NUTRITION CASE STUDY 1.Keep track of everything that you eat or drink for three typical days.  These days should NOT be consecutive days, and should include a weekend day.  See forms provided for more detail.  Record the food on the forms provided.  2.To estimate the nutrient values of the foods you are eating, consult food labels and use the NutritionCalc Plus software available on Connect.  If these resources do not have the serving size you need, adjust the value.  For example, if you drink cup of orange juice, but a table has values only for 1 cup, halve all values before you record them.  Then, consider pooling all the same food to save time; if you drink a cup of 1% milk three times a day, enter your milk consumption only once as 3 cups.    Measure and record the amounts of foods eaten in portion sizes of cups, teaspoons, tablespoons, ounces, slices, or inches (or convert metric units to these units). Record brand names of all food products, such as Quick Quaker Oats. Measure  and  record  all  those  little  extras,  such  as  gravies,  salad  dressings,  taco  sauces,  pickles,  jelly,  sugar, catsup, and margarine. For beverages: oList the type of milk, such as whole, fat-free, 1%, evaporated, chocolate, or reconstituted dry. oIndicate whether fruit juice is fresh, frozen, or canned. oIndicate type for other beverages, such as fruit drink, fruit-flavored drink, Kool-Aid, and hot chocolate made with water or milk. For fruits: o    Indicate whether fresh, frozen, dried, or canned. oIf whole, record number eaten and size with approximate measurements (such as 1 apple3 in. in diameter). oIndicate whether processed in water, light syrup, or heavy syrup. For vegetables: o  Indicate whether fresh, frozen, dried, or canned. oRecord as portion of cup, teaspoon, or tablespoon, or as pieces (such as carrot sticks4 in. long, in. thick). o Record preparation method. For cereals: o Record cooked cereals in portions of tablespoon or cup (a level measurement after cooking). o Record dry cereal in level portions of tablespoon or cup. oIf margarine, milk, sugar, fruit, or something else is added, measure and record amount and type. For breads:
2 o Indicate whether whole wheat, rye, white, and so on. o Measure and record number and size of portion (biscuit2 in. across, 1 in. thick; slice of homemade rye bread3 in. by 4 in., in. thick). oSandwiches: list all ingredients (lettuce, mayonnaise, tomato, and so on). For meat, fish, poultry, and cheese: o  Give size (length, width, thickness) in inches or weight in ounces after cooking for meat, fish, and poultry (such as cooked hamburger patty3 in. across, in. thick). oGive size (length, width, thickness) in inches or weight in ounces for cheese. oRecord measurements only for the cooked, edible partwithout bone or fat left on the plate. oDescribe how meat, poultry, or fish was prepared. For eggs: o Record as soft or hard cooked, fried, scrambled, poached, or omelet. o If milk, butter, or drippings are used, specify types and amount. For desserts: o List commercial brand or homemade or bakery under brand. o Purchased candies, cookies, and cakes: specify kind and size. o  Measure  and  record  portion  size  of  cakes,  pies,  and  cookies  by  specifying  thickness,  diameter,  and  width  or length, depending on the item. OR: Use the Department of Agriculture website: https://fdc.nal.usda.gov/OR: You can do the analysis by hand if you want (but it is tedious).  3.Assess your diet by filling in the packet.  4.Discuss  fully  your  findings.    For  example,  do  you  consume  too  much  fat,  too  little  folic  acid,  or  too much sodium?  5.Describe your plans to rectify any problems found.  6.Completing this case study is mandatory for completing this class.  It is worth 75 points.   
