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Andrew’s Case Study
Discussion Topic :Andrew wants to eat healthier and went online to learn about MyPlate. He came away overwhelmed at all the information and was turned off by reading about ounces and cups-concepts that are unfamiliar to him. He is clearly interested in changing his food habits but is stuck on the idea that that isn’t possible unless he weighs and measures his food. He is wondering if eating healthier is worth the trouble.
How would you encourage him to approach the goal of eating healthier? What information would you gather about his usual intake? His willingness to change?
How would you use MyPlate to help him make better choices without overwhelming him?
Andrew’s wife thinks he is not consuming enough vitamin C. Andrew is worried that he will develop scurvy. Can you assume that he is at risk for scurvy if he isn’t consuming the RDA for vitamin C?
Why may his wife’s assessment be inaccurate? How can you determine if Andrew isn’t consuming enough vitamin C? What would you tell Andrew to calm his fears?
The student must also reply to at least (2) classmates/Peer A & B using 75 words per reply. All replies in the discussion forum should enhance the discussion. Non-informative messages posted in the discussion forum will not be counted towards the required number of replies for that topic.
“The fact that Andrew is eager to take steps to eat healthier is great, and often times getting started is the hardest part. It is important to encourage Andrew by breaking down my plate into simple steps that he will understand easier. I would first ask about his current eating habits and what he eats throughout the day and week, how many meals a day he eats, and how often he consumes junk food. His willingness to change, I don’t think is something that can immediately be known and shown. It takes time for people to adapt and make the changes for healthy eating, but just his showing an interest in taking those next steps shows me his willingness to change even if it takes time to eliminate certain unhealthy eating habits.
MyPlate is a great resource for Andrew to use to help him get started. When you enter the page, you can take a quiz that will guide you in the right direction, but the main nutrients that MyPlate has you eating and drinking for healthy eating habits are: “Fruits, vegetables, grains, protein foods, and dairy (such as low-fat or yogurt). 30% grains, 40% vegetables, 10% fruits, and 20% proteins” (MyPlate, 2022). According to NIH, “fruits and vegetables, whole grains, like oatmeal, whole-grain bread, and brown rice, seafood, lean meats, poultry, and eggs, beans, peas, unsalted nuts, and seeds, sliced vegetables or baby carrots with hummus, fat-free or low-fat milk and milk products. If sensitive to milk/milk products try non-dairy soy, almond, rice, or other drinks with added vitamin D and calcium, lactose-reduced fat-free or low-fat milk, dark leafy vegetables like collard greens or kale” (NIH, 2021)
According to NHS.uk, “Scurvy is caused by not having enough vitamin C in your diet for at least 3 months. Vitamin C is mainly found in fruit and vegetables” (NHS, 2021). That being said, so long as Andrew gets some form of vitamin C, he will not be at risk for scurvy. To avoid this from happening, eating fruits with vitamin c would be a great way to prevent scurvy. His wife could be thinking that he’s not getting enough vitamin C because she herself isn’t aware of all the items that contain vitamin C. As a nurse, I would just explain to Andrew what scurvy is, who is at risk for getting it, and ways to incorporate more vitamin C into his diet. It also wouldn’t hurt to explain signs and symptoms to the patient of scurvy as a way to show him he doesn’t have scurvy, but also what to look out for if he feels he is lacking in vitamin C.
MyPlate. (2022). Are you making every bite count? MyPlate. https://www.myplate.gov/
NHS. (2021). Scurvy. NHS choices. https://www.nhs.uk/conditions/scurvy/
NIH. (2021). Health tips for adults. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/healthy-eating-physical-activity-for-life/health-tips-for-adults
First, I would ask Andrew why he wants to eat healthier and have him share his personal goals. Next, I would ask Andrew to tell me about what he eats on a workday, and what he eats on his day’s off or the weekends. Then find out foods he likes and dislikes. To encourage Andrew to use My Plate, I would suggest imagining that the plate is cut into four sections. This is not completely accurate, but as Andrew becomes more comfortable with portion sizing, small adjustments can be made later on. I would also suggest “eyeballing” portion sizes such as ” 1cup looks like 1 baseball” and “a deck of cards looks like 2-3oz” (Dudek, 2022).
