Meal Planning ProjectType II Diabetic with Crohnrsquos Disease

Kathryn HughesFall 2013

Professor Brenda Orsquo Day

Nutrition Assessment

Diagnosis Type II Diabetic with Crohnrsquos Disease Name Steve Wilson Age 38 Gender Male Dietary intake PO intake Symptoms polydipsia polyphagia polyuria weakness Medications Metformin twice daily Anthropometric measurements

o Ht 5rsquo10 70rdquoo Wt 195lbs 7677kgo BMI= 279o IBW= 150-182lbso IBW= 117

Energy protein and fluids neededo Give a rage

Total Energy= 1900kcal 25kcalkgbody weight Protein= 60-76 PRO Fluid= 26Lday

o Includes basis for estimations For energy used 25 cal per Kg weight For protein used 8-10g PROkg For fluids needed used 35 mlkgday

LabTests- can indicate high or low normal or abnormalo Glucose 345 mgdLo HbA1c 12o Triglycerides 201 mgdLo CRP 14 mgdLo ASCA positive

Nutrition Diagnosis

Inconsistent carbohydrate intake RT no utilizing actuate CHO counting to ensure pt is not over consuming carbohydrates EVB pt usual nutrient intake record of cinnamon rolls french fryrsquos juice glucose levels of 345mgdL HbA1c 12 Triglycerides of 201 mgdL Also pt is incompliant with medication

Nutrition Intervention

1 Meals and snackso Fresh fruits and vegetableso Eggs

o Yogurt amp cheese2 Nutrition Recommendations

o Related medication managemento Small Frequent Meals o Eliminate problem foods

GoalsReduce glucose levels to 70-110 mgdLReduce HbA1c lt7

Monitoring and Evaluation

o Follow-up phone call with in one weeko Ask patient keep a daily food record o Re-assess lab values

o HbA1c- 3 monthso Glucose-1 week

o Check Vitalso Consult MD if the patient proceeds to have high glucose levels

Part B Meal Budget and Meal Plan

Meal One

Breakfast 2 slice of whole wheat toast 1 Large banana 2 eggs scrambled with cheese Glass of almond milk

Lunch Turkey Sandwich

o 4 slices of Turkeyo 1T Mayoo Lettuce o 2 slices Tomatoo 2 Sliced of cheese

Water

Snack Yogurt

Dinner 7 oz Grilled Chicken 1 cup Cooked potatorsquos roasted with herbs no skins Salad

o Lettuceo frac12 cup Tomatorsquoso Dressing olive oil (1teaspoon) and vinegar

Meal Two

Breakfast Oatmeal- 1 cup Glass of almond milk -2 cups Banana -1 large

Lunch Can of soup- chicken noodle Grilled cheese

o 2 slices - whole wheat double fiber breado 1 frac12 slics - cheese

Glass of almond milk -1 cup

Snack Apple Large Water

Dinner 8oz glass of milk Small side salad

o Lettaceo Tomatoo Oilvinegar dressing

Chicken Quesadillao 2 (6 inch) tortillas whole wheato frac12 cup shredded cheese o 6 oz shredded chickeno 1 tbs Butter (for frying the tortillas in)

Food Item

Brand Amount Price Coupon Location Purchased

Almons Milk

O Organics

32oz $199 Member Vons

Eggs Ralphs 12 count 0 Yes (free) Ralphs

Oatmeal Safeway Kitchens Oats Quick

18oz $200 Vons

Chicken Boneless Skinless

O Organics

1lbs $499 Vons

Bread Oroweat Double Fiber Bread

24oz $299 Vons

Apples 1lb $089 Yes North Park Produce

Banana 3eahc=1lbs $099 Yes North Park Produce

Roman Lettuce

Each $039 Yes North Park Produce

Block of Cheese

Ralphs 12oz $299 Member Ralphs

Tomatorsquos Ralphs 1lbs $089 Member Ralphs

Soup Campbellrsquos

Each $150 Member(2 for $3)

Vons

Yogurt O Organics

Each $056 Member Vons

Tortillas Mission 6 count $256 Wal-Mart

Turkey Oscar Mayer

12oz $299 Albertsons

TOTAL 2374

Part C Assessment of Dietary Intake Review

Nutrients Report Meal OneYour plan is based on a default 2000 Calorie allowance

Nutrients Target Average Eaten StatusTotal Calories 2000 Calories 1862 Calories OK

