories =
1167 kcal
2. Karen is certainly not consuming enough Calories and nutrients to facilitate her
metabolic and activity needs. According to the Estimated Energy Requirement (EER)
equation accompanying the Dietary Reference Intakes (DRIs) table published in 2002
by the Food and Nutrition Board, Institute of Medicine (IOM), her energy need is
about 2800 kcals (see page 7 entitled, “Determining Caloric Input” for female caloric
intake). The factors of bodyweight, height, age, and physical activity factor (PA =
1.27 denotes very active level of at least 20 minutes of physical activity at least 3 to 5
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days per week at 75 to 85% HRR) were incorporated into the equation. Based on the
EER, Karen’s caloric intake, adjusted for age, should be about 2900 kcals as
calculated using the following equation:
EER + 10 * (30 – age).
3. Relative to a recommended macronutrient ratio of 60/15/25 of carb/protein/fat to
provide bodyweight maintenance, Karen’s current carb intake is too elevated at 68%
of Calories (see page 8 for current meal plan). The recommended macronutrient
ratio would allow 5.5 and 1.2g of carb and protein, respectively, per kg bodyweight—
an amount sufficient for an active adolescent female. It is recommended that caloric
intake be increased about 1700 kcals to obtain the needed 2900 kcals (see page 9 for
recommended off-season meal plan). Along with increasing her caloric intake and
adjusting her macronutrient ratio, care must also be taken to provide variety, balance
and moderation to facilitate a more healthy diet. Bearing this in mind, the following
food group recommendations should be instituted:

Increase whole grains in the diet by adding at least 3oz daily of wholewheat bagel.

Increase vegetables by adding 0.5 cup of peas and 1 cup of carrots.

Increase dairy consumption by adding 1 cup yogurt and 1/2 cup cottage
cheese.

Take a multivitamin containing 100% of the daily values of vitamins and
minerals. Notable nutrient deficiencies include vitamins E and K and the
minerals calcium and magnesium.
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
Increase daily fluid intake, based on the calculation of 0.5 oz fluid per 1-lb
bodyweight, by an additional 5 cups of fluid.
It will be noted that Karen’s sodium intake will double with this recommended menu
although her active lifestyle (daily tennis practice sessions) will permit the usage of
this electrolytic mineral.
4.
When in season, Karen should consume meals before, during, and immediately
after tennis matches in order to maintain a steady blood glucose level, thus preventing
undue fatigue throughout the day (see page 10 for in-season meal plan). Breakfast
should be consumed at least two to three hours prior to the first match. The meal
should consist of moderate-glycemic index (GI) foods in order to ensure adequate
liver/muscle glucose uptake and glycogen storage. Total carbohydrate amount
should be within the range of three to five grams per kg bodyweight. Carb amount
indicated for Karen is 3.2g/kg bodyweight. Oatmeal, yogurt, and a granola bar are
good examples of moderate-GI foods.
The exercise meal (1st match), which consists of high-GI foods to ensure quick
uptake of glucose within the liver/muscles and throughout the bloodstream, should be
a total carb amount within the range of one to three grams per kg bodyweight. Carb
amount indicated for Karen is 1.5g/kg bodyweight. Gatorade (~6% carb
concentration) and raisins are ideal for easy digestibility and absorption.
The pre-exercise meal (1-hour prior to the second match) should also consist of
high-GI foods in order to replenish glucose energy and enhance recovery. Total carb
amount should be within the range of one to four grams per kg bodyweight. Carb
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amount indicated in Karen’s menu is 1.9g/kg bodyweight. Raisin bagel, rice cakes,
dried fruit mix, and a banana are good examples of high-GI foods.
The next exercise meal (2nd match) is simply a repeat of the first competition
meal. The next pre-exercise meal (1-hour prior to the third match) should be
consistent with the first pre-exercise meal and also contains high-GI foods for quick
recovery. Carb amount indicated in Karen’s menu is 1.2g/kg bodyweight. White
bread, carrots and white rice are wise choices to facilitate energy recovery.
Another exercise meal (3rd match) simply repeats the previous competition meal.
Next, the post-exercise meal (within 1-hour after the final match) consists of high-GI
foods to once again replenish energy stores. Total carb amount should be
approximate the range of one to two grams per kg bodyweight. Carb amount in
Karen’s menu is 0.9g/kg bodyweight.
Finally, the dinner meal is eaten several hours post-exercise and consists of
moderate-GI foods for slower and more prolonged absorption of glucose and
nutrients. Notice this meal is no different from Karen’s off-season dinner meal.
Tennis matches are high-intensity exercise bouts (~8 METS) and require a large
amount of Calories (~640 kcal/hr) to provide this needed energy. Thus, the totality of
three hours of competition may require about an additional 1900 kcals of energy.
Therefore, the total of 4800 kcals (2900 kcal + 1900 kcal) is reasonable in the case of
Karen’s caloric intake during competition days.
Upon observation of the competition day menu plan the following is noted:
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
Increased need for carbohydrates before, during and after
competition requires a macronutrient ratio of 80/10/10 of
carb/protein/fat.

Sodium intake is consistent with off-competition season and is
virtually unchanged.

Fluid consumption is slightly increased from 10 to 12.5 cups daily.
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