Case Study

Annie is an 50-year-old widow who lives alone. She has a long history of hypertension and diabetes and suffers from the complications of CHD and neuropathy. She has diabetic retinopathy, which has left her legally blind. She has never been compliant with a diabetic diet but takes insulin as directed. She is 5 ft 5 in tall and weighs 170 pounds, down from her usual weight of 184 pounds 5 months ago. Annie reluctantly agreed to receive Meals on Wheels so she does not have to prepare lunch and dinner except on weekends. Her daughter buys groceries for Annie every week, and her grocery list generally consists of milk, oatmeal, two cans of soup, two bananas, a bag of chocolate candy, a layer cake, two doughnuts, and mixed nuts. Her weekend meals consist of whatever she has available to eat.

Yesterday, she ate the following:

Breakfast: Two egg and bacon sandwiches on an English muffin, large coffee with cream and sugar.

Morning Snack: One cheese Danish. Lunch: Two cheeseburgers with ketchup, large French fries, soft drink, and cookies.

Afternoon snack: One cup whole milk and an apple

Dinner: A foot-long-submarine with cold cuts, cheese, mayonnaise lettuce, tomato, onion, and pickles; bag of potato chip; soft drink

Evening snack: One cup whole milk & four graham crackers.

Please answer each of the following questions in at least 3-5 complete sentences, to receive full credit.

1.  Visit MyPlate (www.myplate.gov) and create a meal plan for Annie.

2.  How does her intake compare to the MyPlate meal?

3.  What is Annie’s BMI?

4.  How would you assess her weight status?

5.  Is her recent weight loss significant?

6.  What food groups is she undereating? Overeating?

7.  What are the potential nutritional consequences of her current diet?

8.  What would you recommend Annie eat for breakfast? For snacks? For weekend meals? Would you discourage her from eating sweets?

9.  What other information would be helpful for you to know in dealing with Annie?

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