Protein (g) 46 g 118 g OK

Protein ( Calories) 10 - 35 Calories 25 Calories OK

Carbohydrate (g) 130 g 200 g OK

Carbohydrate ( Calories) 45 - 65 Calories 43 Calories Under

Dietary Fiber 25 g 36 g OK

Total Fat 20 - 35 Calories 36 Calories Over

Saturated Fat lt 10 Calories 12 Calories Over

Monounsaturated Fat No Daily Target or Limit

14 Calories No Daily Target or Limit

Polyunsaturated Fat No Daily Target or Limit

7 Calories No Daily Target or Limit

Linoleic Acid (g) 12 g 11 g Under

Linoleic Acid ( Calories) 5 - 10 Calories 5 Calories OK

α-Linolenic Acid (g) 11 g 18 g OK

α-Linolenic Acid ( Calories) 06 - 12 Calories

09 Calories OK

Omega 3 - EPA No Daily Target or Limit

14 mg No Daily Target or Limit

Omega 3 - DHA No Daily Target or Limit

69 mg No Daily Target or Limit

Cholesterol lt 300 mg 649 mg Over

Minerals Target Average Eaten StatusCalcium 1000 mg 1444 mg OK

Potassium 4700 mg 4441 mg Under

Sodium lt 2300 mg 2672 mg Over

Copper 900 microg 1612 microg OK

Iron 18 mg 14 mg Under

Magnesium 310 mg 507 mg OK

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Nutrition Assessment

Diagnosis Type II Diabetic with Crohnrsquos Disease Name Steve Wilson Age 38 Gender Male Dietary intake PO intake Symptoms polydipsia polyphagia polyuria weakness Medications Metformin twice daily Anthropometric measurements

o Ht 5rsquo10 70rdquoo Wt 195lbs 7677kgo BMI= 279o IBW= 150-182lbso IBW= 117

Energy protein and fluids neededo Give a rage

Total Energy= 1900kcal 25kcalkgbody weight Protein= 60-76 PRO Fluid= 26Lday

o Includes basis for estimations For energy used 25 cal per Kg weight For protein used 8-10g PROkg For fluids needed used 35 mlkgday

LabTests- can indicate high or low normal or abnormalo Glucose 345 mgdLo HbA1c 12o Triglycerides 201 mgdLo CRP 14 mgdLo ASCA positive

Nutrition Diagnosis

Inconsistent carbohydrate intake RT no utilizing actuate CHO counting to ensure pt is not over consuming carbohydrates EVB pt usual nutrient intake record of cinnamon rolls french fryrsquos juice glucose levels of 345mgdL HbA1c 12 Triglycerides of 201 mgdL Also pt is incompliant with medication

Nutrition Intervention

1 Meals and snackso Fresh fruits and vegetableso Eggs

o Yogurt amp cheese2 Nutrition Recommendations

o Related medication managemento Small Frequent Meals o Eliminate problem foods

GoalsReduce glucose levels to 70-110 mgdLReduce HbA1c lt7

Monitoring and Evaluation

o Follow-up phone call with in one weeko Ask patient keep a daily food record o Re-assess lab values

o HbA1c- 3 monthso Glucose-1 week

o Check Vitalso Consult MD if the patient proceeds to have high glucose levels

Part B Meal Budget and Meal Plan

Meal One

Breakfast 2 slice of whole wheat toast 1 Large banana 2 eggs scrambled with cheese Glass of almond milk

Lunch Turkey Sandwich

o 4 slices of Turkeyo 1T Mayoo Lettuce o 2 slices Tomatoo 2 Sliced of cheese

Water

Snack Yogurt

Dinner 7 oz Grilled Chicken 1 cup Cooked potatorsquos roasted with herbs no skins Salad

o Lettuceo frac12 cup Tomatorsquoso Dressing olive oil (1teaspoon) and vinegar

Meal Two

Breakfast Oatmeal- 1 cup Glass of almond milk -2 cups Banana -1 large

Lunch Can of soup- chicken noodle Grilled cheese

o 2 slices - whole wheat double fiber breado 1 frac12 slics - cheese

Glass of almond milk -1 cup

Snack Apple Large Water

Dinner 8oz glass of milk Small side salad

o Lettaceo Tomatoo Oilvinegar dressing

Chicken Quesadillao 2 (6 inch) tortillas whole wheato frac12 cup shredded cheese o 6 oz shredded chickeno 1 tbs Butter (for frying the tortillas in)

