Month: February 2019
Effects of Malnutrition
1. Outline the metabolic changes that occur during starvation/inadequate nutritional intake (not related to disease) that could result in weight loss.
During starvation, carbohydrates are depleted after 24 hours, major substrates for gluconeogenesis are amino acids that come from skeletal muscle protein that breakdown, ketone body concentrations rise during prolonged starvation and result in significant excretion of ketones, and the metabolism allows consistent fuel supply to the brain and other tissues during prolonged starvation.
2. Read the consensus statement of the Academy of Nutrition and Dietetics/American Society of Parenteral and Enteral Nutrition: Characteristics recommended for the identification and documentation of adult malnutrition.
Explain the differences between malnutrition associated with chronic disease and malnutrition associated with acute illness and inflammation.
Malnutrition related to chronic disease is when inflammation is mild to moderate but constant (chronic). An example is rheumatoid arthritis. Malnutrition related to acute illness and inflammation is when the inflammation is acute and at a severe degree. An example is major trauma.
3. Find the current definitions of malnutrition in the United States using the current ICD 10 codes. List all of them and describe the criteria for one of the diagnoses.
Malnutrition includes codes E40-E46 going into a category of type 1 or type 2.
E40 Kwashiorkor
E41 Nutritional marasmus
E42 Marasmic kwashiorkor
E43 Unspecified severe protein-calorie malnutrition
E44 Protein-calorie malnutrition of moderate and mild degree
E45 Retarded development following protein-calorie malnutrition
E46 Unspecified protein-calorie malnutrition
Type 1 excludes: intestinal malabsorption ICD-10-CM Diagnosis Code K90
sequelae of protein-calorie malnutrition ICD-10-CM Diagnosis Code E64.0
Type 2 excludes: nutritional anemia ICD-10-CM Range D50-D53
Starvation ICD-10-CM Diagnosis Code T73.0
4. Current ICD definitions of malnutrition use biochemical markers as a component of the diagnostic criteria. Consider the effect inflammation has on visceral proteins and how that may impact the clinician’s ability to diagnose malnutrition. Discuss the following clinical findings and relate to inflammation and ability to diagnose malnutrition.
a) Why is there down-regulation of albumin synthesis? Relate to positive acute-phase protein for the immune system (antibodies, complement, cytokines, C-reactive protein), clotting (fibrinogen) and wound healing.
Malnutrition or long term starvation can reduce a full positive acute phase protein reaction while reducing the negative part as well by the starvation process itself. This starts the depression of hepatic protein synthesis. Which this moves on to affecting pro-inflammatory cytokines in the brain and the rest of the inflammation process. Albumin is characterized as a negative acute phase protein and is affected by inflammatory conditions and drugs which affects liver function. But there are so many disease processes that alter the level of albumin that it becomes an unreliable serum marker for malnutrition.
b) Why is the production of cytokines such as IL-I, IL-6, and tumor necrosis factor (TNF) increased and what is the impact on metabolism and protein synthesis (albumin, prealbumin, transferrin, retinol-binding protein) and muscle repair?
Because pro inflammatory cytokines are released, the vascular system and inflammatory cells are activated. These responses are associated with an increase of production of cytokines. Cytokines IL-I, Il-6 and TNF modulate intermediary metabolism of carbohydrates, fats, and protein, regulate hypothalamic and pituitary outflow and act in the brain to reduce intake of food.
c) What is impact of edema and the ability to interpret some biochemical tests?
Edema is when fluids build up incorrectly in your tissues which will cause abnormal swelling of your body parts. Protein is a common cause of malnutrition edema because if you have the right amount of albumin in your blood, your body can maintain a balance keeping water out. But without enough protein your cells retain water which then leads to edema. So it can be hard to interpret different tests because of the different things that can happen in your body that leads to that fluid retention which can cause more problems.
d) What happens to resting energy expenditure?
I believe that a person’s resting energy expenditure would decrease because if they are not eating enough because malnourished then their body naturally would not have enough to keep burning so it would slow down because it doesn’t have enough nutrients to stay functional like before if getting proper nourishment.
e) If metabolic stress is prolonged, do you feel albumin/prealbumin measurements are an accurate diagnosis of malnutrition when inflammation is present? Why or why not?
I believe it is not because of what has been said about albumin. I read that it is affected by inflammatory conditions and drugs that affects the liver. Also by many disease processes that tend to alter the level of albumin regularly that it becomes an unreliable serum marker for testing for malnutrition.
5. Mr. Campbell was ordered a mechanical soft diet when he was admitted to the hospital. Describe how his meals will be modified with this diet order.
This type of diet is for people who have trouble chewing and swallowing. This will include foods being chopped, ground, and pureed with no need for a knife because they will easily break apart. This diet will allow Mr. Campbell to eat more and obtain the nutrients he needs to help heal his body. The mechanical soft diet includes dairy, vegetables, fruits, starches, meat or meat substitutes, fats, soups, desserts, and beverages. But with all these categories that he can eat they will have to be soft, pureed, whipped and cooked so that he can eat it more easily.
6. What is the Ensure Complete supplement that was ordered? Determine additional options for Mr. Campbell that would be appropriate for a high-calorie, high-protein beverage supplement.
Ensure Complete is a balanced nutrition supplement to help gain or maintain a healthy weight. It is an all in one blend that offers 6 grams fat, 33 grams of carbohydrates and 9 grams of protein. It also included 26 essential vitamins and minerals including antioxidants.
An additional option is carnation breakfast essentials. In 9fl ounces it has 1 gram of fat, 39 grams of carbohydrates and 13 grams of protein.
7. Assess Mr. Campbell’s height and weight. Calculate his BMI and % usual body weight.
Mr. Campbell is 6’3” and 156 pounds.
156lbs/2.2kg=70.9 kg
75inches x .0254m=1.9m
70.9/1.9^2 =19.6 which indicates normal weight with that BMI
Percent usual body weight
156lbs/220lbs x 100= 70.9%
8. After reading the physician’s history and physical, identify any signs or symptoms that support the diagnosis of malnutrition using the proposed definitions of malnutrition by AND/ASPEN malnutrition guidelines.
What characterizes adult malnutrition is inadequate energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, fluid accumulation and evidence of inadequate intake. Looking at Mr. Campbell’s history it says that he has lost weight, is dehydrated, and feels weak. In his physical he says he feels like he cannot do anything and weak all over. He appears to look cachectic which makes him look older than his actual age. His neurological strength is reduced, he has declined muscle tone and his blood work is low which is relates to malnutrition.
9. Evaluate Mr. Campbell’s initial nursing assessment. What important factors noted in his nutrition assessment may support the diagnosis of malnutrition? Mr. Campbell lost over 60 pounds 1-2 years ago. He is at 70.9% of his usual body weight. He is at less than 5% for intake percent of meals with sips of liquids. His recommended fluid requirement is 2000-2500 mL, but he is consuming 360 mL without an IV. Mr. Campbell’s intake has been unsatisfactory to meet the required nutritional needs.
10. What is a Braden score? Assess Mr. Campbell’s score. How does this relate to his nutritional status?
The Braden score is a tool used to help predict a patients level of risk for developing a pressure ulcer. It assess a patient by measuring six different criteria’s:
Sensory perception: this measures a patient’s capability to distinguish discomfort that is related to pressure on different parts of the body. This shows a patients ability to be able to react to pressure related discomfort.
Moisture: constant skin moisture can pose risk to the integrity of a person’s skin by causing damage and being at risk for epidermal erosion.
Activity: this looks at level of physical activity because little activity causes breakdown of muscles and tissue.
Mobility: this assess the physical competency to move and the willingness to move.
Nutrition: this looks at pattern of daily nutrition and if having an imbalance of nutrition which would indicate a high risk in this category.
Friction and Shear: this measures the amount of assistance a person needs to move and the degree of sliding on beds or chairs that they might experience. This looks at the sliding motion that can cause shear which is the skin and bone moving in opposite directions causing breakdown of cell membranes.
Most of the categories have a rate of 1-4 except friction and shear which is a rate of 1-3.
Mr. Campbell’s Braden score is a 17 which means he is at a low risk for developing a pressure ulcer. Getting a Braden score can tell us if that a patients food intake is very poor to excellent.
11. Identify any signs (including laboratory values) or symptoms from the physician’s history and physical and from the nursing assessment that are consistent with dehydration.
Mr. Campbell is very weak. His skin turgor test showed that it is tenting. He is only meeting 360 ml of 2000-2500 mL of his fluid requirements. His skin condition is ecchymosis, dryness and tears. This all relates to being dehydrated. It shows his sodium levels are high which leads to an increase of fluid loss. He does have high blood urea nitrogen levels which forms when protein break down and higher levels can indicate dehydration.
12. Determine Mr. Campbell’s energy and protein requirements. For the critically ill, mechanically ventilated patient, you might consider the Penn State equation (Steps of calculation using Penn State Equation). However, Mr. Campbell is not mechanically ventilated. This is an important factor to consider.
Explain the rationale for the method you use to calculate these requirements.
The usual recommendation for protein is 1.0 to 1.5 g protein/kg/day but for a person who is very ill it should be estimated at 2 grams protein per kg a day with ideal body weight and energy needs. With Mr. Campbell being malnourished I would calculate protein requirement with 1.5 and 2.0.
1.5grams x 70.9 kg (his body weight)= 106.4 grams
2.0grams x 70.9kg= 141.8 grams
So his protein intake should range from 106.4 to 141.8 based on how his body responds to the intake level.
13. Determine Mr. Campbell’s fluid requirements. Compare this with the information on the intake/output report.
He should be receiving around 2000 mL at least of fluids. He is orally in taking 360mL with an IV that gives him 2,160mL and his output is 1,444 with his net I/O being a +1,076.
14. From the nutrition history, assess Mr. Campbell’s usual dietary intake.
a) Use the USDA Super Tracker to estimate intake.
I searched USDA Super Tracker and every link told me that it was discontinued.
b) How does his estimated intake compare to the requirements that you calculated for him?
Egg 70calories 6gprotein
Coffee 5 calories
Toast ½ slice 52 calories 2.5g protein
Ensure complete 220 calories 9g protein
Soup ½ cup 59 calories .9protein
Milk ½ cup 62 calories 4g protein
Ground turkey 3oz 94 calories 15g protein
Potatoes mashed 59 calories 1g protein
Total calories: 621 calories with total 38grams of protein
He is nowhere close to meeting requirements for either. He is very low on calories he should be having a day. And very low on protein as well.
c) Can your evaluation of his dietary intake contribute to the evidence for diagnosing malnutrition?
It can be seen that Mr. Campbell’s intake is very little and not receiving much nourishment from what he is eating. Evaluating his intake can help diagnose malnutrition along with all the other assessments that are done to determine malnourishment.
15. Identify the pertinent nutrition problems and the corresponding nutrition diagnoses and write at least two PES statements with one focused on the clinical domain.
Malnutrition related to tongue squamous cell carcinoma as evidenced by unintended weight loss of 29.1% of usual body weight in the past 2 years, reduced energy intake with lack of appetite and decreased muscle tone of patient.
Insufficient energy intake related to patient’s inability to ingest adequate energy as evidenced by patient’s declined appetite and failure to consume required needs from diet.
16. Determine the appropriate intervention for each nutrition diagnosis.
Being seen that Mr. Campbell cannot meet his nutritional needs orally an enteral nutrition route needs to be started within 48 hours following his admission. The objective will be to accomplish and maintain a healthy body mass and body fat. Enteral nutrition will help promote a heathy weight gain and give him nourishment. His input and output will be monitored along with his GI tolerance to make sure it is all functioning well. His calories, protein, carbohydrates and fats will be upped to a level that will give him his energy needs. He will consume in small quantities and be on a mechanical soft diet so it is easier to intake orally. It will be recommended to intake lots of fluids and consume a nutritious beverage supplement.
17. Identify the steps you would take to monitor Mr. Campbell’s nutritional status while he is hospitalized.
I would monitor his weight, albumin levels, oral intake, enteral caloric intake and when oral intake is increased. Main focus would be looking for a healthy weight gain and that he is receiving nutritional needs to put on that weight and reestablish his muscle.
Cite this page
Effects of Malnutrition. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
Iron and its Importance to Nutrition and Health
It may be taken for granted the impact that the food we eat has to our overall health. The body absorbs nutrients, such as vitamins and minerals, from the food that is consumed and uses it in several functions. These vitamins and minerals play many vital roles in reactions and metabolic pathways. Dietary iron is a mineral that is essential to several functions of the body and deficiency will result in negative effects.
Iron is an element with the symbol Fe on the periodic table. Its atomic number is 26 and its atomic mass is 55.845 g/mol (8). Synonyms of iron include: ferrum, ferrous ion, ferryl ion, and ferric ion (1,8). Iron plays an important role in the human body “existing in complex forms bound to protein (hemoprotein), as heme compounds (hemoglobin or myoglobin), heme enzymes, or nonheme compounds (flavin-iron enzymes, transferrin, and ferritin)” (1). The importance of iron in the body stems from its ability to interconvert readily between two relatively stable oxidation states (Fe2+or ferrous iron and Fe3+or ferric iron). This ability makes iron a useful component of oxygen-binding molecules in hemoglobin and myoglobin, cytochrome and diverse enzymatic reactions including DNA synthesis, lipid metabolism and free radical scavenging.
Iron plays a role in several metabolic pathways. “By exploiting the oxidation state, redox potential and electron spin state of iron, it is particularly suited to participate in a large number of useful biochemical reactions” (12). Iron is a cofactor; a non-protein essential molecule to enzymatic function. A specific enzyme that utilizes iron as a cofactor is tryptophan hydroxylase. This enzyme catalyzes the reaction of tryptophan hydroxylation to produce 5-hydroxytryptophan, which is the first step of the production of serotonin; a neurotransmitter that plays a role in regulating mood (12). Iron’s role in the reaction of tryptophan hydroxylation, “can be described in two parts: 1) reaction of the tetrahydropterin, oxygen, and the active site iron to form the reactive hydroxylating intermediate and 2) insertion of oxygen into the amino acid substrate” (12). The specific mechanism at the iron activation site involves the interaction of 4a-peroxypterin either as the formation of a Fe II-peroxypterin intermediate or the direct transfer of an oxygen atom (12). The result of hydroxylation of tryptophan is the addition of a hydroxyl group to the amino acid. Just as iron is a useful cofactor to tryptophan hydroxylase, it is a cofactor to several other enzymes as well such as: tyrosine hydroxylase, tryptophan hydroxylase, xanthine oxidase and ribonucleoside reductase (12). Without iron, these enzymes would not function properly and the reactions that they catalyze would be affected. Therefore, the body needs iron for the catalysis of metabolic reactions.
For the body to utilize iron, it must be consumed, absorbed and metabolized. Once iron is consumed, it is absorbed in the small intestine, specifically the duodenum and upper jejunum. Absorption occurs by the enterocytes, intestinal absorptive cells, via transport proteins such as divalent metal transporter 1 and heme carrier protein 1 (1). The enterocytes are responsible for reducing insoluble ferric (Fe3+) ions to absorbable ferrous (Fe2+) ions. For nonheme iron, the ionic forms (Fe2+ and Fe3+), the absorption depends on the pH at the absorption site (1). In contrast, absorption of heme iron does not depend on pH and is “metabolized in the enterocytes by heme oxygenase”. Heme iron is absorbed more easily and thus the larger source of dietary iron than non-heme (10).
Dietary iron occurs in two forms: heme and nonheme. Heme iron is only found in the flesh of animals such as meats, poultry, and fish. Heme iron accounts for about 10% of the average daily iron intake but it is so well absorbed that it contributes a significant amount of iron to the body (17). Heme iron is highly bioavailable and is not influenced by the dietary factors. Nonheme iron is found in both plant-derived and animal derived foods such as nuts, beans, vegetables and fortified grain products (16). Nonheme iron is present as either the reduced ferrous (Fe2+) form or the oxidized ferric (Fe3+) form. However, its formation of insoluble ferric complexes reduces bioavailability in the intestine. Besides, there are several dietary factors affecting nonheme iron absorption.
The MFP factor and vitamin C (ascorbic acid) enhance nonheme absorption when foods are eaten at the same meal. Some acids (citric and lactic) and sugar (fructose) will have the same effect on nonheme iron. However, some factors such as the phytates in legumes, whole grains, nuts, seeds, vegetable proteins (soybeans), calcium in milk, the polyphenols (tannic acid in tea, coffee, grain products, oregano, and red wine) have an inhibiting effect on nonheme absorption (16). The balance of iron metabolism is critical because the body lacks a mechanism for iron excretion, thus absorption is the main regulation of iron (1). Absorption of iron increases when the iron storage is empty or low. Iron absorption decreases when the iron storage is full. Once the iron is absorbed from the diet, the iron storage protein called ferritin captures iron from food and stores it in the mucosal cells in the intestine.
The absorption of intestinal iron is regulated in several ways. The first mechanism is called the dietary regulator in which the accumulation of intracellular iron reaches a threshold in which the absorptive enterocytes resist to acquire more iron (17). However, it may occur even in the presence of systemic iron deficiency. The second mechanism is termed as the stores regulator in which iron levels are sensed in response to the saturation of plasma transferrin with iron (17). The third mechanism is known as erythropoietic regulator in which iron responds to the requirements for erythropoiesis. It is achieved by sensing a soluble signal sent out by plasma from the bone marrow to the intestine (13). The protein that helps to regulate iron absorption from the small intestine and controls the release of iron from the liver, spleen and bone marrow is known as hepcidin. Hepcidin is produced in the liver. Production of hepcidin decreases in iron deficiency and increases in iron overloaded by inhibiting ferroportin I to uptake more iron (14).
When the body needs iron, ferritin releases iron from the enterocytes to the transferrin, an iron transport protein. It is achieved by transporting the internalized Fe2+ to the bloodstream through the basolateral membrane via another transporter named ferroportin. The Fe2++is re-oxidized to Fe3++during the transport. The transferrin carries the iron as an iron-transferrin complex and circulates in the plasma until it binds with specific transferrin receptors on erythroid cells in the bone marrow and other tissues. The iron-transferrin-transferrin receptor complex is internalized into the cell through endocytosis. The iron is released from the transferrin and transferrin returns back to plasma to pick up more iron (5). The bone marrow incorporates iron into hemoglobin of red blood cells where iron-containing hemoglobin is able to carry oxygen from lungs to tissues. Iron in hemoglobin can help the red blood cells to maintain their shape and functionality. However, lifespan of the red blood cells is about 4 months. After that, the liver and spleen will dismantle the old red blood cells and remove them from the blood. Iron will be re-attached to the transferrin which transports iron back to bone marrow for making new red blood cells (15). Iron is recycled and reused. The surplus of iron is stored in the protein ferritin, primarily in liver and other storage location is in the bone marrow and spleen.
Ferritin is constantly made and supplies iron to bone marrow and other tissues. When the supply of iron is excessively high, liver will convert some ferritin into hemosiderin. Hemosiderin is an iron storage complex which less readily releases iron (1). Storing excess iron in hemosiderin protects the body against the free iron that could attack cell lipids, DNA and proteins (1). However, if the body does not need iron and the iron is not absorbed, the iron will be excreted in feces.
In order to take in the adequate amount of iron and for these metabolic processes to occur, it is important to know how much should be consumed. The recommended daily intake for infants from birth to 6 months old is 0.27 milligram (mg). For infants between 7 to 12 months, the daily intake is 11 mg. Young children aged 1 to 3 years old needs about 7 mg while 4 to 8 years old need about 10 mg. Daily intake for preteen (9-13 years old) is 8 mg. However, females during puberty (14- 18 years old) require 15 mg and adult women (19 to 50 years) in their reproductive years need 18 milligrams a day due to blood loss during menstruation. Additional iron (27 mg) is needed during pregnancy to support the growth of the fetus, added blood volume and blood loss during delivery. However, women after menopause need only 8 mg per day. The recommended daily intake for male adolescent (14 to 18 years old) and adult men after 19 years old is 11 mg (16). Without meeting the nutritional requirements for iron, deficiency can occur and lead to negative effects.
