Assignment Task

Background Information

• Anthropometry (physical measurements)

• Biochemical and other laboratory tests

• Clinical examination

• Dietary analysis

• Exercise analysis

The focus of this assessment is a dietary analysis and exercise analysis of a case study – Mrs Thomas. You will also have some simple anthropometry and clinical information available to you, which will assist with your estimation of energy needs and your interpretation of results.

Overview

As mentioned in the preceding background information, this assessment is a diet and exercise analysis of a case study. 

How to set up a Foodworks ‘client profile’ and enter food diary data

1. Log into FW online and click on ‘create workspace’. Select ‘professional’ and add a name, such as DTN201 Mrs Thomas or DTN201 AT1.

2. From the left-hand side menu, select the ‘client’ tab and click ‘new client’

3. Fill in the relevant details for the patient – this is essential as it will link the associated nutrient reference values (NRVs) for the patient

4. Once personal details have been added, click into the ‘resources’ tab and click ‘create new’ and select ‘food record’

5. Click onto the ‘foods’ tab which will bring up a blank day. Under breakfast, start to type the product descriptions for the foods listed in the food diary. Note: You may find some food descriptions are brief. Therefore, you will need to make some ‘assumptions’ and select the food that best matches the description in the food diary.

6. Continue to enter all the foods in the diary. You can create a new day for the other two days of Mrs Thomas’ food diary by selecting ‘add day’.

Comparison to NRVs

a. To complete this table, you will need to enter the average daily amount, from Table 1, into the first column. You will need to calculate the energy contribution (kj) by multiplying the average g of the macronutrients by their kj content per gram (this can be found in the LMS and textbook).

Macronutrient Contributions

a. To complete the results % column of Table 3, you will need to divide the energy contribution by the total energy intake and multiply this by 100 to express this as a percentage. You will need to locate the AMDR ranges in the literature. b. For example, if someone’s total energy intake was 6000kj, and they consumed 1580kj from protein, the % would be 1580/6000 x 100 = 26.3%.

Qualitative Analysis

a. Qualitative analysis cannot be performed using Foodworks. Instead, you will need to estimate the average intake for the 3 days by manually comparing each food portion consumed to what constitutes a serve. Qualitative analysis should be reported to the nearest 0.5 serves.

Physical activity Record (Table 6) a. Go through Mrs Thomas 3-day physical activity record and calculate how many hours she spent doing each activity undertaken. Record the activity (using a clear description) and the hours spent in the first two columns

Questions

1. Was Ms Thomas food intake record likely to be representative of her usual eating patterns? How is it likely to be different and why?

2. Was Ms Thomas`s physical activity record likely to be representative of her usual activity pattern? How is it likely to be different and why?

3. Was Ms Thomas food intake record likely to be reliable or was it biased? Discuss any reasons why food intake may be underreported or overreported.

4. Was three days long enough to obtain a reasonable picture of food intake? Why?

5. Comment on the macronutrient contribution to energy in comparison to the Acceptable Macronutrient Distribution Range (AMDR).

6. Comment on the dietary fat ratios (omega 6: omega 3) in relation to recommendations

7. Comment on Mrs Thomas’ qualitative dietary assessment. What food groups are over- or under-consumed?

8. Identify nutrients that do not meet or exceed the Nutrient Reference Values.

9. Comment on changes you would suggest to Ms Thomas, to address any low or excessive intakes. Also, note if these changes influence other nutrients. 

10. What are the limitations associated with using Nutrient Reference Values in this context?

11. What are the limitations associated with using nutrient analysis software?

12. What are the general limitations of using equations for estimating energy requirements and expenditure?

13. How does the estimated energy requirement from the NRV tables compare with Estimated Energy Requirement calculated using the Schofield equation x PAL? What limitations exist with the Nutrient Reference Value figures for estimated energy requirement?

14. How does the Estimated Energy Requirement calculation from Schofield and PAL compare with Ms Thomas`s Energy Intake?

a. Based on Ms Thomas`s measured energy balance from Table 6, is she currently in negative/positive/neutral energy balance?

b. If this energy balance continues, what are the implications for her weight status?