3 7.The  entire  completed  packet,  discussion,  and  your  NutritionCalc  Plus  data  will  be  due  on  the  date specified  through  Canvas  announcements.  Attach  all  documents  as  PDFs  or  word  documents  to [email protected] No late reports will be accepted after the due date.Portion Size Primer One cup of fruit = size of a baseball cup of dried fruit (i.e. raisins) = size of a ping pong ball One cup of lettuce = four leaves One cup of cooked vegetables = size of your fist One small fruit = size of a tennis ball A medium potato = size of a computer mouse Three ounces of meat = size of a cassette tape Three ounces of grilled fish = size of a checkbook One ounce of cheese = size of four stacked dice One ounce of snack foods (pretzels, chips) = large handful One teaspoon of peanut butter/jam = one dice A medium/average bagel = one hockey puck cup of ice cream = one racquetball cup of side salad = tennis ball The following baking equivalents may also be helpful: 3 teaspoons =1 tablespoon 2 tablespoons =1 fluid ounce 4 tablespoons = cup 2 cups =1 pint 4 cups =1 quart 1 quart = approximately 1 liter 4 quart =1 gallon Three Day Food Record Objective: A popular assessment tool used to evaluate a person’s normal dietary intake is the food diary or food record.  Through this activity you will thoroughly document your eating & drinking habits over three days for future analysis and reflection.  This activity will serve as the foundation to your Diet Analysis Project. Assignment Directions: Using the table provided below, record EVERYTHING you eat & drink for a total of three, nonconsecutivedays.  One of the three days should be a weekend day.  Whenever possible include as much detail about the food item (brand, ingredients, cooking method, etc.).  You will need to estimate the portions of the foods
4 consumed.  Standard baking measurements are often the simplest for individuals to estimate (i.e. cups, teaspoons, etc.)  Please refer to the Portion Size Primer above for assistance in estimating the amounts of food you are consuming. It is often helpful (and the most accurate) to have this record with you during meals & snacks or available immediately following. 
5 Time Minutes Spent EatingMeal or SnackDegree of Hunger (0-3)0=none3=maxActivity while eatingPlace of Eating Food and quantity Others presentReason for choice.
6 EVALUATING YOUR ENERGY INTAKE & MACRONUTRIENT DISTRIBUTIONInstructions: Use the data on your diet analysis to fill in and calculate the following information. Remember you have three days of data, so divide by 3 for a 1 day average.  I. TOTAL CALORIES:a.On average, how many calories did you consume?  _____ kcals b.According to the analysis, how many daily calories do you need?    _____ kcals c.Calculate your % of Goal. _____ % Average Daily Kcals Consumed                                              ———————————————  X 100                                    Average Daily Kcals Recommendedd.Is your % of Goal < 75% or >125%? If your answer to part d is yes, comment on this difference.  Are dietary modifications necessary or are do you feel this assessment may be inaccurate? Explain. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ II. MACRONUTRIENTS: a. Complete the chart below using the information provided from your analysis printouts.  SOURCE OF CALORIES YOUR % OF CALORIES Acceptable Macronutrient Distribution Range (AMDR) Protein 10-35% Carbohydrate 45-65% Fat 20-35% Alcohol b. Do you fall within the recommended ranges?  Yes or No c. If your answer to part b is no, comment on the discrepancy. Are dietary modifications necessary or are do you feel this assessment may be inaccurate? (Be sure to consider your responses in Part I as well.) Explain. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________
7 Exercise Habits Do you exercise?  If so, how would you describe your exercise habits?  ___________________________________ ______________________________________________________________________________ Type of exercise: ______________________________Intensity: __________ Duration: __________ Frequency: ________ Please state your goals in exercise (i.e., weight maintenance, weight loss; body building, cardiovascular fitness, etc.). ________________________________________________________________________________  Diet History 1.    Have you recently lost or gained more than 10 lbs.? ________________  If yes, explain the surrounding circumstances (including associated illness, dietary changes, and time frame):        ______________________________________________________________________________ 2.    Do you eat at regular times each day? _________How many times per day? _______________ 3.    Do you usually eat snacks? ___________When? ____________________________________ 4.    What foods do you particularly like? ______________________________________________ 5.    Are there foods you don’t eat for other reasons? _____________________________________ 6.    Do you have difficulty eating? __________________________________________________ 7.    How would you describe your feelings about food? __________________________________ 8.    How do your eating habits change when you are emotionally upset? _____________________ 9.    Are you, or any member of your family, on a special diet? _____________________________ If yes, who and what kind? ____________________________________________________10.  Do you drink alcohol? ________How much? ______________How often? ______________ 11.  Do you smoke? _____________If yes, for how long? _______Packs per day? ____________ 12.  Are there any other facts about your lifestyle that you think might be related to your nutritional habits? _______________________________________________________________ Explain: _______________________________________________________________________        ______________________________________________________________________________