Iron deficiency is the most common nutrient deficiency. It accounts for 30% of world population, mostly found in toddlers, adolescent girls and women of childbearing age (18). Iron deficiency is a state of having depleted iron stores, meaning that ron storage in ferritin and hemosiderin is progressively diminished and no longer meets the needs of normal iron turnover. It then leads to a shortage of iron supply to tissues which results in a decrease in transferrin saturation and an increase in transferrin receptors in the circulation and on the surface of the cells (18). When iron-deficiency results in a low hemoglobin concentration, iron deficiency anemia occurs (IDA). IDA is characterized by pale (hypochromic) and small (microcytic) red blood cells. Since IDA leads to a decrease in hemoglobin synthesis, the red blood cells are not able to carry enough oxygen from the lungs to tissues which causes the energy metabolism in the cells to decrease (3).
According to the World Health Organization (WHO), iron deficiency and iron deficiency anemia have a significant impact on cognitive performance, work capacity and productivity and pregnancy (18). WHO reported that iron deficiency anemia is related to delay in psychomotor development, impaired cognitive performance, lower IQ scores, weakness, tiredness, headaches, apathy, pallor, poor resistance to cold temperature, increased maternal mortality, prenatal and perinatal infant loss and prematurity, and increased morbidity from infectious diseases. It is reported that “leukocytes have a reduced capacity to kill ingested microorganism and lymphocytes a decreased ability to replicate when stimulated by mitogen” (18).
Another iron deficiency related disorder is known as pica. It is especially common among women and children in low-income groups (7). Pica is a craving for and consumption of nonfood substances such as clay, baby powder, chalk, ash, ceramics, paper, paint chips, or charcoal. In fact, those substances commonly craved and consumed inhibit iron absorption making pica associated with iron deficiency (7).
Iron supplementation is the most common way to treat iron deficiency and iron deficiency anemia. Usually oral iron therapy is the first choice because it is simple, inexpensive and relatively effective in treating iron deficiency. However, noncompliance is common. Long course treatment (3 to 4 weeks) and limited intestinal absorption makes the oral iron therapy less ideal. Treatment with intravenous (IV) iron therapy is an alternative to the oral iron therapy. The advantage of IV iron therapy is “faster higher increases of hemoglobin levels and body iron stores” (19). Intravenous ferric carboxymaltose is a stable complex, not predisposed to anaphylactic reactions and allows administration of large doses (15mg/kg maximum of 1000 mg/infusion) in a single shot. It also has a shorter therapeutic session (15 minutes infusion) that makes IV iron therapy more appealing (19). Taking supplements between meals, before bedtime, or on an empty stomach enhance iron absorption. However, constipation is a common side effect. Moreover, iron supplementation always works better with an iron-rich, absorption enhancing diet.
Iron is a critical mineral to the body with many functions including: supporting metabolism, cofactors to enzymes to aid in metabolic reaction, and aiding normal cellular growth and development. Careful iron balance and adequate iron intake are important to prevent iron deficiency and iron deficiency anemia. As is important with adequate nutritional intake of iron, it is also important to consume the recommended amounts of all vitamins and minerals. A well balanced diet can meet these nutritional requirements, which will aid in metabolic pathways needed for proper bodily function.
Cite this page
Iron and Its Importance to Nutrition and Health. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
Nutrition and Diabetes
Type two diabetes is a chronic disease caused by different lifestyle factors, with a focus on diet, and is the leading cause of morbidity and mortality in Australia (Ball, 2016). Many patients who are diagnosed with type two diabetes manage this by seeing a primary health care provider. Since diet plays such an important role in the progression of this disease it is vital that these patients maintain a healthy, balanced diet. The United Kingdom Prospective Diabetes Study has shown that establishing short-term optimal glycemic control in the early stages after diagnosis reduces the risk for both macrovascular and microvascular complications, as well as all-cause mortality 10 years after diagnosis (Murray et al 2010). After diagnosis patients receive nutritional care from their doctors or nutritionists. Ensuing these interventions patients typically modify their diets but, the changes were short-lived. In this article the reasons for the temporary modifications are analyzed. The method used for this study was a longitudinal, qualitative design with the goal of describing the perceptions and experiences of patients who were recently diagnosed with type two diabetes. All the chosen individuals were involved in three telephone interviews; one at baseline, 3 months, and 6 months. Each interview lasted between 30 and 60 minutes, were semi structured, and probative.
Research Article
There are a couple of problems that this research was focused on. The main concern was the lack of adherence to diet modifications after diagnosis of type two diabetes and nutritional guidance. The other issues involved open communication with health care providers and patient relationships which then lead to the decrease in ongoing engagements with healthcare providers. The purpose of this research was to explore patients’ perceptions of their diagnosis of type two diabetes mellitus, understand their experiences of dietary adjustments, and explore their views on how healthcare providers can support long term dietary changes. Because diet has such a big role in self-management of diabetes it is important for healthcare providers to understand the experiences of their patients. These three topics are important to address because it has a direct impact on the patients’ success in handling their chronic illness in the future. The nursing intervention that was the focus of this article was open communication and relationships with their patients.
The findings of this article were broken down into three categories; adjusting to diagnosis, modifying dietary behaviors, and receiving support from healthcare providers. In the adjusting to diagnosis category patients described feeling “shocked and surprised at being diagnosed with T2DM” (Ball 2015). After those feelings of shock went away they then had negative feelings toward diet because they considered themselves to have eaten a healthy diet. In the modifying dietary behaviors category, the experiences of the patients during diet changes were addressed. Some experienced emotional and food preparation challenges in the beginning, then progressed to having little issues keeping up with the diet modifications, which then halted because the participants felt restricted with their diets. The last category, receiving support from healthcare provider, seemed to have the most issues. Many participates expressed feeling overwhelmed by the information they received as well as having challenges within interactions with the dietitians because of the instructional nature of the care provided (Ball, 2015). In this situation the participants began to feel as though they were an item on the list of things to get done. They also felt as though there was no room for individualization for their dietary changes. The biggest issue for patients seemed to be that they felt rushed and not heard in consultations because open communication was not always achieved (Ball, 2015). The participants felt like they weren’t heard and therefore had limited engagements with healthcare providers in the future.
Reflection
Nursing care is composed of several different things such as building therapeutic relationships and open communication. While building a therapeutic relationship, it is important that we establish rapport and trust with our clients. I think that those are the building blocks which eventually lead to an increase compliance with all treatment modalities. Better adherence and compliance leads to better outcomes for the patient. Another important way to view building therapeutic relationships is that now there is a partnership and the patient doesn’t have to feel like they are alone when it comes to their healthcare. As Ball stated in the article, patients began to feel overwhelmed with the information they were receiving from different sources, so it is our responsibility to help them, but we can’t do that without first establishing a relationship. With patients, especially those who were recently diagnosed with a chronic condition, building a relationship is extremely important.
Cite this page
Nutrition and Diabetes. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
Nutrition and Dentition
Background
Foods are made up of different nutrients. These nutrients include but are not limited to vitamins, minerals, carbohydrates, protein, and fat. Each of these nutrients is necessary to maintain a healthy, functioning body.
Chewing is one of the first steps a person does to eat their food and get these nutrients. There are 32 teeth in the mouth, sixteen on the top and bottom. When talking about the state or condition of teeth, we are talking about dentition. When an individual has a lack of teeth, they are edentulous. These words are used throughout this article to describe teeth.
The Issue
Dentition in older adults can highly affect nutritional status 7, 11. The aim of this article is to review the nutritional status for older adults who have either decreased or complete lack of teeth. While oral health is important for all ages, it is especially important in the elderly population.
According the Center for Disease Control, 1 in 5 individuals aged 65 years or older have lost their teeth6. This leaves individuals at a greater risk for a number of health issues including malnutrition and increased risk of chronic diseases 1,7,9,11. Malnutrition is defined in multiple ways, however, it is generally known as a “lack of nutrition” due to a decreased food intake 10. Food intake is important because it contains nutrients that are essential for body function.
There are modified texture diets such as mechanical soft, pureed, and chopped meat, which change the consistency of food and make it easier to chew. However, those without teeth have a lower intake of fruits and vegetables, due to the tough texture of these foods 1, 3. These foods have a greater amount of nutrients that are necessary to a healthy diet.
Dentures or artificial teeth can be an option for edentulous individuals. There are partial and full dentures, however, those can be painful, expensive, and fit poorly. This issue is not just prevalent in the United States but worldwide.
The Evidence
Research has shown that poor dentition can play a important role in food intake and quality 1, 5, 7,9,11. Finding that smokers and individuals with a lower level of education have a greater risk of periodontal disease, a disease of the gums and mouth11. They were also less likely to consume adequate servings of fruits and vegetables, leading to decreased overall food intake 11. Lower food intake over a period can lead to loss of lean body mass and malnutrition4. This can lead to a disease known as sarcopenia, which is a loss of lean tissue mass with that comes with age 4. Edentulous individuals that consume decreased amounts of fruits and vegetables are at a higher risk for Type 2 Diabetes and heart disease 1, 7,9,11. These are lifelong diseases that can affect the heart and the body’s ability to process sugar 2. This begs the question, what can be done preventatively to improve oral health?
Evidence has also shown that poor dentition can be related to poor nutrition through anxiety and fear 1. Imagine going to lunch with friends, and not knowing if a restaurant will have food you will be able to eat, so you don’t eat lunch. These are the concerns that can lead to malnutrition and put older individuals at risk for hospitalization related to chronic diseases.
Recently, a study published in 2014 found that, those with less than 21 teeth, which was defined as ‘poor dentition’, was linked to decreased protein, micronutrient, and dietary fiber intake 1, 11. Educating the older population on appropriate oral health care as well as options to main appropriate nutritional status may be key to decreasing hospitalizations and preventing malnutrition.
Summary
There is clear evidence of an increased risk of type 2 diabetes and heart disease when dentition is poor in the elderly population 1, 7,9,11. This can be related to multiple factors, which include living situation and the type of job they have as well as overall health status, and poor oral health habits. Some of these factors listed above are related to habits formed at a young age. While this was not discussed in detail, perhaps some preventative measures can help with to increase oral health and prevent dental issues later on in life. As well the need for education and counseling for the older population to make them aware of the dental issues.
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Nutrition and Dentition. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
Nutrition and Health
Part I: Identification of Nutrient
In the case of an Asian female, she is 35 years old, 5'2'' and 95 pounds. She is HIV/AIDs positive, single and does very light activities. She has poor dentition and has poor malnutrition. She is currently under the National Institute of Health which provide her 1200 calorie diet. She takes the antiretroviral drug which includes the one-day tablet containing 150mg and 800mg, 1000mg calcium daily. The diet that the patient is taking has a deficiency of CHO, PRO and fat since the patient's weight is meager that is 43kg. This value is small for an adult with 35yrs. This means that the diet is deficient of protein for bodybuilding and carbohydrate.
The diet does not meet the Recommended Dietary Allowance (RDA) since the patient seems to have insufficient calcium in her body. This is indicated by the poor dentition conditions that she has. The 5 nutrients that are recommended for the patient with a deficiency in macronutrient are the calcium, vitamin A, potassium, vitamin C and Iron. Calcium is a very essential mineral in the body because it helps in the development of the teeth and also strong bones. The patient is associated with performing a light activity which indicate that the patient's bones are weak due to deficiency of calcium. Vitamin A is another essential nutrient which is highly recommended by the people living with HIV/AIDs because the diet with vitamin A has a very vital role in improving the immune system of the patient. The people living with HIV/AIDs has very low immunity and it is essential for them to boost their diet with vitamin A (Hummelen et al, 2011). Poor dentition of the patient show that she lacks a diet with enough vitamin A because vitamin A contributes in the development of bones and teeth.
Part II(Disease &Nutrient)
The patient with HIV/AIDS should have a much-planned diet because if the diet lack some important nutrient or vitamin may cause a lot of complication and cause the health of the person to deteriorate. The victims are associated with diarrhoea which is caused by malabsorption as a result of the gut not able to uptake in the appropriate manner which causes loss of protein in the patient's body. The patient with diarrhoea symptoms needs to take diet which is rich in protein to build up all the muscle tissue that breakdown. The patient whose diet does not have some certain nutrients which do not boost the immune system may cause the patient's disease symptom to increase because the patients are associated with high-stress levels which has an adverse effect to the immune system. The patient may be eating a lot of food but the disease symptoms progress meaning that the diet that the person is undertaking does not help to boost the immune system.
The patient should avoid food with a lot of sugar and salt since they have high chances of getting the cardiovascular disease because the ARV drugs the patient is taking makes them prone to heart diseases. The patient should limit the consumption of sugar to evade diseases such as diabetes and blood pressure. The patient should avoid drinking alcohol because it will deteriorate their health since it causes loss of water from the body. Water is essential in the body because it helps in the transportation of the important nutrient to all parts of the body.
The HIV patient needs to eat foods that have high energy such as the sweet potatoes, cereals, rice, and the bread which enables the body to keep their bodies stable. To boost their immune system, the patients need to take fruits and vegetables which strengthen the immune system. Vitamin C is very important and can be obtained from citrus fruits like lemon, oranges, grapefruit and other fruits like tomatoes and mangoes. Vitamin A is also important in their body which can be obtained from red fruits, green fruits and also from green vegetables like spinach, kales, broccoli leaves from pumpkin and others. The patients are supposed to eat the fresh fruits and vegetables and they need not be over-cooked because they lose the nutrient in them. The vegetables are supposed to be cooked with moderate heat. Dairy products, meat, pork, milk which are food that is rich in protein which is an important diet in building body tissue and to strengthen the immune system of the patient (Liu, 2011). Even though the HIV patient should limit the levels of sugar and salt, it is important to take moderate sugar. These sugars can be obtained from biscuits, desserts, and cakes.
The other nutrients which the HIV patient need to eat are flavonoid and phytosterols which are the nutrient from the fruits which helps to strengthen the immune system. Flavonoids nutrient can be obtained from fruits such as the carrots, apples, strawberries, and peppers. The phytosterols nutrients are obtained from whole grains such as the nuts, sunflower seeds, seafood, and peas.
When the food and the drugs are consumed, they interact differently, and it is essential to consider how the nutrient is absorbed and whether medicine has a side effect. People living with HIV need to utilize the nutritionist, in case there is a side effect of the medicine and food the nutritionist can advise the patient on the alternative way to supplement the food to get the same health benefit without causing any side effect. There is some food which affects the action of the drug-modifying conjugase and systems of MFO. For instance, some substances are found in some foods such as charcoal roasted meat, cabbage that influences the action of the MFO system through the induction of the enzyme (Willby, 2012).
There is some herbal dietary supplement which has negative effects when they interact with therapeutic drugs like the ARV. These supplements have a potential threat to the drugs because of the stimulation of the enzyme and affect some categories of the medication (Wilby, 2012). There are some studies which show that the nutrient found in garlic has been reported to minimize the concentration of plasma of saquinavir to the human health. The nutrient restriction that has been made for the patient with HIV/AIDs taking ARV are, food rich in calcium should be separated from dosing by 2hours because affect the action of integrase. When using the capsules medication, the garlic consumption should be avoided by the patient (Bayan et al, 2014). Food which has vitamin E should be evaded to prevent the danger of bleeding which is caused by TPV. It is recommended that the patient should observe those restriction to avoid the nutrient-drug side effects which affect the health of the patient.
Part III: Patient Education.
Calculation of the patient, BMI, BMR, CHO, and PRO
Parameters: age-35yrs, weight-95lb or 43kg, Height-5'2.
BMI
95/61.5 X61.5 (4225) X0.703=15.8
The value of BMI of the Asian Woman is below the healthy weight standard which ranges from 18.5 to 24.9; this indicates that the lady is underweight.
BMR
BMR is the amount of calorific need that the patient needs in her diet
BMR=[{(950X0.2 (activity)) + 950 }x0.1}+1140 =1254calories per day
CHO
The amount of carbohydrate she needs should be determined to restrict the amount she feeds because she does light activity.
(1254X0.45 Calories=565)/4calories /gram =141grams/day
( 1254 X 0.65=815)/4 Calories/gram=204
Dairy range 565-825 calories per day from 141-204 grams per day
PRO
The intake of protein recommended is approximately 1.5 to 2.0 times and the recommended protein for adults is 0.8g/kg (Dudek, 2014)
95lb/2.2kg/lb =43.8kgX0.8=34.5 grams protein daily
34.5grams X 1.5 times =51.8grams per day x 4calories/gram= 207calories per day
34.5grams X 2 times as much required for an adult =69 grams per day X 4 calories per gram= 276carories/day
Dairy range 207-276 calories per day or 34.5-51.8 grams per day.
FAT
The recommended fat for the patent is 35% to 40 % (Dudek, 2014)
Part III. Smart Goals and Patient Care Plan
In the SMART goals, the patient needs to eat at least three meals per day which are rich in protein so that she will be able to build all the worn out tissues in the body. She needs to eat a special diet because of the underweight levels she is of 15.8. The patient needs to work hard and increase the more foods which are rich in protein and also more calories which are in the form of fats and carbohydrates. The patient should add protein to her diets such as eating hard boiled eggs, eating more legumes such as nuts and beans, chopped meals and soups. To add the Calories she needs to take foods like rice, potatoes, and crackers. The patient should try to limit the number of sugary drinks and spicy foods. This is to prevent diarrhea.
References
Bayan, L., Koulivand, P. H., & Gorji, A. (2014). Garlic: a review of potential therapeutic effects. Avicenna journal of phytomedicine, 4(1), 1.
Dudek, S. G. (2014). Nutrition essentials for nursing practice (7th ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Hummelen, R., Hemsworth, J., Changalucha, J., Butamanya, N. L., Hekmat, S., Habbema, J. D. F., & Reid, G. (2011). Effect of micronutrient and probiotic fortified yogurt on immune-function of anti-retroviral therapy naive HIV patients. Nutrients, 3(10), 897-909.
Liu, E., Spiegelman, D., Semu, H., Hawkins, C., Chalamilla, G., Aveika, A.,& Fawzi, W. (2011). Nutritional status and mortality among HIV-infected patients receiving antiretroviral therapy in Tanzania. Journal of Infectious Diseases, 204(2), 282-290.
Wilby, K. J., Greanya, E. D., Ford, J. A. E., Yoshida, E. M., & Partovi, N. (2012). A review of drug interactions with boceprevir and telaprevir: implications for HIV and transplant patients. Annals of Hepatology, 11(2), 179-185.
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Nutrition and Health. (2019, Feb 20).
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Disease and Nutrition
Part I: The Diet
The present paper will focus on Case 001 with the goal to analyze the patient’s nutrition and provide recommendations. At first glance, there is not enough information to determine the individual’s daily protein intake. However, it can be concluded that the patient eats excessive amounts of carbohydrates and fats daily as his diet consists primarily of fast food. Foods that are high in sugar and fat are unhealthy for the patient since he suffers from hypertension and type II diabetes. These medical conditions are greatly influenced by one’s diet and can be caused by high fat and sugar intake. J.W. is 6 feet tall and weighs 230lb, with a BMI of 31.2. The high BMI indicates obesity, which contributes to type II diabetes and hypertension and impairs the effectiveness of treatment.
Interestingly, J.W.’s diet meets the RDA for five or more micronutrients. Setiawan et al. (2016) argue that, while frying does in fact damage some micronutrients, it also enhances others. First, it has little or no impact on protein, which means that a person eating fast food each day might still have enough protein in their diet (Setiawan et al., 2016). Secondly, frying enhances dietary fiber content due to the formation of resistant starch. Setiawan et al. (2016) add that fried foods can be a great source of thiamine, vitamin C, and vitamin E. Nevertheless, it is important to note that some crucial micronutrients, such as unsaturated fatty acids and some antioxidants, are lost during the frying process. Thus, although the patient may be obtaining enough protein, dietary fiber, vitamin C, thiamine, and vitamin E, his intake of saturated fat, sugar, and calories is too high for his age and medical condition.
Part II: Disease and Nutrition
As stated above, the patient’s diet negatively affects his health condition. Olawuyi and Adeoye (2018) confirm that non-communicable diseases are mainly brought on by lifestyle choices. For instance, obesity, which is J.W.’s main health concern, is caused by excessive calorie intake. Rightfully, the patient has been asked to reduce weight by losing one pound every week for the next three months. Since there is no cure for diabetes and hypertension, the patient will have to manage the conditions throughout his life using medication and proper nutrition. Hypertension and diabetes are also linked to excessive consumption of fats and carbohydrates. If the patient continues to eat fast foods, he will not lose weight, and this will negatively affect the management of his conditions. For example, a high level of fat in J.W.’s diet will lead to excessive blood cholesterol, which causes fatty deposits in blood vessels, thus increasing blood pressure and cardiovascular risks.