Food Item

Brand Amount Price Coupon Location Purchased

Almons Milk

O Organics

32oz $199 Member Vons

Eggs Ralphs 12 count 0 Yes (free) Ralphs

Oatmeal Safeway Kitchens Oats Quick

18oz $200 Vons

Chicken Boneless Skinless

O Organics

1lbs $499 Vons

Bread Oroweat Double Fiber Bread

24oz $299 Vons

Apples 1lb $089 Yes North Park Produce

Banana 3eahc=1lbs $099 Yes North Park Produce

Roman Lettuce

Each $039 Yes North Park Produce

Block of Cheese

Ralphs 12oz $299 Member Ralphs

Tomatorsquos Ralphs 1lbs $089 Member Ralphs

Soup Campbellrsquos

Each $150 Member(2 for $3)

Vons

Yogurt O Organics

Each $056 Member Vons

Tortillas Mission 6 count $256 Wal-Mart

Turkey Oscar Mayer

12oz $299 Albertsons

TOTAL 2374

Part C Assessment of Dietary Intake Review

Nutrients Report Meal OneYour plan is based on a default 2000 Calorie allowance

Nutrients Target Average Eaten StatusTotal Calories 2000 Calories 1862 Calories OK

Protein (g) 46 g 118 g OK

Protein ( Calories) 10 - 35 Calories 25 Calories OK

Carbohydrate (g) 130 g 200 g OK

Carbohydrate ( Calories) 45 - 65 Calories 43 Calories Under

Dietary Fiber 25 g 36 g OK

Total Fat 20 - 35 Calories 36 Calories Over

Saturated Fat lt 10 Calories 12 Calories Over

Monounsaturated Fat No Daily Target or Limit

14 Calories No Daily Target or Limit

Polyunsaturated Fat No Daily Target or Limit

7 Calories No Daily Target or Limit

Linoleic Acid (g) 12 g 11 g Under

Linoleic Acid ( Calories) 5 - 10 Calories 5 Calories OK

α-Linolenic Acid (g) 11 g 18 g OK

α-Linolenic Acid ( Calories) 06 - 12 Calories

09 Calories OK

Omega 3 - EPA No Daily Target or Limit

14 mg No Daily Target or Limit

Omega 3 - DHA No Daily Target or Limit

69 mg No Daily Target or Limit

Cholesterol lt 300 mg 649 mg Over

Minerals Target Average Eaten StatusCalcium 1000 mg 1444 mg OK

Potassium 4700 mg 4441 mg Under

Sodium lt 2300 mg 2672 mg Over

Copper 900 microg 1612 microg OK

Iron 18 mg 14 mg Under

Magnesium 310 mg 507 mg OK

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

o Yogurt amp cheese2 Nutrition Recommendations

o Related medication managemento Small Frequent Meals o Eliminate problem foods

GoalsReduce glucose levels to 70-110 mgdLReduce HbA1c lt7

Monitoring and Evaluation

o Follow-up phone call with in one weeko Ask patient keep a daily food record o Re-assess lab values

o HbA1c- 3 monthso Glucose-1 week

o Check Vitalso Consult MD if the patient proceeds to have high glucose levels

Part B Meal Budget and Meal Plan

Meal One

Breakfast 2 slice of whole wheat toast 1 Large banana 2 eggs scrambled with cheese Glass of almond milk

Lunch Turkey Sandwich

o 4 slices of Turkeyo 1T Mayoo Lettuce o 2 slices Tomatoo 2 Sliced of cheese

Water

Snack Yogurt

Dinner 7 oz Grilled Chicken 1 cup Cooked potatorsquos roasted with herbs no skins Salad

o Lettuceo frac12 cup Tomatorsquoso Dressing olive oil (1teaspoon) and vinegar

Meal Two

Breakfast Oatmeal- 1 cup Glass of almond milk -2 cups Banana -1 large

Lunch Can of soup- chicken noodle Grilled cheese

o 2 slices - whole wheat double fiber breado 1 frac12 slics - cheese

Glass of almond milk -1 cup

Snack Apple Large Water

Dinner 8oz glass of milk Small side salad

o Lettaceo Tomatoo Oilvinegar dressing

Chicken Quesadillao 2 (6 inch) tortillas whole wheato frac12 cup shredded cheese o 6 oz shredded chickeno 1 tbs Butter (for frying the tortillas in)