MY Plate offers several educational links when it comes to eating healthy. “The website MyPlate.gov provides a wealth of information under the headings of Eat Healthy, Life Stages, Resources, Professionals, and MyPlate Kitchen” (Dudek, 2022). A few of the tools My Plate offers is “details about each of the food groups, what counts as a cup or ounce equivalent for individual foods, and the nutritional value and health benefits of each group, a calorie-appropriate plan based on the individual’s age, sex, height, weight, and activity level, and a My Plate app” (Dudek, 2022). I would also suggest to Andrew that changing food items, such as choosing 97/3% ground beef instead of 80/20%, or boneless, skinless chicken thighs instead of skin on, would make an impact, as well.
I cannot assume that Andrew is not at risk for scurvy because I do not know the types of food he is consuming to be able to make that decision. However, “overt deficiency symptoms occur only if vitamin C intake is approximately ≤10 mg/day for many weeks. Even though scurvy is deadly, it can be cured within a matter of days with moderate doses of vitamin C. Severe vitamin C deficiency is rare in developed nations but can occur in people who do not eat enough fruits and vegetables. It is estimated that 90% of vitamin C in the typical diet comes from fruits and vegetables” (Dudek, 2022). I would also need to know if Andrew was a smoker because, “the groups most at risk of vitamin C inadequacy include smokers who need more vitamin C because smoking increases oxidative stress and metabolic turnover of vitamin C” (Dudek, 2022).
One way that I would determine if Andrew was not consuming enough vitamin C is to “look inside his mouth for gum disease, check his skin for poor wound healing, or thin skin/easy bleeder” (NCBI, n.d.). I would tell Andrew that that Vitamin C takes anywhere for 1-3 months for a deficiency to occur, however; consuming fruits and vegetables high in vitamin C will alleviate the issue within a matter of days. I would then educate him on food high in vitamin C, as well.
Dudek, S. G. (2022). Nutrition Essentials for Nursing Practice. Wolters Kluwer
Vitamin C deficiency – statpearls – NCBI bookshelf. (n.d.). https://www.ncbi.nlm.nih.gov/books/NBK493187/N
ReplyReply to Comment
Collapse SubdiscussionCaitlin Dransfield
ThursdaySep 1 at 8:19pm
Changing your eating and dietary habits can be very difficult. I don’t blame Andrew for being overwhelmed at all of the information that he saw online, but I think there are a few ways to encourage him to go back onto the website to read the information and make a change in his eating habits. The first tip I would give Andrew that could encourage him to reach his goal of eating healthier would be to take a cooking class. I feel like this would be a great way to get involved with food, see what different types of food are out there, and the multiple ways to prepare it. The questions that I would ask Andrew about his usual intake would be:
-How many times a day do you eat?
-What type of snacks do you eat?
-What foods do you like/dislike?
-Why do you want to make an adjustment in regards to your eating habits?
-What would motivate you to stay on track?
Since Andrew was overwhelmed after looking at the MyPlate website, I would first start by having Andrew look at the visuals on the website, because the infographics on the website will provide him with information and it wont require him to read multiple paragraphs which could be part of what is overwhelming him. I would also encourage him to look at the “healthy eating on a budget” tab, because it would provide great information about making a meal plan to help lose weight, as stated on the website “As you age, manage your calories to stay at a healthy weight. This will prevent gradual weight gain over time. Find the amount of calories right for you using the MyPlate Plan” (MyPlate.gov).
If Andrew does not consume enough Vitamin C over a long period of time, he could be at risk for scurvy, “Overt deficiency symptoms occur only if vitamin C intake is approximately ≤10 mg/day for many weeks” (Dudek, 2021. p. 113). The disease is rare, but I supposed if he has not consumed enough Vitamin C for a long period of time he could develop scurvy, but scurvy can be cured in days with a moderate increase in Vitamin C (Dudek, 2021. p. 113). His wife’s assessment could be inaccurate since Vitamin C is in most of the fruits and vegetables that we consume on a daily basis. To help reassure Andrew that he does not have scurvy I would remind him that he probably consumes a typical diet with enough Vitamin C and remind him that if he were to somehow get it, it is curable in days.
Adults. MyPlate. (n.d.). https://www.myplate.gov/life-stages/adults
Dudek, Susan. Nutrition Essentials for Nursing Practice. Available from: VitalSource Bookshelf, (9th Edition). Wolters Kluwer Health, 2021.