Excessive consumption of carbohydrates is also evident in J.W.’s case. Most types of fast food include fried potatoes and some kind of fried meat (e.g., chicken, pork, beef, etc.). As the share of potatoes in one portion is larger than the share of meat, the patient eats more carbohydrates than any other type of food. While high fat consumption influences cardiovascular health, the increased intake of carbohydrates affects diabetes type II pathophysiology. As Lee et al. (2018) explain, insulin helps to control blood sugar levels by breaking down carbohydrates. However, as J.W. suffers from type II diabetes, his cells have reduced sensitivity to insulin, or insulin resistance, which means that eating too many carbohydrates results in unhealthy blood glucose levels.
Based on the information above, the patient should eat foods that are rich in fiber, such as fresh fruits and vegetables, as they will make him feel fuller. This will help J.W. to maintain the recommended calorie deficit, leading to weight loss. Replacing high-sugar foods with complex carbohydrates, such as whole grains, will also help the patient to control blood sugar levels. In order to reduce the amount of fat in his diet, J.W. should try to prepare most meals at home with little to no oil, and substitute butter or frying oil for cold pressed olive oil, which is low in saturated fat and high in omega acids.
Additionally, the type of food J.W. eats influences the effectiveness of his medications. Currently, the patient takes 500mg Metformin twice daily for diabetes, 200 mg Metroprolol daily for hypertension, and a multivitamin. The first two drugs (metformin and metroprolol) have several side effects. For example, Metformin serves to decrease insulin resistance but may cause stomach upset and diarrhea if a patient does not maintain a healthy diet. Metroprolol can cause vomiting, constipation, heartburn, and stomach upset, the probability of which also increases with an unhealthy diet. To reduce the possibility of experiencing side effects, doctors typically recommend that patients who take these drugs refrain from foods that are high in fat and sugar and increase their daily fiber intake to normalize bowel function and promote healthy elimination.
Part III: Patient Education
The patient’s BMI is 31.2, and his Basal Metabolic Rate (BMR) is 1,891 calories. His CHO, PRO, and fat needs are 190-220, 83-104, and 45-70 grams per day, respectively. It would also be useful to calculate the recommended intake of certain nutrients, including sodium and calcium. A viable nutritional plan can be made from this information. The table below is a seven-day diet plan that the patient can use. This diet is based on the meal plan suggested by Zacharia and Pletcher (2016) for patients with type II diabetes.
Day Breakfast Lunch Dinner
Monday: Cream cheese-stuffed French toast Salmon salad with white beans Grilled fish with a side of fresh or steamed vegetables
Tuesday: Oatmeal with apples and Greek yogurt Roasted turkey meat with cranberry sauce and steamed vegetables Steamed fish with vegetables
Wednesday: Oatmeal, almond milk and fruit smoothie Pasta with chicken breast meat, tomato, and spinach Grilled turkey burgers
Thursday: Veggie and goat cheese scramble Chicken and fresh vegetable salad served in pita bread Jamaican pork tenderloin with lemony green beans
Friday: Granola with nuts, seeds, and dried fruit Salad with fresh vegetables, quinoa, and parsley Beef and rice stuffed peppers
Saturday: Homemade muffins with bananas and pecans Homemade hummus with celery sticks and carrots Chicken tortilla soup
Sunday: Tomato and Basil Frittata Butternut squash and carrot soup Grilled shrimp skewers with steamed vegetables
(Source: Zacharia & Pletcher, 2016).
Additionally, there are three SMART goals that can help the patient to adhere to a healthy lifestyle and become healthier. The first goal is to lose 1lb per week, totaling to 4-5lbs every month. By reaching this goal through healthy eating and regular exercise, J.W. will be able to improve his BMI, reduce blood sugar levels, and control hypertension. Secondly, it is recommended that the patient spreads carbohydrates evenly throughout the day. While adhering to the given meal plan, J.W. can distribute carbohydrates through portion control, which is a strategy used by nurses in inpatient settings to control the patients’ nutrition. Thus, the specific SMART goal will be to eat 15% of daily carbohydrates with every meal. Finally, the third SMART goal is to eat at least two servings of lean protein on a daily basis. The main reason for this is that lean protein, such as fish, turkey, or chicken breast, creates a feeling of fullness, thus helping patients to adhere to their meal plan and achieve their goal weight.
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Nutritional Sources and Salinity
Abstract
In the laboratory, Serratia marcescens was utilized to test Growth and Prodigiosin production under various environmental factors. The environmental conditions were temperature, pH, oxygen availability, nutritional sources, and salinity. The temperatures tested were 4 degrees Celsius, 25 degrees Celsius, and 65 degrees Celsius, and the pH values were (3, 7, 11). The carbon source was maltose and glucose. The salinity measurements consisted of 0.1% NaCl, 1.0% NaCl, and 3.0% NaCl. Lastly, the oxygen requirement was tested by using two groups, one group was tested using aeration (shaking), and one group was tested with no aeration (no shaking). The results indicate that optimal growth was experienced at a temperature of 65 degrees Celsius, a pH of 7, NaCl concentration of 0.1% and no aeration. Prodigiosin production was affected under most of the same conditions, for example, it experienced optimal growth at a temperature of 65 degrees Celsius, a pH of 7, and the same carbon source. However, results differ because Prodigiosin production experiences a higher rate at a salt concentration of 3% NaCl, and, under conditions of no aeration.
Introduction
Serratia marcescens is a pathogenic bacterium that invades humans and mimics the red color of blood making it hard to detect. S. marcescens was once considered a harmless saprophyte, which is a type of microorganism that lives on dead or decaying organic matter. However, S. marcescens is now recognized as a significant opportunistic pathogen which has a tendency to create healthcare related infection and antimicrobial resistance (Herra and Falkiner 1984). Prodigiosin is an antifungal red pigment produced by S. marcescens, it holds antibacterial, antimalarial, and antifungal activities, however, it is used primarily as a biochemical tool (NCBI 2014).
Although bacteria are highly adaptable in nature, which is why they are found in nearly every place on earth, certain environmental conditions affect optimal growth for different types of bacteria. For instance, most disease-causing bacteria thrive in warm temperatures, which is why the human body provides an ideal environment for many types of bacteria to grow. On the other hand, some bacteria are able to survive in freezing temperatures of 5 degrees Celsius, yet other types of bacteria would not survive in temperatures below 60 degrees Celsius (Wagner 2008). In another way, optimal growth of bacteria is affected by pH. pH is used to classify the hydrogen ion concentration in a solution, pH values range from 1.0 (very acidic) to 14.0 (very basic). Most bacterium grow best around a neutral pH value (7). However, some bacteria thrive in very basic conditions, yet some can tolerate a pH of 1.0 (Blamire 2000).
Carbon sources also play a significant role in the growth of bacteria. Carbon is known as the structural backbone of organic compounds, and each carbon source may support different bacterial growth rates. Salinity is the amount of salt dissolved in an amount of water, the percent of sodium chloride present in the solution used for this lab accounts for the salinity. Because bacteria are extraordinarily diverse, certain types of bacteria thrive in salty environments while others do not. For example, research suggests that S. Marcescens is highly adaptable to salty environments and can continue to reproduce under harsh conditions (classified as 80 g/L) and extreme conditions (classified as 100 g/L salt concentrations) (Ketola and Hiltunen 2014). On the other hand, oxygen requirements, also known as aeration or no aeration play an important role in the growth of bacteria. Aeration is believed to stimulate the growth of bacteria because it provides much needed oxygen to the environment for bacteria to use for growth and development (Mattick 1940). Such environmental conditions affect the metabolic functioning of bacteria, and as a result the growth of the cell.
S. marcescens is a bacterium which, like many others, requires a relatively warm temperature, neutral pH, and a low salt concentration to experience optimal growth. The objectives of this laboratory are to develop an experiment which will test the impact of environmental conditions on the growth of S. Marcescens and prodigiosin, to understand how different experimental conditions affect bacterial growth and prodigiosin production, and to gain a better understanding of the stages of the bacterial growth curve & the production of prodigiosin throughout the growth cycle of S. Marcescens. In order to address each objective, students were separated into groups and each group focused on one environmental condition. This allowed each group to fully test and experiment the possible implications of their environmental condition. For each group, a proper lab protocol was created and followed accordingly. After testing the condition through a series of experiments, each group recorded their data and made it available to all other groups.
In order to obtain the most thorough results possible, and to ensure the experiment was carried out as accurately as possible, it is important to generate hypotheses which can be compared to the acquired end results. For instance, the null hypothesis for temperature expects that temperature will not have an effect on the growth of S. marcescens or Prodigiosin production. While the alternative hypothesis for temperature expects that temperature will have an effect on the growth of S. marcescens and/or Prodigiosin production. The null hypothesis for pH expects that pH values will not have an effect on the growth of S. marcescens or Prodigiosin production. And, the alternative hypothesis claims pH values will have an effect on the growth of S. marcescens and/or Prodigiosin production. The null hypothesis for the carbon source condition expects that different carbon sources will not have an effect on the growth of S. marcescens or Prodigiosin production. While the alternative hypothesis for the carbon source condition expects that carbon sources will cause an increase or decrease on the growth of S. marcescens and/or Prodigiosin production. The null hypothesis for the NaCl concentration condition, also known as salinity, expects that sodium chloride concentrations will not affect the growth of S. marcescens or Prodigiosin production. However, the alternative hypothesis expects that differing sodium chloride concentrations will cause and increase/decrease on the growth of S. marcescens and/or Prodigiosin production.
The null hypothesis for the oxygen requirement
Suggests that there will be no difference in the growth of S. marcescens and Prodigiosin production due to aeration or no aeration. While the alternative hypothesis suggests that depending on the condition, aeration or no aeration, an effect on the growth of S. marcescens and/or Prodigiosin production will occur. The null hypothesis in each condition suggests that no change will occur, regardless of the environmental condition. The primary purpose of the null hypothesis is for scientists to reject or disprove it, it is impossible to ""accept"" the null hypothesis, in a scenario where the null hypothesis is not rejected, it would simply be said that it failed to be rejected. And, the alterative hypothesis is simply the opposite of the null hypothesis.
Materials and Methods
The environmental condition tested in this experiment was oxygen requirement. The oxygen requirement refers to the practice of using aeration (shaking) or no aeration (no shaking) during the experiment. Aeration is important because it provides oxygen to bacteria, and it is commonly believed that aeration helps to increase optimal growth/prodigiosin production.
In order to carry out this experiment and to test the effects of aeration/no aeration, the lab group had to utilize a machine called a Spectrophotometer. Sterile technique was used to remove 2mL of fresh media which was then pipetted into two cuvettes and set as blanks. Sterile technique was used again to remove 2 ml of each of the S. Marcescens cultures, Culture a which was shaken at 30 C, and Culture b which was not shaken at 30 C, into a cuvette. The spectrophotometer was set to 499 wavelength and measurements were recorded for each culture group after blanking. Next, the spectrophotometer was set to read absorbance's at 600 wavelength and measurements were recorded for each culture after blanking. These steps were repeated every 30 minutes for the course of 180 minutes. Finally, after obtaining all necessary measurements, each S. Marcescens culture was returned to their respective incubators.
The full dataset obtained through this group can be found in Figures 5 & 10. This group found that bacterial growth was higher when no aeration was implemented, and prodigiosin production experienced a higher rate during no aeration as well. The equation A499/(OD600 x 5.8x108 cell/ml x 2 ml)= units of prodigiosin per cell was utilized to calculate prodigiosin production.
Results
The graphs pictured above show a complete summary of all the data collected throughout the experiment. Each graph shows data points that were collected and recorded every 30 minutes throughout the testing period, for both Growth and Prodigiosin Production. For temperature, the graph (Figure 1) indicates that optimal bacterial growth was reached at a temperature of 25 degrees Celsius. Yet, growth was more consistent at a temperature of 65 degrees Celsius, this in agreement with the idea that most bacteria tend to thrive in environments of higher temperatures. However, consistency alone is not effective at drawing a proper conclusion, so due to the growth curve, 25 degrees provides for optimal growth. Likewise, optimal growth was reached when the pH stayed at 7 consistently. This result was expected as many bacteria, including S. marcescens, thrive in neutral conditions. And, S. marcescens remained constant throughout the carbon source experiment, there was no rapid increase/decrease of S. marcescens, this can be expected due to the fact that carbon is a substance found in all organic matter and is the backbone of all living organisms. Next, it was revealed that optimal growth was reached when the concentration of NaCl was at 0.1% NaCl, again, this is expected as most bacteria are not able to survive in environments that are high in NaCl. Lastly, it was determined that S. marcescens reached optimal growth under conditions of no aeration, this is different than what was expected as it is believed that aeration provides stimulation for growing bacteria.
Prodigiosin production experienced a more significant increase at a temperature of 65 degrees Celsius and a pH of 7, the same temperature and pH which was consistent with optimal bacterial growth. And, carbon source also remained the same throughout this part of the experiment. However, salinity experienced a significant shift, for instance, growth was more optimal at an NaCl concentration of 0.1%, yet prodigiosin production experienced a higher rate at 3.0% NaCl. While prodigiosin production did decrease with aeration, there was a more significant decrease in no aeration, this is contradictive to the ""Aeration vs. Growth"" graph, and in agreement with scientific research.
Discussion
The objective of this experiment was to test the effect of various environmental conditions and on the growth and Prodigiosin production of S. Marcescens. In order to efficiently and accurately detect any possible change that these environmental conditions had we composed two different hypotheses, a null and an alternative. The null hypotheses suggest that the various factors would not significantly alter the amount of growth or Prodigiosin production. On the other hand, the alternative hypothesis speculated that each of the environmental conditions would significantly change the growth or Prodigiosin production of the S. Marcescens in comparison to the bacterial scientific conventional wisdom. While this numerical change in the alternative hypothesis was not initially mentioned, it would later be calculated following the completion of the experiment. Following the experiment and analysis of data, the results were both revealing and expected. In the end, each of the environmental conditions had an effect on growth and Prodigiosin production, some of these effects were expected, while others came as a surprise, such as the observation that no aeration provided more optimal growth for S. Marcescens.
As it was aforementioned in the results paragraph, some of the manipulated variables yielded results parallel to the umbrella beliefs on optimal bacteria growth. The S. Marcescens had the highest optimal growth when exposed to a temperature of 65 degrees Celsius (Figure 1). It was revealed that optimal growth occurred at 65 degrees Celsius, and at a pH of 7. This is consistent with scientific data that suggests a neutral pH and high temperature are optimal conditions for bacterial growth (Herra and Falkiner 1984). In a similar sense, results showed that optimal growth was reached at an NaCl concentration of 0.1%, this is in agreement with scientific research which states that bacteria grow best in an environment with a low salt concentration. On the other hand, it was revealed that optimal growth was reached during conditions of no aeration, which is contradictive to the idea that aeration provides important stimulation to bacteria (Mattick 1940).
As for Prodigiosin production, results stayed in agreement with optimal growth, with the exception of aeration. It was revealed that the rate of Prodigiosin production experienced an increase during conditions of aeration.
Difficulties that may have impacted the results of this experiment were kept at a minimum, and if any occurred, they were minor. For example, groups relied on each other to relay correct information throughout the experiment, and since each group had a different environmental condition, it was nearly impossible to indicate whether the information being relayed was correct. If a group made a slight mistake or accidentally relayed the wrong information, it is unlikely that the error would have been caught and corrected, which could result in possible errors and inaccuracies in the end.
With the exception of the oxygen requirement, the growth results obtained in this experiment support the findings by others based on the literature research. As mentioned, temperature, pH, carbon sources, and salinity are in agreement with the results of others. The Prodigiosin production results are the most supportive of the findings of others, as every environmental factor is in agreement with that of other scientific data, while in the growth section, aeration was the only one that separated from a common trend in thought.
In order to enhance Prodigiosin production, it would be important to increase the amount of S. Marcescens used in this laboratory experiment. The more S. Marcescens we are able to use, the more Prodigiosin production will occur, and likely the results will become more accurate.
In order to continue working on this project, it would be wise to consider adding more environmental factors and to further test the ones that have already been used. For instance, it would be a good idea to test more temperatures other than the three that are being used, and to test more pH values than the current three. All conditions can be expanded on, and it would provide more information and accurate details to expand more on each one. Other nutritional requirements such as energy source, nitrogen source, and mineral source would be interesting to look at since they all provide important chemical nutrients, and by doing this, we would be able to determine more accurately the effects of the current nutritional requirements.
Works Cited
Blamire, John. ""Properties of Microbes."" BIOdotEDU, 2000, www.brooklyn.cuny.edu/bc/ahp/CellBio/Growth/MGpH.html.
Herra, Celine, and Frederick Falkiner. ""Serratia Marcescens."" Brief History of Bacillus Anthracis, www.antimicrobe.org/b26.asp.
Ketola, Tarmo, and Teppo Hiltunen. Advances in Pediatrics., U.S. National Library of Medicine, Oct. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4242574/.
Mattick, A. T. R., et al. ""AN INSULATED BOX FOR THE CARRIAGE OF MILK SAMPLES."" Wiley Online Library, Wiley/Blackwell (10.1111), 11 Mar. 2008, www.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2672.1940.tb03933.x.
""Prodigiosin."" National Center for Biotechnology Information. PubChem Compound Database, U.S. National Library of Medicine, pubchem.ncbi.nlm.nih.gov/compound/Prodigiosin.
Wagner, Al B. ""Bacterial Food Poisoning | Food Technology & Processing."" Wine Cup, 2008, aggie-horticulture.tamu.edu/food-technology/bacterial-food-poisoning/.
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Combating Obesity with Nutrition and Exercise
Describe the health problem. Why is this a concern for this target group?
Poor dietary intake and low physical activity are major causes of obesity for adults in the United States. Due to an increase in access via communication devices and technology, adults are more prone to work longer hours and spend less time on self-care (Bull F. et al., 2017). Jobs often require many hours of sitting in front of a computer screen, in meetings, or traveling, which contributes to a lack of physical exertion. A quick bite to eat at a fast-food restaurant can easily replace healthier home-cooked meals attributing to poor nutritional choices.
Chronic illnesses plague adults in our nation as obesity has risen to an epidemic level. Evidence shows an increase in stroke, heart disease, and metabolic diseases earlier than ever (George, M., Tong, X., & Bowman, B. 2017). They are among the deadliest conditions in the world, with heart disease and stroke being the top two causes of death in 2016 (The top 10 causes of death, 2018). Adults must learn proper nutrition and find ways to exercise that keep them motivated. Actions such as these will lower overall body weight, reducing body mass index (BMI), and decreasing risks of metabolic syndrome, a condition with the potential to rob them of a high quality of life in the years to come (Nyberg ST. et al., 2018).
What are the current actions/interventions taken for this health concern?
Teaching patients is a major part of a nurse’s role. Nurses advocate for the health and well-being of every patient who is placed under their care. Clinical and research nurses already recognize the need for special events to help spread the message that proper nutrition and exercise are essential to decreasing the rate of obesity (Speroni, K, 2014). They have organized short marathons and set up tents at local fairs or community centers. The events are fun and informative, and the nurses interact with the general public to provide blood pressure screenings, group exercise lessons, information on stress reducing behaviors, and guidelines on how to plan healthier meals. Nurses also recommend weight loss approaches to individual patients such as lifestyle modifications, commercial diets, the need for physical activity, and, for those who may qualify, surgical options (Budd, G., & Peterson, J., 2015). Nurses work with individuals as patients, but they also work in the communities where they live to help people understand the need for a healthier way of living.
What are two nursing interventions that can be implemented for this health concern?
One nursing intervention that can be done on a case-by-case basis, which may help to give patients who need to lose weight and learn to eat healthier a starting point, is for nurses to share knowledge of local fitness professionals and registered dietitians. The nurses can include this information while teaching patients the importance of making healthy lifestyle choices. Patients will feel empowered to start on a better path when they know they are not alone. Stressing the importance of behavior modifications conducive to the goal of achieving better health can be emphasized by giving patients the contact information of people who are willing to help them make the appropriate changes.