Food Item

Brand Amount Price Coupon Location Purchased

Almons Milk

O Organics

32oz $199 Member Vons

Eggs Ralphs 12 count 0 Yes (free) Ralphs

Oatmeal Safeway Kitchens Oats Quick

18oz $200 Vons

Chicken Boneless Skinless

O Organics

1lbs $499 Vons

Bread Oroweat Double Fiber Bread

24oz $299 Vons

Apples 1lb $089 Yes North Park Produce

Banana 3eahc=1lbs $099 Yes North Park Produce

Roman Lettuce

Each $039 Yes North Park Produce

Block of Cheese

Ralphs 12oz $299 Member Ralphs

Tomatorsquos Ralphs 1lbs $089 Member Ralphs

Soup Campbellrsquos

Each $150 Member(2 for $3)

Vons

Yogurt O Organics

Each $056 Member Vons

Tortillas Mission 6 count $256 Wal-Mart

Turkey Oscar Mayer

12oz $299 Albertsons

TOTAL 2374

Part C Assessment of Dietary Intake Review

Nutrients Report Meal OneYour plan is based on a default 2000 Calorie allowance

Nutrients Target Average Eaten StatusTotal Calories 2000 Calories 1862 Calories OK

Protein (g) 46 g 118 g OK

Protein ( Calories) 10 - 35 Calories 25 Calories OK

Carbohydrate (g) 130 g 200 g OK

Carbohydrate ( Calories) 45 - 65 Calories 43 Calories Under

Dietary Fiber 25 g 36 g OK

Total Fat 20 - 35 Calories 36 Calories Over

Saturated Fat lt 10 Calories 12 Calories Over

Monounsaturated Fat No Daily Target or Limit

14 Calories No Daily Target or Limit

Polyunsaturated Fat No Daily Target or Limit

7 Calories No Daily Target or Limit

Linoleic Acid (g) 12 g 11 g Under

Linoleic Acid ( Calories) 5 - 10 Calories 5 Calories OK

α-Linolenic Acid (g) 11 g 18 g OK

α-Linolenic Acid ( Calories) 06 - 12 Calories

09 Calories OK

Omega 3 - EPA No Daily Target or Limit

14 mg No Daily Target or Limit

Omega 3 - DHA No Daily Target or Limit

69 mg No Daily Target or Limit

Cholesterol lt 300 mg 649 mg Over

Minerals Target Average Eaten StatusCalcium 1000 mg 1444 mg OK

Potassium 4700 mg 4441 mg Under

Sodium lt 2300 mg 2672 mg Over

Copper 900 microg 1612 microg OK

Iron 18 mg 14 mg Under

Magnesium 310 mg 507 mg OK

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Part B Meal Budget and Meal Plan

Meal One

Breakfast 2 slice of whole wheat toast 1 Large banana 2 eggs scrambled with cheese Glass of almond milk

Lunch Turkey Sandwich

o 4 slices of Turkeyo 1T Mayoo Lettuce o 2 slices Tomatoo 2 Sliced of cheese

Water

Snack Yogurt

Dinner 7 oz Grilled Chicken 1 cup Cooked potatorsquos roasted with herbs no skins Salad

o Lettuceo frac12 cup Tomatorsquoso Dressing olive oil (1teaspoon) and vinegar

Meal Two

Breakfast Oatmeal- 1 cup Glass of almond milk -2 cups Banana -1 large

Lunch Can of soup- chicken noodle Grilled cheese

o 2 slices - whole wheat double fiber breado 1 frac12 slics - cheese

Glass of almond milk -1 cup

Snack Apple Large Water

Dinner 8oz glass of milk Small side salad

o Lettaceo Tomatoo Oilvinegar dressing

Chicken Quesadillao 2 (6 inch) tortillas whole wheato frac12 cup shredded cheese o 6 oz shredded chickeno 1 tbs Butter (for frying the tortillas in)