8 EVALUATING YOUR CARBOHYDRATE INTAKE Instructions: Use the data on your diet analysis to fill in and calculate the following information.You will also need to utilize your textbook, notes, & food records to complete this assignment.1. TOTAL CARBOHYDATE (CHO): Average grams (g) of carbohydrate consumed per day: ________ g a.  The minimum amount of CHO needed to avoid ketosis is 130 g/day. Did you meet or exceed this level?  If no, how could you specifically increase your CHO intake? b.  What percentage of your total calories came from carbohydrates?                      ____________To calculate, use this formula: (Average grams of CHO x 4 kcal/g)                    ———————————————————— X 100                                            Total kcals consumed c. The recommended level of calories from CHO in a diet is 45-65%. Do you need to make any dietary adjustments to better meet the recommendation? _________ If yes, explain why, and what specific changes you might make. Please include some carbohydrate-rich foods that you enjoy and would be able to add to your diet. (Even if your intake was within the recommended amount). _______________________________________________________________________________2. FIBER: Average grams of fiber consumed per day:                                            ____________ g a.  Did you eat the 20-35 g that is recommended? b.  What are good ways to increase dietary fiber intake? What foods could you substitute (exchange) in your current diet? Use your text for suggestions. ________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3. SUGAR: a.  There are simple sugars in many of the foods we eat each day.  It is recommended that no more than 10% of our total caloric intake is in the form of simple sugar.  In the typical American diet, what percentage of the diet consumed comes from added sugars?  _________ % b.  The following table contains some of the more concentrated forms of sugar we eat on a daily basis, followed by how much carbohydrate is in each food.  Using your 3-Day Food Records, tally up how many times you ate something on this list and include the total amount in the third column.  Next, multiply the amount you ate times the amount of sugar contained in the serving size specified.  Add up the numbers in the last column, and enter the sum on the line that says “Total.”  This is the total number of grams of carbohydrate that came from simple sugars (in concentrated sweets) during the three days recorded.
9 FOOD Grams of CHO Total Amount Consumed Grams of CHO Consumed Soda 3 grams per ounce Jelly 1T = 13 grams Syrup 1T = 13 grams Candy 1 piece = 6 grams Sugar 1 tsp. = 4 grams Brownie 1 brownie = 18 grams Cookie 1 serving = 11 grams Cake 1/12 cake = 22 grams Pie 1/8 pie = 21 grams Ice Cream cup = 19 grams Honey 1T = 17 grams Ketchup 1T = 4 grams Chocolate 1 bar = 21 grams Total (g): _________  c.  Now do the following calculation to determine what % of your daily caloric intake came from the simple sugars listed above:  _________ % Total (g) of CHO from sugar + 3 days x 4 kcals/g                        ——————————————————————————- X 100                                                      Average Daily kcals consumed d.  Was your intake of simple sugars 10% or less of your average daily intake?  e.  List 3 “do-able” (practical & specific) recommendations for decreasing simple sugar intake. 1.  __________________________________________________________________________2.  ___________________________________________________________________________3.  ___________________________________________________________________________
10 EVALUATING YOUR PROTEIN INTAKEInstructions: Use the data on your diet analysis to fillin and calculate the following information. You willalso need to utilize your textbook, notes, and food records to complete this assignment.I. TOTAL PROTEIN INTAKE: 1.  On average, how many grams of protein did you consume: ________g 2.  Calculate your RDA for protein using the following formula: ________g Your weight in pounds  ————————– x 0.8g protein/kg  =  ______g 2.2lb/kg 2a. Protein recommendations for athletes are slightly higher than the protein RDA for nonathletes. Depending on the type of activity, protein recommendations range from 1.2 – 1.6 g protein/kg body weight for athletes. If you classify as an athlete, re-calculate your protein needs (for simplicity, use the upper limit of 1.6 g protein/kg body weight). ________g 3.  What percentage of the RDA for protein are you consuming? (Athletes should use their      answer from question 2a.)    _______ % To calculate, use this formula Total grams of protein                            —————————————- X 100%                                        RDA for protein 4.  Another way to evaluate your protein intake is in terms of caloric distribution.  It is recommended that 10 – 35% of your total calories come from protein.  Using the formula below, determine what percentage of your calories comes from protein.                                                                                  _______ % (Avg. grams of protein consumed x 4 kcal/g)              —————————————————————-  X 100 Average daily kcals consumed 5.  The recommended percentage is 10-35%.  How does your diet compare? ________________________________________________________________________________6.  If you consumed significantly more or less of the recommended level, how could you alter your diet to meet it more closely?      ________________________________________________________________________________ 7.  In the table below, list three protein-rich foods that you consumed considering both animal & plant sources. You may find your 3-day food record helpful in determining these.