Another way nurses can highlight the priority of wellness is by patterning a healthy lifestyle for themselves. Nurses serve as role models for the patients who trust them. It’s easier for patients to take advice from health professionals who adhere to high standards of self-care. Nurses who exercise, eat a well-balanced diet, who don’t smoke, and who strive to maintain a desirable weight will show by example the benefits of a healthy approach.
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Combating Obesity with Nutrition and Exercise. (2019, Feb 20).
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Nutrition Related Diseases & Conditions
My patient is J.W., he is a 60 year old African-American male who identifies as Catholic. J.W. is 6’0” in height and weighs 230lbs. The patient is married and has three children. He leads a fairly sedentary lifestyle as he travels three days a week for work and tends to eat out three meals per day. His current diet consists of high calorie fast food which is low in nutrients. The patient has been diagnosed with hypertension (HTN), and dibetes mellitus type to (DM2) and his doctor has recommended that he lose one pound per week for three months in order to help him achieve a healthy weight. Medications that J.W. is currently taking are Metformin 500mg twice a day, Metropolol 200mg once daily as well as a multivitamin. J.W.’s body mass index is at 31.2 which categorizes him as obese. For a male of his height, the BMI chart recommends that he should weight between 140lbs-180lbs in order to be considered healthy (aim for healthy weight 2018).
J.W. stated that he eats fast food three times a day, and although there are some healthy choices that can be made when eating out, most people opt for the less healthy options. Based on what Americans commonly eat in fast food restaurants, such as burgers and fries with say, a coke, J.W.’s diet is high in fat, cholesterol, sodium, and sugar. There is definitely some protein in there, however, fat, cholesterol and sodium far outweigh the amount of protein. In order for J.W. to achieve the one pound weight loss per week, he will have to learn what the healthier options are at the places he eats and stick to those when eating on the go. Restaurants such as Subway offer healthier options. They serve egg white omelets for breakfast and lean meats or veggie subs for lunch. McDonalds and Starbucks offer oatmeal for breakfast, chicken wraps, and chicken salads as their healthier options. One of the most popular now, Chick-Fil-A offers a variety of salads as well as skinless grilled nuggets and chicken strips. Panera also has some sensible meals, soup or salad and a sandwich for lunch for example (fast food places that serve healthy foods). Most people in our society today are always on the go and it is less likely that we eat homecooked meals every day, which is why it is important that we educate patients on proper nutrition even when having to eat out often.
Micronutrients are defined as “nutrients that are needed in small amounts” (Dudek, 2018), these are our vitamins and minerals. Vitamins A, D, E, and K, are fat soluble vitamins. Since these are not easily excreted through urine and so it is important to take only what is needed to avoid toxicity (Dudek 2018). Vitamin A aids with eyesight, bone development, teeth development, immune function, and promotes healthy skin and hair (Dudek, 2018). Due to the foods that J.W. eats such as the beef in cheeseburgers, it is unlikely that he would develop a deficiency in vitamin A. There are however healthier options such as fruits and vegetable by which he can obtain the needed amount of vitamin A. Carrots and sweet potato are known to be a great source of vitamin A. Vitamin D is extremely important in bone development. Vitamin D comes from sunlight, oil, milk, fish, egg yolks, and liver (Dudek 2018). A deficiency in vitamin D could cause hormonal imbalances, affect bone growth and density, decay teeth, and negatively affect absorption in the GI tract (Dudek 2018). If vitamin D levels drop low enough, the patient could experience muscle twitches, tingling around the mouth and tingling in the distal extremeties (Dudek 2018).
Since J.W. travels for work, I suspect he does not spend much time in the sunlight. Also, because J.W. is African American, he would need to be in the sunlight for a prolonged amount of time in order fully benefit. It is very likely that J.W. is deficient in vitamin D or at the very least he has a low level of vitamin D. A deficiency in vitamin E, although rare, can cause a patient to be anemic, swollen or produce skin lesions (Dudek 2018). Foods that provide vitamin E are vegetable oils, leafy green vegetables, whole grains, and nuts (Harvard Health Publishing). With the description of J.W.’s diet, I would suspect that his vitamin E is on the lower end. Finally, vitamin K aids in clotting of the blood. Some foods that provide vitamin K cabbage, eggs, milk, spinach, broccoli, and kale (Harvard Health Publishing), again, I would suspect that J.W. is also deficient in vitamin K or at least has low levels of vitamin K. Because J.W. does have hypertension, he also needs to monitor his sodium level intake. The recommended daily intake of sodium is 2300mg. This number should be greatly reduced due to J.W.’s age and condition. J.W. should consume no more than 1500mg of sodium per day (Shaking the salt habit to lower blood pressure, 2019).
J.W. has been diagnosed with two major conditions, type 2 diabetes, and hypertension. Hypertension has both modifiable factors and non modifiable factors (Nutrition ATI). Some modifications that J.W. could make to help with his hypertension are to lower sodium consumption, incorporate physical activity at least 30 minutes a day, even if it is just a brisk walk, lose weight, smoking cessation, and adding more fruits and vegetables to his diet (Nutrition ATI). Type two diabetes also has some modifiable risk factors such as exercising and maintaining a healthy weight. According to the American Heart Association, adults with diabetes are more likely to die from heart disease than adults without diabetes. Cardiovascular disease is the number one killer for diabetics (Dudek 2018). Since J.W. leads a very sedentary lifestyle, even light exercise will make a huge difference in his health. As he loses weight and gains endurance, he can aim for higher intensity workouts.
J.W. currently takes Metformin, Metropolol, and a multivitamin. Metformin is used in controlling blood sugar in type 2 diabetes. J.W. should be educated on the effects of Metformin and should monitor his blood glucose levels regularly while on this medication. He should also know the signs and symptoms of hypoglycemia such as pallor, tremors, diaphoresis, palpitations, and anxiety as hypoglycemia could be fatal if not treated effectively (Copstead and Banasik 2013). Metropolol is a Beta-adrenergic blocker used to regulate blood pressure. When taking this medication J.W. should monitor himself for hypotension as it is one of the side effects. According to Copstead and Banasik, this medication could also cause anxiety and heart palpitations. It is important that J.W. talk to his provider about all medications, prescribed and over the counter, in order to prevent any contraindications or sever interactions.
According to Dudek, a diabetic patient should consume 1500-2000 calories per day. In order for J.W. to lose one pound per week, his daily consumption should be as follows:
Calories (1500-2000)
Carbohydrates (231g/day)
Fat (62g/day)
Protein (93g/day)
Cholesterol (
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Nutritional Tips for Building Muscle
A balanced diet is very important for fitness. Especially the protein is a true energy supplier. The demand may therefore be much higher for athletes. With a supply of this protein-containing food the muscle building is optimally supported. It is best to take a protein-rich meal after a training session. Even small snacks should be on the menu throughout the day. Sufficient protein intake is extremely important for muscle growth, but in addition, the balanced diet should not be ignored.
Carbs from whole grains, fresh fruits and vegetables as well as high quality fatty acids can be very helpful. In addition, these foods contain all the important nutrients. Furthermore, they make the musculoskeletal system fit and contribute to a pleasant well-being. Which foods lead to a more muscular body structure, we would like to briefly explain in 5 different tips.
Tip 1: Oh, you sweet egg
In the past, the eggs had a bad reputation. It has often been said that eggs have a major impact on cholesterol levels. However, this thesis was created wrongly. Today it is known that eggs have only a small influence on the blood cholesterol level. Therefore, one can consume without hesitation an egg a day. The preparation does not have to be done in one variant only. You can eat it as hard boiled, as fried eggs or as breakfast in the form of a scrambled egg. Thus you take an ideal source of protein.
Tip 2: High protein content by tuna
Tuna not only tastes buttery and aromatic, but it is a true delicacy among the fish. It can be distorted raw and enjoyed in sushi or as a tartar. Fried tuna is also very popular. He is wonderfully versatile. The preparation always takes place in a different way. Either as an insert in the salad, the steak or it is added to pasta dishes as well as on a sandwich. Whether fresh or canned, it is tried in classic and sophisticated recipes. In addition to a high protein content, the tuna can score especially with healthy fatty acids and B vitamins. However, if you are very intent on your figure, then you should eat the fish natural and do without the pickled variant with oil.
Tip 3: Oatmeal a staple
It depends on the mix. A combination of carbohydrates, protein and fiber make the oatmeal so valuable. In addition, it is long-lasting and provides enough energy for training. That's why you should never miss a balanced breakfast. Mixed with fruit and yoghurt, it makes for an ideal cereal. You can also soak the oatmeal overnight or for a few hours. Either with water or apple juice, then you also get a sufficient meal. Refine this diet with dried fruit or fresh fruit, with some sugar and you will receive a high-quality dish. An oatmeal soup is a traditional home remedy and is often used in gastrointestinal diseases.
Tip 4: Animal protein in beef
Vital minerals, vitamins and trace elements are found in beef. The fat content of this meat is low. Many vital and indispensable amino acids are included. This is needed to build up the body's own protein, for example, for the muscles. In addition, the organism of a human can use this animal protein particularly well. The preparation can be made on a different recipe. There are a lot of different meats. For example, boiled beef is cooked or steaks or roast roast are briefly fried in a pan or on the grill. In addition, dried beef is often a favorite snack among athletes.
Tip 5: Chickpeas are healthy
Legumes contain a lot of protein and magnesium. Here, the body is supplied with energy. Magnesium also prevents muscle spasms. Chickpeas are a big part in oriental cuisine. For example, falafel is made from chick pea porridge. If one uses paste with sesame, then the dish Hummus arises. Likewise, chickpeas in salads and soups look good. Furthermore, this food stimulates digestion. Chickpeas have a positive effect on the blood sugar level and the cardiovascular system. These nutrient bombs contain proteins, minerals and trace elements. They are also rich in B vitamins and fiber.
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Cultural Impact on Food Choice and Nutrition
People have a tendency to live together. Over the course of human evolution, humans have organized themselves in the forms of tribes, villages, cities, states, and countries. Within all of these organizations of people developed cultures that distinguished what people should consume and what they should avoid (Barilla Center For Food & Nutrition). Food choice and nutrition are influenced by multiple facets of culture. Culture is defined by Cambridge Dictionary as “the way of life of a particular people”. A person’s diet is influenced by and regulated through the cultural facets of faith, heritage, and the vernacular.
A person’s diet is influenced by and regulated through the cultural facet of faith. This facet is based on the fact that certain belief systems set dietary rules and guidelines. Societies differ in their adherence to these religious dietary rules and guidelines, but those with higher numbers of orthodox and devout religious followers are more likely to adhere to them and oppose genetic food modifications. Followers of orthodox Judaism follow kosher diets - diets based on Jewish laws. Some examples are Jewish diet laws include consuming no pork or seafood products and limiting alcohol consumption to wine made by faithful Jews. Followers of orthodox Islam have similar but different dietary restrictions to follow compared to their Jewish counterparts. Similar to Jewish law, pork consumption is forbidden. Unlike Jewish law, all forms of alcohol are forbidden for followers of orthodox Islam.
Followers of orthodox Islam and Judaism also get their diets impacted through periods of consuming no food in order to observe days or periods of fasting (Heiman, Amir, et al). The religious act of fasting is associated with different meanings and purposes depending on the religion. In the Abrahamic religions, the act of fasting is associated with learning modesty, patience, and spirituality as well as being a symbol of one’s faith (Barilla Center For Food & Nutrition). Some faith systems also set guidelines that relate to socio-economic status. Hinduism is one such faith system that does this is when it is accompanied with the caste system. Hinduism does not strictly forbid the consumption of foods, but sets standards to determine how “polluted” or unclean certain acts, foods, and drinks are. In general, members of socio-economic lower status consume food and drinks that are considered to be less clean. In addition, Hindu followers that maintain a vegetarian diet are regarded as having a higher status than their meat-eating counterparts because any interaction with dead animals is viewed as polluting (Stephon, Yehudi).
A person’s diet is influenced by and regulated through the cultural facet of heritage. Heritage and tradition shape what a culture views as ideal for sizes of meals and body shapes. In January, 2018 a cross-sectional study of 81 adult Kiribati and European male seafarers was conducted to better understand cultural differences in food, body image attitudes, and eating behavior. The study was setup to make cultural background the primary difference between participants. This was done by limiting participation for the study to four transatlantic merchant cargo ships that were operated by the same company and shared similar diets and access to recreation. The study found that the Kiribati participants consumed more food and displayed larger body shapes than their European counterparts. Researchers found that this correlated with the Kiribati participants saying that larger body shapes are more respectable despite slimmer body shapes being more attractive.
European participants on the other hand reported slimmer body shapes being more respectable and attractive (Westenhoefer, Joachim, et al). Another example of cultural heritage impacting food consumption can be seen through analyzation of how plate size influences how filling a meal will or will not be. In October, 2017, a cross-cultural analysis was published on this phenomena. It observed a correlation of western cultures objectifying perceived fullness from food based on plate size which is not shared by Asian cultures. Potential reasoning for this correlation lays behind the practice of western cultures to load their plates at mealtime prior to eating whereas Asian cultures tend to fill their plates at mealtime with smaller portions throughout the time they spend eating (Peng). The influence of how varying plate size can be used to perceive fullness in western cultures can be utilized by meal preppers and restaurants to encourage consumers to eat more or less food.
Cultural heritage influences what foods and drinks people will consume. Traditional diets based off of the available resources of a particular area can influence what forms of food are or are not acceptable. For example, Japan has a seaside culture that dates back thousands of years and has incorporated raw fish into traditional recipes, sushi being an example. On the other hand, sushi and other raw fish meals have only recently begun to become acceptable in western cultures (Nordström). The phenomenon of cultures varying what is acceptable to eat has roots in the evolution of human survival. Being biologically omnivorous, humans have a wide array of food that could be edible. As humans started to live together, they were able to share ideas of what food was safe to eat and what was not. They also were able to share ideas regarding why to eat or not to eat certain food, how to prepare food, and how food should be eaten. In addition to culture limiting the food choices consumers choose, other cultures’ food choices can be used to differentiate them and begin to assess relatability or perceived threat level (Barilla Center For Food & Nutrition). The narrative of a population’s origins can also strongly influence what a culture consumes. An example of this is the culture of the Guatemalan Maya. There culture has an origin story that states that people originated from maize. As a result, maize is incorporated into almost all of all meals, and a feeling of ‘fullness’ or satiation lacks without it (Fischer).
Vernacular culture influences a person’s food choice and nutrition. This cultural facet is based on the idea that people are influenced by what is perceived as socially normal and food selection being limited what the local food culture demands. This facet can be utilized analyzing the food culture of the United States. The United States food culture has been undergoing a change in the nutrition of their diets. Compared to the 1970s, Americans in 2010 consumed more than twice the amount of cheese and poultry while consuming less red meat and dairy milk. Between the 1970s and 2010,average fruit and vegetable caloric intake dropped by 1.3% (DeSilver). One reason for the shift of consumption rates is the push or strive for Americans to eat healthier.
Consumer demand and grocery suppliers have not ignored this changing diet and research done by Catalina Marketing found that a majority of shoppers have observed increased rates of food options and “healthful foods and beverages” in their grocery stores. Despite the increased rates of food variety and healthy options, the United States remains as the top meat consuming country in the world with its meat and poultry dominating its 2012 agricultural industry production (Reynolds). Within the greater food culture is subculture of consumers who do not consume meat. This sub-culture of vegetarians and vegans consist of 4.4% of the United States population. The American Dietetic Association acknowledges that following meatless diets has many potential benefits beyond getting enough nutrients such as developing a resistance to obesity and cardiovascular diseases. However, the prevalence of meat consumption in American culture makes the act of following a meatless diet counter-cultural and has potential to cause alienation due to the cultural tendency to bond over meals (Potter-Dunlap, Tse)
A person’s diet is influenced by and regulated through the cultural facets of faith, heritage, and the vernacular. Cultural adherence to certain faith systems limits what food and drinks people are allowed to or will consume. Cultural heritage establishes standards for how people can view nutrition differently and determine what foods and drinks are favored or acceptable to eat and which to avoid. Vernacular culture sets standards for what people will eat when they gather together and can affect the diets people choose to follow to avoid social alienation.
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Nutritional Prevention in Alzheimer’s Disease
Alzheimer’s disease is a very complicated disorder and it is not completely understood yet. There have been very few studies in relation to dietary intake and nutritional prevention of Alzheimer’s disease. Some recent researchers have been geared towards finding out what preventions would best combat Alzheimer’s disease or cognitive depression in general. Some people recommend a specific diet, while others suggest to raise or lower just a few specific nutrients. There is varying opinions as to what the best method for prevention is, but the general consensus was to eat a healthy diet and stay active throughout the aging process. Some researchers have attempted to get more specific and determine which nutrients are important for Alzheimer’s prevention. There are some different organizations and groups with interest in helping prevent the onset of Alzheimer’s disease. BrightFocus is a foundation that currently funds research for Alzheimer’s prevention.
A long with funding a researcher, Alzheimer’s Prevention: Nutrition & lifestyle (2016) also discusses some strategies that could be taken immediately, and potentially decrease the risk of Alzheimer’s disease. The people at BrightFocus say that cardiovascular disease, diabetes, and obesity can all contribute to the onset of Alzheimer’s. They believe that someone should maintain active, both mentally and physically, as well as eat an appropriate diet to reduce the risk of cardiovascular disease. The only Dietary advice given is to eat healthy fats like Omega-3’s, and generally have a low-glycemic diet (Alzheimer’s Prevention: Nutrition & lifestyle, 2016). The website does not list any evidence for their claims, but it is presented in a simple manor for the average person to understand. There are other organizations and people who want to spread the information about Alzheimer’s disease and possible prevention strategies. Another website discusses similar ideas for prevention of Alzheimer’s; (About dementia/Alzheimer’s disease, n.d) gets into more detail about the healthful food options and the reasons for making the dietary changes. They suggest a diet rich in omega-3 fatty acids as well as vitamin E and a few others for the antioxidant behaviors.
The most important dietary influence to Alzheimer’s disease in the harmful protein compound homocysteine (About dementia/Alzheimer’s disease, n.d). They then discuss a couple studies that associate low levels of homocysteine with high levels of the vitamins B12, B6, and folate. Lowering levels of the protein homocysteine can reduce or slow cognitive decline, and can be lowered with B12, B6 and folate supplements (About dementia/Alzheimer’s disease, n.d). Some other people recommend specific diets in order to highlight the good nutrients and limit the harmful ones. Murad from Mayoclinic.org (2018) has a few suggestions for the average person. She recommends a type of Mediterranean diet called the MIND diet; this diet is meant to highlight the beneficial nutrients while limiting the harmful ones. The diet is higher in green veggies, with minimal red meat, and fish frequently as with other healthy fats like oils and nuts. This diet emphasizes on reducing risks for other health problems like cardiovascular disease and hypertension, which can be risks for cognitive decline.
While the diet cannot reverse anything that has already been done, it is seen with reducing the cognitive decline or delaying it (Murad, 2018). On the other hand, the actual researchers suggest that Omega-3 fatty acids, found mostly in fish, is an invaluable source for Alzheimer’s prevention. The intake of Omega-3 fats was inversely associated with the risk for Alzheimer’s disease (Morris, Evans, & Bienias, 2003). Morris et al. (2003) claims that one or more fish meal per week can reduce Alzheimer’s risk by over half. The people who consumed more Omega-3’s a 70% reduction of risks, as compared to the people who hardly consumed the Omega-3’s. In general, Morris et al. (2003) claims that Omega-3’s and fish consumption is associated with lowering the risks of Alzheimer’s disease or cognitive decline. According to this study, DHA was the main Omega-3 having the strongest effects on Alzheimer prevention (Morris et al., 2003). Other researchers have been interested in the association of omega-3 fats, eating fish, and the prevalence of Alzheimer’s disease. Another study by Devore et al (2009) has findings of no benefit in increasing Omega-3 intake or fish consumption. Their study shows that someone still has the same amount of risk for getting Alzheimer’s with high fish consumption or not.