Food Item

Brand Amount Price Coupon Location Purchased

Almons Milk

O Organics

32oz $199 Member Vons

Eggs Ralphs 12 count 0 Yes (free) Ralphs

Oatmeal Safeway Kitchens Oats Quick

18oz $200 Vons

Chicken Boneless Skinless

O Organics

1lbs $499 Vons

Bread Oroweat Double Fiber Bread

24oz $299 Vons

Apples 1lb $089 Yes North Park Produce

Banana 3eahc=1lbs $099 Yes North Park Produce

Roman Lettuce

Each $039 Yes North Park Produce

Block of Cheese

Ralphs 12oz $299 Member Ralphs

Tomatorsquos Ralphs 1lbs $089 Member Ralphs

Soup Campbellrsquos

Each $150 Member(2 for $3)

Vons

Yogurt O Organics

Each $056 Member Vons

Tortillas Mission 6 count $256 Wal-Mart

Turkey Oscar Mayer

12oz $299 Albertsons

TOTAL 2374

Part C Assessment of Dietary Intake Review

Nutrients Report Meal OneYour plan is based on a default 2000 Calorie allowance

Nutrients Target Average Eaten StatusTotal Calories 2000 Calories 1862 Calories OK

Protein (g) 46 g 118 g OK

Protein ( Calories) 10 - 35 Calories 25 Calories OK

Carbohydrate (g) 130 g 200 g OK

Carbohydrate ( Calories) 45 - 65 Calories 43 Calories Under

Dietary Fiber 25 g 36 g OK

Total Fat 20 - 35 Calories 36 Calories Over

Saturated Fat lt 10 Calories 12 Calories Over

Monounsaturated Fat No Daily Target or Limit

14 Calories No Daily Target or Limit

Polyunsaturated Fat No Daily Target or Limit

7 Calories No Daily Target or Limit

Linoleic Acid (g) 12 g 11 g Under

Linoleic Acid ( Calories) 5 - 10 Calories 5 Calories OK

α-Linolenic Acid (g) 11 g 18 g OK

α-Linolenic Acid ( Calories) 06 - 12 Calories

09 Calories OK

Omega 3 - EPA No Daily Target or Limit

14 mg No Daily Target or Limit

Omega 3 - DHA No Daily Target or Limit

69 mg No Daily Target or Limit

Cholesterol lt 300 mg 649 mg Over

Minerals Target Average Eaten StatusCalcium 1000 mg 1444 mg OK

Potassium 4700 mg 4441 mg Under

Sodium lt 2300 mg 2672 mg Over

Copper 900 microg 1612 microg OK

Iron 18 mg 14 mg Under

Magnesium 310 mg 507 mg OK

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Meal Two

Breakfast Oatmeal- 1 cup Glass of almond milk -2 cups Banana -1 large

Lunch Can of soup- chicken noodle Grilled cheese

o 2 slices - whole wheat double fiber breado 1 frac12 slics - cheese

Glass of almond milk -1 cup

Snack Apple Large Water

Dinner 8oz glass of milk Small side salad

o Lettaceo Tomatoo Oilvinegar dressing

Chicken Quesadillao 2 (6 inch) tortillas whole wheato frac12 cup shredded cheese o 6 oz shredded chickeno 1 tbs Butter (for frying the tortillas in)

Food Item

Brand Amount Price Coupon Location Purchased

Almons Milk

O Organics

32oz $199 Member Vons

Eggs Ralphs 12 count 0 Yes (free) Ralphs

Oatmeal Safeway Kitchens Oats Quick

18oz $200 Vons

Chicken Boneless Skinless

O Organics

1lbs $499 Vons

Bread Oroweat Double Fiber Bread

24oz $299 Vons

Apples 1lb $089 Yes North Park Produce

Banana 3eahc=1lbs $099 Yes North Park Produce

Roman Lettuce

Each $039 Yes North Park Produce

Block of Cheese

Ralphs 12oz $299 Member Ralphs

Tomatorsquos Ralphs 1lbs $089 Member Ralphs

Soup Campbellrsquos

Each $150 Member(2 for $3)

Vons

Yogurt O Organics

Each $056 Member Vons

Tortillas Mission 6 count $256 Wal-Mart

Turkey Oscar Mayer

12oz $299 Albertsons

TOTAL 2374

Part C Assessment of Dietary Intake Review

Nutrients Report Meal OneYour plan is based on a default 2000 Calorie allowance

Nutrients Target Average Eaten StatusTotal Calories 2000 Calories 1862 Calories OK

