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Anita Davila Dietary Analysis Form Food Food Group Exchange Amount Calories Carbohydrat e (g) Protein (g) Fat (g) 1 waffle Starch/ bread 1 80 15 2 0 1 Tbsp Peanut butter High-fat Meat substitute/plant based protein Milk/ fat-free 1 100 0 7 8 1 100 13 8 0 Free foods/ beverages Fats/saturated 1 0 0 0 0 1 45 0 0 5 Other carbohydrates Fast food combination of/ starch- bread, medium-fat meat substitute, fat Free foods/ beverages Starch/ bread 1 100 15 1 1 2 1/2 carbs + 2 medfat meat + 1 1/2 fats 200 + 150 + 67.5 = 417.5 37.5 14 7.5 1 0 0 0 0 1/2 40 7.5 1 0 4 300 0 28 20 1 100 0 7 8 1 0 0 0 0 8 oz Skim milk Medium-fat Meat High-fat Meat substitute Free foods/ condiments Milk/ fat-free 1 100 12 8 0 I cup full-fat chocolate ice cream Sweets, Desserts 2 carbs + 4 fats 100 + 190 =320 30 4 21 1702.5 130 80 70.5 8 oz Skim milk Coffee with Splenda 2 Tbsp Cream on coffee One Weight Watchers snack bar 1 oz 1 medium slice cheese pizza Unsweetened Tea 1 hamburger bun 1 beef patty 4 oz 1 slice American cheese Ketchup and mustard Totals Anita Davila Critique of patient's diet compared with 2010 Dietary Guidelines for Americans The 2010 Dietary Guidelines for Americans are recommendations aimed at promoting health and lowering risk of diet-related chronic disease. Some of these recommendations include: balancing calories to manage weight; increasing vegetable, fruit and whole grains in the diet; consuming low-fat or non-fat dairy; reducing consumption of high-sodium, high-fat foods, and added sugars; increasing consumption of foods containing certain vitamins and minerals such as potassium, calcium, and vitamin D; and building healthy eating patterns. I think the patient's diet does take into account some of the recommendations from the Dietary Guidelines. For example she does drink skim milk instead of the full-fat version. She does eat a regular intervals without skipping meals. She doesn't consume sugary drinks like soda. However her diet falls short on some aspects, most notably the fact that she consumes virtually no vegetables or fruit. She did mentioned to me that she tries to eat a salad here and there but I believe even consuming a salad a few days of the week it still does not meet the recommended servings of vegetable and fruit intake. Another problem is that her evening or after-dinner snacks tend to be full-fat ice cream. This sends her calories and grams of fat consumed through the roof. When we analyze the proportions of her macronutrient consumption we can see that the total calories coming from fat are higher than those coming from carbohydrates. This means that her consumption of fat falls well outside the Macronutrients Distribution Ranges. The areas that need most improvement then are her very low intake of fresh fruits and vegetables, as well as whole grains; and her high consumption of fat. The recommendations I would make to her is to include a piece of fruit at breakfast or for a snack. Also for snacking she could skip the snack bar and eat veggies, examples are celery sticks with peanut butter or ranch, Anita Davila carrot sticks or broccoli crowns with dip. I would suggest eating breads, waffles and bagels that are 100 % whole wheat. I would encourage her to keep staying away from sodas and sugar laden drinks, but I would suggest that she cuts her portion of ice cream by half and she switches to a lower fat version. I think overall her diet will be good if she makes the suggested changes. On top of this she should persevere to incorporate some physical activity in her daily routine to help her balance her calories in and calories out. Sources U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010. Date accessed 19 September 2013 <http://www.cnpp.usda.gov/DGAs2010PolicyDocument.htm>