Case Study 5
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University Of Arizona *
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225
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Health Science
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May 3, 2024
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docx
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CASE STUDY 5: More Diet Analysis with Exchanges
30 points
Directions
: For this case study you will be working with a professional athlete and using current macronutrient recommendations for athletes to estimate needs. Review the case information below and complete the exchange table and calculations. Be sure to take note of the portions for all the foods on the exchange table, especially the protein foods. You will notice that the client consumes very high amounts of protein and very little carbohydrate. Learning objectives reviewed in this case study
:
Modules 4 & 5 The Exchange System I & II
3.
Convert foods in a given diet recall to exchanges, including corresponding grams of CHO, protein, and fat, as well as kcals. (SLO C)
Case Profile
:
Jeremiah is a 28 y/o professional basketball player who wants to bulk up and lose fat weight. At the time of consultation, he weighs 250 lbs (height 6’8”). He wants to lose about 15-20 lbs while maintaining muscle mass (this is not necessarily reasonable for him). A 24-hour recall reveals that for breakfast he is eating three hard-
boiled eggs, one sausage patty (3 oz), an English muffin and two cups of 2% milk. For lunch he consumes 3 (3
oz each) microwaved chicken breasts and with 2 cups of steamed vegetables and a large glass of water. As a snack he consumes one large protein shake (2 scoops of protein powder = 260kcals, 5g fat, 10g CHO, 40g protein). For dinner he might eat four chicken breasts with BBQ sauce and two cups of 2% milk. He states that this is the diet he usually goes on to lose weight and gain lean tissue. He complains of being able to only last 15-20 minutes in the weight room and has trouble staying alert and awake in the afternoon. He believes that by
eating more protein and taking a protein supplement, he will add bulk to his muscles and at the same time lose
fat weight. 1.
Complete the Exchange table below to analyze Jeremiah’s dietary intake. (10 pts)
# & Type of Exchange
CHO (g)
Protein (g)
Fat (g)
Kcals
Breakfast:
3 hardboiled eggs
3 protein
0
21
15
225
1 sausage patty (3 oz)
3 protein
0
21
24
300
1 English muffin
2 starch
30
9
3
240
2 cups 2% milk
2 milk
24
16
10
240
Lunch:
3 chicken breasts (3 oz ea)
9 protein
0
63
18
405
2 cups steamed veggies (non-starchy)
4 non starchy
20
8
0
100
Water
0
0
0
0
0
Snack:
Protein shake, large (see case profile)
N/A
10
40
5
260
Dinner:
4 chicken breasts (3 oz ea)
12 protein
0
108
24
540
3 Tbs BBQ sauce
0
1
0
0
0
2 cups 2% milk
2 milk
24
16
10
240
TOTAL
XX
109
204
109
2,550
2.
Complete the following calculations using the diet analysis above. Show your work. (7 pts)
How many total kcals did Jeremiah consume? Jeremiah consumed 2,550 kcals
How many kcals from fat did Jeremiah consume?
% of total kcals from fat = 109g x 9 = 981 kcals / 2,550kcals = 38% of total kcals comes from fat
How many kcals from protein did Jeremiah consume? % of total kcals protein = 204g x 4 = 816 kcals / 2,550 kcals = 32% of total kcals comes from protein
How many kcals from CHO did Jeremiah consume?
% of total kcals from CHO = 109g x 4 = 436 kcals / 2,550 kcals = 17% of total kcals comes from CHO
* NOTE: the three macronutrient %’s likely will not add up to 100% as the exchange kcals do not exactly align with the macronutrient profiles. This is just a quirk of the system.
3.
Estimate Jeremiah’s kcal and macronutrient needs using the steps outlined below. NOTE: this is a different
method than we have been using, as these calculations are appropriate for athletes. SHOW YOUR WORK. (8 pts)
Step 1: Determine CHO needs: 5-7 g CHO/kg body weight (pick a number within the range), then convert grams to kcals
Step 2: Determine protein needs: 1.6-1.7 g protein/kg body weight (pick a number within the range), then convert to grams to kcal Step 3: Add CHO kcals and protein kcals together to get a subtotal (fat not included) = Step 4: Pick a % fat within the AMDR. Divide the kcal subtotal above by 100% - your fat %...
kcal total from #3/(100%-AMDR %) For example, if you determined the kcal subtotal to be 2000 kcals (CHO + protein), and you wanted to give 30% of total kcals as fat: 2000/(100%-30%)…2000/70%...2000/0.7 = 2857 kcals total (CHO, pro, and fat). Step 5: Calculate fat kcals and grams. Using the example from above…2857-2000= 857 kcals; 857/9 = 95 g fat
Step 1 - CHO:
250lbs / 2.2kg = 113.6kg x 5g = 568g x 4 kcals = 2,272 kcals
Step 2 - Pro:
250lbs / 2.2kg = 113.6kg x 1.6g = 182g x 4 kcals = 728 kcals
Step 3 - KCAL subtotal: 3,000 kcal
Step 4 - % FAT: 3,000 kcals / .7 = 4,285 kcals
TOTAL kcals: 4,285 kcals
Step 5 - Fat:
4,285 kcals – 3,000 kcals = 1,285 kcals 4.
Compare Jeremiah’s estimated needs with actual intake. How does this relate to his reported performance issues? (3 pts) I believe that Jeremiah should be consuming between 300g – 400g of CHO, but his actual intake shows that he is consuming 109g. The consumption of CHO is very important because that is what gives you energy and it can be a big issue for him if he’s only lasting 15-20 minutes in the gym and can’t stay awake and alert throughout the day. 5.
What recommendations do you have for Jeremiah to balance out his diet? (2 pts)
The recommendation that I have for Jeremiah to balance out his diet is to consume more CHO if
he wants to have more energy in the gym and to be more alert and awake throughout the day.
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