Protein (g) 46 g 118 g OK

Protein ( Calories) 10 - 35 Calories 25 Calories OK

Carbohydrate (g) 130 g 200 g OK

Carbohydrate ( Calories) 45 - 65 Calories 43 Calories Under

Dietary Fiber 25 g 36 g OK

Total Fat 20 - 35 Calories 36 Calories Over

Saturated Fat lt 10 Calories 12 Calories Over

Monounsaturated Fat No Daily Target or Limit

14 Calories No Daily Target or Limit

Polyunsaturated Fat No Daily Target or Limit

7 Calories No Daily Target or Limit

Linoleic Acid (g) 12 g 11 g Under

Linoleic Acid ( Calories) 5 - 10 Calories 5 Calories OK

α-Linolenic Acid (g) 11 g 18 g OK

α-Linolenic Acid ( Calories) 06 - 12 Calories

09 Calories OK

Omega 3 - EPA No Daily Target or Limit

14 mg No Daily Target or Limit

Omega 3 - DHA No Daily Target or Limit

69 mg No Daily Target or Limit

Cholesterol lt 300 mg 649 mg Over

Minerals Target Average Eaten StatusCalcium 1000 mg 1444 mg OK

Potassium 4700 mg 4441 mg Under

Sodium lt 2300 mg 2672 mg Over

Copper 900 microg 1612 microg OK

Iron 18 mg 14 mg Under

Magnesium 310 mg 507 mg OK

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Food Item

Brand Amount Price Coupon Location Purchased

Almons Milk

O Organics

32oz $199 Member Vons

Eggs Ralphs 12 count 0 Yes (free) Ralphs

Oatmeal Safeway Kitchens Oats Quick

18oz $200 Vons

Chicken Boneless Skinless

O Organics

1lbs $499 Vons

Bread Oroweat Double Fiber Bread

24oz $299 Vons

Apples 1lb $089 Yes North Park Produce

Banana 3eahc=1lbs $099 Yes North Park Produce

Roman Lettuce

Each $039 Yes North Park Produce

Block of Cheese

Ralphs 12oz $299 Member Ralphs

Tomatorsquos Ralphs 1lbs $089 Member Ralphs

Soup Campbellrsquos

Each $150 Member(2 for $3)

Vons

Yogurt O Organics

Each $056 Member Vons

Tortillas Mission 6 count $256 Wal-Mart

Turkey Oscar Mayer

12oz $299 Albertsons

TOTAL 2374

Part C Assessment of Dietary Intake Review

Nutrients Report Meal OneYour plan is based on a default 2000 Calorie allowance

Nutrients Target Average Eaten StatusTotal Calories 2000 Calories 1862 Calories OK

Protein (g) 46 g 118 g OK

Protein ( Calories) 10 - 35 Calories 25 Calories OK

Carbohydrate (g) 130 g 200 g OK

Carbohydrate ( Calories) 45 - 65 Calories 43 Calories Under

Dietary Fiber 25 g 36 g OK

Total Fat 20 - 35 Calories 36 Calories Over

Saturated Fat lt 10 Calories 12 Calories Over

Monounsaturated Fat No Daily Target or Limit

14 Calories No Daily Target or Limit

Polyunsaturated Fat No Daily Target or Limit

7 Calories No Daily Target or Limit

Linoleic Acid (g) 12 g 11 g Under

Linoleic Acid ( Calories) 5 - 10 Calories 5 Calories OK

α-Linolenic Acid (g) 11 g 18 g OK

α-Linolenic Acid ( Calories) 06 - 12 Calories

09 Calories OK

Omega 3 - EPA No Daily Target or Limit

14 mg No Daily Target or Limit

Omega 3 - DHA No Daily Target or Limit

69 mg No Daily Target or Limit

Cholesterol lt 300 mg 649 mg Over

Minerals Target Average Eaten StatusCalcium 1000 mg 1444 mg OK

Potassium 4700 mg 4441 mg Under

Sodium lt 2300 mg 2672 mg Over

Copper 900 microg 1612 microg OK

Iron 18 mg 14 mg Under

Magnesium 310 mg 507 mg OK

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Part C Assessment of Dietary Intake Review