At the same time, other studies have found associations between the fish, omega-3 fats, and Alzheimer’s risk. Fish consumption is associated with less cognitive decline in 5-years (Gelder, Tijhuis, Kalmijn, & Kromhout, 2007). This still coincides with the study from Devore et al (2009), because they found some benefits to fish consumption, but for only about 8 years. Fish consumption is a major source of the fatty acids, and protects in limiting cognitive decline in older men (Gelder et al., 2007). Fish consumption was consistent throughout each of the articles or studies; the only difference is the length of time for the protection against cognitive decline. The MIND diet suggested by Murad (2016) highlights the key nutrients from the other studies performed. This is helpful for the average person, because it gives them ideas of the foods they should eat. In general, the information geared for the consumers was similar to the information found from the studies. Each of the websites recommended consuming fish regularly, while watching other risk factors such as cardiovascular disease and hypertension. In Morris et al., (2003) and Gelder et al., (2007) fish consumption was associated decreased risk for Alzheimer’s; furthermore, Devore et al., (2009) goes the furthest out in timespan for the study.
Devore et al., (2009) found that the benefits only last about 8 years before cognitive abilities are about the same as people who consume less fish. Overall, the studies seem to support the evidence that was presented in the websites. The studies and the website all shared similar information, with the websites being in a much simpler format for the average adult concerned with their cognitive abilities. Alzheimer’s prevention still is not completely clear, but researchers are starting to learn more about it in the recent years. Some websites and blogs relay the information, at the same time they try to push their specific products or diets. The websites suggested their solutions as the answer to the question, while the studies still require more data to completely prove the association. There is some evidence for this nutritional prevention of Alzheimer’s disease, but it is not as sure as the websites are claiming it to be.
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Nutrition Recommendations
Josephine’s current height and weight are 5’2” and 117lbs. At 20 years old this puts her BMI in the normal range at 21.4 (Bmi-calculator.net, 2018). Even though she has an eating disorder, it’s not until the BMI reaches less than 18.5 that it is considered underweight (Bmi-calculator.net, 2018). Of course, BMI isn’t always the most accurate anthropometric measurement. Body type should be taken into consideration as well as the ratio of body fat mass to lean mass.
The last time Josephine was in my office I put in an order for blood work. I recently received the results of those tests and have been able to evaluate them. Of the five vitamins and minerals, as well as albumin I tested for, only one came within normal range. Her potassium, although on the lower end of the scale was still in the normal range at 3.8 mEq/L. Josephine’s albumin, sodium, iron, and vitamin B12 were all lower than what is considered in normal range. In short, the reason her levels were lower than normal is because her food intake has decreased due to her eating disorder. However, I have assessed her dietary record and looked into why each nutrient was insufficient.
Potassium is essential in maintaining the balance of fluids and electrolytes (Healthyeating.sfgate.com, 2018). I believe the reason Josephine’s potassium levels are at least in range is because navy beans and avocado, both foods of Guatemalan culture, are rich in potassium. Her iron is very low because she is not eating enough red meat or a lot of dark leafy greens (Healthline, 2018). Down the road Josephine may suffer from anemia due to her lack of iron in her diet. I see that she consumes very little meat and dairy which is making her deficient in B12. This deficiency can cause her to experience weakness and fatigue (Skerrett, 2018). Although it’s encouraged to intake a lower amount of sodium to ward off high blood pressure, consuming too little can be harmful as well. Sodium, like potassium, helps our bodies regulate fluids around our cells (Verywell Fit, 2018). Josephine teaches salsa throughout the week and most likely sweats during her classes. I don’t see that she is drinking beverages with electrolytes as she teaches or that her mother cooks with salt, which explains why her sodium is low. Lastly, her albumin levels were lower than normal range. Albumin binds with other substances in the blood and transports the substance to different parts of the body. Josephine’s weight and malnourished state is the cause of her low albumin levels and can lead to the accumulation of fluid in the abdomen and lungs if she does not change her diet (Hepatitiscentral.com, 2018).
After reviewing Josephine’s food record, I see many areas that need improvement. The first recommendation I have for Josephine is to increase her intake of red meats and dark leafy greens in order to increase her iron levels. It will become difficult for Josephine to maintain going to school and teaching salsa classes if she is feeling weak or fatigued. My second recommendation is to add in 2-3 snacks throughout the day. Josephine may feel less guilty about eating snacks if they are healthy. It may also be not as overwhelming to her if the snacks are small. She will not experience feeling overfull and she will also have the added benefit of subtly increasing her caloric intake. Thirdly, I recommend adding some sodium to her diet. This can be in the form of moderate amounts of salt added to prepared foods or even drinking Gatorade in the evenings when she teaches salsa. This will help her body maintain the proper fluid balance.
It’s important to have specific and measurable goals for Josephine to work on in order to improve her diet and overall her health. The first goal is to maintain her weight so that she does not fall into the underweight BMI category. Considering she is teaching salsa throughout the week, Josephine needs to be eating 1,725kcal/day in order to maintain her current weight. I think it’s a good goal for Josephine to commit to meeting her current daily energy requirements. I don’t recommend that she counts the calories herself, but I would like her mother to be in charge of that task, so Josephine does not become obsessed with the number. The second goal I have for Josephine is to increase her dairy intake to 2 servings a day in the form of 2 snacks. The first snack can be Greek yogurt with fresh fruit and granola and the second snack can be whole-wheat crackers with a soft cheese spread and avocado slices. This increase in dairy will help increase her B12 intake. My last goal for Josephine is to make a conscious effort to consume one 16fl oz. bottle of Gatorade on the nights she teaches salsa. This increase in sodium will stabilize her fluids and prevent her from becoming dehydrated or weak, while also contributing to her daily energy requirements. I believe that these are manageable goals for Josephine, especially with the support from her family.
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Gene and Genetic Expression and its Contribution to Nutritional Assessment
Nutrition and diet has become a focal point in the prevention of disease. The tools doctors have at their disposal have done a fair job, but what if there could be a better and more individualized way of making recommendations regarding nutrition for disease prevention? The nutritional assessment tools doctors have been using lack an individualized look at a patient’s genes and genetic expressions. Nutrition in a perfect world would be tailored to an individual’s unique needs and requirements since genetics vary from person to person. A new way of looking at nutrition and disease prevention is through the use of Nutritional Genomics. Nutritional Genomics offers patients and doctors an in depth look at genes and genetic expressions, taking into account the smallest of aspects regarding a patient’s health. With the assistance of this analysis, doctors have an opportunity to help patients who don’t fall under the umbrella of the average individual find the nutrition and disease prevention they’ve been looking for.
In the United States, the use of Dietary Guidelines is the source of information regarding nutrition and helps in the development of the Federal governments food polices and other important information regarding health, nutrition, and disease prevention.1 Traditional ways of analyzing a patient’s health come from plans such as Dietary Guidelines, which aims to give advice and guide our way of planning, managing, and executing health.1 The issue with this way of thinking comes down to the fact that these plans are based off average individuals making all of society seem uniform, when in reality there is much diversity in age, sex, race, genetics, gene expressions, and disease predisposition. Instead of relying on the government to fulfill its duty of guiding proper health and nutrition, the use of Nutritional Genomics can be implemented to give patients a more individualized approach to their health.
Nutritional Genomics can look at an individual’s unique genes and assess what type of disease the individual may be predisposed to. When analyzing the genetics, a key maker is Single-Nucleotide Polymorphisms (SNP’s) which helps make each person unique in their own genetic way. Looking at SNP’s allows doctors to focus on 30 genes that could play a role in a patient having a disease or getting a disease and how their diet and nutrition could be correlated. By looking this deep, it allows us to give the patient exactly what they need and slow if not prevent any complications in their future health. Getting doctors and health professionals to think Nutritional Genomics is a difficult task though. Analyzing an entire genome is costly and that could be a deciding factor when choosing how to make nutritional and disease prevention recommendations. What will help drive cost down and get doctors to choose this as a standard will be further testing and positive results.
The use of Nutritional Genomics in formulating diet and nutrition recommendations for patients has the potential to be a significant breakthrough. Utilizing this method provides the patient with a more thorough guide to their health and nutritional needs and helps doctors be more precise in their recommendations. The primary obstacle for Nutritional Genomics to get past is the cost to benefit ratio. Until we can get the cost of genetic analysis to come down, it will remain difficult to implement this as a new standard of thinking in nutrition among health professionals. Further research and trials must continue to reproduce positive results in an attempt to swing momentum in favor of Nutritional Genomics as part of our diet and nutritional planning. Nutritional Genomics plans will allow us to move in a more modern direction of thinking in regards to an individual’s nutrition and leave behind the classic all-encompassing ways that have been limiting us for years.
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Energy Balance in Relationship to Nutritional Health
May 22, 2018 DRI Recommendations in comparison to Energy Intake Intake Status kcal 2082 UNDER Carbohydrates (g) 124 UNDER Fats (% of kcal) 62 OVER Proteins (g) 114 OK Table 5: May 23, 2018 DRI Recommendations in comparison to Energy Intake Intake Status kcal 1784 UNDER Carbohydrates (g) 119 UNDER Fats (% of kcal) 61 OVER Proteins (g) 103 OK Table 6: May 23, 2018 DRI Recommendations in comparison to Energy Intake Intake Status kcal 1884 UNDER Carbohydrates (g) 119 UNDER Fats (% of kcal) 61 OVER Proteins (g) 103 OK Table 7: DRI Recommendations in comparison to Average Energy Intake (May 22- May 24, 2018) Intake Status kcal 1917 UNDER Carbohydrates (g) 121 UNDER Fats (% of kcal) 61 OVER Proteins (g) 104 OK Energy Expenditure In table 8 you can see the data from my energy expended over the course of three days. As you can see in table 8 the results had significant variation. You can see a similarity between days 2 and 3 due to the low intensity exercise completed on those days. Although on day 1 there is a significant increase in the energy expenditure due to the increased time and intensity of exercise completed. Total Energy Expenditure (kcals) by Date of Data Collection Date of Collection Energy Expenditure (kcal) Difference between day (kcal) May 22, 2018 3532 May 23, 2018 2800 Decrease by 732 May 24, 2018 2454 Decrease by 346
Throughout the three consecutive days of data recorded and compared, the energy expenditure greatly exceeded the dietary intake on day 1, moderately exceeded on day 3, and minimally exceeded on day 2. There is a visualization of the overall trend between intake and expenditure over the course of the three day collection period located in figure 4. Overall I consumed an average of 1917 kcals and expended an average of 2928.6 kcals, so on average I exceeded my dietary intake with energy expenditure by 1011.66 kcals.
Discussion
As I was looking at my daily averages in my dietary intake and energy expenditure over the consecutive three days of data collection, my hypothesis was proven to be correct. In my hypothesis I had predicted that I would have a negative energy balance, and because my dietary intake was less than my energy expenditure it resulted in a negative energy balance and proved my hypothesis to be correct. I wasn’t surprised by my results because I plan my meals and my exercise requirements from my doctor are very precise.
Throughout this period of time I was meticulous with my meal preparation and completing every task with accuracy because I want to heal from my recent sickness and feel better. I was recently taken off of a steroid called prednisone which caused me to get sick in the first place, and that made me extremely hungry all of the time, so now that I am off of that medication and am back on my ADHD medication and am taking the proper supplements, my cravings have subsided and given me the ability to have more self control and precision within my dietary intake. The data from the three consecutive days only varies within the exercise because of my limited food options and meal preparation required to meet my dietary restrictions and requirements. Although depending on the level of movement planned for the day I increased or decreased my planned amount of food to be consumed. This is a good representation of my recent lifestyle and the lifestyle I will maintain over the next three months or until otherwise specified by my doctor. It was difficult initially to abstain from eating out with my friends, but due to my dietary limitations it is a requirement, so when we would go out I would either bring my tupperware of food or just drink ice water, this reduced my calories substantially when I first started this diet.
It was difficult to plan and prepare my meals during a time when I can barely attend my classes and am trying to catch up in school, as well as navigating the die off symptoms that occur with this diet. On May 22nd I expanded significantly more energy than on the other days recorded because of the jogging I completed. The other two days were supposed to be easy forms of movement which were yoga, hiking, strength training, and biking. Those activities are not as hard on the body and expend less energy. On this diet plan it is imperative that I do not work my body too hard due to the massive amount of dietary restriction that has been implemented. My intake values were consistently either over or under the recommended DRI values because of the unique diet I am on restricting the amount of carbohydrates consumed and increasing the amount of fat and protein consumed. I was also consistently below the DRI recommendations for daily kcals. This information tells me that I should be eating more food per day and more nutrient dense food that provide higher amounts of kcals. It also tells me that I should reduce my fat intake and increase my carbohydrate intake.
This poses a conflict to my doctors recommendations, although these are good for the majority of people with my attributes, the recommendations are inherently flawed because they do not account food allergies or dietary restrictions. I was not surprised about the lack of carbohydrate intake throughout the three days because on the specific diet I am on, it is requested that I do not consume traditional carbohydrate filled foods such as fruits and most grains, and if I do they need to be on the specified list given by my doctor. This series of data collection helped me analyze my consumption and recognize the amount of fat within meat proteins and the amount of carbohydrates within foods that we often do not assume to be carbohydrate filled. I am a college student on a budget, so abiding by a strict diet while sticking to a strict budget presents a challenge. But I overcame this challenge through strategic meal planning and changing the spices on similar dishes with the same ingredients in order to obtain some variability in the food that I am consuming. I realized that it is hard to consume the amount of calories recommended by the DRI while abiding by a strict diet such as the one I am partaking in.
The candida diet usually results in major weight loss which I have found, but through this activity I have found that when I track the calories closely I can adjust my energy expenditure and intake to slow the weight loss because it is all about calories in versus calories out. Throughout my process collecting data, I initially used the notes application within my iPhone for the purpose of collecting specifics and the times in which I consumed each food. Then I implemented the data into the myfitnesspal application which I have been using since I was a junior in high school when I trained with a personal trainer in pursuit of competing in a bodybuilding competition. This app is incredibly helpful when tracking your food and exercise because it has an expansive database with majority of food types and brands, as well as a label scanning option where you can scan any packaged food you have. You can also enter your own food item if you cannot find it in their database. This application provided me with knowledge and ease when measuring and calculating my micro and macro nutrients to make sure I am meeting all of my doctors requirements. Although this application provided a vast amount of information and was easy to use, when I came to inputting my data into the USDA SuperTracker, I found some difficulty because of their limited options.
This provided me the opportunity to add my own information into their database using the data from MyFitnessPal in order to reach the level of precision I was looking for in my data analysis. I thought it was important to enter the data, although it was an extra step, if I would have just picked the closest alternative it would have squed my ending data. There are a variety of databases connected to the SuperTracker that provide ease to the user when comparing their personal intakes and expenditures with the DRI recommendations, but the lack of variety and minimal alternative food options it creates either an extra step for the user or if the user chooses to estimate what the closest type of food and amount would be, it changes their data and results in inaccurate results. The data I recorded from the three consecutive days of intake and expenditure were relatively consistent other than the expenditure and overall calories, but are a quality representation of what a typical week would look like for me. In an effort to follow the guidelines of my doctor and save money buying food, I usually buy in bulk and then freeze what I do not use while preparing my meals.
The meal preparation and consumption of similar foods given my limited options and budget provided a lot of consistency in my diet, versus the diet I had prior to my diagnosis. This reduced my consumption in kcals and the importance of movement and precise recording of my intake and expenditure has substantially changed my habits and required a lot of planning. Planning my meals and days around exercise and timely food consumption has increased my kcal expenditure as well because I am making my health a priority. Although my intake and expenditure data prior to this lifestyle change are not recorded, my kcal expenditure has significantly gone up. There was some difference in energy expenditure due to the distance between classes per day as well as the required exercise and level of intensity of the specific exercise. On May 22nd I showed an increased energy expenditure because it was my heavy cardio day and I had the longest distance to walk to class. I also went on a walk with my friend and her dog because it was a nice day, so that added to my kcal expenditure.
Conclusion
Concluding my analysis, my hypothesis was that I would be at a negative energy balance, and that was supported through my three day data collection and analysis. I expected that my dietary intake would be lower than my energy expenditure which would result in an negative energy balance which was accurate because of my precise recommendations given by my doctor. My results were relatively consistent regarding my dietary intake besides the increase and decrease in calorie intake, the composition of overall calorie intake regarding macronutrients were relatively similar. Although, my energy expenditure varied depending on the day due to workout differentiation and the distance walked between classes. I found that there are various flaws within USDA’s Supertracker and many features I think would be a great addition to the program. First, they could partner with Nike and MyFitnessPal to braden their ability and food database because it was difficult to find certain foods. It would grow the amount of users and give them a broader, deeper look at their food intake and expenditure and how their bodies respond to that regarding their energy intake and expenditures and nutritional composition.
References:
Boose, K. (2018). Lecture 2. Anth. 220, Nutritional Anthropology. University of Oregon. USDA. (2016). SuperTracker. Retrieved from https://supertracker.usda.gov/default.aspx
A way out of the junk-food eating cycle. (2017, January 27). Retrieved from https://www.sciencedaily.com/releases/2017/01/170127112939.htm
Hyman, M. M. (2017, February 08). Food As Medicine, The Blood Type Diet And The Ketogenic Diet. Retrieved from https://www.huffingtonpost.com/entry/food-as-medicine-the-blood-type-diet-and-the-ketogenic_us_5899ddede4b02bbb1816bfd3
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Nutritional Anthropology
Introduction
Throughout the field of nutritional anthropology, energy balance is used to obtain data and insight regarding the nourishment required by food intake in order to sustain our bodies in relation to the physical activity needed to sustain a healthy lifestyle that is balanced with our energy intake. Although you can be in positive, negative or perfect energy balance, a person’s energy balance does not determine their nourishment and health. Although the USDA gives recommendations regarding intake and expenditure, they are inaccurate similar to the recommendations on food labels (lecture 2, Boose) because they do not take into account the various diversifications that contribute to a person's health. Energy balance is a good indicator of health, but not a perfect indicator because someone could be eating poorly and be within the calories in versus calories out metrics of energy balance. A healthy lifestyle goes beyond energy balance, it is composed of micro and macro nutrient fulfillment within a person's diet, exercise, sleep, and water consumption.
Although someone may be consuming the proper amount of calories they may not be getting the recommended micro and macronutrient recommendations, and even if they are consuming the recommended nutrients they may not be absorbing them due to food allergies resulting in nutrient deficiencies. My hypothesis is that I will be relatively close to achieving energy balance, but I will be over the recommendations for fat and protein in my diet and under on the amount of carbohydrates consumed within my diet. I predict that my expenditure will exceed my intake, yet I will feel energized due to the increased nutrient absorption within this new diet. Methods & Materials I started my intake and expenditure diary on May 22nd, 2018 and ended on May 24th, 2018. I recorded data points from these three consecutive days because they were the closest representation to what a common week looks like for me in this season of healing my gut from food allergy damage.
I collected my data in Eugene, Oregon on my Iphone through the notes application, then I put the information into the MyFitnessPal application starting on Wednesday and synced my expenditure data with the movement data from my apple watch. After that I inputted the data into the USDA SuperTracker and created reports for the following selected three days and analyzed the reports provided by the USDA on the SuperTracker website. I used my processed data and compared it to the information and recommendations from the Anthropology 220 videos, modules and the appendix. I also recorded how I was feeling during workouts and before and after meals so that I could monitor the absorption and energy relationship throughout the three days. I analyzed the data recorded using the Anthropology 220 lecture materials, readings, and the SuperTracker information. (Boose,2018)
DIETARY INTAKE
The data I collected consisted of intake from when I woke up until I went to sleep during the three day period selected. I recorded all of the food, drinks and water that I consumed throughout this time period using my notes on my Iphone and MyFitnessPal, which is an app on my Iphone. I recorded the quantity and mealtimes in my notes prior to entering the information into any applications. After I entered the information into my phone, at the end of the day I would enter it into an Excel spreadsheet on my Laptop. I am required to closely measure the food which I consume outside of this assignment due to a recent illness and food allergies, so all of all of my food intake was measured closely and prepared at home with as many fresh ingredients as possible. Using the MyFitnessPal application assisted me in measuring the different nutrients that I consumed over the three day period and gave me more accuracy and knowledge due to the large database provided on the application. My water intake was measure by the 1 gallon jug that I use to make sure I am getting all of the recommended water which my doctor asks me to consume daily. I utilize a food scale to precisely measure how much meat I am consuming in ounces.
