A Case Study of Diabetes, Hypertension, and the Kosher Diet Mr. Goren is a 54 ye

Question

A Case Study of Diabetes, Hypertension, and the Kosher Diet Mr. Goren is a 54 year old man who was diagnosed with type 2 diabetes 6 months ago. He also has hypertension. He is currently taking Glucophage to help control his diabetes, and Lopressor for his blood pressure. At his checkup, he reports that his blood sugars have been inconsistent (both high and low) and he is having a hard time getting them under control. His blood pressure is also slightly high at the visit. He is 5'7" and weighs 175 pounds. He gets a moderate amount of physical activity by walking for 20 minutes three days a week. The nurse asks him what he ate yesterday. The client states that he is Jewish and follows some basic Kosher diet guidelines, and he is currently celebrating Hannukah with his family. He provides the following 24 hour recall: Breakfast (8:00am) Lunch Snacks Dinner (6:30pm) (1 6 ounces Roasted Chicken 8 ounces grilled Tilapia 1 cup light yogurt 1 cup chopped tomato 1 cup chopped cucumber 1 cup 4% fat cottage cheese 3 potato pancakes (cooked in oil) Breast (10:30am) 2 Pita Bread (white) % cup hummus 1 oz. roasted peanuts 1 large bagel 1 cup herbal tea % cup sliced carrots % cup steamed broccoli (4:00pm) 1 small apple 1 cup 1% milk cup chopped onions cup chopped red pepper | % jelly doughnut 4 ounces apple juice Breakdown of Macronutrient Ranges for this Diet: % of Calories 45% 28% 28% Macronutrient Carbohydrate Protein Fat Other Results: Actual Intake 2957 Recommended 2702 (to maintain current weight) Less than 27 grams Less than 200 mg. 25-40 grams (no official recommendations) Nutrient Calories Saturated Fat Cholesterol Dietary Fiber Sugar Sodium 22 grams 351 mg. 28 grams 115 grams 3,664 mg Less than 1,500 mg

Explanation / Answer

1. No, the macronutrients are not within the normal range for diabetes. The adults with diabetes, should have the macronutrient distribution as a percentage of total energy range from 45-60% carbohydrate, 20-35% fat and 15-20% protein. So protein content should be reduced a little and unsaturated fats should be added in the diet.

2. Patient’s actual intake of calories is more than the recommended intake. The actual intake of sodium and saturated fatty acid is also greater than the required quantity. That’s why he is having trouble controlling his blood glucose. There is excess of carbohydrates in his diet. Having lean diet is recommended.

3. At the age of 54, he has a BMI of 27.41 kg/m2 which falls in the overweight category. His moderate exercising factor and obesity is a concern.

4. The recommended sodium intake is 2,300 mg per day. As his blood pressure is already high, he should be recommended to lower the intake to maximum 1,600 mg per day.

5. The patient should Lower the carbohydrate intake, lower the protein intake, lower the saturated fatty acid and add more unsaturated fatty acids for controlling his diabetes and lesser sodium intake for lowering hypertension.

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