Nutrients Report Meal OneYour plan is based on a default 2000 Calorie allowance

Nutrients Target Average Eaten StatusTotal Calories 2000 Calories 1862 Calories OK

Protein (g) 46 g 118 g OK

Protein ( Calories) 10 - 35 Calories 25 Calories OK

Carbohydrate (g) 130 g 200 g OK

Carbohydrate ( Calories) 45 - 65 Calories 43 Calories Under

Dietary Fiber 25 g 36 g OK

Total Fat 20 - 35 Calories 36 Calories Over

Saturated Fat lt 10 Calories 12 Calories Over

Monounsaturated Fat No Daily Target or Limit

14 Calories No Daily Target or Limit

Polyunsaturated Fat No Daily Target or Limit

7 Calories No Daily Target or Limit

Linoleic Acid (g) 12 g 11 g Under

Linoleic Acid ( Calories) 5 - 10 Calories 5 Calories OK

α-Linolenic Acid (g) 11 g 18 g OK

α-Linolenic Acid ( Calories) 06 - 12 Calories

09 Calories OK

Omega 3 - EPA No Daily Target or Limit

14 mg No Daily Target or Limit

Omega 3 - DHA No Daily Target or Limit

69 mg No Daily Target or Limit

Cholesterol lt 300 mg 649 mg Over

Minerals Target Average Eaten StatusCalcium 1000 mg 1444 mg OK

Potassium 4700 mg 4441 mg Under

Sodium lt 2300 mg 2672 mg Over

Copper 900 microg 1612 microg OK

Iron 18 mg 14 mg Under

Magnesium 310 mg 507 mg OK

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Phosphorus 700 mg 1951 mg OK

Selenium 55 microg 138 microg OK

Zinc 8 mg 12 mg OK

Vitamins Target Average Eaten StatusVitamin A 700 microg RAE 770 microg RAE OK

Vitamin B6 13 mg 34 mg OK

Vitamin B12 24 microg 31 microg OK

Vitamin C 75 mg 96 mg OK

Vitamin D 15 microg 5 microg Under

Vitamin E 15 mg AT 19 mg AT OK

Vitamin K 90 microg 173 microg OK

Folate 400 microg DFE 369 microg DFE Under

Thiamin 11 mg 13 mg OK

Riboflavin 11 mg 25 mg OK

Niacin 14 mg 34 mg OK

Choline 425 mg 503 mg OK

Information about dietary supplements

If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 and older need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and α-linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake 2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

MEAL PLAN ASSIGNMENT

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Meal One Name Steve Wilson

Diet Rx Diabetic Diet

50 Kcals CHO= 950 238 gm CHO20 Kcals Pro = 380 95 gm Pro30 Kcals Fat = 570 63 gm Fat

Reminders Think well-balanced meals Snacks are optional if you would like to include them

B S L S D S Total CHO (g)

Pro (g)

Fat (g)

Kcals

Starches 2 2 2 6 90 (15g)

18(3g)

6(1g)

360+72+54=486

Fruit 2 1 3 45(15g)

180

Milk 2 1 1 4 48(12g)

32(8g)

20(158g

)

192+128+180=500

Vegetables 1 2 3 15(5g)

6(2g)

60+24=84

MeatsSubstitutes

2 2 2 8 42(7g)

30(358g

)

168+270=438

Fats 1 1 5(5g)

45

CHO Choices 16 198g 63g 61gKcals

gmTOTAL Kcals

1733Kcals

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Nutrients Report Meal Two

Your plan is based on a default 2000 Calorie allowanceNutrients Target Average Eaten Status