My naturopath asked me to measure my fruits and vegetables in cups for accuracy in my diet prior to consumption. The data points I recorded for this assignment were extremely precise due to the diligence and specificity required by my doctor in order to heal my gut and return to optimal health. Energy Expenditure I collected the data for my energy expenditure from 12:00 am on May 8th to 11:59 pm on May 22nd. When calculating one day of expenditure I started at 12:00 am and concluded that day at 11:59 pm the following night in order to get a full 24 hours. This data was recorded in kilocalories (kcal) of the energy expended within the daily time period and compiled for an overall energy expenditure from the total energy expenditure over the 72 hour time period. The activities producing increased energy expenditure were recorded in minutes, I also recorded the amount of steps I had taken throughout the day using my apple watch pedometer. I utilized an Iphone application called Nike Runner’s app to measure the mileage and pace of exercise. I was following a precise exercise regimen from my doctor in order to keep my immune system healthy so my body could heal. All of my exercise was recorded in steps, miles and minutes which helped me calculate overall energy expenditure.
I also recorded my peak heart rate and level of difficulty of the exercise to help evaluate my bodies changes in health when sticking closely to my doctors guidelines. After recording data and inputting it into programs on my Iphone and computer I did hand calculations and wrote them into my diet and exercise journal for my doctor. Exercise and expenditure was as precise as possible due to the deficiencies of technology, sometimes miscalculating steps or heart rate, but overall relatively accurate. Data Analysis Initially I recorded three consecutive days of data in my iPhone using the notes application. Then I used myfitnesspal, Microsoft Excel, USDA’s SuperTracker, the Anthropology Appendix and information provided, research, and my doctors information, and guidelines, I analyzed my data points and adjusted my food and exercise to be more precise and in line with my doctors requests. Often the foods and supplements were not included in the SuperTracker so I entered them based on the information on MyFitnessPal or on the label of the food.
A computer generated Nutrient Intake Report on MyFitnessPal and SuperTracker was used to find the micronutrient and macronutrient breakdown of the foods individually and collectively. This report contained the daily averages and totals of proteins, carbohydrates and fats all measured in grams, micronutrient totals, and the average expenditure measured in kilocalories.Then this data was calculated in my excel document and recorded in my journal to measure the averages and adjust my intake and activity over the course of three days. My intake and expenditure was compared to the guidelines given by the Dietary Reference Intake (DRI) provided to users by the USDA. The DRI guidelines that people are given are calculated based on their attributes including their weight, height, gender, and their age in order to determine the best DRI recommendations for that specific person which can be found on the SuperTracker program. We produced different data points for each day of data collected because of the daily differentiation in intake and expenditure. We used the appendix provided to determine the physical activity data to input into the formula and into Microsoft Excel to determine the kilocalories(kcal) expended per day. All of our data was entered into Microsoft Excel, resulting in the total kcal expended per day as well as the summation of kcals expended over the course of three consecutive days. After we calculated the total kcal expenditure we utilized Microsoft Excel to compare the dietary intake data using a correlation coefficient analysis on Microsoft Excel.
Results Energy Intake Table 1: Total Energy Intake (kcals) by Date of Data Collection Date of Collection Energy Intake (kcal) Difference between days (kcal) May 22, 2018 2082 ------ May 23, 2018 1784 Decrease by 298 May 24, 2018 1884 Increase by 100 My total energy intake for each day that I collected data is shown within table 1. The energy intake varied throughout the three days, on the first day I consumed significantly more kcals because I prepared higher caloric meals due to the expected increase of expenditure during my higher intensity exercise day. The last two days were closer in intake. You can find the average macronutrient distribution within Figure 4.
In table three you can find the DRI values established based on my height, weight, age, and gender (USDA, 2018)According to the USDA these are the values of kcals and macronutrients someone with my attributes listed above should achieve and maintain in order to establish and sustain a good measure of health.
Table 3: DRI Targets Based on Age, Sex, Height, and Weight kcal Carbohydrates (g) Fats (% of kcal) Proteins (g) 2500 130 20-35% 46 You can find the comparisons of my daily dietary intake in comparison to the recommended intake values of the DRI over the course of the three day consecutive period recorded in tables 4, 5, and 6. To decipher the tables it is helpful to know that the status column tells the user if they have satisfied the recommended DRI value for the specific macronutrient. If it says “OK” that means you have satisfied the recommendation, “OVER” tells the user that their intake of that specific category exceeded the recommendations given by the DRI, and if it says “UNDER” that means that the user did not meet the given recommendations of intake based on the DRI. These words although they are helpful do not give a precise indication to the user because you could be almost in the OK category but it would still read OVER or UNDER the same regardless of if it is substantially over or under or minorly in either category.
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Malnutrition in College Campuses
Malnutrition is a huge concern among universities across the United States, more specifically for students, staff, faculty, and other lawmakers that surround California State University: San Jose. The World Health Organization defines malnutrition as “deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients.” This may be found as a result of eating too little, eating too much, and eating unhealthy foods. Solving this problem in an ethical manner would constitute virtue ethics in which individuals do the right thing, in this case help for the greater good and help properly nourish those fighting malnutrition, while building their character at the same time. People decide what kind of moral compass shape up their beliefs and unite as one in the shape of clubs and organizations to fight for one cause. The Greek Philosopher Aristotle rejected absolutism in regard to ethics and believed that Greek virtue are the skills and opportunities you managed well. To be virtuous is to act with excellence and to discover something’s purpose, and investigate what that thing does best.
Therefore, if something performs its function or purpose effectively it is virtuous. When it comes to accomplishing a certain task or a certain goal we must constantly practice the virtue and make it a habit according to Aristotle. Deciding to start living a healthier lifestyle and be a great way of practicing virtue ethics. This would not only benefits ourselves but the people the surround us as well. There’s two forms of virtue, which are moral and intellectual virtues. The moral virtues are when our soul is trying to control desires. Intellectual virtue is when our soul concentrates on intellectual and spiritual matters. With this they are able to learn well, think straight and act accordingly. Moral virtue is determined by the intellectual virtue of wisdom. Then there’s the Golden mean which is discovered through various reasons such as, the concept of moderation, by utilizing the golden mean we can become a good person, and that a moral person knows how to balance what is too much and too little. The actions that are wrong we should avoid but should strive for the ones that are right according to this ethical theory. As a college student it’s definitely hard to have a healthy lifestyle but every action or feeling can be done in the right amount.
This ethical theory is criticized of being an ethical relativist because virtue is relative to situation and culture. However, Aristotle says that the virtues are universally there, soft universalism is a great example of that. They also say that virtues are to vague, that it is so uncertain to say something is the right amount or what to avoid and what not to avoid. When it comes to our health though we know what we should be consuming and what we should not. In order to have a healthier life in the long run we start deciding the right and wrong for our bodies now. They also ask themselves what happens when two virtuous people disagree? Well there’s always a reason why people disagree but that is when compromise kicks in. It’s important to recognize that college students are most likely living their first years as independent individuals but unfortunately, this has both its ups and downs especially its huge down - one’s diet. These students are open to a pandora box that gives them the option to freely choose what they’ll consume, something that may be influenced by various factors and unfortunately, the healthier alternative typically isn’t the optimal alternative for the student. Often times, it may be much more practical for students to consume foods and drinks that are much more accessible to them such as fast food, grab n’ go junk food, and many other unhealthy choices since it takes much less time to get a hold of these kinds of foods.
In the long term, these food choices will ultimately harm students’ bodies as a result of constant consumption. Moreover, this problem may be experienced much more heavier by students living in off-campus housing as their susceptibility to fast food is much greater. It’s much more conventional for them to grab something from a fast food joint as a result of its prep and serve time along with the price tag. In contrast, students opting to cook at home may usually find themselves spending much more time preparing the food, cooking it, and sitting at the table to consume for a most likely bigger cost although this option most likely is a much more healthy one as a result of avoiding the high-fat and high-carbohydrate foods typically found in fast food places such as McDonald’s or Chipotle. Additionally, these foods most likely will contain little to no servings of fruits and vegetables, options that are a huge part of having a balanced meal as a result of its important nutrient properties. Choosing to stick with on-campus food or dining at home may be better for the body as a result of choosing to opt for smaller portions of food. Another dilemma that typically complements malnutrition is that composing food insecurity, which typically plays a big part in students’ performance and participation in the institution. It’s notable that many organizations and programs have made continuous efforts to fight this issue for the future generations of college students in the Silicon Valley.
The USDA, the United States Department of Agriculture, defines food insecurity as “a lack of consistent access to enough food for an active, healthy life.” A tangent related to food insecurity many students might have in relation to this topic is the negligence of the on-campus and off-campus programs and resources available to them. Though this may be as a result of exposure/marketing by these programs, it’s important to note that a bigger role should be played by these organizations to make their voice heard in order to help others. This relates to the virtue ethics as people are willing to help for the greater good but more often than not, their efforts must be increased in order to help those in need of it. Moreover, the topic of this essay relates to combating malnutrition at a local level at California State University: San Jose since combating this problem on a worldwide scale would require much more research and specifics on economies of each governing body and countries around the world. Multiple food opportunities are available to CSU San Jose students to combat the devastating effects of malnutrition on the daily including the Spartan Food Pantry, Just in Time mobile food pantry, and CalFresh application assistance.
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Nutrition and Foods
Asking the question “why do we eat?” seems like an obvious one. We eat because we’re hungry. Food provides us with the energy we need to support our everyday activities and, ultimately, promote our survival. The sad reality is that nutrition education is rarely a priority in the school system. This is most likely due to the fact that most schools simply don’t have the time or the resources to focus on food/nutrition education. Also, people can “easily” educate themselves on the internet. Many people are unaware that diet plays an essential role in preventing and treating certain chronic diseases. Thus, without the proper guidance, patients may follow a dangerous pathway and produce greater complications. Physicians and nurses are often the first people to counsel patients about how their diets and lifestyle habits affect their everyday activities. As a future nurse, this course taught me how to create a meal plan that promotes good health. It also taught me how important it is to make necessary lifestyle changes to live a normal life, specifically for someone who lives with diabetes. Finally, this course taught me how nutrition affects changes in the immune system and vice versa.
One important aspect I learned from this nutrition course was how to use diet-planning guidelines to make wise nutrition decisions that promote good health. We live in a world with more than enough food to choose from. Our daily food choices are greatly influenced by taste and habit. Therefore, it is easy for us to choose food without paying any attention to its nutrient contributions or health consequences. According to the Understanding Normal and Clinical Nutrition textbook, you must keep in mind six basic diet-planning principles when developing a meal plan: adequacy, balance, kCalorie control, Nutrient density, moderation, and variety. Adequacy in a diet provides the body with “enough of all the nutrients to meet the needs of healthy people” (Rolfes and Pinna Whitney 38). We lose nutrients every day by participating in regular activities; therefore, we must replace these nutrients with more found in our food. I’ve noticed that I feel very lethargic after a few hours of not eating. I will plan to eat small snacks throughout the day to keep my energy level consistent.
Balance refers to “consuming enough – but not too much – of different types of foods in proportion to one another” (Rolfes and Pinna Whitney 38). All foods are not created equal. I learned that it is important to not eat too much of one type of food because it may lack essential nutrients. When I was in college, I ate a lot of rice and broccoli because I knew it was fairly healthy and incredibly easy to make. However, I ignored the fact that rice and broccoli don’t contain all the essential nutrients my body needs. Therefore, I will add a variety of foods into my meal plan to get an adequate amount of nutrients. kCalorie control is another important principle to keep in mind when planning a meal; the key is to choose foods of high nutrient density. Nutrient dense foods “deliver the most nutrients for the least food energy” (Rolfes and Pinna Whitney 38). In addition, moderation refers to eating foods rich in solid fats and added sugars only on occasion. This principle emphasizes how our food choices are often influenced by taste. Therefore, adding variety will not only give the body with many nutrients, but it may refrain you from going back to those tasteful foods – rich in solid fats and added sugars – by keeping the meal plan interesting and new.
Another facet I learned from this course was the significance of making necessary dietary and lifestyle changes to allow people to live long, healthy, and productive lives – especially people with diabetes. I am not diabetic; nevertheless, I learned many approaches to help patients manage diabetes as well as how to prevent myself and others from ever getting diabetes. Type I diabetes is a condition where destroyed pancreatic cells cannot produce insulin. This condition often develops during childhood or adolescence and has a genetic component. On the other hand, type II diabetes is the most common form and is known as non-insulin dependent diabetes. Your body does not make enough insulin to keep your blood glucose at normal levels. Type II diabetes is often diagnosed in individuals who are over 40 years old; however, children and teenagers who are obese and physically inactive are at risk. Therefore, there are simple lifestyle strategies – weight management, dietary modifications, active lifestyle, and regular monitoring – that help prevent the development of diabetes. Millions of individuals have diabetes and so many don’t even recognize they have the condition. Therefore, it is important that we, as future health care provides, educate our fellow citizens with the knowledge and skills necessary for prevention and treatment. Maintaining a healthy body weight is an important guideline for diabetes prevention.
This recommendation is accomplished by adopting a healthy eating behavior and a moderate daily exercise. Physical activity helps prevent hypoglycemia, which is the main focus of this disease. According to the Understanding Normal and Clinical Nutrition textbook, “adults with diabetes are advised to perform at least 150 minutes of moderate-intensity aerobic activity per week” (Rolfes and Pinna Whitney 38). However, physical activity benefits other aspects of health such as, reducing the risk of a heart attack, lowers blood pressure, lowers blood cholesterol levels, creates stronger bones, and manages weight. It is a goal of mine to include a modest amount of physical activity in my daily routine. I will encourage and educate others to do the same as it is such a simple way to increase long-term health. For individuals who have diabetes, managing homeostatic glucose levels becomes the essential reason for treatment. Good glycemic control requires frequent evaluations and an appropriate meal plan. This class has taught me to be more mindful of my meal planning. I am more aware of how certain foods are beneficial for my body while others can cause harm.
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An Active Client’s Nutrition
Introduction and Background of Client
The client assigned, named Glenn, is an active individual with a busy life style. He is a nurse at a local hospital who is on feet a lot during the day, but still makes time to exercise regularly. He enjoys running, hiking, and all things active with his family and friends. He has twin toddlers to chase around as well, but he has been struggling with fatigue recently. Although he has been struggling with fatigue, he has still made it a priority to keep up his active lifestyle. Since he does not want his fatigue to increase or effect his lifestyle anymore, he has reached out to a nutritionist to find out if there could be something in his diet that could be causing it. We asked to document his food for 7 days to see what we could find. He does his best to incorporate vegetables and watch what he eats, but his diet is lacking in some areas.
Results of Diet and Exercise Analysis
Glenn is 5 feet and 10 inches and weighs 150 pounds, making his body mass index 22.2. He falls into the normal category for his body mass index, which reflects his active lifestyle. In the seven days he recorded for us, he exercised 6 of those days. His exercise routine consisted of 3 days of weight training with running 25 minutes and 3 days of running for 45 minutes. In reviewing his full nutritional analysis, we found several deficiencies that could be attributing to his fatigue. In reviewing his overall macronutrient intake, he was deficient all categories nearly every day.
Glenn’s vitamin intake for the week showed a deficiency of Vitamin C, also called ascorbic acid. See Figure 2 for a view of his vitamin c intake for the week. Finally, for his mineral analysis for the week, he was deficient in his potassium, calcium, and iron intake, but was in excess with his sodium.
Discussion and Impacts
Minerals Discussion and Impacts
We discovered two minerals that could be impacting Glenn’s health. The first mineral that we found to be the most significant to attribute to Glenn’s health was sodium. In the week we observed, he was in excess for sodium every single day. Hypertension does not typically have any symptoms, but having a high sodium intake is a risk factor for it (Drenjan?evi?-Peri?, et. al 2010). To counteract the effect of his high sodium intake, he consumed a lot of water at around 3 liters a day. The combination of a high salt diet and a high water and fund intake could pout pressure on his arteries by increasing the volume in his blood. With greater volume, his cardiac output will be higher, therefore causing him fatigue. If this happens over a period of time, Glenn’s diet long term could cause him to have hypertension. Another point the group made was that increase sodium in an individual’s diet might lead to stomach cancer later on (Consumer Reports 2017) and a major symptom of cancer is fatigue. We would suggest that he reduce the amount of chips, fries, and prepackaged desserts in his diet.
The second mineral we found to be significant to his health would be his calcium intake. We found that he was deficient in calcium over the 7 days he recorded. Our major concern with his insufficient calcium intake would be osteoporosis. Again, this is something that does not normally cause symptoms until there is a fracture. Calcium in needed in the diet to help produce the salts in teeth and bone and a deficiency in this could eventually lead to osteoporosis (Peterlik 2013). With Glenn’s active lifestyle and consistent running, osteoporosis could cause him to have a stress fracture later on. Wen would suggest that he add in more dairy products or drink calcium fortified orange juice.
Vitamin Discussion and Impacts
In reviewing his vitamin intake, he was deficient in vitamin C. Glenn’s only complaint was of his fatigue, and one of the first and main symptoms of vitamin C deficiency is fatigue (Johnston, et. al 2014). One of the 7 days he recorded only had 14% of his daily recommended value. Over time, scurvy could develop and lead to periodontitis (Pussinen, et. al 2003) and severe fatigue. Glenn would like to stay as active as possible, so chronic fatigue would negatively impact this. We suggest that Glenn add in more citrus fruits, peppers, and broccoli to his diet.
Macronutrient Discussion and Impacts
Although it appears he did not meet his recommended daily allowance, the major impact on his health of his macronutrient consumption was a deficiency of protein. A deficiency of protein could lead him to muscle loss (Khan, et. al 2017). As Glenn does not want to lose weight, including muscle mass, he should increase his protein intake by eating more meats. This in combination of his calcium intake and his activity level, this poses him at risk of weak bones.
Calories, Exercise, and BMI Discussions and Impacts
For Glenn’s overall caloric intake for the week, he was under his caloric recommended amount for the week. In combining his active lifestyle and caloric intake, this could cause him to have unintentional weight loss. He wanted to stay at his current weight, which allows him to fall under the normal weight category of his body mass index. When in a caloric deficiency, an individual loses weight. Unintentionally being in a caloric deficiency over a long period of time could cause him to actually lose his muscle mass (Hord, et. al 2016). Losing muscle mass leads to weight loss which puts him at risk to fall in the underweight body mass index category. Muscle tissue helps support bones, therefore if he loses his muscle tissue, this could leave his bones less protected. With this in mind, I would recommend Glenn to take up more weight lifting and to run a little less. This will help keep his muscles strong and prevent them from atrophy.
Summary of Overall Diet and Exercise Impacts
Glenn leads a an active life and tries to watch what he eats as best as he can. However, his nutrition does fall short in a few categories. The first recommendation for Glenn would be to reduce his sodium intake. We found this to be the most important for him to change first. Second, we suggest that he add in more vitamin c to hep with his fatigue. Finally, we recommend that he eat more protein and run a little less to prevent muscle and unintentional weight loss. With these changes to his diet, it could improve his overall health and wellness, and decrease his fatigue so he can enjoy his active lifestyle.
Cite this page
An Active Client's Nutrition. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
The Supplemental Nutrition Assistance Program
Abstract
This paper will attempt to encompass the Supplemental nutrition program, but specifically, fraud in this program. The author will detail the history of SNAP, give a description of the program itself, and then go onto analyze the program. From here, the paper will detail how how the program is exploited by fraud, how politicians present this epidemic in mainstream media, and if these claims are true. Finally, the paper will provide an alternate to SNAP, analyze its strengths and weaknesses and compare this to the current program in place. The goal of this research is to try to discover if there can be an alternate to SNAP, or if it would be more sensible to patch the holes in the existing program. Keywords: SNAP, Fraud, Alternative, staple food The Supplemental Nutrition Assistance Program
Introduction
The Supplemental Nutrition Assistance Program is a program that is designed to help people in the United States who at or below the poverty level. In an ideal state, the United States government will give a stipend to impoverished people, and they can use this money to buy food. But as with any bureaucratic program, there are a lot of holes in this program that would allow someone to take advantage of the American tax payer.