11 Animal Protein Sources Plant Protein Sources 1. 1. 2. 2. 3. 3.a.  In  regards  to  cardiovascular  disease,  why  is  a  diet  indulgent  in  animal  protein  potentially  a  health  risk? _________________________________________________________________________________b. Individuals who consume exclusively (or primarily) plant-derived foods must be more conscious of their protein intakes. Why? _______________________________________________________________ EVALUATING YOUR FAT INTAKE Instructions: Use the data on your diet analysis to fill in and calculate the following information.  You will also need to utilize your textbook, notes, and food records to complete this assignment.Dietary Recommendations from the American Heart Association: (Fill in the blanks)Consume no more than ______________ % or calories from total fat. Consume no more than ______________ % or calories as saturated fat. Consume no more than ______________ mg of cholesterol per day. TOTAL FAT CONSUMPTION a.  On average, how many grams of fat did you consume: _______  g b. What percentage of your total calories came from fat? _______ % (Avg. daily grams of fat x 9 kcal/gram)          ———————————————————-  Average daily kcals consumed x 100 c. Is your total fat intake less than what is recommended? If your answer to part c is no, how can you change your diet to better meet the guidelines?  What foods can you limit or eliminate from your diet? ___________________________________________________________________________________  SATURATED FAT CONSUMPTION a. On average, how many grams of saturated fat did you consume?  _______ g b. What percentage of your total calories came from saturated fat?    ______ %(Avg. daily grams of saturated fat x 9 kcal/gram)                            —————————————————————-  X 100                                                Average daily kcals consumed
12 c.How do your totals compare to the recommendation?      ______________________________________________________________________d.What can you do to decrease levels of saturated fat in your diet?______________________________________________________________________  e.Why is it desirable to have low levels of saturated fat in your diet?        ______________________________________________________________________CHOLESTEROL CONSUMPTION a.  On average, how many milligrams of cholesterol did you consume?  ____    mg b.  Is your intake less than the recommended levels? c.  What foods can you eliminate or substitute to decrease your cholesterol intake?  __________________________________________________________________________MONOUNSATURATED FAT CONSUMPTION a. On average, how many grams of monounsaturated fat did you consume?  _______ g b. What percentage of your total calories came from monounsaturated fat?  ______  % (Avg. daily grams of monounsaturated fat x 9 kcal/gram)                        —————————————————————————-          X 100 Average daily kcals consumed c.  Is your percentage of monounsaturated fat less than 10%? d.  If yes, what foods could you add to your diet to increase your intake of monounsaturated fats? ___________________________________________________________________________TRANS-FATTY ACID CONSUMPTION a.  In the U.S. diet, what percentage of total calories comes from trans-fatty acids?  _______ % b.  What phrase found in the beginning of an Ingredient List (on a food label) indicates the food probably contains high levels of these fatty acids? ________________________________________  c.  Using your 3-Day Food Records, list three items that you suspect are particularly high in trans-fatty acids. 1. _________________________________________________________________  2. _________________________________________________________________  3. _________________________________________________________________ 
13 EVALUATING YOUR VITAMIN &MINERAL INTAKE Instructions: Use the data on your diet analysis to fill in and calculate the following information.  You will also need to utilize your textbook, notes, and food records to complete this assignment. Your Vitamin Intake Following the instructions below, complete the table. 1.  RDA/AI = Recommended Amount per day (will be listed on your Profile printout under Recommendations) 2.  Dietary Intake = Amount you consumed on average from your diet in one day (will be listed on your Bar Graph – Daily Average Printout under the Value column)  3.  