Total Calories 2000 Calories 1880 Calories OKProtein (g) 46 g 83 g OKProtein ( Calories) 10 - 35 Calories 18 Calories OKCarbohydrate (g) 130 g 198 g OKCarbohydrate ( Calories) 45 - 65 Calories 42 Calories UnderDietary Fiber 25 g 33 g OKTotal Fat 20 - 35 Calories 44 Calories OverSaturated Fat lt 10 Calories 19 Calories OverMonounsaturated Fat No Daily Target or Limit 16 Calories No Daily Target or LimitPolyunsaturated Fat No Daily Target or Limit 4 Calories No Daily Target or LimitLinoleic Acid (g) 12 g 6 g UnderLinoleic Acid ( Calories) 5 - 10 Calories 3 Calories Under10488781048878 Linolenic Acid (g) 11 g 11 g OK10488781048878 Linolenic Acid ( Calories) 06 - 12 Calories 05 Calories UnderOmega 3 - EPA No Daily Target or Limit 10 mg No Daily Target or LimitOmega 3 - DHA No Daily Target or Limit 20 mg No Daily Target or LimitCholesterol lt 300 mg 258 mg OKMinerals Target Average Eaten Status Calcium 1000 mg 2356 mg OKPotassium 4700 mg 2845 mg UnderSodium lt 2300 mg 1950 mg OKCopper 900 g 1501 g OKμ μIron 18 mg 13 mg UnderMagnesium 310 mg 425 mg OKPhosphorus 700 mg 1685 mg OKSelenium 55 g 121 g OKμ μZinc 8 mg 11 mg OKVitamins Target Average Eaten StatusVitamin A 700 g RAE 1202 g RAE OKμ μVitamin B6 13 mg 19 mg OKVitamin B12 24 g 13 g Underμ μVitamin C 75 mg 42 mg UnderVitamin D 15 g 11 g Underμ μVitamin E 15 mg AT 52 mg AT OKVitamin K 90 g 44 g Underμ μFolate 400 g DFE 266 g DFE Underμ μThiamin 11 mg 12 mg OKRiboflavin 11 mg 31 mg OKNiacin 14 mg 26 mg OK

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Choline 425 mg 224 mg Under

Information about dietary supplements If you are African American hypertensive diabetic or have chronic kidney disease reduce your sodium to 1500 mg a day In addition people who are age 51 andolder need to reduce sodium to 1500 mg a day All others need to reduce sodium to less than 2300 mg a day

Nutrients that appear twice (protein carbohydrate linoleic acid and 10488781048878linolenic acid) have two separate recommendations

1) Amount eaten (in grams) compared to your minimum recommended intake2) Percent of Calories eaten from that nutrient compared to the recommended range

You may see different messages in the status column for these 2 different recommendations

Steve Wilson is a 37 year olds male who is in a remission state of Crohnrsquos disease and is

currently struggling with regulating his type II Diabetes He is slight over weight with a

BMI of 279 and has been advised that by regulating his diet and increasing his exercise

he would be able to get a better handle on his glucose levels Steversquos Regular diet

consists of high sugar and high fat foods such as cinnamon rolls fast food burgers and

fryrsquos regular juices He is not currently struggling with his Crohnrsquos disease but has been

advised to stay away from foods that pose a problem with him

Because Steve has been struggling with his glucose control it has been advised

that he takes his Metformin twice daily and begin to practice carbohydrate counting or

utilize the exchange to help better manage his food intake According to the CHO

exchange method Steve is allotted 238g of CHO or 950 kcals Due to his high glucose

Steve has cut back him CHO intake to about 190-200 or about 42 to help maintain good

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

glucose control Due to his cute back in CHO he remain under the MyPlate

recommendations of 45-65 of daily Kcal coming from CHO

In the past Steve has also struggled with a mild case of lactose intolerance due to

his Crohnrsquos Disease Therefore he shies away from drinking regular milk and opts to

consume Almond milk But because he can tolerate some lactose cheese does not seem to

affect his gut and therefore he eats cheese and yogurt on a regular basis

I would also recommend a daily multi vitamin for Steve to help increase his

intake of potassium iron folate and vitamin D for which he is just slightly under the

recommended intake levels

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

Part D Review

I very much enjoy this project It was very time consuming but also very eye

opening Being a type one diabetic myself I deal with CHO counting on a day-to-day

biases but I never had learned the exchange method It was very interesting to learn a new

tool that could potentially help me in the long run

This project could be very valuable for an aspiring dietitian This is what they will

be doing everyday with many patients Also it allows them to understand how hard it is to

obtain 2 days of food in such a tight budget It was very difficult to obtain a well-

balanced meal with two disease states and while also staying in a budget Although it was

fun like a puzzle as times it got frustrating I could not imagine having to do this on day-

to-day biases and this is one reason I do not want to be clinical dietitian

I would recommend this project to future students It will allow them to get a very

good picture of what life will be like at a registered dietitian This gives students great

practice for meal planning ADIME note and nutrient analysis All of this is very

important in the clinical setting

APENDEX

• CHO Choices

APENDEX

• CHO Choices

• CHO Choices