The original intent of the program was to help out a struggling American get back on its feet, a helping hand in dark times. But today, instead of a hand up, the program is being used as a hand out. According to “Time Magazine,” SNAP, also known as “Food Stamps” is a $70 billion program that provides assistance to 44 million Americans. A government program this big is bound to have some holes that allow for the system to be exploited. This paper will attempt to provide a description of the program, detail the programs structure, how fraud is committed, how politicians use this as a platform, give an alternative to the program, explain its strength and weaknesses, and compare this to the existing program. The end of the paper will decide whether to keep the current system, or whether to move towards an alternative measure. What is the Supplemental Nutrition Program and how does one Qualify? As previously discussed in the paper, SNAP, or “food stamps” is a program that is designed to help those in need. The program itself is run by the United States Department of Agriculture, however, requirements vary from State to State, and for how many people reside in that household.
For example, according to “benefits.gov”, a four-person household in the State of Florida has a maximum total income of $49,200 before taxes in order to receive benifts. Overall, standard requirements across the country require the applicant to be a citizen of the United States and a citizen of the state that you are applying for benefits from, and a Social Security number. According to the “Center on Budget and Policy Priorities”, the average household receives $253. This money is then distributed on an Electric Benefit Transfer (EBT) card and can be used like a debit card. According to the “United States Department of Agriculture: Food and Nutrition service,” EBT benefits can be used to purchase food for a household. Food can be classified into two categories; Luxury and staple. The staple foods include bread, foods fruits, vegetables, meat, fish, poultry dairy, and seeds. Luxury foods include junk food, sodas, steak, bakery items, and seafood. The benefits received can also not be used on things that are inessential to the household, such as pet food, paper products, or medicine.
Retailers and SNAP
However, it is not just people who need benefits that who have criteria to meet in regards to EBT. Retailers have to meet eligibility requirements in order to accept a customer’s EBT benefits. According to the “United States Department of Agriculture: Food and Nutrition,” there are one of two criteria that a retailer must meet. These criteria are “inventory of staple foods” and “sales of staple foods.” In order to qualify under the criteria “inventory of staple foods” the retailer has to have “three stocking units of three staple food varieties in each of the four staple food categories, including three stocking units of one perishable in at least two food categories” (United States Department of Agriculture: Food and Nutrition Services). In order to qualify for “sale of staple foods,” the retailer has to have at least 50% of its total sales come from the sales of staple foods. It is important to mention the retailer because they can commit SNAP fraud as well. What is SNAP Fraud?
According to the “United States Department of Agriculture: Food and Nutrition Services,” there are three kinds of SNAP benefit fraud. The first kind, is when SNAP benefits are exchanged for cash, or also known as trafficking. The second way to commit SNAP fraud, happens when someone lies on their application and receive benefits, or get more than they were supposed to. The third way fraud is committed is when the retailer has been disqualified from the program for prior abuse and lies on the application to get back in. Although these terms seem full of jargon, “Time” gives a couple of really good examples. According to “Time,” food stamp recipients in Ohio were selling their benefits to merchants in exchange for cash. Ever since the economy collapsed in 2008, there has been a staggering increase in benefit fraud. The most recent data, according to “Forbes,” SNAP fraud has increased 61%. What is most fascinating about this fact, is that 5% fewer people are receiving benefits. The United States Department of Agriculture estimates that every cent on the dollar is being used fraudulently by members of SNAP. It is estimated by “Forbes” that annually $592.7 million was stolen in 2016, which is comparable to $367.1 million in 2012. “Forbes also estimates in 2016 there have been 963,965 investigations nation wide. Much like the statistic stated above, although the investigations have increased by 30%, the program cut spending by $8.1 billion in a four-year period.
According to “CNN,” we should expect to see another $17 billion cut in 2019. What should be taken away from these statistics, is that the USDA is doing its job by cracking down on fraud. The Statistics These statistics were provided by the “Center on Budget and Policies Prioritie” article “SNAP is effective and efficient.” These statistics show people who were both over paid, and under paid from the years 1990-2011. According to the “Center on Budget and Policy Priorities,” over paid is defined as “benefits either went to to ineligible house holds, or went to eligible house holds in incorrect amounts.” As we can see by this graph, less than three percent of household were overpaid in 2011. Moreover, the article goes on to say that a majority of the time, overpayment is not done out of malicious intent, but rather, are honest mistakes by either the applicant, the application reviewers, or by the data enters. The United States Department of Agriculture has begun to put in safety net systems to make sure that all eligible households are receiving the proper amount, and ineligible households are declined from the program. Punishment for Fraud Depending on how much an individual fraudulently took, they can be charged with either a felony or a misdemeanor in the state of Florida.
According to “Hussein and Webber Law Firm,” anytime a person uses less than $200 a month for twelve consecutive months, this individual will be charged with a misdemeanor in the first degree, which is punishable by a $1,000, a year of probation, or a year in jail. If an individual has taken more than $200 a month for twelve consecutive months, this individual can be charged with a felony in the third degree, which is punishable by a $10,000 fine, five years in jail or five years of probation. SNAP Fraud in Politics The past couple of years, SNAP has become the target of the republican party. In an effort “protect the American tax payer,” several politicians have made made the reform, or at least targeting abusers, of the Supplemental Nutrition Assistance Program a part of their platform. As a result, the Obama and Trump administrations have aggressively targeted abusers of the program. The most recent statistics on fraud was published in 2017 by the “United States Department of Agriculture: Food and Nutrition Services,” which claims they used a “robust investigation process” which has lead to 849 stores being permanently removed from the program, and sanctioned 549. In 2012, 1,400 were permanently removed from the program. These statistics give credibility to their claim that they indeed have among the lowest fraud rate in federal programs.
Anti-Obesity SNAP: An alternative
There has been a vein of thought running through the Public Administration community which Craig Gurdsen addresses in “SNAP Matters: How food stamps effect Health and Well-being,” which is that SNAP leads to higher levels of obesity. The individuals who contend this point that by moving SNAP in the direction of anti-obesity, they can begin to eradicate fraud, and end a perceived problem of recipients of SNAP being obese. Logic would tell one, that you cannot make someone do something that they do not want to do. As Gurdsen notes, this program was founded to help end hunger in the country. Although he did find that SNAP had positive effects on obesity on a subset of the population, if this program was implemented, it would be likely that both poverty and hunger levels will rise across the country. People who receive the benefits would rather use the cash-like system to continue to buy what they want, rather than being constrained to fight the new criteria of an “anti-obesity” welfare service. American Harvest Box: An alternative According to “CNN,” Another reform to the program that the Trump administration has suggested is taking an approach much like “Blue apron” and providing “meal kits.” What the administration dubs “American Harvest Box,” includes canned good and cereals. Considering the constraints that the institution faces, this is as realistic of an alternative where the government distributes food is going against.
This American Harvest Box the idea of “staple foods” which allows the individual to buy nutritious food, and instead would deliver the box of food to the door of the recipient. When this idea is given some thought, it is easy to see how terrible this idea is. The recipient would go from receiving benefits to buy nutritious foods, to receiving food which Jill Filipovic calls “canned sodium saturated goods.” If the administration implements this, sure it would solve a short term problem of ending fraud and extortion of the American tax payer, but the long term implications are much scarier than the current implications. Much like the anti-obesity reform, it is possible to see an increased level of poverty, but also the level of obesity would increase because of the content of the food being distributed. Besides this, because it would be a large government-operation, it would be possible for the food to go bad, and to still be distributed. Although this is the most feasible option to end the Supplemental Nutrition Assistance Program, it is still not a good reform. Final decision After considering the anti-obesity program and the American Harvest Box, the choice is clear.
The Supplemental Nutrition Assistance Program, with all of its flaws, is the best option. Even though there is a problem with fraud, the United States Department of Agriculture has implemented new investigative techniques, and has announced new programs that would allow for States, such as Massachusetts to communication with the headquarters in Washington DC, and communicate with other states. “Communicate” in the Context of the previous sentence means to exchange information regarding potential fraudulent occurrences. With the Anti-Obesity program, there was in fact a positive relationship between Obesity and receiving SNAP benefits, but to change the entire program because of a subset of the population is unreasonable. There are certain needs that an individual needs that cannot be catered to if they have to abide by a certain standard of food under the program. There is a similar problem with the American Harvest Box. This program would deny people the freedom to buy their own food, and would instead give them a box food that could have gone bad, regardless of their health conditions, such as allergies or high blood pressure. While both of these programs have potential, you cannot deny the allure of freedom to buy the foods that you need.
A potential way to fix the problem in the Supplemental Nutrition assistance program, is to only allow chain retailers to use benefits, instead of anyone who meets the minimum requirements, because most cases of fraud come from small stores. Another way to fix the problem, is to create a wider safety net around the application pool, by making sure both the date entered, and the application is reviewed properly, and entered into their system correctly, to make sure that households are neither receiving more benefits than they need, or receiving less benefits. Conclusion To conclude, the problem of fraud is not as wide spread as it once was. Under previous administrations, the United States Department of Agriculture has been given the tools necessary to end the exploitation of the tax payer.
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The Supplemental Nutrition Assistance Program. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
What is Nutrition?
Nutrition is the process of taking in food and using it for growth, metabolism and repair” (Medical net). Our body depends on the about of nutrients we eat from carbohydrate, protein, fats, water to function well. The nutrients we eat helps our body to work together to it full capacity. During my 24-hour diet tracking it seems like my eating habits are not the best. I do not eat bad food daily, but I am not getting all of my nutrients.
Due to me working, school, and hanging out with my friends I do not make the best choice when it comes to choosing what to eat. For example, during the 24-hour diet recall I notice that most of my food intake was not part of the five-food group. Most of my food was not heavy food, it was mostly snacks. Tracking my food intake during this 24-hour diet recall help me to realize that my diet is poor. It was hard for me to remember to recall my food intake during the 24-hour because I did not eat a lot daily, but my reminder helps me to recall the food that I ate.
Hunger and fullness diet tracking reminds me of when I was younger. I remember eating naturally without worrying about anything. For example, when we were born our parents did not count the able of calories or measure the amount of food we were eating. I remember when my little brother was born, my parents will know that it’s time to feed him when he cries and that he’s full when we stop crying. Even though babies have nothing to do with the assignment, but they are a perfect of hunger and fullness diet tracking. For example, most of the time we eat when food is available. It is something we have being doing since we were younger. Sometimes we eat without being hungry, but because we are hanging out with our friends, family members, or at a social function we decide to eat something even though we might be full. During my hunger/fullness food tracking I discover that when I eat certain food my body reacts to it differently. For example, when I eat Jamaican bee patty for breakfast, I will usually feel tired and heavy, but when I eat blue berry muffin two hours later, I felt excited and had more energy. Whenever I eat noodles for dinner, I felt sleepy. I also notice that I ate a lot of chips, and fruit snacks while I was on campus because I was around my friends and will eat them even though I was not hungry. The pros to doing this assignment was me observing how my body feel after eating most of the food I eat daily. One con I notice while during this assignment was, I had a had time trying to stop myself from eating when I was not hungry.
The past two assignment enough me to improve a little bit on my diet. In my one-week diet tracking on my fitness pal, I recorded all the food I ate during that week with accuracy. I recorded my nutrients, vitamins, carbohydrate, and fats. While tracking my food intake for that week, I notice that my calories level was not high as I expected it to. For example, somedays I was not meeting my daily calories requirements. One factor that made my diary interesting was that I was able to see the able of vitamins, sodium, potassium and other nutrients I eat regularly. When doing this I discover that I have been lacking two of my vitamin’s intake, like vitamin A, and vitamin C. One cons I notice while doing this assignment was that it was hard and disturbing because I have never track what I ate for breakfast, lunch, dinner or for snacks. I found the one-week tracking log useful because it helps me to watch and realize what I have being eating regularly.
For example, my total calories for one day was about 1,533 compare to the daily goal of 1,490. This assignment was my favorite and it made me very emotional because I knew that my eating habit was not the best, but I did not realize that I was lacking my major nutrients for my body to function well. On the third day, I remember telling my mom that we need to start buying more healthy food because I felt depressed that I was not meeting my daily goal for my nutrients. Especially since I was eating food that are high in fats, because of that I felt like I was gaining a lot of weight while tracking during that one week. It was my favorite assignment because this one help to observe my diet for a longer period. As compare to the other assignments that was for a day, this assignment gives me account for the number of vitamins, proteins, carbohydrates, fats, and other nutrients that your body will need to function properly.
Micronutrients is when things are required in a small amount. They consist of our vitamins, potassium, iron, sodium, calcium and water. Because of the name micronutrient our body only need small amount or it to function properly. While doing this assignment I notice the essential need for micronutrients in our body. Each nutrient has a specific job in our body. While tracking my micronutrients I notice that I was always over my daily limit for sodium, which I discover might maintain my fluid proper balance. I discover that I was lacking in vitamin A, and C. day 1, I was 88% under my daily limit for vitamin A. I am also lacking with iron and a few cups of water. This assignment was an eye opening for me to make a better choice in my food choice. One pro to tracking my micronutrient is being inform of my health risk if I continue to lack my daily nutrients. This assignment also made me emotional because I did not know about the major health risk of lacking my daily nutrients. While doing this assignment I felt like the information was being through at me, I was shocked when I discover the pros and cons of lacking your micronutrients.
My smart goal was to eat breakfast that has all the four food groups everyday still thanksgiving. While doing this goal I had to plan out my daily breakfast food. For example, most days my breakfast will be a whole grain bagel, peanut butter, apple and a glass of milk. Some days I will eat fry eggs, waffles, banana, and apple juice. My goal was successful till the day before thanksgiving when I skip breakfast and did not following my smart goal. I chose this smart goal because of the past four assignments. I discover that my daily meals did not include the four different food groups. Some unexpected barriers that arose was me running out of food that had the four-food group in it. Another was that I forgot to eat breakfast at home is I had to get something to eat at trinity deli I ate corn flakes and milk. In the future when face with these barriers I will make sure to go grocery shopping for a lot breakfast food before starting the goal. I will choose the same goal in the future because it helps me to move closer to a healthy lifestyle. While doing this goal I will add another goal to it. probably decide to eat more dark vegetables like spinach and broccoli for a week first.
Cite this page
What is Nutrition?. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
Nutrition Self Analysis
BMI & Hamwi:
My weight is 172 lbs. and my height is 5’0”. The formula that I will be utilizing to achieve my BMI is (Weight in Kilograms / (Height in Meters x Height in Meters)). When I converted my information to the appropriate units, my weight in kilograms is (172 lbs)/(2.2 lbs) = 78 kg and for my height I converted feet into inches then to meters (60 in)/(39 in) = 1.54 m. My BMI calculation comes out to (78 kg / 1.54 m x 1.54 m) = 33 kg/m2. According to the required textbook, I am considered “obese class 1” (Dudek, 2014). Although the BMI is highly recognized as an appropriate screening tool, it does not take into account body composition and genetic differences in individuals. I do agree with the conclusion that I am obese. The Hamwi method is a fast approach to calculate the “ideal” body weight by using the individual’s gender and height. For women, the equation allows 100 lbs. for the first 5 ft. of height, then adds 5 lbs. for each additional inch (Dudek, 2014). My calculated weight for the Hamwi method is (100 lbs. + 0) = 100 lbs. For this method, I do not agree that my ideal weight should be 100 lbs. If I have reflected this ideal weight, I would look malnourished.
Overall, I do agree that I am obese. I would like to lose overall about 50 lbs. but still maintain my muscle tone. The Hamwi method does not make any sense to me, it only considers the individual’s gender and height. The BMI’s formula is a better screening tool in identifying individuals’ ideal body weight.
Food Diary
November 12, 2018
FOODS Calories Carbs Fat Protein Cholest Sodium Sugars Fiber
Meal 1
Premier Protein Chocolate high protein shake 160 5g 3g 30g 0mg 0mg 1g 3g
Bigelow Green Tea, bag (1) 0 0g 0g 0g 0mg 0mg 0g 0g
Meal 2
Steam white rice, 1 cup 243 53g 0.5g 5.1g 0mg 1mg 0.1g 0.7g
Orange glaze chicken, 1 serving
190 11g 9g 16g 40mg 330mg 0g 0g
Vegetable egg roll 153 25g 3.6g 5.2g 0mg 437.6mg 5.3g 2.2g
Total: 746 94g 16.1g 56.3 40mg 768.6 6.4 5.9g
Food Notes
Breakfast - woke up, had a cup of green tea then the protein shake. I was satisfied.
Lunch – Since I was at my clinical site all day, I had the white rice with orange glaze chicken and an egg roll. I was not very hungry, so after eating my lunch I was satisfied.
Dinner – After getting out of clinical, went to go pick up my son at cub scouts. Once I arrived home, I was still hungry from lunch, I felt satisfied. Didn’t eat anything.
November 13, 2018
FOODS
Calories Carbs Fat Protein Cholest Sodium Sugars Fiber
Meal 1
Bigelow Green Tea bag, 1bag 0 0g 0g 0g 0mg 0mg 0g 0g
Premier protein Chocolate high protein shake 160 5g 3g 30g 0mg 0mg 1g 3g
Meal 2
Hot dog, beef, 1 147 1.1g 13.6g 5.1g 25.2mg 461.2mg 0.7g 0g
Bun, Hot dog, 1 120 21.3g 1.9g 4.1g 0mg 206mg 2.7g 0.9g
Total: 427 27.4g 18.5 39.2g 25.2 667.2mg 4.4g 3.9g
Food Notes
Breakfast – Had my routine green tea then the protein shake. I was satisfied.
Lunch – Had one hot dog at home, not too hungry still full from breakfast.
Dinner – I was busy studying and getting my kids ready for bed, I was not hungry.
November 14, 2018
FOODS Calories Carbs Fat Protein Cholest Sodium Sugars Fiber
Meal 1
Bigelow Green Tea bag, 1 bag 0 0g 0g 0g 0mg 0mg 0g 0g
Premier Protein Chocolate High Protein shake 160 5g 3g 30g 0mg 0mg 1g 3g
Meal 2
Ready Pac Bristo salad, chicken Caesar 230 8g 16g 16g 20mg 400mg 3g 1g
FOODS Calories Carbs Fat Protein Cholest Sodium Sugars Fiber
TOTAL: 390 13g 19g 46g 20mg 400mg 4g 4g
Food Notes
Breakfast – Had the green tea and then the protein shake as usual.
Lunch – I was at home, so I had a Bristo ready salad, I was satisfied.
Dinner – I was unable to eat dinner, I was at the hospital with my husband.
Analysis
Based on 1200 calorie diet with nutritional goal of 55% carbohydrates, 20% protein, and 25% fat (Your Fitness Goals, 2016)).
Carbohydrates:
For my first day, I was under 63g for my carbohydrates. On the second day, I was 134g under, and on the third day I was 144g under. According to my fitness pal, I should be in taking 157 grams per day for my 1,260 calorie meal plan. Most of my carbohydrates came from my lunch. The foods that I ate that were high in carbohydrates were steam rice, vegetable egg roll, and hot dog bun. I need to incorporate more selection of foods that are high in carbohydrates, such as legumes (Mayoclinic.org, 2018). Carbohydrates are the main source of energy (Dudek, 2014). This is important, because I am going to school 2 days out of the week and I’m very active with my two young kids. I need foods that are enrich in carbohydrates for energy.
Fat:
According to my recommended dietary allowance, I should only be in taking 42 grams of fats. Analyzing these three days of food diary, I am pretty pleased on how I did, I thought I was consuming more fats than I really was. The meal that had the greatest amount of fat was my lunch. By eating similar foods for breakfast and lunch has helped me control the fat intake.
Protein:
Protein is the key structural and functional component of every living cell (Dudek, 2014). According to my fitness pal, my recommended dietary allowance for protein is 64 grams. From the foods that I was in taking, like chicken and protein shake, I thought I would have met the recommended amount. My highest protein came from breakfast. The protein shake was high in protein, which is where I got most of my protein. Even though I tried to eat chicken for lunch, I still did not reach my protein goal. Fiber (g):
Overall, the total amount of fiber intake was low from the past three days. According to the required text, total fiber is set at 14g/1,000 or for women it is approximately 25g/day (Dudek, 2014). My recommended dietary allowance from my fitness pal is 25g/day. My consumption for fiber ranged from 4-6 grams in my food diary. I received the most amount of fiber from the protein shake. Fiber is not an essential nutrient, but it is important to consume the recommended amount to decrease GI disturbances (Dudek, 2014). I plan to eat more vegetables and fruits that are enriched in fiber. I would eat 1 medium banana that yields 3.1 grams of fiber for snack (Mayoclinic.org, 2018).