Supplement Intake =1f you take a daily supplement, enter the quantity of each vitamin in the supplement. Please also list the name of the supplement on the line provided. If you do not take a supplement, please mark this column with N/A. 4.  % of RDA/AI = If you take a daily supplement, use the formula below to calculate the % RDA/AI you are consuming. If you DO NOT take a supplement, this value will be on your printout (on your Bar Graph-Daily Average Printout under Goal %). (Amount of Vitamin from Diet) + (Amount of Vitamin in Supplement)                —————————————————————————————-      X 100% RDA/AI 5.  Evaluate IntakeHigh – Intake was higher than the UL (see Appendix A) or for those vitamins in which no Upper Level has been set, > 400% of RDA/AI Low – Intake was less than 90% of the RDA/Al OK – Intake was less than the UL yet greater than 90% of RDA/Al value Name of Daily Supplement: ____________________________________________________  Vitamin RDA/AI Dietary Intake Supplement Intake % of RDA/AI Evaluate Intake(High Low, OK) A mgmg** E mgmg*** C mg*mgThiamin  mgmgRiboflavin mgmgNiacin mgmgB6mgmgFolate mcg mcg B12mcg mcg *Smokers should add 35 mg to their RDA. ** 1 RE = 5 IU (for Vit. A) *** 1 mg = 1 IU = l TE (for Vit E) 1.  Which of your vitamin intakes were sufficient (roughly equal) according to the RDA /AI? ______________________________________________________________________________ ______________________________________________________________________________
14 2.  Which of your vitamin intakes were below the RDA/AI (< 90%)? ______________________________________________________________________________ ______________________________________________________________________________ 3.  For each vitamin listed in #2, list two good food sources you could (would) consume to increase your dietary intake of that vitamin. ______________________________________________________________________________ ______________________________________________________________________________ 4.Of all the vitamins listed in the preceding table, which group of vitamin(s) would toxicity be a realistic concern if consumed in quantities far higher than the RDA/AI? Explain. __________________________________________________________________________________________________________________________________________________________________Your Mineral Intake Following the instructions below, complete the table on the following page. 1.  RDA/AI = Recommended Amount per day (will be listed on your Profile printout under Recommendations) 2.  Dietary Intake = Amount you consumed on average from your diet in one day (will be listed on your Bar Graph – Daily Average under the Value column) 3.  Supplement Intake = If you take a daily supplement, enter the quantity of each vitamin in the supplement. Please also list the name of the supplement on the line provided. If you do not take a supplement, please mark this column with N/A. 4.  % ofRDA/AI = If you take a daily supplement, use the formula on the following page (in box) to calculate the % RDA/Al you are consuming. If you DO NOT take a supplement, this value will be on your printout (on your Bar Graph-Daily Average Printout under Goal %).                    (Amount of Mineral from Diet) + (Amount of Mineral in Supplement)                                                                      ————–  x 100% RDA/AI Name of Daily Supplement: _________________________________________________  5.  Evaluate Intake High – Intake was higher than the UL (see Appendix A) or for those vitamins in which no Upper Level has been set, > 400% of RDA/Al Low – Intake was less than 90% of the RDA/AI OK – Intake was less than the UL yet greater than 90% of RDA/AI value
15 Mineral RDA/AI Dietary Intake Supplement Intake % of RDA/AI Evaluate Intake (High, Low, OK) Calcium mgmgPhosphorous mgmgSodium mgmgPotassium mgmgIron mgmgZinc mgmg1.  Which of your mineral intakes were sufficient (roughly equivalent) according to the RDA/Al? ____________________________________________________________________________________ 2.  Which of your mineral intakes were below (<90%) the RDA/AI____________________________________________________________________________________3.  For each mineral listed in #2, list two good food sources you could (would) consume to increase your dietary intake of that mineral. ____________________________________________________________________________________4.  Compare your sodium intake with the established Upper Limit (2.3 g/day). Why is a diet low in sodium beneficial?  ____________________________________________________________________________________