Sugar:
My recommended amount of sugar intake is 48 grams on my fitness pal. I was actually surprised at my sugar levels, they were lower than the recommended. Like my intake of fat, I do have a problem controlling my sugar intake per day, which I have been trying to decrease. To my surprise, I have been successful in decreasing my sugar.
Saturated:
My recommended amount of saturated fat on my fitness pal is 14 grams. On all three days, I did not met the required amount. Saturated fat is known as the “bad” fat and is also referred to as the solid fats (Dudek, 2018). I was quite surprised that I stayed in the range of the recommended amount. A lot of the foods that I enjoy eating are high in saturated fats. Overall, I would not make any changes and I would still continue to stay away from foods that are high in saturated fats.
Polyunsaturated:
Polyunsaturated fats are considered the “good fats”. Evidence has showed that by replacing saturated fats with unsaturated fats such polyunsaturated, LDL cholesterol would decrease therefore the risk of cardiovascular diseases will follow (Dudek, 2014). My recommended amount on my fitness pal was 0 grams, but I consumed 2 grams on my first day. I will continue to consume foods with 0 polyunsaturated foods.
Monounsaturated:
Like polyunsaturated fat, monounsaturated also holds the same benefits (Dudek, 2014). My recommended amount on my fitness pal was 0 grams. Again, I consumed only 1 gram on the first day and did not consume any on the other days. I will continue to consume foods with no monounsaturated just like polyunsaturated.
Trans (g):
High intake of trans fat increases LDL cholesterol and lowers HDL cholesterol (Dudek, 2014). My recommended dietary allowance is 0 grams. To my surprise, I did not consume trans fat at all during my food diary. I will continue the same type of foods, and avoid trans fat.
Cholesterol (mg):
My recommended dietary allowance for cholesterol is 300 mg. Throughout the three days, I was below my allowance. The descriptions of good or bad cholesterol refer only to the lipoproteins that moves the cholesterol through the blood, there are no such thing for cholesterol itself (Dudek, 2014). I would change my foods to incorporate a little more cholesterol in my diet.
Sodium (mg):
Sodium is largely responsible for regulating fluid balance, when an individual had a salty meal thirst will be triggered (Dudek, 2014). According to my fitness pal, my recommended dietary allowance is 2,300 mg. My sodium intake on day 1 and 2 of my food diary stayed under 830mg and on the third day I had 1,190mg. I could incorporate more sodium in my diet.
Potassium (mg):
According to my fitness pal, my recommended dietary allowance is 3,500 mg of potassium. In my food diary, I stayed in the range of 400 mg to 710 mg. The adjustment that I would do is to increase my potassium intake by at least 2,000 mg per day. I would add eating more leafy green vegetables like spinach and Brussel sprouts into my diet. 1 cup of cooked spinach is 838 mg of potassium and 1 cup of cooked Brussel sprouts is 494 mg (Mayoclinic.com, 2018).
Vitamin A %:
My recommended dietary amount for vitamin A is 100 %DV. Vitamin A is important for immune function and development of bones, but with excess amount it can cause headaches, vomiting, and double vision (Dudek, 2014). On my second day, I was very below (only had 25%DV. On day one and three, I was still under, however, I was closer to the 100%DV. I consumed 75%DV. I would continue consuming similar foods, however, I would try to keep my intake of vitamin A closer to the 100%.
Vitamin C %:
According to the required text, vitamin C is needed for antibody formation, wound healing, and collagen formation. If an individual has an influx of vitamin A they can experience diarrhea and mild GI upset (Dudek, 2014). My recommended dietary amount is 100 %DV. Throughout my food diary, I was well above the recommended amount by at least 70-76 %DV. The consumed foods that consisted of the highest amount of vitamin C are the strawberries and broccoli (Dudek, 2014). My adjustment is to eat 0.5 cup of strawberries instead of 1 cup of strawberries. This will lessen both my sugar and vitamin C intake.
Calcium %:
Calcium is responsible for bone structure and muscle contraction, deficiency can lead to osteoporosis (Dudek, 2018). My recommended dietary amount for calcium is 100% DV per day. My daily intake ranged from 40-60% DV. To increase my intake, I will drink more milk or dairy products.
Iron %:
Iron is responsible for oxygen transport and is an essential part of enzyme systems. Iron deficiency can cause impaired immune function, lethargy, fatigue, and impaired wound healing (Dudek, 2014). My recommended dietary amount is 100 %DV and my range was only between 31-48 %DV. The adjustment that I will take to increase my intake is to eat fish (Dudek, 2018).
Drug/Medication Interactions:
Currently, I am not taking any prescribed or over the counter medication.
Physical & Emotional Analysis:
Day 1:
Having the green tea gives me energy and the protein shake actually filled me up. I did not feel hungry until lunch time came around. For lunch, since I was at my clinical site, I did not have much options to chose from, so my carbohydrates were higher. Since I was running around til late at night, I did not hungry later on and I did not want to eat so late.
Day 2:
Again, the green tea and the protein shake filled me up til lunch time. At first, I thought one hot dog was not going to fill me, however, after I finished the first hot dog I was full. For dinner, I was getting hungry, but I was busy with the kids then with my homework that I suddenly forgot to eat. I was so busy that night, that I didn’t even noticed that I was hungry anymore.
Day 3:
On this day, I did wake up hungry. I was stressed because I have class on Wednesday mornings, I had a quiz that day, and I didn’t eat the night before. I had the green tea and the protein shake and I was satisfied again. I only had a ready to eat chicken Caesars salad because I was going to go out to dinner with my family, I didn’t want to over eat that day. But, unexpected things happened, and I ended up at the hospital with my husband and due to the stress of being there and worrying, I forgot to eat. I was tired by the end of the night and I felt weak and dizzy.
Medical Conditions:
I have no medical conditions. There are no medical conditions in my family that I am aware of. I do, however, need to exercise. Since I’m in nursing school, I have had a bad diet and don’t exercise anymore. I even forget to eat due to the stress and the work load. I am aware though, that I do have to start to exercise and change my eating habits to a healthier diet and exercise.
Culture:
As a Mexican, my culture truly did reflect my food choices. Before I started implementing weight loss ideals in what I eat, on the majority days I would eat foods that were fried, high in carbs, fats, and sugars. My parents were strong on their cultural roots. My parents always taught us that a good and real meal, we always had to have rice, beans, and tortillas. Every dish that my parents cooked were fried. So, as I got older, that was my diet. Until recently when I realized that my diet was horrible and that I needed to change. I do try to bake, incorporate more vegetables, and a variety of foods, but now I see that clinicals, school, and everyday stressors can alter my diet.
Diet Plan
Looking back at my BMI of 33, I would like to start by losing 40 pounds. According to this BMI, I am obese class 1. My water intake, the recommended amount of water for women is 2.7 L per day (Dudek, 2014). My water intake that was documented on the food diary ranged around 2.4-2.9 L. In regard to weight loss, it is important to consume the recommended daily amount of water because it will help you feel full, speed up the metabolism, and flush out fats/toxins (Publichealth.lacounty.gov, 2018).
According to my fitness pal, on some days I ate excessive amounts of sodium, sugar, fat, and carbohydrates. To decrease these levels, I will reduce the portion size of food items that yielded the most of value.
In regards to making any changes into my activity level, I will start to exercise 5 days out of my week. I will use my membership to the gym to get my exercise time in. To achieve my goal of weight loss, I plan on counting the calories I have taken in versus the calories I have burned off. According to Mayoclinic.org, replacing high-calorie foods with lower calorie replacements and decreasing portion size can improve weight control. I will utilize this method and as well incorporate physical activity.
Goals/Implementation/Obstacles
By December 12, 2018, I will be eating 6 small meals, with different types of foods. I will implement this by using different tools, such as my plate, to help me decide what kind of foods I need to consume and how much. An obstacle that I can run into is that I have so many errands to do that I forget to eat and cause more harm to myself. By December 12, 2018, I will increase my carbohydrates to 140-160 g daily. I will implement this by consuming milk and milk products, whole grain products, bananas, and legumes. An obstacle would be that I usually don’t wat breads, bananas, or milk or milk products.
Reflection
I have always struggled with my weight. I had taken control of my weight for a while, but then I started nursing school and I lost control. Looking at my BMI and breaking down my food intake has shown me that I need to start taking some action and changing my diet. Putting food on the side and not eating the appropriate amount of times, I am not getting enough nutrients in my diet. Now, I have a better understanding that not getting the appropriate amount of nutrients can be bad.
References
Dudek, Susan, G. (2014). Nutrition essentials for nursing practice. Philadelphia: Lippincott Williams & Wilkins.
Your fitness goals (2016). Retrieved from https://www.myfitnesspal.com/account/my
Cite this page
Nutrition Self Analysis. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
Sexual Violence and Assaults on Campus
The best four years of your life are known to be the ones spent in college, which is supposed to be an incomparable and unequivocally life altering experience. Students leave high school with the hope of making memories that’ll last a lifetime as well as finding a route towards a successful future. Knowing what students are in search for, what many college tours neglect to say is that 23.1% of females and 5.4% of males are rendered victims of sexual assault in their time as undergraduate students, and only 20% of these students will report to law enforcement. Two thirds of college students experience some type of sexual violence in their four years at their university (“Campus Sexual Violence”).
This paper draws information from various forms of evidence including online publications, a documentary film, and academic journals. All of these references help examine the prevalence of sexual assault on college campuses in recent years as well as the universities involvement in the lack of reporting. Although there have been laws implemented, like Title IX, that try to approach the issue, there are far too many cases that have gone without justice due to the various flaws that appear in the system. Given the recent decision by administration to make a sexual predator into a Supreme Court Justice, the need to address the ongoing issue of sexual violence on college campuses is more urgent than ever.
Sexual assault refers to any form of unwanted or nonconsensual sexual activity. Not all sexual assault is technically considered rape, as there are other forms of sexual violence. Acts of sexual violence include forced fondling or touching, but not all forced sexual acts are necessarily physical. Many predators overpower their victims using psychological or emotional methods, most of which include drugs and alcohol (“Sexual Assault”). Statistics show that about 43% of sexual assault incidents involve the use of alcohol by the victim, and 69% by the perpetrator (“The”). Some aggressors are even known to spike their victims’ drinks, using things such as date rape drugs, to take advantage of their vulnerability (“The”). It is more common that the predator already knows their targeted victim, which makes it easier for them to exploit that trust. In 2014, the National Crime Victimization Survey stated that, “In about half of the incidences reported in the NCVS, alcohol and drugs were involved. Offenders were almost always male, and in 80 percent of the cases both parties involved were acquainted” (). Considering that one in five women are victims of these crimes, it’s hard to question why only 20% of them report to authorities.
Reasons as to why people don’t report their attacker can vary widely. A very common reason for the underreporting of sexual assault is shame, a feeling of being worthless and exposed that can often cause victims to blame themselves instead of the perpetrator (Engel). Sexual assault can sometimes feel humiliating, which prevents someone from speaking out about it. Shame and embarrassment are especially prevalent among male victims, who face different types of stigma that stem from stereotypes of manhood and machismo (“Realities”). Some men may come to think that sexual assault would make them “less of a man” therefore are not likely to report the incident. A large group of people also deny that what happened to them was an act of sexual violence due to the mortification they feel, which again leads to blaming themselves. Another recurrent reason for the underreporting of sexual assault is the lack of information and distrust in authority. There have been multiple instances in which students have reported their sexual assault victimization and have been silenced by their college’s administration in order for the university to maintain their reputation or simply to cover up for the predator.
The Hunting Ground is a documentary where survivors of sexual abuse on college campuses tell their stories about the obstacles they had to endure to receive the justice that they deserve. Annie Clark was a freshman at the University of North Carolina when she was physically and sexually assaulted at a college party. Without having much knowledge on how to report a situation like hers she went to administration in search for answers. The administrator told Annie that rape was like a football game and asked, if she could go back, what might she have changed about it. Annie felt as if she was receiving the blame for being raped, for wearing what she might have been wearing, or drinking too much. Annie isn’t the only woman that has received answers like these to a cry of help. Many women report responses like these from their administrators: “Did you say no?” “What were you wearing?” “How much did you have to drink?” Caroline Heldman, a professor at Occidental College, says, “There’s a lot of victim-blaming with this crime, which has a silencing effect on survivors” (The). Consequently, 88% of women won’t report their assault. With responses like these, women don’t bother telling their administrative teams about their abusers, leaving thousands silenced.
Universities very often put their own reputations before the safety of their students. In order to maintain their sexual assault numbers low, schools try to discourage victims from reporting to a higher order of authorities, like the police. Many universities not only cover up sexual assault cases for the sake of their own reputation, but also for the sake of their athletic team’s reputation. Florida State University is known for its division one athletics, especially its football team. Erica Kinsman, who attended FSU, was raped by quarterback Jameis Winston in 2012. Before she was aware of the identity of her rapist, she went to the police and, instead of checking cameras or investigating anyone, they did nothing. After Erica came to realize who her rapist was, she went straight to the police, who told her that she should really think about what she was doing considering how big of a football town that was.
Jameis Winston continued his football career as a quarterback for FSU even after the authorities had knowledge of his crime; later he would be drafted into the NFL. Although DNA on Erica’s rape kit matched Jameis Winston’s DNA, the attorney claimed that there wasn’t enough evidence to convict Winston. Schools like FSU invest millions of dollars into their athletic programs, so they are willing to do as much as possible to not lose an athlete like Winston, even though he was guilty for the crime. After students at FSU heard about the accusations against Winston, most of them ridiculed Erica calling it a cry for attention rather than what it actually was. Stories like Erica Kinsman’s make it so much more difficult for women or men to have the courage to speak out about a rape incident to the point where many sexual assault victims say nothing at all.
Due to circumstances like Erica Kinsman, Annie Clark, and so many other victims, there must be organizations implemented for people to turn to someone they can trust in a moment of fear. In 1972 President Nixon signed Title IX into law. Title IX is a federal statute which prohibits sex discrimination in education programs or activities funded by the government (Seaver). After being implemented, this law clearly provided protection in things like academics, extracurricular activities, and athletics, but there was still some ambiguity when it came to sexual harassment. There were some revisions that are stated here, “The Revised Sexual Harassment Guidelines, published by the U.S. Department of Education's Office for Civil Rights state that an educational institution must take action to respond to sexual harassment that is so severe and pervasive that it deprives or limits the victim's enjoyment of educational rights, privileges, advantages, or opportunities” (Seaver). Government funded educational systems are required to act, yet some schools do so with minimal punishment to the guilty party. The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act states that colleges are required to disclose their crime information with their respective campuses. Schools also have to provide statistics about their sexual assault cases annually (Seaver). There are multiple ways in which schools try to avoid the regulations set by these laws. In order for there to be an actual case, there must be proof that the school had knowledge of the crime committed. A lot of these universities try to convince the victim not to bring the case further which leads to them believing it was their own fault.
The Title IX legislation does not specifically mention sexual assault, but Title IX was first tied to sexual assault allegations by the Second Circuit Court involving male staff in Alexander v. Yale University. The court came to the conclusion that school districts would be accountable for student-on- student sexual assault on three conditions: (1) the school have some knowledge of the incident, (2) school personnel show no sympathy or interest to the circumstances, and (3) the harassment is so severe that it stands in the way of the victims access to educational opportunities (Stader). These conditions mean that when acts of sexual harassment occur, there should be consequences, but schools find ways to maneuver out of it with things like victim blaming which causes people to turn away from administration in times like this. The District Court of Connecticut alongside with others established that it was the school’s responsibility to report sexual violence under Title IX. In 2011, the US Department of Education Office for Civil Rights (OCR) sent out a “Dear Colleague” letter to colleges and universities that laid out their duty under Title IX to respond to sexual assault accusations in a timely matter.
The “Dear Colleague” letter stated that “a school that knows, or reasonably should know, about possible harassment must promptly investigate to determine what occurred and then take appropriate steps to resolve the situation” (Stader). Under Title IX, colleges and universities are required to investigate cases that may involve sexual assault as well as hold hearings. These investigators usually don’t go through specific training for dealing with victims of sexual assault trauma therefore victims are more inclined to falsify information or omit some of the truth. This is a crucial part of the Title IX legislation because with false information, Title IX investigators gather inconsistent and inaccurate data (Dudley). The fact that there is no specific training for these investigators can also be a reason as to why some cases are dropped so suddenly. There must be accountability for the trauma that survivors of sexual violence live with when it comes to these hearings and investigations to receive proper information.
The issue of sexual assault has been a topic many people toss to the side, but as new administration considered Brett Kavanaugh as a new Supreme Court Justice there must be more to investigate about sexual assault. Brett Kavanaugh was accused of being a sexual predator by Christine Bailey Ford in the years they shared as teenagers. Kavanaugh was accused of sexually assaulting Ford while she was intoxicated at a party and after these allegations two more women emerged with similar stories (Hauser). There must have been ways in which these women could have reported these incidents at the time of which it happened but the 1980s didn’t provide many resources when it came to sexual assault. Today there can be a change for situations like this with implementation of safe places at every university that students can go to after being a victim of sexual assault. Investigators should be properly trained to deal with trauma ridden students in order to evaluate the situation with this in consideration or else there will be no progress with this system.
Sexual harassment has been a reoccurring issue that leaves victims with long term mental and psychological repercussions that must be put to an end. Both men and women should feel safe in an environment meant for prospering and change. Universities across the United States should implement programs and organizations in order to assist students who find themselves in situations like these to fight for the justice they deserve.
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Sexual Violence and Assaults on Campus. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
Sexual Assault in College-age Women
Sexual assault on college campus’ is becoming more frequent with 15% of women attending college facing some sort of sexual assault every year (Wood, Stichman 1). Rape culture is becoming a increasingly talked about topic in young adult audiences, with more mental health resources becoming available and pushes for women to involve the criminal justice system to report their assaults. With these advancements taken in consideration, why do so many cases of sexual assault still go unreported and how do universities reduce it from happening all together? The threat of sexual assault is a constant fear for most women, especially in college age populations. According to Rape, Abuse and Incest National Network, “310 out of every 1,000 rapes are reported to the police and that college-aged women have the lowest reporting rate”.
Universities and police alike need to create an encouraging environment, access to counseling, and trauma-sensitive training that allows victims to feel comfortable in reporting these attacks. Reporting sexual assault immediately following an attack is incredibly difficult for survivors, especially for women seeking legal action and reporting their assault to the authorities. These women are all too commonly met with disbelief, judgment, and a poor understanding of the psychological trauma associated. This is more common among college aged women, as most of them are often exposed to sexual assault in varying degrees and have witnessed people brush it under the rug or ignore it . Often times younger women are seen as fabulists in the eyes of the law, with a focus on crimes of sexual assault.
Women in college aren’t taken seriously and constantly seen as being childish or dramatic. This furthers a younger woman’s reluctance to involve police, instilling a fear that is grounded in concerns about not being taken seriously, blamed, or embarrassed. As a community, our understanding and treatment of sexual assault is dim and bleak. Even more so for those that directly fall on the path of a victim seeking litigation, such as law enforcement. With further sensitivity training and education that discourages placing blame on the victims, and an attitude that makes these women feel as though their story is important and should be given careful attention and due process, the percentage of sexual assaults going unreported will decrease.
Universities are expanding their resources to encourage victims of sexual assault to come forward and report their assaults, but the availability of these resources for sexual assault prevention, reporting, and treatment on college campuses does not mean that they are adequate or sufficient. Problems may arise when university therapists and counselors harbor gender biases, buy into rape myths, or are unprepared to be sympathetic and understanding to the trauma that sexual assault victims are experiencing. Colleges need to focus on how they can provide an environment that facilitates an understanding and supportive atmosphere. Gathering information related to help-seeking behaviors can lead to campus policies in regard to encouraging victims to report their experiences and seek medical and emotional assistance, as well as aid in the development of prevention policies.
Cite this page
Sexual Assault in College-age Women. (2019, Feb 20).
Retrieved November 2, 2025 , from
https://studydriver.com/2019/02/
